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Biomedical subjects

M S Younger

Publications and source records attributed to M S Younger.

7 recordsLinked to original sources
PubMed1999

Reduced cortisol potentiates the exercise-induced increase in corticotropin to a greater extent in trained compared with untrained men.

We examined the effect of acute exercise and reduced cortisol on pituitary and adrenal responsiveness and the impact of reduced plasma cortisol on maximal oxygen consumption (VO2max) in eight trained (T) and eight untrained (UT) males. Subjects completed two graded maximal exercise tests (GXT), each preceded by either overnight metyrapone (MET) or placebo (PLA) administration. Blood samples were collected before and after GXT. With PLA, resting corticotropin (ACTH) levels were higher in T versus UT men; however, cortisol and 11-deoxycortisol were similar between groups. Following GXT on PLA, cortisol was unchanged but 11-deoxycortisol increased in both groups; however, ACTH increased only in UT men. For both groups, cortisol, 11-deoxycortisol, and ACTH were different post-GXT with MET versus PLA. Furthermore, following GXT with MET, the ACTH response was greater in T versus UT subjects. VO2max was not altered by MET in either group. We conclude that (1) at rest, only ACTH levels differed between T and UT men; (2) individually, the GXT and MET provide a similar ACTH response in UT but not in T subjects; (3) when GXT and MET are superimposed, they provide a stronger stimulus to pituitary and adrenal reserve than either test alone; (4) the combination of MET and GXT elicits a greater ACTH response in T compared with UT men; and (5) an acute reduction in plasma cortisol does not alter VO2max.

Adrenocorticotropic Hormone↗
PubMed1998

Metabolic effects of low cortisol during exercise in humans.

This study examined the physiological effect of reduced plasma cortisol (C) during prolonged exercise in humans. The effects of normal C (NC) were compared with metyrapone-induced low C (LC) on plasma substrate availability and the respiratory exchange ratio during 2 h of exercise at approximately 60% peak O2 consumption in nine subjects. The C responses were compared with preexercise (Pre) levels and with a rest day (Con). At rest, C was attenuated by approximately 70% for LC compared with NC. At rest, plasma glucose, lactate, glycerol, beta-hydroxybutyrate, alanine, branched-chain amino acids, insulin, glucagon, growth hormone, epinephrine, and norepinephrine were similar under LC and NC (P > 0.05). During exercise under NC, plasma C increased compared with Pre, whereas it remained unchanged during LC. During NC, plasma C was elevated at 90 min (compared with Con) and at 120 min (compared with Con and Pre). During exercise, plasma glucose decreased to the same extent and lactate was similar under both conditions, whereas plasma glycerol, beta-hydroxybutyrate, alanine, and branched-chain amino acids were higher (P < 0.01) under NC. Plasma insulin declined (P = 0.01) to a greater extent under LC, whereas growth hormone, epinephrine, and norepinephrine tended to be higher (0.05 </= P </= 0.10). Plasma glucagon increased under both conditions (P < 0.01). The respiratory exchange ratio did not differ between conditions. We conclude that, during exercise, 1) C accelerates lipolysis, ketogenesis, and proteolysis; 2) under LC, glucoregulatory hormone adjustments maintain glucose homeostasis; and 3) LC does not alter whole body substrate utilization or the ability to complete 2 h of moderate exercise.

Adult↗
PubMed1993

Relationships between self-reported symptoms of infection, menstrual-cycle-related distress, and cycle phase.

This study examined the relationships between symptoms of common infectious illnesses, menstrual cycle phase, and cycle-related distress. Sixty-five women who had regular menstrual cycles and were not taking birth control pills were the convenience sample for this research. Subjects completed the Menstrual Distress Questionnaire (MDQ), the Perceived Stress Scale (PSS), and an investigator-developed symptom checklist (SCL) that inventoried symptoms of common respiratory, skin, gastrointestinal, and genitourinary infections. The subjects completed all questionnaires three times during the menstrual cycle (during menstruation, midcycle, and premenstruum). The results of the study indicated a highly significant clustering of infectious illness symptoms during the perimenstrual period compared with midcycle. There were significant relationships between scores on the MDQ and PSS and the frequency and intensity of infection symptoms throughout the cycle. Analysis of covariance (ANCOVA) of the effects of phase, PSS, MDQ, and SCL scores revealed that phasic influences were not significant when MDQ scores were controlled. PSS and MDQ scores significantly influenced symptom scores when phase was controlled, suggesting a general relationship between distress and infectious symptoms during the menstrual cycle.

Adolescent↗
PubMed1986

Satisfaction with hospital emergency department as a function of patient triage.

For most people, waiting is inherently dissatisfying and emergency department patients are no exception. Most patients and people accompanying the patient find the treatment waiting time in emergency medical care facilities to be a source of great dissatisfaction. The dissatisfaction is compounded in many cases by the anxiety of all associated with the patient and the discomfort or pain the patient feels. Consequently it was not surprising to find in this investigation that waiting time for treatment and treatment cost were major causes of consumer dissatisfaction. Satisfaction of emergency department patients decreased as the medical need became less urgent. This finding should be of considerable concern to hospital administrators. With the trend toward new forms of health care delivery systems such as "emergicenters" and the increase in the number of physicians per capita, the emergency department will no longer be the most attractive or the only alternative available to the patients who have a nonemergency medical need. For emergency departments to remain profitable, it will be more important than ever before to meet the needs and expectations of their current and potential users. This can be accomplished by a program designed to reduce cost and waiting time and improve communication, and by other programs to educate the user so that the user's expectations more closely conform with what is actually needed or can be economically provided.

Anxiety↗
PubMed1984

Consumer opinions of emergency room medical care.

If hospital management is to adapt successfully to an increasingly competitive environment, and to retain a viable emergency department, it well be necessary to objectively and accurately assess the hospital's image in the community served. Knowledge of the consumers' views is an essential input into the formulation of strategic plans. This article reports on a study in which consumer opinions on 15 dimensions of emergency room health care were obtained from 723 respondents using a mail questionnaire. Findings reveal that consumers view the emergency room as being more expensive than other health care providers. Except for being available or convenient, little or no advantage is perceived for the emergency room over the personal physician. Even though the emergency room has specialized staff and equipment, consumers do not believe patients receive better or faster treatment in an emergency room than would be obtained in a physician's office. Unless changed, these perceptions will diminish the role of the emergency room in the delivery of health care services.

Consumer Behavior↗