Reducing the risk of user error with infusion pumps

Many of the adverse reports received by the Medical Devices Agency concern infusion pumps. Clinical governance aims to ensure that both employers and employees reduce the hazards related to device use. Full training is required to help staff avoid user errors.

Psychiatric practice variations in the diagnosis and treatment of major depression

OBJECTIVE

Practice variations in the diagnosis, treatment, and outcomes of patients with major depression were examined within six psychiatric practices participating in a national outcomes-management project.

METHODS

Six of 20 psychiatric clinics met selection criteria for this study and provided a database of 5, 106 patients. Patients completed the BASIS-32, the Short-Form-36 Health Survey, and a Beginning Services Survey. Treatment information was also obtained directly from the clinician or through a medical record review.

RESULTS

Although 73.1 to 77 percent of patients screened positive for a depressive disorder, only 18.5 to 36.8 percent were diagnosed with major depression (p<.001). Between 39 and 72 percent of patients received psychotropic medications, a significant difference across sites (p<.001). In addition, the number of psychotherapy sessions was significantly different across sites (p<.001).

CONCLUSIONS

Patient care varies considerably across psychiatric practices, a finding that is particularly relevant for developers of performance indicators and risk-adjustment strategies for mental health.

The Verge Videometer wound measurement package

Wound measurement can be made as simple or as complex as time allows, but there is no doubt that wound measurement is required in some degree as part of the patient documentation process. To help assess the progress of wound healing, BES Rehab Ltd is distributing the Verge Videometer (VeV), a wound tracking system which can be used for precise wound measurement, tracking and documentation. The VeV is suitable for use in hospitals, outpatient clinics and in the community as well as being useful for those conducting research into wound progression.

Effects of oligomerization on the epitopes of the human immunodeficiency virus type 1 envelope glycoproteins

To understand the differential expression of epitopes on monomeric and oligomeric forms of the envelope glycoproteins, nine human monoclonal antibodies (mAbs) were derived from the cells of human immunodeficiency virus-infected subjects by selection with soluble oligomeric gp140 (o.140). These nine mAbs and 12 human mAbs selected with V3 peptides, viral lysates, and rgp120, specific for the V2, V3, C5, CD4-binding domain (CD4bd), and gp41, were tested in a binding assay to compare the exposure of these regions on monomeric gp120 or gp41 and on o.140. None of the 21 mAbs were oligomer specific. However, mAbs to V3 and CD4bd were "oligomer sensitive," whereas mAbs to V2 and the distal epitope of C5 tended to be "monomer sensitive" (i.e., to react better with the oligomer or monomer, respectively). The majority of anti-gp41 mAbs reacted similarly with monomer and oligomer. Although the uncleaved o.140 used in this study differs from the cleaved gp120/41 oligomer found on the native virus particle, these results suggest that new epitopes are not introduced by oligomerization of viral envelope proteins, that such oligomer-specific epitopes, if they exist, are not highly immunogenic, and/or that they are not efficiently selected using soluble o.140.

Doing health, doing gender: teenagers, diabetes and asthma

Although most research linking health disadvantage with gender has focused on women, recent work indicates that hegemonic masculinities can also place the health of men at risk. The importance of comparing the experiences of women and men has been emphasised and this paper focuses on the ways in which the social constructions of femininities and masculinities affect how teenagers live with asthma or diabetes. The majority of girls incorporated these conditions and the associated treatment regimens into their social and personal identities, showing a greater adaptability to living with asthma or diabetes. However, this could have detrimental effects in terms of control, as girls sometimes lowered expectations for themselves. In addition, two aspects of the treatment regimens, diet and exercise, were found to disadvantage girls and advantage boys, because of contemporary meanings of femininities and masculinities. The social construction of femininities meant that these conditions were not seen as the threat that they were by the majority of boys interviewed, who made every effort to keep both conditions outside their personal and social identities by passing. The majority of boys maintained a 'valued' identity by feeling in control of their body and their condition. However, for the small minority of boys who were no longer able to pass the impact of chronic illness led to a 'disparaged' identity. The interaction of gender and health is seen as a complex two-way process, with aspects of contemporary femininities and masculinities impacting on the management of these conditions, and aspects of these conditions impacting in gendered ways upon the constructions of gender.

The Loughborough Intermittent Shuttle Test: a field test that simulates the activity pattern of soccer

The aims of this study were to describe and determine the test-retest reliability of an exercise protocol, the Loughborough Intermittent Shuttle Test (the LIST), which was designed to simulate the activity pattern characteristic of the game of soccer. The protocol consisted of two parts: Part A comprised a fixed period of variable-intensity shuttle running over 20 m; Part B consisted of continuous running, alternating every 20 m between 55% and 95% VO2max, until volitional fatigue. Seven trained games players (age 21.5+/-0.9 years, height 182+/-2 cm, body mass 80.1+/-3.6 kg, VO2max 59.0+/-1.9 ml x kg(-1) x min(-1); mean +/- s(x)) performed the test on two occasions (Trial 1 and Trial 2), at least 7 days apart, to determine the test-retest reliability of the sprint times and running capacity. The physiological and metabolic responses on both occasions were also monitored. The participants ingested water ad libitum during the first trial, and were then prescribed the same amount of water during the second trial. The 15 m sprint times during Trials 1 and 2 averaged 2.42+/-0.04 s and 2.43+/-0.04 s, respectively. Run time during Part B was 6.3+/-2.0 min for Trial 1 and 6.1+/-1.3 min for Trial 2. The 95% limits of agreement for sprint times and run times during Part B were -0.14 to 0.12 s and -3.19 to 2.16 min respectively. There were no differences between trials for heart rate, rating of perceived exertion, body mass change during exercise, or blood lactate and glucose concentrations during the test. Thus, we conclude that the sprint times and the Part B run times were reproducible within the limits previously stated. In addition, the activity pattern and the physiological and metabolic responses closely simulated the match demands of soccer.

Biotechnology match making: screening orphan ligands and receptors

To date there has been a considerable amount of interest and success in the pharmaceutical industry in the discovery of drug targets and diagnostics via genomic technologies, namely DNA sequencing, mutation/polymorphism detection and expression monitoring of mRNA. As the ultimate targets for the majority of these methods are actually proteins, more and more emphasis has been placed upon protein-based methods in an effort to define the function of proteins discovered by genomic technologies. One of the most challenging areas of drug target discovery facing researchers today is the search for novel receptor-ligand pairs. Database mining techniques in conjunction with other computational methods are able to identify many novel sequences of putative receptors, but the ability to similarly identify the receptor's natural ligand is not possible by these methods. The past few years have seen an increase in methodology and instrumentation focused on the ability to discover and characterize protein-protein interactions, as well as receptor-ligand pairs. Significant advances have been made in the areas of instrumentation (biosensors and fluorescent plate readers) as well as methodologies relating to phage/ribosome display and library construction.

The integration of SPR biosensors with mass spectrometry: possible applications for proteome analysis

The successful integration of biospecific interaction analysis based on surface plasmon resonance and mass spectrometry produces a powerful technique that couples the benefits of sensitive affinity capture and characterization of binding events with the ability to characterize interacting molecules. A variety of biosensors has been used to capture proteins and peptides biospecifically on sensor surfaces, with subsequent analysis using mass spectrometry. Applying this type of analysis to proteomic studies could lead to ligand and protein-complex identification, and might provide clues leading to the identification of pathways.

The use of Askina saline in the wound cleansing process

After the removal of a dressing from a wound, wound cleansing is often the first action to be taken by the nurse. Saline or tap water is often used to loosen the dressing and therefore help to remove it. It can also be used for the subsequent cleansing of the wound if required. B/Braun Medical has a range of modern wound care products for all healing phases of acute and chronic wounds and this article will look at their saline range.

Physiological and metabolic responses of female games and endurance athletes to prolonged, intermittent, high-intensity running at 30 degrees and 16 degrees C ambient temperatures

Eight female games players (GP) and eight female endurance athletes (EA) ran intermittently at high-intensity and for prolonged periods in hot (30 degrees C) and moderate (16 degrees C) ambient temperatures. The subjects performed a two-part (A, B) test based on repeated 20-m shuttle runs. Part A comprised 60 m of walking, a maximal 15-m sprint, 60 m of cruising (90% maximal oxygen uptake, VO(2max)) and 60 m of jogging (45% VO(2max)) repeated for 75 min with a 3-min rest every 15 min. Part B involved an exercise and rest pattern of 60-s running at 100% VO(2max) and 60-s rest which was continued until fatigue. Although the GP and EA did not respond differently in terms of distances completed, performance was 25 (SEM 4)% less (main effect trial, P < 0.01) in the hot (HT) compared with the moderate trial (MT). Sprints of 15 m took longer to complete in the heat (main effect, trial, P < 0.01), and sprint performance declined during HT but not MT (interaction, trial x time, P < 0.01). A very high correlation was found between the rate of rise in rectal temperature in HT and the distance completed [GP, r =-0.94, P < 0. 01; EA (n = 7), r = -0.93, P < 0.01]. Blood lactate [La(-) ](b) and plasma ammonia [NH(3)](p1) concentrations were higher for GP than EA, but were similar in HT and MT [La(-) ](b), HT: GP vs EA, 8.0 (SEM 0. 9) vs 4.9 (SEM 1.1) mmol x l(-1); MT: GP vs EA, 8.0 (SEM 1.3) vs 4.4 (SEM 1.2) mmol x l(-1); interaction, group x time, P < 0.01; [NH(3)](p1), HT: GP vs EA, 70.1 (SEM 12.7) vs 43.2 (SEM 6.1) mmol x l(-1); MT: GP vs EA, 76.8 (SEM 8.8) vs 32.5 (SEM 3.8) micromol x l(-1); interaction, group x time, P < 0.01. Ad libitum water consumption was higher in HT [HT: GP vs EA, 18.9 (SEM 2.9) vs 13.5 (SEM 1.7) ml x kg(-1) x h(-1); MT: GP vs EA, 12.7 (SEM 3.7) vs 8.5 (SEM 1.5) ml x kg(-1) x h(-1); main effect, group, n.s.; main effect, trial, P < 0.01]. These results would suggest that elevated body temperature is probably the key factor limiting performance of prolonged, intermittent, high-intensity running when the ambient temperature is high, but not because of its effect on the metabolic responses to exercise.

Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of H. pylori

BACKGROUND & AIMS

Helicobacter pylori is believed to predispose to gastric cancer by inducing gastric atrophy and hypochlorhydria. First-degree relatives of patients with gastric cancer have an increased risk of developing gastric cancer. The aim of this study was to determine the prevalence of atrophy and hypochlorhydria and their association with H. pylori infection in first-degree relatives of patients with gastric cancer.

METHODS

H. pylori status, gastric secretory function, and gastric histology were studied in 100 first-degree relatives of patients with noncardia gastric cancer and compared with those of controls with no family history of this cancer.

RESULTS

Compared with healthy controls, relatives of patients with gastric cancer had a higher prevalence of hypochlorhydria (27% vs. 3%) but a similar prevalence of H. pylori infection (63% vs. 64%). Relatives of cancer patients also had a higher prevalence of atrophy (34%) than patients with nonulcer dyspepsia (5%) matched for H. pylori prevalence. Among the relatives of cancer patients, the prevalence of atrophy and hypochlorhydria was increased only in those with evidence of H. pylori infection, was greater in relatives of patients with familial cancer than in relatives of sporadic cancer index patients, and increased with age. Eradication of H. pylori infection produced resolution of the gastric inflammation in each subject and resolution of hypochlorhydria and atrophy in 50% of the subjects.

CONCLUSIONS

Relatives of patients with gastric cancer have an increased prevalence of precancerous gastric abnormalities, but this increase is confined to those with H. pylori infection. Consequently, prophylactic eradication of the infection should be offered to such subjects.

Impaired regulation of brain serotonin function during dieting in women recovered from depression

BACKGROUND

Amino acid mixtures that lower brain availability of the serotonin (5-HT) precursor tryptophan produce acute depressive relapse in women with a history of major depression. Dieting also lowers brain tryptophan availability, but its effects on brain 5-HT function in recovered depressed women have not been studied.

AIM

To test the hypothesis that women with a history of major depression would show impaired regulation of brain 5-HT function during a period of dieting-induced tryptophan depletion.

METHOD

Women with and without a history of major depression were placed on a daily 1000 kcal (approximately 4200 kj) diet for three weeks. Before the diet and in the final week we measured fasting plasma tryptophan levels and the prolactin response to an intravenous tryptophan challenge.

RESULTS

Dieting lowered plasma tryptophan levels equivalently in women with and without a history of depression. In women without a history of depression, dieting also increased the prolactin response to tryptophan. This increase did not occur in women with a history of depression.

CONCLUSIONS

Women with a history of depression showed impaired regulation of brain 5-HT function in response to dieting.

Prevention validation and accounting platform: a framework for establishing accountability and performance measures of substance abuse prevention programs

The field of substance abuse prevention has neither an overarching conceptual framework nor a set of shared terminologies for establishing the accountability and performance outcome measures of substance abuse prevention services rendered. Hence, there is a wide gap between what we currently have as data on one hand and information that are required to meet the performance goals and accountability measures set by the Government Performance and Results Act of 1993 on the other. The task before us is: How can we establish the accountability and performance measures of substance abuse prevention programs and transform the field of prevention into prevention science? The intent of this volume is to serve that purpose and accelerate the processes of this transformation by identifying the requisite components of the transformation (i.e., theory, methodology, convention on terms, and data) and by introducing an open forum called, Prevention Validation and Accounting (PREVA) Platform. The entire PREVA Platform (for short, the Platform) is designed as an analytic framework, which is formulated by a collectivity of common concepts, terminologies, accounting units, protocols for counting the units, data elements, and operationalizations of various constructs, and other summary measures intended to bring about an efficient and effective measurement of process input, program capacity, process output, performance outcome, and societal impact of substance abuse prevention programs. The measurement units and summary data elements are designed to be measured across time and across jurisdictions, i.e., from local to regional to state to national levels. In the Platform, the process input is captured by two dimensions of time and capital. Time is conceptualized in terms of service delivery time and time spent for research and development. Capital is measured by the monies expended for the delivery of program activities during a fiscal or reporting period. Program capacity is captured by fourteen measurement units, tapping into the dimensions of staff resources and community assets. Staff resources are, in turn, operationalized in terms of staff size, staff certification status, staff turnover rate, and the accreditation status of a provider agency. Community assets are operationalized by the number of community centers accessible to the funded agency, number of formalized teams or antidrug coalitions active in the catchment area, and other social/human services providers with whom the prevention agency has formalized networks. The totality of process output from all sources of program activities is reduced to eighteen classes of measures. These are operationalized by thirty-three summary measures. Some of these include: total count of events facilitated; total number of clients served; average number of clients served per event; clients served by single and multiple program sessions; classification of target population in terms of the severity of risk as defined by the Institute of Medicine; age groups and race/ethnicity of clients served; number of program participants retained by recurring programs; number of clients who have completed the program; penetration rates to the target population; client attrition rates; average referral rates per provider per time interval; referral success rates; and so on. All process output measures specified in the Platform are derived from two broad classes of events classified as either products or services. The collectivity of these measures is expected to present a cost-effective, parsimonious, yet comprehensive picture of the entire spectrum of the process output, i.e., "what came out of the program as program activities". For the measurement of performance outcomes, two types of data are incorporated into the Platform: outcome data from individuals and the behavior (or performance) of social indicators from aggregated data bases. Individual data are used to evaluate the outcome of substance abuse programs

Falling by the wayside: a phenomenological exploration of perceived breast-milk inadequacy in lactating women

OBJECTIVE

To provide insight into the lived experience of breast feeding, in primiparous women. The main focus was upon women's perceptions related to the adequacy of their breast milk, for the purpose of exclusively nourishing their babies.

DESIGN

A longitudinal, phenomenological study involving in-depth, interactive interviews, conducted at 6, 12 and 18 weeks following the birth of the women's babies.

PARTICIPANTS AND SETTING

A convenience sample of ten primiparous women were recruited prior to discharge from a maternity unit, in the north of England, in 1998.

FINDINGS

Two groups of participants emerged, three who became increasingly confident and empowered by breast feeding and the remaining seven whose confidence progressively diminished, with six of them expressing concern that their breast milk was inadequate. Four major themes related to the participants' perceptions emerged from the analysis: the quest to quantify and visualise breast milk; anxiety regarding the adequacy of their diet; breast feeding as a challenging journey, with most feeling that they had 'fallen by the wayside' (this related partly to inadequate and conflicting advice given by health professionals); and finally, unmet needs for support, nurturing and replenishment in return for 'giving out'.

CONCLUSION

Perceived breast-milk inadequacy is underpinned by a complex and synergistic interaction between socio-cultural influences, feeding management, the baby's behaviour, lactation physiology and the woman's psychological state.

IMPLICATIONS

Education of midwives and health visitors is required in relation to the needs of breast-feeding mothers within a Western industrialised society. Strong social policy is vital in the UK, to initiate socio-cultural changes, which would enable women who commence breast feeding to perceive it as an empowering and fulfilling experience and not one of 'falling by the wayside'.

Wound irrigation techniques: new Steripod normal saline

Wound cleansing is performed on a regular basis by many healthcare professionals. However, the modern concept of cleansing has not always been a priority in wound management. There are many questions which challenge those responsible for cleaning wounds such as how often a wound should be cleaned and which techniques should be used. This article begins with a brief guide to wound cleansing and then focuses on the new Steripod normal saline produced by SSL International.

Gender, adolescence and the management of diabetes

Health professionals view adolescence as a difficult time in which to manage diabetes. Adherence to treatment may be a problem, and there is also an expectation that young people should become independent in self-care. Drawing on data from a qualitative study which interviewed teenagers with diabetes and their mothers, this paper focuses on the ways in which gender and adolescence interact to affect how young people live with diabetes. Key themes explored include: the gendered meanings of diabetes; gendered management strategies; gendered dependencies; and adherence to treatment regimes. Gender was found to have a major impact on how young people managed diabetes. Gender also impacted on the involvement of mothers, with the mothers of sons much more likely to be involved in helping their sons than the mothers of daughters. In discussing some of the implications for health policy, it is suggested that in their ways of managing diabetes, young people should be seen as acting rationally within the confines of their gendered identities. Therefore, a uniform policy which promotes the independence of young people may not always be an appropriate way of working with young people or their families.

A high frequency of sequence alterations is due to formalin fixation of archival specimens

Genomic analysis of archival tissues fixed in formalin is of fundamental importance in biomedical research, and numerous studies have used such material. Although the possibility of polymerase chain reaction (PCR)-introduced artifacts is known, the use of direct sequencing has been thought to overcome such problems. Here we report the results from a controlled study, performed in parallel on frozen and formalin-fixed material, where a high frequency of nonreproducible sequence alterations was detected with the use of formalin-fixed tissues. Defined numbers of well-characterized tumor cells were amplified and analyzed by direct DNA sequencing. No nonreproducible sequence alterations were found in frozen tissues. In formalin-fixed material up to one mutation artifact per 500 bases was recorded. The chance of such artificial mutations in formalin-fixed material was inversely correlated with the number of cells used in the PCR-the fewer cells, the more artifacts. A total of 28 artificial mutations were recorded, of which 27 were C-T or G-A transitions. Through confirmational sequencing of independent amplification products artifacts can be distinguished from true mutations. However, because this problem was not acknowledged earlier, the presence of artifacts may have profoundly influenced previously reported mutations in formalin-fixed material, including those inserted into mutation databases.

Comparison of costing tools in paediatric intensive care

The cost of service provision is an issue of concern to all professionals working in health care. Department of Health reports have highlighted the need for more effective costing mechanisms for provision of paediatric intensive care (PIC). This study aimed to determine whether nurse-patient dependency scoring would be as effective as the Therapeutic Intervention Scoring System (TISS) at providing a differential costing tool for PIC. Data were collected on 251 patient admissions over 1,741 nursing shifts and analysis of variance undertaken. Findings suggest that a modified nurse-patient dependency score would be as good as TISS as a potential costing tool in PICU.

CACP, encoding a secreted proteoglycan, is mutated in camptodactyly-arthropathy-coxa vara-pericarditis syndrome

Altered growth and function of synoviocytes, the intimal cells which line joint cavities and tendon sheaths, occur in a number of skeletal diseases. Hyperplasia of synoviocytes is found in both rheumatoid arthritis and osteoarthritis, despite differences in the underlying aetiologies of the two disorders. We have studied the autosomal recessive disorder camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP; MIM 208250) to identify biological pathways that lead to synoviocyte hyperplasia, the principal pathological feature of this syndrome. Using a positional-candidate approach, we identified mutations in a gene (CACP) encoding a secreted proteoglycan as the cause of CACP. The CACP protein, which has previously been identified as both 'megakaryocyte stimulating factor precursor' and 'superficial zone protein', contains domains that have homology to somatomedin B, heparin-binding proteins, mucins and haemopexins. In addition to expression in joint synovium and cartilage, CACP is expressed in non-skeletal tissues including liver and pericardium. The similarity of CACP sequence to that of other protein families and the expression of CACP in non-skeletal tissues suggest it may have diverse biological activities.

The influence of intermittent high-intensity shuttle running and fluid ingestion on the performance of a soccer skill

The aim of this study was to examine the effect of intermittent high-intensity shuttle running and fluid ingestion on the performance of a soccer skill. Nine semi-professional soccer players volunteered to participate in the study. Their mean (+/- s(x)) age, body mass and maximal oxygen uptake were 20.2+/-0.4 years, 73.2+/-1.8 kg and 59.1+/-1.3 ml x kg(-1) min(-1) respectively. The players were allocated to two randomly assigned trials: ingesting or abstaining from fluid intake during a 90 min intermittent exercise protocol (Loughborough Intermittent Shuttle Test: LIST). This test was designed to simulate the minimum physical demands faced by soccer players during a game. Before and immediately after performance of the test, the players completed a soccer skill test and a mental concentration test. Performance of the soccer skill test after the 'no-fluid' trial deteriorated by 5% (P<0.05), but was maintained during the fluid trial. Mean heart rate, perceived exertion, serum aldosterone, osmolality, sodium and cortisol responses during the test were higher (P<0.05) in the 'no-fluid' trial than in the fluid trial. The results of this study suggest that soccer players should consume fluid throughout a game to help prevent a deterioration in skill performance.

Variance in transneuronal retrograde ganglion cell degeneration in monkeys after removal of striate cortex: effects of size of the cortical lesion

The extent of transneuronal retrograde degeneration of ganglion cells in the primate retina depends on the age at which striate cortex was damaged, the survival time, the species, and retinal eccentricity. We here report on the effect of lesion size beyond striate cortex, which we assessed along with retinal ganglion cell degeneration in three groups of macaque monkeys who, in each group, had undergone striate cortical ablation at similar ages and survived for similar periods, which ranged from 302 days to 8 years. Where possible, the number of surviving projection neurones in the degenerated dLGN and its volume were also estimated. Results confirm that both geniculate and retinal degeneration correlate significantly with survival time but that the differences within a group can exceed differences between groups and are best accounted for by the extent of the damage to extra-striate visual cortex and underlying white matter.

Carbohydrate-electrolyte ingestion during intermittent high-intensity running

PURPOSE

The purpose of this study was to examine the effects of ingesting a carbohydrate-electrolyte beverage or a noncarbohydrate placebo on muscle glycogen utilization during 90 min of intermittent high-intensity running.

METHODS

Six trained games players (age 24.6 +/- 2.2 yr; height 179.6 +/- 1.9 cm; body mass 74.5 +/- 2.0 kg; VO2max 56.3 +/- 1.3 mL x kg(-1) x min(-1); mean +/- SEM) performed two exercise trials, 7 d apart. The subjects were university soccer, hockey, or rugby players. On each occasion, they completed six 15-min periods of intermittent running, consisting of maximal sprinting, interspersed with less intense periods of running and walking. During each trial, subjects consumed either a 6.9% carbohydrate-electrolyte solution (CHO-E: the CHO trial) or a noncarbohydrate placebo (the CON trial) immediately before exercise (5 mL x kg(-1) BM) and after every 15 min of exercise thereafter (2 mL x kg(-1) BM). Drinks were administered in a double-blind, counter-balanced order, and the total volume of fluid consumed during each trial was 1114 +/- 30 mL. Needle biopsy samples were obtained from the vastus lateralis muscle before and after 90 min of exercise. Venous blood samples were collected from an antecubital vein at rest and every 30 min during exercise.

RESULTS

Muscle glycogen utilization in mixed muscle samples was lower (P < 0.05) during CHO [192.5 +/- 26.3 mmol glucosyl units (kg x DM(-1))] than CON [245.3 +/- 22.9 mmol glucosyl units (kg x DM(-1))]. Single fiber analysis on the biopsy samples of the subjects during the CON trial showed a greater glycogen utilization in the Type II fibers compared with Type I fibers during this type of exercise [Type I: 182.2 +/- 34.5 vs Type II: 287.4 +/- 41.2 mmol glucosyl units (kg x DM(-1)); P < 0.05). After 30 min of exercise, blood lactate was significantly greater (P < 0.05) and serum insulin concentration lower (P < 0.05) in CON.

CONCLUSIONS

In summary, when trained games players ingested a carbohydrate-electrolyte beverage, muscle glycogen utilization was reduced by 22% when compared with a control condition.