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PubMed1971

Cholera.

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Africa, Northern↗
PubMed1999

Effect of 20% in vitro haemodilution with warmed buffered salt solution and cerebrospinal fluid on coagulation.

We have conducted an in vitro coagulation study consisting of two separate groups of 20 subjects using the thrombelastograph. In the first group, haemodilution was performed with a physiological balanced salt solution similar to plasma, with the exception of calcium, and buffered to a normal pH (Plasmalyte B) at 37 degrees C on blood obtained from consenting volunteers. In the second group, a protein-poor body fluid (cerebrospinal fluid (CSF)) obtained from parturient patients undergoing spinal anaesthesia for Caesarean section was used as the diluent. There were statistically significant differences between the warmed Plasmalyte B treated samples and their untreated controls for all variables measured by the thrombelastograph, except for maximum amplitude, and between the CSF treated samples and their untreated controls for all variables. We conclude that electrolyte and acid-base composition of the diluent fluid had no effect on the observation that crystalloid haemodilution produces hypercoagulability. The marked increase in coagulability produced by addition of CSF cannot be explained on a simple haemodilution basis and confirms previous suggestions of the presence of a procoagulant factor in CSF.

Blood Coagulation↗
PubMed2002

The athlete's diet: nutritional goals and dietary strategies.

When talented, motivated and highly trained athletes meet for competition the margin between victory and defeat is usually small. When everything else is equal, nutrition can make the difference between winning and losing. Although the primary concern of many athletes is to supplement the diet with protein, vitamins and minerals, and a range of more exotic compounds, key dietary issues are often neglected. Athletes must establish their nutritional goals, and must also be able to translate them into dietary strategies that will meet these goals. Athletes are often concerned with dietary manipulations in the period around competition, but the main role of nutrition may be to support consistent intensive training which will lead to improved performance. Meeting energy demand and maintaining body mass and body fat at appropriate levels are key goals. An adequate intake of carbohydrate is crucial for maintaining muscle glycogen stores during hard training, but the types of food and the timing of intake are also important. Protein ingestion may stimulate muscle protein synthesis in the post-exercise period, promoting the process of adaptation in the muscles. Restoration of fluid and electrolyte balance after exercise is essential. If energy intake is high and a varied diet is consumed, supplementation of the diet with vitamins and minerals is not warranted, unless a specific deficiency is identified. Specific strategies before competition may be necessary, but this requirement depends on the demands of the sport. Generally, it is important to ensure high pre-competition glycogen stores and to maintain fluid balance. There is limited evidence to support the use of dietary supplements, but some, including perhaps creatine and caffeine, may be beneficial.

Adaptation, Physiological↗
PubMed2000

Short-term recovery from prolonged constant pace running in a warm environment: the effectiveness of a carbohydrate-electrolyte solution.

Recovery from prolonged exercise involves both rehydration and replenishment of endogenous carbohydrate stores. This study examined the influence of drinking a carbohydrate-electrolyte solution on short-term recovery and subsequent exercise capacity in a warm environment. Thirteen healthy male volunteers completed two trials, at least 7 days apart. On each occasion subjects performed an initial treadmill run at 60% of maximal oxygen uptake (VO2max), for 90 min or until volitional fatigue (T1), in a warm environment (35 degrees C, 40% relative humidity, RH). Volitional ingestion of water was permitted during each of the exercise trials. During a subsequent 4-h recovery period (REC) subjects consumed either a 6.9% carbohydrate-electrolyte solution (CES) or a sweetened placebo (P), in a volume equivalent to 140% of body mass loss. Following REC, subjects ran to exhaustion at the same % VO2max in order to assess their endurance capacity (T2). Mean (SEM) run times during T1 did not differ between the CES [74.8 (4.6) min] and P [72.5 (5.2) min] trials. Body mass was reduced (P < 0.01) by 1.9 (0.2)% (CES) and 1.7 (0.2)% (P), and plasma volume (P < 0.01) by 6.0 (0.9)% (CES) and 5.4 (1.0)% (P) during the T1 trials. During REC 2006 (176) ml and 1830 (165) ml of fluid was ingested, providing 138 (12) g and 0 g of carbohydrate in the CES and P trials, respectively. Prior to T2, plasma volume and net fluid balance were similarly restored [CES +58 (26) g; P -4 (68) g] in both trials. During T2 the exercise duration was longer (P < 0.01) in the CES compared to the P trial [CES 60.9 (5.5) min; P 44.9 (3.0) min]. Thus, provided that an adequate hydration status is maintained, inclusion of carbohydrate within an oral rehydration solution will delay the onset of fatigue during a subsequent bout of prolonged submaximal running in a warm environment.

Adult↗
PubMed1984

Modulation of jejunal ion and water absorption by endogenous angiotensin after hemorrhage.

In the pentobarbital sodium-anesthetized rat, hemorrhage of blood equivalent to 1% body weight (18.4% blood volume) increases plasma renin activity and plasma aldosterone concentration and also markedly elevates jejunal ion and water absorption. Infusion of angiotensin II (AII) also stimulates jejunal absorption, and in a manner similar to hemorrhage. The elevation of jejunal absorption in response to hemorrhage is not affected by removal of the adrenals but is totally inhibited by the converting enzyme inhibitor captopril and by bilateral nephrectomy. Thus, increased jejunal absorption following hemorrhage is mediated by the renin-angiotensin system and is not secondary to aldosterone release. Further experiments demonstrated that norepinephrine released from enteric sympathetic nerves controls jejunal absorption through activation of alpha-adrenergic receptors. The stimulation of jejunal absorption by tyramine was unaffected by propranolol but was totally abolished by phentolamine and by peripheral sympathectomy was 6-hydroxydopamine (intact adrenal medulla). The increase in jejunal absorption in response to hemorrhage also was unaffected by propranolol but was inhibited totally by phentolamine, prazosin, and peripheral sympathectomy. It is proposed that AII generated by hemorrhage facilitates norepinephrine release from enteric sympathetic nerves. The norepinephrine released by AII stimulates jejunal absorption by enhancing transepithelial transport processes or by altering the balance of Starling forces governing fluid absorption across enteric capillaries.

Adrenalectomy↗