Energy at high altitude.

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 Corps

authors

Hill NE,Stacey MJ,Woods DR

doi

10.1136/jramc-157-01-08

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

43-8

issue

1

eissn

0035-8665

issn

2052-0468

journal_volume

157

pub_type

杂志文章,评审
  • Militaries and the duty of care to enhanced veterans.

    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

    authors: Henschke A

    更新日期:2019-08-01 00:00:00

  • Tracheobronchomalacia. A rare cause of respiratory distress in children.

    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

    authors: Moorthy B,Robertson H

    更新日期:1992-06-01 00:00:00

  • A systematic review of performance-enhancing pharmacologicals and biotechnologies in the Army.

    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

    authors: Ko H,Hunter KE,Scott AM,Ayson M,Willson ML

    更新日期:2018-07-01 00:00:00

  • Successful management of a severe combat penetrating brain injury.

    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

    authors: Hoffmann C,Falzone E,Dagain A,Cirodde A,Leclerc T,Lenoir B

    更新日期:2014-09-01 00:00:00

  • Surgical management of hydatid disease of the liver: a military experience.

    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

    authors: Akin ML,Erenoglu C,Uncu EU,Basekim C,Batkin A

    更新日期:1998-10-01 00:00:00

  • A study of the selection and control of exercise casualties for hospital collective training.

    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

    authors: Clarke K,Robinson RG

    更新日期:1986-02-01 00:00:00

  • Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces.

    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

    authors: Zimmermann WO,Helmhout PH,Beutler A

    更新日期:2017-04-01 00:00:00

  • Is methoxyflurane a suitable battlefield analgesic?

    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

    authors: McLennan JV

    更新日期:2007-06-01 00:00:00

  • Japanese encephalitis in southeastern Nepal: clinical aspects in the 1986 epidemic.

    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

    authors: McCallum JD

    更新日期:1991-02-01 00:00:00

  • Early adoption of screening and the changing pattern of cervical cancer in UK military women: evidence from the Scottish Veterans Health Study.

    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

    authors: Bergman BP,Mackay DF,Pell JP

    更新日期:2016-10-01 00:00:00

  • Systemic blood pressure, arterial stiffness and pulse waveform analysis at altitude.

    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

    authors: Rhodes HL,Chesterman K,Chan CW,Collins P,Kewley E,Pattinson KT,Myers S,Imray CH,Wright AD,Birmingham Medical Research Expeditionary Society.

    更新日期:2011-03-01 00:00:00

  • An outbreak inside an epidemic: managing an infectious disease outbreak while treating Ebola.

    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

    authors: Horne S,Forbes K,Burns D,Tuck J

    更新日期:2017-02-01 00:00:00

  • The effectiveness of a military pre-hospital fluid infusion strategy.

    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

    authors: O'Meara M,Wood P,Thurgood A,Porter K

    更新日期:2007-09-01 00:00:00

  • Psychological briefing, prevention or priming? or, How many psychiatrists does it take to change a mind?

    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

    authors: Palmer I

    更新日期:2004-06-01 00:00:00

  • Cutaneous leishmaniasis in Royal Marines from Oruzgan, Afghanistan.

    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

    authors: Matheson A,Williams R,Bailey MS

    更新日期:2012-09-01 00:00:00

  • Alcohol associated deaths in British soldiers.

    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

    authors: Lynch P

    更新日期:1987-02-01 00:00:00

  • The Pre-Hospital Emergency Care Course (PHEC). A TA initiative.

    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

    authors: Greaves I

    更新日期:1997-10-01 00:00:00

  • Paediatric traumatic cardiac arrest: data from the Joint Theatre Trauma Registry.

    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

    authors: Hillman CM,Rickard A,Rawlins M,Smith JE

    更新日期:2016-08-01 00:00:00

  • Acute tibial compartment syndrome secondary to psychosomatic disorder.

    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

    authors: Eskander MB,MacDonald R

    更新日期:1994-06-01 00:00:00

  • An inexpensive method of quality assessment in anastomosis workshops.

    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

    authors: Royle CA,Phillips RK

    更新日期:1993-10-01 00:00:00

  • Battlefield Advanced Trauma Life Support (BATLS).

    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

    authors:

    更新日期:2004-03-01 00:00:00

  • The Triservice Anaesthetic Apparatus: a review.

    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

    authors: Frazer RS,Birt DJ

    更新日期:2010-12-01 00:00:00

  • A personal view--6 months in a FOB.

    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

    authors: Cooper DJ

    更新日期:2010-03-01 00:00:00

  • A two year review of the treatment and complications of mandibular angle fractures.

    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

    authors: Dhariwal DK,Gibbons AJ,Murphy M,Llewelyn J,Gregory MC

    更新日期:2002-06-01 00:00:00

  • Safe removal of combat body armour lightweight following battlefield wounding -- a timely reminder.

    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

    authors: Ryan JM,Bailie R,Diack G,Kierle J,Williams T

    更新日期:1994-02-01 00:00:00

  • Smoking prevalence amongst UK Armed Forces recruits: changes in behaviour after 3 years follow-up and factors affecting smoking behaviour.

    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

    authors: Bray I,Richardson P,Harrison K

    更新日期:2013-03-01 00:00:00

  • Case of venom ophthalmia following contact with Naja pallida: the red spitting cobra.

    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

    authors: Handford C

    更新日期:2018-05-01 00:00:00

  • Renal replacement in the deployed setting.

    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

    authors: Nesbitt I,Almond MK,Freshwater DA

    更新日期:2011-06-01 00:00:00

  • Delay in treatment of testicular tumours in the Army.

    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

    authors: Attard GJ

    更新日期:1985-10-01 00:00:00

  • Comparative clinical and radiographic study of the lumbar spine between parachute infantry soldiers and non-parachute infantry soldiers in Japanese Ground Self-Defense forces.

    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

    authors: Nemoto O,Kitada A,Naitou S,Tsuchihara T,Ito Y,Tachibana A

    更新日期:2014-12-01 00:00:00