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Biomedical subjects

B L Smoak

Publications and source records attributed to B L Smoak.

14 recordsLinked to original sources
PubMed1997

Dengue fever in US military personnel in Haiti.

OBJECTIVE: To describe clinical manifestations and public health implications of an outbreak of dengue fever (DF) during Operation Uphold Democracy, Haiti, 1994. DESIGN: Consecutive sample. SETTING: Military combat support hospital, Port-au-Prince, Haiti. PATIENTS: A total of 101 US military personnel with acute febrile illnesses. INTERVENTIONS: A disease surveillance team collected clinical and epidemiologic data from US military clinics throughout Haiti. Febrile patients admitted to the combat support hospital were evaluated with standardized clinical and laboratory procedures. The surveillance team followed patients daily. MAIN OUTCOME MEASURES: Arbovirus isolation and specific antibody determination and symptoms and physical findings. RESULTS: Febrile illnesses accounted for 103 (25%) of the 406 combat support hospital admissions during the first 6 weeks of deployment. All patients with febrile illness recovered. A total of 30 patients had DF; no patient had evidence of infection with malaria. Dengue virus serotypes 1, 2, and 4 were isolated from 22 patients, and 8 patients developed IgM antibody to dengue virus. Patients with DF could not be distinguished from other febrile patients on clinical grounds alone. No arboviruses other than dengue were identified. CONCLUSIONS: Active surveillance, with clinical and laboratory evaluation directed by an epidemiologic team, led to the timely recognition of an outbreak of febrile illness among US troops in Haiti. Viral isolation and serological studies were essential in confirming DF. During the surveillance period, DF accounted for at least 30% of the febrile illnesses among hospitalized US troops. Dengue fever is a significant threat to military personnel and civilian travelers in Haiti and has the potential for introduction to and transmission in the United States.

Adult↗
PubMed1997

The effects of inadvertent exposure of mefloquine chemoprophylaxis on pregnancy outcomes and infants of US Army servicewomen.

During US military operations in Somalia, mefloquine, a drug for malaria chemoprophylaxis, was not approved for use in pregnant women. Some female soldiers inadvertently used mefloquine before becoming aware of their pregnancy. A registry was established to follow the outcomes of these pregnancies. Questionnaires were administered at the time the pregnancy was diagnosed, after termination or delivery, and at 1 year after birth. Seventy-two soldiers were eligible for the registry. There were 17 elective abortions, 12 spontaneous abortions, 1 molar pregnancy, and 23 live births. The outcome for 19 soldiers was unknown. An unexpected high rate of spontaneous abortions was observed. All infants were healthy at birth, with no major congenital malformations. One infant died at 4 months of viral pneumonitis. At 1 year of age, 13 infants were reported to be healthy, with normal cognitive and motor development. This study provides additional postmarketing data that mefloquine does not cause gross congenital malformations.

Adult↗
PubMed1997

Plasmodium vivax infections in U.S. Army troops: failure of primaquine to prevent relapse in studies from Somalia.

Different strains of Plasmodium vivax vary in their sensitivity to primaquine, the only drug that prevents relapses. Described are the clinical data and relapse pattern for 75 soldiers treated for vivax malaria since returning from Somalia. Following their initial attack of malaria, 60 of the 75 cases received a standard course of primaquine (15 mg base daily for 14 days). Twenty-six of the 60 soldiers subsequently relapsed for a failure rate of 43%. Eight soldiers had a second relapse following primaquine therapy after both the primary attack and first relapse. Three of these soldiers had received a higher dosage of primaquine (30 mg base daily for 14 days) after their second attack. The apparent ineffectiveness of primaquine therapy in preventing relapses suggests the presence of primaquine-resistant P. vivax strains in Somalia.

Adolescent↗
PubMed1994

Seroprevalence of Helicobacter pylori infections in a cohort of US Army recruits.

To study the prevalence and risk factors of Helicobacter pylori infection in healthy young adults, sera were collected from a nationwide sample of 404 females and 534 males (mean age, 20.2; range, 17-26 years) at induction into the US Army at Fort Jackson, South Carolina, during the fall of 1990. An enzyme-linked immunosorbent assay (PYLORI STAT, BioWhittaker, Inc., Walkersville, MD) was used to detect H. pylori-specific immunoglobulin G antibodies. Demographic data were obtained from a personnel database and by linking US census information to the subject's home address. The observed crude seropositivity rate was 26.3% (95% confidence interval 23.2-28.9). The direct sex-, race-, and geographic region-adjusted seropositivity rate was 20.8% (95% confidence interval 17.9-23.7). Seropositivity rates for blacks, Hispanics, and whites were 44%, 38%, and 14%, respectively, (chi 2, p < 0.001), and rates increased progressively from 24% in the age group 17-18 years to 43% in the age group 24-26 years (chi 2 for trend, p < 0.001). The age trends remained strong after controlling for race Median income was also an important predictive variable for seropositivity (chi 2, p < 0.0001). Sex, the percent urbanization, and population density of the home county were not significant predictors of seropositivity when age and race-ethnic group were controlled in a statistical model. The sharp increase in seroprevalence in this narrow age range suggests that the incidence rates are higher in young adults than previously reported.

Adolescent↗
PubMed1994

Evidence for a recent decrease in measles susceptibility among young American adults.

As part of an ongoing evaluation of US Army immunization policies, two serologic surveys were conducted at an army basic training center. Antibody status to measles, mumps, and rubella were determined by an ELISA in 969 soldiers in 1989 and 992 soldiers in 1990. Measles seronegativity rates, directly adjusted to the 15- to 24-year-old US population in 1980, decreased from 21.3% in 1989 to 12.5% in 1990 (P < .001). Decreases also were observed in mumps (16.2% to 14.7%) and rubella seronegativity rates (18.4% to 14.3%) from 1989 to 1990 but were not statistically significant. In subgroup analyses, significant decreases in measles seronegativity were observed in younger, white, male, and female cohorts. There is evidence that susceptibility among young adults had declined, although it remains unclear if this is due to increased immunization or exposure to natural disease.

Adolescent↗
PubMed1992

Plasma zinc uptake from a supplement during submaximal running.

The uptake of zinc (Zn) into the plasma after the ingestion of 25 mg of Zn from multivitamin-mineral supplement was studied in 10 men during running (R) and control (C) conditions; the R was for 2 h at 60-65% of their maximal oxygen uptake. Subjects took the supplement with 200 ml of deionized water before the R or C (0-time). Blood was drawn before the Zn load and every 30 min for 3 h. By 2 h, plasma Zn concentrations had risen to values that were 151 +/- 7% and 149 +/- 5% of (0-time) R and C concentrations, respectively. Furthermore, the average rates of Zn uptake into the plasma did not differ between the R and C (4.4 vs 3.8 mumol.l-1.h-1) conditions. Finally, areas under the curve were not different (R: 13.2 +/- 1.8 mumol.l-1.3h-1; C: 11.5 +/- 1.5 mumol.l-1.3h-1). In summary, submaximal endurance running did not affect plasma Zn uptake and therefore absorption of Zn from a supplement taken just prior to exercise. The effect of chronic exercise on Zn absorption remains to be determined.

Absorption↗
PubMed1991

Biochemical indices of selected trace minerals in men: effect of stress.

Plasma zinc, iron, copper, and selenium and selected blood proteins were measured in 66 men before (BHW) and after (AHW) a 5-d period of sustained physical and psychological stress called Hell Week. Recovery blood samples were obtained from 26 men 7 d after Hell Week. Dietary intakes were determined BHW and during Hell Week; zinc, iron, copper, and selenium intakes during Hell Week averaged 23.6 +/- 3.4 mg/d, 35.4 +/- 3.9 mg/d, 3.0 +/- 0.5 mg/d, and 92.5 +/- 26.7 micrograms/d, respectively. C-reactive protein was detected in only five subjects BHW and in all subjects AHW. Zinc, iron, selenium, and albumin decreased by 33%, 44%, 12%, and 9%, respectively, whereas ferritin, ceruloplasmin, and creatine kinase concentrations increased AHW by 59%, 8%, and 266%, respectively. Haptoglobin concentrations increased 57% in 30 subjects but decreased 32% in 23 subjects AHW. The biochemical changes were transitory because protein (except ferritin) and mineral concentrations were similar to BHW values 7 d after Hell Week. Hell Week induced changes characteristic of an acute-phase response in physically active men.

Analysis of Variance↗
PubMed1991

Plasma pyridoxal and pyridoxal 5'-phosphate concentrations in response to ingestion of water or glucose polymer during a 2-h run.

The effects of ingesting a glucose polymer solution (GP) or water (W) on plasma pyridoxal 5'-phosphate (PLP) and pyridoxal (PL) concentrations were compared in six men (age: 30 +/- 2 y; VO2max: 57.4 +/- 3.2 mL.kg-1.min-1) under running (R) and control (C) conditions. Subjects ran for 2 h at 60-65% of VO2max for R and remained standing for C. For both R and C, 200 mL W or GP was ingested before (0-time) and every 30 min while running (30, 60, and 90 min). Plasma PLP decreased to 95% and 87% of 0-time at 180 min for WC and GPC and increased to 126% and 119% at 90 min and to 124% and 119% at 120 min for WR and GPR. By 60 min postrun, plasma PLP was 98% (WR) and 101% (GPR) of 0-time. There were no significant differences between W and GP conditions. Changes in PLP were not related to plasma volume or blood glucose, free fatty acids, lactate, alkaline phosphatase, aspartate aminotransferase, or alanine aminotransferase. No significant changes in plasma PL were noted. Exercise induces an increase in plasma PLP, perhaps due to transfer of B-6 vitamers from liver to skeletal muscle.

Adult↗
PubMed1990

Changes in lipoprotein profiles during intense military training.

The effects of intense military training on lipoprotein concentrations were monitored in a group of 44 Navy trainees. Dietary intakes and lipoprotein profiles were obtained before and after 5 weeks of physical conditioning and after 5 days of continuous, extremely intense physical and psychological stress. Body weight did not change significantly and dietary intakes were consistently high in saturated fat and cholesterol. After physical conditioning, serum total cholesterol and triglyceride concentrations were unchanged, while high-density lipoprotein (HDL) concentrations increased 31% (p less than 0.05). After 5 days of severe stress, total cholesterol and low-density lipoprotein concentrations decreased 17.2% and 30%, respectively (p less than 0.05), whereas HDL concentrations increased 12.1%. These data indicate that marked changes in lipoprotein profiles occur, not only with long-term physical conditioning, but also with strenuous training that lasts several days, despite high energy, fat, and cholesterol intakes.

Adult↗
PubMed1989

Prolonged whole-body cold water immersion: fluid and ion shifts.

To characterize fluid and ion shifts during prolonged whole-body immersion, 16 divers wearing dry suits completed four whole-body immersions in 5 degrees C water during each of two 5-day air saturation dives at 6.1 msw. One immersion was conducted at 1000 (AM) and one at 2200 (PM) so that diurnal variations could be evaluated. Fifty-four hours separated the immersions, which lasted up to 6 h; 9 days separated each air saturation dive. Blood was collected before and after immersion; urine was collected for 12 h before, during, and after immersion for a total of 24 h. Plasma volume decreased significantly and to the same extent (approximately 17%) during both AM and PM immersions. Urine flow increased by 236.1 +/- 38.7 and 296.3 +/- 52.0%, urinary excretion of Na increased by 290.4 +/- 89.0 and 329.5 +/- 77.0%, K by 245.0 +/- 73.4 and 215.5 +/- 44.6%, Ca by 211.0 +/- 31.4 and 241.1 +/- 50.4%, Mg by 201.4 +/- 45.9 and 165.3 +/- 287%, and Zn by 427.8 +/- 93.7 and 301.9 +/- 75.4% during AM and PM immersions, respectively, compared with preimmersion. Urine flow and K excretion were significantly higher during the AM than PM. In summary, when subjects are immersed in cold water for prolonged periods, combined with a slow rate of body cooling afforded by thermal protection and enforced intermittent exercise, there is diuresis, decreased plasma volume, and increased excretions of Na, K, Ca, Mg, and Zn.

Adult↗
PubMed1989

Variability of responses across training levels to maximal treadmill exercise.

The variability of peak VO2 (ml/min, ml.kg-1.min-1), time on treadmill (TMILLTM), maximal heart rate (HRmax), respiratory exchange ratio at peak VO2 (Rmax), rate of respiration at peak VO2 (FREQ), and exercise-induced changes in plasma lactate concentration (LACDIF) was measured across three maximal treadmill runs in five highly trained, seven moderately trained, and five untrained males. No effect of training level on the variability of any of the parameters was found. Test-retest correlation coefficients for peak VO2 (r = 0.95, run 1 with run 2; r = 0.92, run 1 with run 3; r = 0.92, run 2 with run 3) were similar to previously reported values. Variance component distributions suggested that the underlying physiological mechanisms of response for peak VO2, TMILLTM, and HRmax were different from those of FREQ, Rmax, and LACDIF. Minimum detectable differences for peak VO2 (ml.kg-1.min-1, n = 5, minimum detectable within subject difference, 11.5%; minimum detectable among subject effects, 21.3%) indicated a need for careful attention to research design in future studies.

Adult↗
PubMed1988

Changes in nutrient intakes of conditioned men during a 5-day period of increased physical activity and other stresses.

Nutrient intakes and selected blood and urinary constituents of 16 Navy servicemen were obtained before and during a period of 113 hours of physical activity, sleep deprivation, and psychological stress, to document the dietary adaptation of physically conditioned men to an extended period of hard physical work and other stresses. Food intakes were monitored by 1-day diet records prior to and by direct observation during the period. The factorial method was used to calculate energy expenditure. Carbohydrates provided 45 and 43% of the total energy intake before and during the experiment. Protein intakes and intakes of all the vitamins and minerals studied exceeded the Recommended Dietary Allowances, both before and during the period. Total energy intake averaged 18.7 MJ.d-1 before and 24.4 MJ.d-1 during the experiment. Body weight increased significantly by 2.7 +/- 0.4 kg (mean +/- s.e.) during the experiment (p less than 0.0001). There was a significant correlation (r = 0.74; p less than 0.001) between the change in body weight and urinary sodium from before to after the experiment suggesting that increased dietary sodium may have contributed to the weight gain. A significant increase in plasma volume (11.9 +/- 3.2%; p less than 0.0003) provided further support that the observed weight gain was due to sodium intake rather than a positive energy balance. In conclusion, conditioned men increased food consumption adequately to meet increased energy demands.

Adult↗