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Biomedical subjects

P G Chapman

Publications and source records attributed to P G Chapman.

6 recordsLinked to original sources

Effect of altered pre-exercise carbohydrate availability on selection and perception of effort during prolonged cycling.

This study assessed the effect of altered carbohydrate (CHO) availability on self-selected work rate during prolonged time-trial cycling. Eight endurance-trained men undertook two experimental cycling time-trials after glycogen-depleting exercise and 2 days of: (a) high (9.3 +/- 0 g CHO kg(-1) day(-1)) (HC) and (b) low CHO intakes (0.6 +/- 0.1 g CHO kg(-1) day(-1)) (LC), via a double-blinded crossover design. All feedback regarding performance was removed during both exercise trials. Self-selected external power output was not different during the first 2 h of exercise between experimental conditions (P > 0.05), despite reported sensations of increased tiredness before and during exercise, significantly reduced whole body CHO oxidation (P < 0.05), plasma lactate concentrations (P < 0.05) and earlier onset of fatigue during exercise in LC versus HC. Perceived exertion was not different throughout exercise between conditions (P > 0.05). Mean power output declined significantly in LC versus HC (P < 0.05) after approximately 2 h of exercise, and was associated with significant reductions in cadence, heart rate and plasma glucose concentration (P < 0.05). These results demonstrate that when compared with time-trial cycling performed after a HC diet, reduced CHO availability does not initially alter self-selected work rate in endurance athletes who are deceived of their CHO status prior to exercise. This finding suggests that reduced work rate during exercise following lowered CHO intake may, in part, be a consequence of the subject's awareness of dietary CHO restriction rather than solely a physiologically mediated action. Further research is required to distinguish the influence of circulating glucose and peripheral glycogen availability on pacing strategy during prolonged exercise.

Adaptation, Physiological↗

Short-term suppression of plasma free fatty acids fails to improve insulin sensitivity when intramyocellular lipid is elevated.

AIMS: Metabolic responses to manipulation of the plasma free fatty acid (FFA) concentration were assessed in six healthy men via cross-over design to determine whether FFAs independently influence insulin sensitivity. METHODS: Intramyocellular lipid (IMCL) was measured by proton magnetic resonance spectroscopy and insulin sensitivity via frequently sampled intravenous glucose tolerance test (IVGTT) after 67 h of two identical low carbohydrate/high fat (LC) diets which were used to elevate IMCL and plasma FFAs. To uncouple the influence of FFAs and IMCL on insulin sensitivity, FFAs were suppressed 30 min prior to and during IVGTT in one treatment [LC + nicotinic acid (NA)] by NA ingestion. RESULTS: Vastus lateralis IMCL was significantly elevated in LC (13.3 +/- 1.1 x 10(-3)) and LC + NA (13.5 +/- 1.1 x 10(-3)) (P < 0.01 for both), but was not different between conditions (P > 0.05). Plasma FFAs were raised in LC (0.79 +/- 0.08 mmol/l) and LC + NA (0.80 +/- 0.11 mmol/l) (P < 0.01 for both) and were significantly reduced by NA ingestion prior to (0.36 +/- 0.05 mmol/l, P < 0.01) and during IVGTT (P < 0.05) in LC + NA. Despite marked differences in plasma FFA availability, insulin sensitivity and glucose tolerance were not different between LC and LC + NA (P > 0.05 for both). CONCLUSIONS: Plasma FFAs appear to exert no immediate effect on insulin sensitivity/glucose tolerance independent of their action on intracellular lipid moieties. Further research is required to elucidate the duration of FFA suppression required to restore insulin sensitivity following lipid-induced insulin resistance.

Adult↗

Early outcome and cost-effectiveness of endoscopic versus open carpal tunnel release: a randomized prospective trial.

Proponents of endoscopic carpal tunnel release have been advocating the technique for more than 10 years but there is still debate about its efficacy, safety and cost-effectiveness. We have performed a randomized, prospective, blind trial to compare early outcome after single portal endoscopic or open carpal tunnel surgery and to assess the cost-effectiveness of the procedures. There were no significant differences in symptom and functional activity scores, grip strength or anterior carpal pain in the first 3 months. For those in employment, we found a statistically significant difference between the two treatment groups with the endoscopic group returning to work, on average, 8 (95% CI, 2-13 days) days sooner than the open group. This translates into a cost saving to industry. There were no major neurovascular complications in either group. On the basis of these findings, we recommend that endoscopic carpal tunnel release should be considered in the employed as a cost-effective procedure, but perhaps not in the general population as a whole.

Activities of Daily Living↗

The drain sleeve.

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Casts, Surgical↗

The bacteriology of bone allografts.

We report the contamination rate in the Cambridge bone bank of 35 consecutive allograft specimens, all harvested in a clean-air environment, using a strict aseptic technique and antibiotic cover. Five of 27 femoral heads taken from living donors and three of eight massive allografts taken from cadavers were found to be contaminated. The contaminated femoral heads were discarded. All massive allografts were rendered sterile by gamma-irradiation. It is important to exclude bacteriological contamination of harvested and banked bone.

Adult↗