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Biomedical subjects

M H Williams

Publications and source records attributed to M H Williams.

At least 19 recordsLinked to original sources

Ergogenic and ergolytic substances.

Genetic endowment and proper training are the major factors contributing to athletic success in endurance and ultraendurance events. Proper nutrition, primarily adequate carbohydrate and fluid, prior to and during the event is also critical. Endurance athletes often utilize other nutritional substances or practices, often referred to as ergogenics, in attempts to obtain a competitive edge by enhancing energy utilization and delaying the onset of fatigue. Numerous nutritional ergogenics have been used in attempts to enhance endurance performance, but with several exceptions most have been shown to be ineffective, including bee pollen, L-carnitine, CoQ10, inosine, amino acids, alkaline salts, and vitamin E at sea level. Research findings are equivocal relative to the ergogenicity of caffeine, phosphate salts, and vitamin E at altitude. Loss of excess body fat, a nutritional practice, may be an effective ergogenic. Conversely, some agents such as alcohol may impair performance, an ergolytic effect. Additional research is necessary to support the efficacy of several nutritional ergogenics to enhance prolonged endurance performance, such as caffeine, phosphates, specific amino acids, and various commercial products. Such research should involve exercise tasks comparable in intensity and duration to that experienced in the marathon and similar endurance events.

Amino Acids, Branched-Chain

Pulsus paradoxus in asthma.

Ninety-three patients with asthma were examined on 308 occasions for systolic fluctuation of blood-pressure during quiet breathing. Pulsus paradoxus (fluctuation of 10 mm Hg or greater) was present on 110 occasions. A pulses paradoxus was associated with greater airflow obstruction (average peak expiratory flow-rate 33.6% of the predicted) than an absent pulsus paradoxus which was associated with a peak expiratory flow-rate of 55.4%. However, pulsus paradoxus was often present in mild obstruction and absent in severe obstruction. In six patients the effect of changing respiratory pattern on systolic fluctuation was studied. Systolic fluctuation was directly related to the inspiratory flow-rate. This is probably one of the major reasons why association of airflow obstruction with pulsus paradoxus is not constant.

Airway Obstruction

Response to corticosteroids in chronic bronchitis.

Corticosteroid drugs are often employed in the treatment of patients with chronic bronchitis. Although some patients respond favorably to such therapy, the characteristics of such patients are not known. Twenty-four patients with chronic bronchitis were treated with prednisone 30 mg daily or placebo for one week each in a double-blind crossover study. The following were monitored before and after each treatment period: physical examination, symptoms, peripheral blood eosinophil count, sputum cell exmination, forced vital capacity (FVC), before and after isoproterenol aerosol. Seven of 24 patients had an FEV1 increase greater than 30% of the control value on prednisone but not on placebo. Blood eosinophil count was elevated (greater than or equal to 350/mm(3)) in 7 patients; 2 of these 7 improved on steroid. Sputum cell examination revealed preponderance of eosinophils in 1, and occasional clumps of eosinophils in 8. Seven of these 9 responded to steroid. Sputum but not blood eosinophilia is a good predictor of a favorable response to steroid therapy.

Aged

The effect of blood infusion upon endurance capacity and ratings of perceived exertion.

The purpose of this investigation was to study the effect of blood infusion upon maximal endurance capacity and ratings of perceived exertaion (RPE). Sixteen long-distance runners, 13 of whom were marathoners, undertook four trials (T1-T4) of a treadmill run to exhaustion over a five week period. Criterion measures were time to exhaustion (TE) and RPE during each T. Data on Hb, Hct and RBCs were collected prior to each trial. Based on TE at T1, Ss were matched and assigned to either the experimental (E) or control (C) group. One week after T1, all Ss had 460 ml blood withdrawn. T2 was undertaken 2 weeks postwithdrawal. One week after T2, or 21 days postwithdrawal, the E group was infused with their own RBCs while the C group received 460 ml normal saline. T3 was taken 2 hours postinfusion and T4 one week later. The results of the factorial repeated measures ANOVA revealed no significant differences (p less than .05) between groups for either TE or RPE, even though the Hb level for the E group was significantly higher (P less than .01) than the C group at T3 and T4.

Analysis of Variance

Apneusis.

Two cases of apneustic breathing that had several unusual features, as compared with experimental apneusis, are reported here. Both patients had intact vagal function. Respiratory rhythm showed mainly inspiratory apneusis, with a relatively smooth background rhythm. Frequency and duration of apneusis either decreased or were unaffected by breathing CO2, and increased, in one case, after hyperventilation. Both patients were alert and conscious. One had a long history of narcotic abuse, but had no other neurological or respiratory abnormality. Another had been deaf and mute since an episode of meningitis in childhood and had had apneusis for over 35 years, but suffered no other neurological abnormality. These unusual features suggest that the pathogenic mechanisms for apneusis are not the same in experimental models and patients.

Aged

Dose response of patients with asthma to inhaled isoproterenol.

In 12 patients with asthma, inhalation of approximately 0.02 mg of isoproternol produced as much increase in peak expiratory flow rate (PEFR) as had a previous inhalation of approximately 0.16 mg of isoproternol at a time when the pre-treatment PEFRwas similar. A group or patients recorded measurements of their PEFR before and after inhalation of varying doses of isoproterenol, ranging from 0 to 0.08 mg. In each patient, only data obtained when control PEFRs were similar were utilized. A maximal effect was noted after inhalation of 0.02 mg of isoproterenol, and no further increase of PEFR was noted after inhalation of larger doses. Inhalation of 0.02 mg or less of isoproterenol produces a maximal effect on PEFR of patients with asthma.

Aerosols

Treatment of asthma with triamcinolone acetonide aerosol.

Thirty-five steroid-dependent asthmatic patients have been treated with an aerosol of triamcinolone acetonide for periods ranging from 8 to 26 months. Fourteen patients discontinued the oral use of steroids for the first time in from 2 to 19 years and throughout the period of treatment with aerosol, have not required any other steroid medication. Fifteen patients were able to discontinue oral use of steroids but have required one or more short supplemental courses of oral steroid treatment for exacerbations of asthma. Six patients have either continued to require oral steroid therapy, or their symptoms have been incompletely controlled by the aerosol. Steroid aerosols represent an important advance for the treatment of asthma. Small doses which do not suppress adrenal function and do not produce hyperadrenocorticism make it possible for most patients to eliminate or substantially reduce their requirement for oral steroid therapy.

Administration, Oral