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Biomedical subjects

M Hargreaves

Publications and source records attributed to M Hargreaves.

At least 55 records · Page 3Linked to original sources
PubMed1996

Muscle glycogen storage after prolonged exercise: effect of the frequency of carbohydrate feedings.

We reported previously that intake of carbohydrate foods with a high glycemic index (GI) produced greater glycogen storage and greater postprandial glucose and insulin responses during 24 h of postexercise recovery than did intake of low-GI carbohydrate foods. In the present study we examined the importance of the greater incremental glucose and insulin concentrations on glycogen repletion by comparing intake of large carbohydrate meals ("gorging") with a pattern of frequent, small, carbohydrate snacks ("nibbling"), which simulates the flattened glucose and insulin responses after low-GI carbohydrate meals. Eight well-trained triathletes [x +/- SEM: 25.6 +/- 1.5 y of age, weighing 70.2 +/- 1.9 kg, and with a maximal oxygen uptake (VO2max) of 4.2 +/- 0.2 L/min] undertook an exercise trial (2 h at 75% VO2max followed by four 30-s sprints) to deplete muscle glycogen on two occasions, 1 wk apart For 24 h after each trial, subjects rested and consumed the same diet composed exclusively of high-GI carbohydrate foods, providing 10 g carbohydrate/kg body mass. The "gorging" trial provided the food as four large meals of equal carbohydrate content eaten at 0, 4, 8, and 20 h of recovery, whereas in the "nibbling" trial each of the meals was divided into four snacks and fed at hourly intervals (0-11, 20-23 h). However, there was no significant difference in muscle glycogen storage between the two groups over the 24 h (gorging: 74.1 +/- 8.0 mmol/kg wet wt; nibbling: 94.5 +/- 14.6 mmol/kg wet wt). The results of this study suggest that there is no difference in postexercise glycogen storage over 24 h when a high-carbohydrate diet is fed as small frequent snacks or as large meals, and that a mechanism other than lowered blood glucose and insulin concentrations needs to be sought to explain the reduced rate of glycogen storage after consumption of low-GI carbohydrate foods.

Adult↗
PubMed1996

Effect of timing of carbohydrate ingestion on endurance exercise performance.

This study compared the effects of carbohydrate ingestion throughout exercise with ingestion of an equal amount of carbohydrate late in exercise. Eight well-trained men cycled 2 h at 70 +/- 1% VO2 peak, followed immediately by a 15-min performance ride, while ingesting either a 7% carbohydrate-electrolyte solution (CHO-7), an artificially sweetened placebo (CON), or the placebo for the first 90 min then a 21% glucose solution (CHO-0/21). At the start of the performance ride, plasma glucose averaged 4.2 +/- 0.2, 5.2 +/- 0.1, and 5.7 +/- 0.2 mmol.l-1 in CON, CHO-7, and CHO-0/21, respectively (all different, P < 0.05). Plasma insulin levels were similar just prior to the performance ride in CHO-7 and CHO-0/21, with both higher than CON. A similar pattern was observed with respiratory exchange ratio (RER). Work performed during the performance ride was significantly greater in CHO-7 (268 +/- 8 kJ) compared with CON (242 +/- 9 kJ). Performance in CHO-0/21 (253 +/- 10 kJ), however, was not improved compared with CON, despite higher plasma glucose levels and plasma insulin levels similar to CHO-7. Seven of the eight subjects performed best in CHO-7. In conclusion, performance was improved, relative to the control trial, only when carbohydrate was ingested throughout exercise. Carbohydrate ingestion late in exercise did not improve performance despite increases in plasma glucose and insulin.

Adult↗
PubMed1996

Blunting the rise in body temperature reduces muscle glycogenolysis during exercise in humans.

To examine the effect of blunting the rise in body temperature on exercise metabolism, seven endurance-trained men cycled for 40 min at 65% of maximal oxygen consumption (VO2,max) in an environmental chamber at either 20 degrees C and 20% relative humidity (RH) (T20) or 3 degrees C and approximately 50% RH (T3). The trials were conducted in random order at least 1 week apart. Mean oxygen consumption (VO2) during exercise was not different when comparing the two trials. In contrast, the mean respiratory exchange ratio (RER) was lower (P < 0.05) at T20 compared with T3. Heart rate, rectal temperature and plasma catecholamines were higher (P < 0.05) during exercise at T20 compared with T3, as was post-exercise muscle temperature (P < 0.01). Muscle and blood lactate and blood glucose concentrations were not significantly different when comparing T20 with T3. Net muscle glycogen utilization was greater (P < 0.05) at T20 compared with T3. These results suggest that glycogenolysis in contracting skeletal muscle is reduced during exercise when the rise in body core temperature is attenuated. These changes in carbohydrate metabolism appear to be influenced by alterations in muscle temperature and/or sympatho-adrenal activity.

Adrenal Glands↗
PubMed1996

Exercise-induced increase in glucose transport, GLUT-4, and VAMP-2 in plasma membrane from human muscle.

A major effect of muscle contractions is an increase in sarcolemmal glucose transport. We have used a recently developed technique to produce sarcolemmal giant vesicles from human muscle biopsy samples obtained before and after exercise. Six men exercised for 10 min at 50% maximal O2 uptake (Vo2max) and then to fatigue at 100% Vo2max (5.7 +/- 0.2 min). Vesicle glucose transport at 5 mM increased from 3.3 +/- 0.6 pmol.microgram-1.min-1 at rest to 6.6 +/- 1.0 pmol.microgram-1.min-1 at fatigue (mean +/- SE, n = 6, P < 0.05). This increase in glucose transport was associated with a 1.6-fold increase in vesicle GLUT-4 protein content. Glucose transport normalized to GLUT-4 protein content also increased with exercise, suggesting increased intrinsic activity of GLUT-4. Furthermore, exercise resulted in a 1.4-fold increase in sarcolemmal vesicle-associated membrane protein (VAMP-2) content, suggesting that muscle contractions may induce trafficking of GLUT-4-containing vesicles via a mechanism similar to neurotransmitter release. Our results demonstrate for the first time exercise-induced translocation of GLUT-4 and VAMP-2 to the plasma membrane of human muscle and increased sarcolemmal glucose transport.

Adult↗
PubMed1996

Influence of elevated muscle temperature on metabolism during intense, dynamic exercise.

This study examined the effects of elevated muscle temperature on muscle metabolism during exercise. Seven active but untrained men completed two cycle ergometer trials for 2 min at a workload estimated to require 115% maximal oxygen uptake (VO2) either without pretreatment (CT) or after having their thigh wrapped in a heating blanket for 60 min before exercise (HT). HT increased (P < 0.01) muscle temperature (Tm) and resulted in a difference in Tm between the two trials before (delta = 1.9 +/- 0.1 degrees C, P < 0.01) and after exercise (delta = 0.6 +/- 0.2 degree C, P < 0.05). HT did not affect rectal temperature or plasma catecholamines. In addition, these parameters were not different between CT and HT either before or after exercise. No differences in resting intramuscular concentrations of the adenine nucleotides (ATP, ADP, AMP) or their degradation products (inosine 5'-monophosphate, ammonia), lactate, glycogen, creatine phosphate, or creatine were observed between HT and CT. During exercise, the magnitude of ATP degradation and inosine 5'-monophosphate and ammonia accumulation was higher (P < 0.05) in HT compared with CT. Although preexercise concentrations of glycogen and lactate were not different between the two trials, postexercise lactate concentration was higher (P < 0.05) and glycogen lower (P < 0.05) in HT compared with CT. In addition, net muscle glycogen use was higher (P < 0.05) in HT. It is concluded that an elevated Tm per se increases muscle glycogenolysis, glycolysis, and high-energy phosphate degradation during exercise. These alterations may be the result of an increased rate of ATP turnover associated with the exercise and/or changes in the anaerobic/aerobic contribution to ATP resynthesis.

Adenosine Diphosphate↗
PubMed1996

Effect of fluid ingestion on muscle metabolism during prolonged exercise.

Five trained men were studied during 2 h of cycling exercise at 67% peak oxygen uptake at 20-22 degrees C to examine the effect of fluid ingestion on muscle metabolism. On one occasion, the subjects completed this exercise without fluid ingestion (NF) while on the other they ingested a volume of distilled deionized water that prevented loss of body mass (FR). No differences in oxygen uptake during exercise were observed between the two trials. Heart rate was lower (P < 0.01) throughout exercise when fluid was ingested, and rectal temperature after 2 h of exercise was lower (38.0 +/- 0.2 and 38.6 +/- 0.2 degrees C for FR and NF, respectively; P < 0.01), as was muscle (vastus lateralis) temperature (38.5 +/- 0.4 and 39.1 +/- 0.5 degrees C for FR and NF, respectively; P < 0.05). Resting muscle ATP, creatine phosphate, creatine, glycogen, and lactate levels were similar in the two trials, as were the postexercise ATP, creatine phosphate, and creatine levels. In contrast, muscle glycogen was higher (P < 0.05) and muscle lactate was lower (P < 0.05) after 2 h of exercise in FR compared with NF. Net muscle glycogen utilization during exercise was reduced by 16% when fluid was ingested (318 +/- 46 and 380 +/- 53 mmol/kg dry weight for FR and NF, respectively; P < 0.05). These results indicate that fluid ingestion reduces muscle glycogen use during prolonged exercise, which may account, in part, for the improved performance previously observed with fluid ingestion.

Adult↗
PubMed1996

Skeletal muscle GLUT-4 and postexercise muscle glycogen storage in humans.

The purpose of this study was to examine the relationship between skeletal muscle GLUT-4 protein and postexercise glycogen storage in human subjects fed adequate carbohydrate. Eleven men completed 2 h of cycling, and a biopsy of the vastus lateralis was performed immediately after exercise cessation for the determination of muscle GLUT-4 protein and glycogen concentrations, glycogen synthase activity, and citrate synthase activity. The subjects ingested meals providing 2.0 g carbohydrate/kg body weight at 0, 2, and 4 h postexercise, and a second biopsy was performed 6 h postexercise. Muscle glycogen concentration increased significantly during the 6-h recovery period (glycogen immediately postexercise, 27.2 +/- 5.4 mmol/kg wet weight; glycogen storage, 52.4 +/- 2.9 mmol x kg wet weight-1 x 6 h-1; P<0.05). Glycogen storage during recovery was directly related to GLUT-4 protein (2.20 +/- 0.33 arbitrary standard units; r = 0.63; P<0.05) and inversely related to glycogen immediately postexercise (r = -0.70; P < 0.05). A direct correlation existed between glycogen storage during recovery and the activity of the I form of glycogen synthase (r = 0.60; P < 0.05). These results suggest that muscle GLUT-4 protein concentration, as well as factors relating to glucose disposal, may affect postexercise glycogen storage in humans fed adequate carbohydrate.

Adult↗
PubMed1996

Preexercise glucose ingestion and glucose kinetics during exercise.

The present study was undertaken to examine the effects of glucose ingestion before exercise on liver glucose output and muscle glucose uptake during exercise. On two occasions, at least 1 wk apart, six trained men (peak pulmonary O2 uptake = 5.11 +/- 0.17 l/min) ingested 400 ml of a solution containing either 75 g glucose [carbohydrate (CHO)] or a sweet placebo [control (Con)] 30 min before 60 min of exercise at 71 +/- 1% peak pulmonary O2 uptake. Glucose kinetics (rates of appearance and disappearance) were measured by a primed continuous infusion of [6,6-2H2]glucose. Liver glucose output was derived from total glucose appearance and the appearance of ingested glucose from the gut. After glucose ingestion, plasma glucose increased to 6.4 +/- 0.4 mmol/l immediately before exercise, fell to 4.2 +/- 0.5 mmol/l after 20 min of exercise, and then increased to a higher value than in the Con group (5.4 +/- 0.3 vs. 4.7 +/- 0.1 mmol/l; P < 0.05) after 60 min of exercise. In the CHO group, plasma insulin was higher immediately before exercise (P < 0.05) and, despite falling during exercise, remained higher than in the Con group after 60 min of exercise (57.0 +/- 11.4 vs. 24.8 +/- 1.7 pmol/l; P < 0.05). The rapid fall in plasma glucose in the CHO group was the result of a higher muscle glucose uptake with the onset of exercise (P < 0.05), which could not be matched by the glucose rate of appearance. Liver glucose output was decreased by glucose ingestion, and although it increased during the early stages of exercise in the CHO group, it did not rise above the basal values and was reduced by 62% over the 60 min of exercise compared with the Con group. In summary, preexercise glucose ingestion results in increased muscle glucose uptake and reduced liver glucose output during exercise.

Adult↗
PubMed1996

Effect of heat stress on glucose kinetics during exercise.

To identify the mechanism underlying the exaggerated hyperglycemia during exercise in the heat, six trained men were studied during 40 min of cycling exercise at a workload requiring 65% peak pulmonary oxygen uptake (VO2peak) on two occasions at least 1 wk apart. On one occasion, the ambient temperature was 20 degrees C [control (Con)], whereas on the other, it was 40 degrees C [high temperature (HT)]. Rates of glucose appearance and disappearance were measured by using a primed continuous infusion of [6,6-2H]glucose No differences in oxygen uptake during exercise were observed between trials. After 40 min of exercise, heart rate, rectal temperature, respiratory exchange ratio, and plasma lactate were all higher in HT compared with Con (P < 0.05). Plasma glucose levels were similar at rest (Con, 4.54 +/- 0.19 mmol/l; HT, 4.81 +/- 0.19 mmol/l) but increased to a greater extent during exercise in HT (6.96 +/- 0.16) compared with Con (5.45 +/- 0.18; P < 0.05). This was the result of a higher glucose rate of appearance in HT during the last 30 min of exercise. In contrast, the glucose rate of disappearance and metabolic clearance rate were not different at any time point during exercise. Plasma catecholamines were higher after 10 and 40 min of exercise in HT compared with Con (P < 0.05), whereas plasma glucagon, cortisol, and growth hormone were higher in HT after 40 min. These results indicate that the hyperglycemia observed during exercise in the heat is caused by an increase in liver glucose output without any change in whole body utilization.

Adult↗
PubMed1995

Transcervical endometrial resection syndrome.

During transcervical endometrial resection the uterine cavity is irrigated under pressure with 1.5% glycine solution. This solution may be absorbed, with consequent fluid and electrolyte shifts. Plasma sodium concentration was analysed in 21 women undergoing transcervical endometrial resection and decreased in every case. In five cases this decrease was > 10 mmol.l-1. Hyponatraemia is a potential risk with this procedure.

Adult↗
PubMed1995

Influence of muscle glycogen on glycogenolysis and glucose uptake during exercise in humans.

To examine the effects of alterations in preexercise muscle glycogen availability on glycogenolysis and glucose uptake during exercise, 12 active but untrained men [22.8 +/- 1.6 (SE) yr, 71.7 +/- 2.0 kg, peak pulmonary oxygen uptake 3.85 +/- 0.16 l/min] were studied during 40 min of cycle ergometer exercise at 65-70% peak pulmonary oxygen uptake on two separate occasions, at least 1 wk apart. Preexercise muscle glycogen concentrations were manipulated by having the subjects perform glycogen-lowering exercise either 24 or 48 h before a trial, in combination with either high or low dietary carbohydrate intake. In series 1 (n = 7), increasing muscle glycogen from 90.3 +/- 6.0 to 124.7 +/- 10.8 mmol/kg wet wt increased muscle glycogenolysis during exercise (62.7 +/- 7.9 vs. 49.1 +/- 6.6 mmol/kg; P < 0.05). Similarly, in series 2 (n = 5) when muscle glycogen was reduced from 96.2 +/- 6.6 to 53.7 +/- 6.0 mmol/kg, glycogen utilization during exercise was reduced from 51.8 +/- 4.6 to 28.3 +/- 3.8 mmol/kg (P < 0.05). The altered muscle glycogen utilization was associated with alterations in carbohydrate oxidation during exercise, without effect on tracer ([3H]glucose)-determined glucose uptake. These results indicate that preexercise muscle glycogen availability influences muscle glycogenolysis, but not glucose uptake, during exercise.

Adult↗
PubMed1995

Effect of coingestion of fat and protein with carbohydrate feedings on muscle glycogen storage.

Dietary guidelines for achieving optimal muscle glycogen storage after prolonged exercise have been given in terms of absolute carbohydrate (CHO) intake (8-10 g.kg-1.day-1). However, it is of further interest to determine whether the addition of fat and protein to carbohydrate feedings affects muscle glycogen storage. Eight well-trained triathletes [23.1 +/- 2.0 (SE) yr; 74.0 +/- 3.4 kg; peak O2 consumption = 4.7 +/- 0.4 l/min] undertook an exercise trial (2 h at 75% peak O2 consumption, followed by four 30-s sprints) on three occasions, each 1 wk apart. For 24 h after each trial, the subjects rested and were assigned to the following diets in randomized order: control (C) diet (high glycemic index CHO foods; CHO = 7 g.kg-1.day-1), added fat and protein (FP) diet (C diet + 1.6 g.kg-1.day-1 fat + 1.2 g.kg-1.day-1 protein), and matched-energy diet [C diet + 4.8 g.kg-1.day-1 additional CHO (Polycose) to match the additional energy in the FP diet]. Meals were eaten at t = 0, 4, 8, and 21 h of recovery. The total postprandial incremental plasma glucose area was significantly reduced after the FP diet (P < 0.05). Serum free fatty acid and plasma triglyceride responses were significantly elevated during the FP trial (P < 0.05). There were no differences between trials in muscle glycogen storage over 24 h (C, 85.8 +/- 2.7 mmol/kg wet wt; FP, 80.5 +/- 8.2 mmol/kg wet wt; matched-energy, 87.9 +/- 7.0 mmol/kg wet wt).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Needlestick injuries. A multidisciplinary concern.

This article outlines a variety of steps implemented by the medical center in an effort to reduce the number of needlestick injuries among nurses within our institution. Overall, we have seen a decline in needlestick injuries with the greatest decline among the nursing staff. We attribute this decline to staff education, improved needle-disposal containers, and the addition of needleless products for IV infusions. More important, a rigorous quality-management approach, including employee involvement, the sharing of data throughout the institution, and management commitment to the issue, has enabled continuous improvement. We are in the process of refining our methods so that future decisions regarding neddlestick injury reduction-activities will more specifically address problem areas.

Academic Medical Centers↗
PubMed1994

Postcardiotomy syndrome following transvenous pacemaker insertion.

We describe a case of postcardiotomy syndrome following permanent pacemaker insertion. A 79-year-old woman presented with complete heart block. Following temporary pacing, a dual chamber permanent pacemaker was inserted. Two weeks later she developed fevers and malaise with an acute rise in inflammatory markers. After systemic infection had been carefully excluded, she was commenced on prednisolone with immediate benefit. Prednisolone was withdrawn over 2 months without recurrence of symptoms. Although the postcardiotomy syndrome is rare following transvenous pacemaker insertion it should be considered in the differential diagnosis of fevers and malaise after implantation.

Aged↗
PubMed1994

Impending paradoxical embolism: a case report and literature review.

Paradoxical embolism occurs following the passage of embolic material from the venous to the arterial circulation through a right to left shunt--frequently a patent foramen ovale. The diagnosis is usually presumptive when arterial emboli occur in the appropriate clinical setting. We describe a case of impending paradoxical embolism in a patient with massive pulmonary embolism. Transoesophageal echocardiography revealed a thromboembolus straddling a patent foramen ovale. The patient underwent emergency removal of the intracardiac clot with closure of the patent foramen ovale.

Aged↗
PubMed1994

Glucose kinetics during exercise in trained men.

Six trained men were studied to examine the relative increases in hepatic glucose output and peripheral glucose uptake during 40 min of exercise at 75% VO2max. Rates of appearance (Ra) and disappearance (Rd) were measured using a primed, continuous intravenous infusion of D-[3-3H]glucose. Plasma glucose increased (P < 0.05) from 4.8 +/- 0.2 mmol l-1 at rest to 6.2 +/- 0.5 mmol l-1 after 40 min of exercise. Both Ra and Rd increased (P < 0.05) during exercise, however, during the early phase of exercise, Ra exceeded Rd (P < 0.05). Ra peaked at 42.0 +/- 3.2 mumol kg-1 min-1 after approximately 15 min of exercise. In contrast, the highest Rd of 33.9 +/- 4.3 mumol kg-1 min-1 was measured at the end of exercise. In additional experiments, five men were studied during 40 min of exercise at 70-75% VO2max, 2 h after ingestion of the non-selective beta-adrenergic antagonist timolol or a placebo capsule. Subjects were unable to complete the exercise bout following timolol, fatiguing after 28.0 +/- 4.0 min (P < 0.05). The increase in blood glucose from 4.3 +/- 0.1 to 4.7 +/- 0.3 mmol l-1 (P < 0.05) following 20 min of exercise under control conditions was completely abolished by prior timolol ingestion (4.2 +/- 0.2 to 4.1 +/- 0.2 mmol l-1). These results demonstrate that during exercise at 75% VO2max in trained men, hepatic glucose output is not always closely matched to peripheral muscle glucose uptake and may be subject to feed-forward regulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1994

Mechanism of pacemaker induced cough.

Single chamber ventricular pacing (VVI) may be associated with a group of adverse symptoms known as the pacemaker syndrome. Cough is an unusual but recognised feature of the pacemaker syndrome. A patient with a VVI permanent pacemaker experienced a disturbing cough during VVI pacing. There were no other symptoms associated with the pacemaker syndrome. The effects of short-term ventricular pacing on the cough were examined while the subject was standing and lying. After control recordings, the pulse generator was programmed to either VVI 50 beats/min or 90 beats/min and recordings made over 60 seconds. There was an interval of 60s between recordings. Overall, five recording periods at VVI of 50 beats/min and VVI of 90 beats/min were made in random order. The patient was blinded to the order of programming. The recordings were repeated with the subject lying. Cough was not found during normal sinus rhythm. During VVI pacing the patient experienced a tickling sensation in the throat associated with intermittent coughing. The number of coughs decreased during each successive recording period. The pacing cough reflex was enhanced when the patient was lying down. The mechanism of cough during VVI pacing is uncertain. The findings suggest a possible role for afferent vagal receptors from the airways.

Cough↗