An interesting complication of the Heimlich manoeuvre.

The removal of inhaled foreign bodies using the Heimlich manoeuvre is recommended as part of the immediate management of the choking child. We report on a case of witnessed laryngeal obstruction by a foreign body in which repeated Heimlich manoeuvres failed to expel the foreign body, but temporarily relieved the obstruction. The repeated Heimlich manoeuvres dislodged the foreign body into the trachea and may have contributed to the rapid development of extensive surgical emphysema, pneumomediastinum and pneumopericardium. The purpose of this report is to demonstrate that the Heimlich manoeuvre was effective in relieving the airway obstruction, but was associated with potentially severe complications.

Influence of a carbohydrate-electrolyte solution ingested during running on muscle glycogen utilisation in fed humans.

This study investigated whether the ingestion of a carbohydrate-electrolyte solution during running would influence muscle glycogen utilisation in subjects who had consumed a carbohydrate meal 3 hours before exercise. Eight men completed two 60-min treadmill runs at 70% VO(2)max. Before each run they consumed a carbohydrate meal (183 +/- 7 g) 3 hours before exercise and either 1) a carbohydrate-electrolyte solution during the run (46 +/- 1 g) (M+C), or 2) water during the run (M + W). Biopsy samples were obtained from the vastus lateralis muscle at rest and after 60 min of running. Serum insulin concentrations were higher (p < 0.01) in both trials at the start of exercise compared with fasting values, whereas blood glucose concentrations were higher (p < 0.01) after 60 min of running in the M+C trial. Pre-exercise muscle glycogen concentrations were similar in both trials (M+C: 321.9 +/- 27.2 vs M+W: 338.8 +/- 32.8 mmol x kg x dry weight (-1) [dw]; NS). There was no difference in the amount of glycogen used during exercise (M+C: 96.1 +/- 22.1 vs M+W: 77.9 +/- 11.7 mmol x kg x dw (-1); NS). In conclusion, a carbohydrate-electrolyte solution ingested during treadmill running at 70 % VO(2)max does not influence muscle glycogen use during the first hour of exercise when a carbohydrate meal is consumed 3 hours before exercise.

Case report: psychosis associated with hepatitis B.

An acute disintegrative disorder in a child with acute hepatitis B virus (HBV) infection is described. Both hepatitis B surface antigen (HBsAg) and HBV-DNA were detected in cerebrospinal fluid (CSF) by means of enzyme-linked immunosorbent assay (ELISA) and the polymerase chain reaction (PCR) technique respectively. A markedly elevated level of CSF adenylate kinase (AK), which normalised as the patient recovered spontaneously, suggested an organic brain disorder. Demonstration of intra-blood-brain barrier production of IgG supported the possibility of local infection by HBV within the central nervous system.

Exogenous carbohydrate oxidation from maltose and glucose ingested during prolonged exercise.

Intestinal perfusion studies have shown that glucose absorption from maltose occurs faster than from isocaloric glucose. To determine whether ingested maltose might be a superior source of carbohydrate (CHO) for endurance athletes, we compared the rates of gastric emptying, absorption and oxidation of 15 g.100 ml-1 solutions of maltose and glucose. Six endurance-trained cyclists drank 1200 ml of either U-14C maltose or U-14C glucose as a 400-ml loading bolus immediately before exercise, and as 8 x 100-ml drinks at 10-min intervals during a 90-min ride at 70% of maximal oxygen consumption. The rates of gastric emptying [maltose 690 (SD 119) ml.90 min-1; glucose 655 (SD 93) ml.90 min-1], the appearance of U-14C label in the plasma, and the peak rates of exogenous CHO oxidation [maltose 1.0 (SD 0.09) g.min-1; glucose 0.9 (SD 0.09) g.min-1] were not significantly different. Further, the 51 (SD 8) g of maltose and the 49 (SD 9) g of glucose oxidised during exercise were similar. Each accounted for approximately 20% of the total CHO oxidised during the 90 min of exercise. Since only half of the CHO delivered to the intestine was oxidised in the 90-min ride (maltose 49%; glucose 50%), we conclude that neither the rate of gastric emptying, nor digestion limited the rate of ingested CHO utilisation during the early stages of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of ingesting a carbohydrate-electrolyte solution on endurance capacity during intermittent, high-intensity shuttle running.

The aim of this study was to examine the effects of ingesting a carbohydrate-electrolyte solution on endurance capacity during a prolonged intermittent, high-intensity shuttle running test (PIHSRT). Nine trained male games players performed two exercise trials, 7 days apart. On each occasion, they completed 75 min exercise, comprising of five 15-min periods of intermittent running, consisting of sprinting, interspersed with periods of jogging and walking (Part A), followed by intermittent running to fatigue (Part B). The subjects were randomly allocated either a 6.9% carbohydrate-electrolyte solution (CHO) or a non-carbohydrate placebo (CON) immediately prior to exercise (5 ml kg-1 body mass) and every 15 min thereafter (2 ml kg-1 body mass). Venous blood samples were obtained at rest, during and after each PIHSRT for the determination of glucose, lactate, plasma free fatty acid, glycerol, ammonia, and serum insulin and electrolyte concentrations. During Part B, the subjects were able to continue running longer when fed CHO (CHO = 8.9 +/- 1.5 min vs CON = 6.7 +/- 1.0 min; P < 0.05) (mean +/- S.E.M.). These results show that drinking a carbohydrate-electrolyte solution improves endurance running capacity during prolonged intermittent exercise.