Abstract:
:For the military doctor, an understanding of the metabolic effects of high altitude (HA) exposure is highly relevant. This review examines the acute metabolic challenge and subsequent changes in nutritional homeostasis that occur when troops deploy rapidly to HA. Key factors that impact on metabolism include the hypoxic-hypobaric environment, physical exercise and diet. Expected metabolic changes include augmentation of basal metabolic rate (BMR), decreased availability of oxygen in peripheral metabolic tissues, reduction in VO2 max, increased glucose dependency and lactate accumulation during exercise. The metabolic demands of exercise at HA are crucial. Equivalent activity requires greater effort and more energy than it does at sea level. Soldiers working at HA show high energy expenditure and this may exceed energy intake significantly. Energy intake at HA is affected adversely by reduced availability, reduced appetite and changes in endocrine parameters. Energy imbalance and loss of body water result in weight loss, which is extremely common at HA. Loss of fat predominates over loss of fat-free mass. This state resembles starvation and the preferential primary fuel source shifts from carbohydrate towards fat, reducing performance efficiency. However, these adverse effects can be mitigated by increasing energy intake in association with a high carbohydrate ration. Commanders must ensure that individuals are motivated, educated, strongly encouraged and empowered to meet their energy needs in order to maximise mission-effectiveness.
journal_name
J R Army Med Corpsjournal_title
Journal of the Royal Army Medical Corpsauthors
Hill NE,Stacey MJ,Woods DRdoi
10.1136/jramc-157-01-08subject
Has Abstractpub_date
2011-03-01 00:00:00pages
43-8issue
1eissn
0035-8665issn
2052-0468journal_volume
157pub_type
杂志文章,评审abstract::This article argues that there is a duty of care held by the State to military veterans who have been technologically enhanced as part of their military service. It suggests that enhancements may be permanent, persistent or protracted and demonstrates how enhancements generate additional moral responsibilities from th...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2018-001140
更新日期:2019-08-01 00:00:00
abstract::Tracheobronchomalacia is a rare cause of respiratory distress in children. An infant with tracheobronchomalacia is presented. The aetiology, pathophysiology and management are discussed. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-138-02-08
更新日期:1992-06-01 00:00:00
abstract:INTRODUCTION:In 2015, the Australian Army commissioned a systematic review to assess the evidence on effectiveness and safety of pharmacological and biotechnological products for cognitive enhancement specifically in Army personnel. METHODS:Searches for studies examining biotechnological and pharmacological products i...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-2016-000752
更新日期:2018-07-01 00:00:00
abstract::We report the case of successful management of a transcranial penetrating high-energy transfer injury in a 20-year-old soldier. The bullet traversed both cerebral hemispheres and lacerated the superior sagittal sinus rendering him unconscious. We detail the care received at all stages following injury from 'Buddy Aid'...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000121
更新日期:2014-09-01 00:00:00
abstract::Hydatid disease of the liver is highly prevalent in oriental countries including Turkey, in which their population live mostly in rural areas. The outcome of surgical methods used in the management of a cystic cavity in patients with hepatic hydatid disease was evaluated. Three hundred and forty consecutive patients w...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-144-03-04
更新日期:1998-10-01 00:00:00
abstract::A project sponsored by HQ AMS TA and executed by an experienced TA Commanding Officer enhanced the effectiveness of Hospital Collective Training by improving the standard of selection and documentation of the input of exercise casualties, and set up the basis of a comprehensive library of casualty cards for future use...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-132-01-07
更新日期:1986-02-01 00:00:00
abstract::Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from th...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-2016-000635
更新日期:2017-04-01 00:00:00
abstract::Anecdotal reports of mechanical failure of morphine autojets have triggered a review of possible alternatives. Methoxyflurane is one such alternative already widely used by the Australian and New Zealand Defence Forces. The potential benefits and likely significant drawbacks of methoxyflurane are reviewed with the aim...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-153-02-08
更新日期:2007-06-01 00:00:00
abstract::A multi disciplinary team furthered the collaborative study of acute encephalitis in southeastern Nepal during a major epidemic which occurred in the monsoon period of 1986. Viral studies of serum and cerebro-spinal fluid (CSF) confirmed Japanese Encephalitis Virus (JEV) as the causative agent. Analysis of epidemiolog...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-137-01-03
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:To examine the risk of cervical cancer in a large national cohort of military veteran women followed up for up to 30 years. METHODS:Retrospective cohort study of 5235 veteran women born between 1945 and 1985, and 20 703 women with no record of service matched for age and area of residence, using Cox proporti...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000544
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:Systemic arterial pressure rises on acute exposure to high altitude and changes in blood pressure (BP) and endothelial function may be important in the pathogenesis of clinical syndromes occurring at high altitude. METHODS:Arterial BP, stiffness (SI) and tone (RI) were studied over 11 days in 17 subjects (t...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-157-01-18
更新日期:2011-03-01 00:00:00
abstract::Even in the middle of an epidemic of a very serious illness, outbreaks of other infectious diseases will continue. Clinicians need to be able to make rapid decisions about the nature of the outbreak and how to manage it. A balance needs to be struck between managing all patients as if they have the worst-case scenario...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-2016-000684
更新日期:2017-02-01 00:00:00
abstract::We performed a study to assess the effectiveness of a fluid infusion strategy currently used in the military pre-hospital environment using the patient's own body weight as an infusion device. Thirteen healthy volunteers were cannulated and 0.9% sodium chloride infused over a period of ten minutes. The volumes infused...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-153-03-06
更新日期:2007-09-01 00:00:00
abstract::This paper is a corollary of the recent Class Action against the MoD 2003 and should be read in conjunction with Palmer 2003. As fear is a prerequisite for the diagnosis of Post Traumatic Stress Disorder (PTSD) it was examined in some detail during this case. This paper serves to amplify those deliberations. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-150-02-03
更新日期:2004-06-01 00:00:00
abstract::Leishmaniasis is an infectious disease caused by Leishmania protozoa and occurs as a spectrum of clinical syndromes ranging from various forms of cutaneous leishmaniasis (CL) to mucosal leishmaniasis (ML) and visceral leishmaniasis (VL). CL in Afghanistan is either zoonotic (ZCL) due to L. major or anthroponotic (ACL)...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-158-03-15
更新日期:2012-09-01 00:00:00
abstract::In the decade 1968-77, 203 (12%) of the 1723 deaths in off duty British Army males were associated with a blood alcohol concentration (BAC) in excess of 80 mgs/100 mls. These deaths occurred in road traffic accidents (49%), acute alcohol poisoning (23%), suicide (9%), drowning (8%), falling from a height (7%), burns (...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-133-01-06
更新日期:1987-02-01 00:00:00
abstract::The Pre-Hospital Emergency Care (PHEC) course is a 3 day course run by BASICS Education for the Royal College of Surgeons of Edinburgh, Royal College of Nursing and the NHS Ambulance Service. PHEC teaches and examines the care of medical, trauma, paediatric and obstetric patients in the pre-hospital environment. 243 (...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-143-03-03
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Traumatic cardiac arrest (TCA) in children is associated with a low probability of survival and poor neurological outcome in survivors. Since 2003, over 600 seriously injured local national children have been treated at deployed UK military medical treatment facilities during the Iraq and Afghanistan conflic...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000464
更新日期:2016-08-01 00:00:00
abstract::A case of a 28 years old Caucasian woman is presented with acute tibial compartment of her left leg secondary to repeated self inflicted soft tissue injuries, together with literature review on Dermatitis Artefacta. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-140-02-11
更新日期:1994-06-01 00:00:00
abstract::A method of comparing the quality of intestinal anastomoses performed in craft workshops is described. The equipment is readily available in any hospital, inexpensive and requires no technical construction. The apparatus accurately measures the intraluminal pressure at the first sign of anastomotic leak and a method o...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-139-03-06
更新日期:1993-10-01 00:00:00
abstract::The vast majority of casualties will only require a common sense approach to their preparation for evacuation, by asking simple questions, most problems can be identified and resolved prior to the evacuation. Ask? Are aeromed teams available to undertake this task? (Contact them). If aeromed teams are unavailable but ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-150-01-07
更新日期:2004-03-01 00:00:00
abstract::The Triservice Anaesthetic Apparatus was designed around 30 years ago as a robust and highly portable anaesthesia delivery system for medical support to airborne operations and it has been the core anaesthesia system for the Defence Medical Services since then. Over this period there have been a number of equipment ch...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-156-04s-19
更新日期:2010-12-01 00:00:00
abstract::General Duty Medical Officers (GDMOs) may deploy within days of completing their Entry Officers Course thereby missing the pre-deployment training undertaken by the Regiment that they join. They can be attached to a unit that they have never worked with and it is often the first time that they have worked in isolation...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-156-01-14
更新日期:2010-03-01 00:00:00
abstract::A review of all patients with treated mandibular angle fractures at a district general hospital, over a two year period, was undertaken. Forty one consecutive patients with 43 mandibular angle fractures were identified. Thirty eight fractures were treated by open reduction and internal fixation with miniplates and 5 b...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-148-02-01
更新日期:2002-06-01 00:00:00
abstract::Medical Support Troop Bravo (MST Bravo) provides third line medical support for the United Kingdom Battle Group currently deployed on operation Grapple 2 in Bosnia Herzegovina. Standing operating procedures for the initial assessment and resuscitation of all casualties are based on the protocols taught on Advanced Tra...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-140-01-06
更新日期:1994-02-01 00:00:00
abstract::OBJECTIVES: The purpose of this study was to investigate smoking prevalence of Tri-Service recruits, and changes in smoking behaviour at 3-year follow-up, by trade group and gender. Associations with educational attainment and deprivation were also assessed. METHODS: Analysis of a survey into the health behaviours of ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000009
更新日期:2013-03-01 00:00:00
abstract::Venom ophthalmia is a condition that can be eyesight threatening. This article describes a case of venom ophthalmia due to the Naja pallida (red spitting cobra) and is aimed to educate readers regarding the management of an uncommon, yet important, pathology that deployed military personnel may encounter. Simple first...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2017-000891
更新日期:2018-05-01 00:00:00
abstract::We present a case of a UK soldier suffering multiple injuries in Afghanistan including a lacerated liver, complicated by acute anuric renal failure. His condition was stabilised prior to transfer to the UK using continuous venovenous haemofiltration. This is the first deployed use of renal replacement therapy by UK fo...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-157-02-11
更新日期:2011-06-01 00:00:00
abstract::Modern drug treatment, added to our previous experience of surgery and radiotherapy, is currently producing nearly 90% cure of all patients with testicular tumours. Most of the failures of treatment today occur in patients with a large mass of diseased tissue which has accumulated due to delayed diagnosis. A retrospec...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-131-03-04
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:The long-term effect of repetitive trauma by military parachuting on the lumbar spine is not well investigated. Therefore, the purpose of this study was to examine the development of lumbar degenerative changes during a 30-year follow-up in Japanese Ground Self Defense Forces (JGSDF) parachute infantry soldi...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000149
更新日期:2014-12-01 00:00:00