Purpose Dietary nitrate (NO 3 − ) has repeatedly been shown to improve endurance and intermittent, high-intensity events in temperate conditions. However, the ergogenic effects of dietary NO 3 − on intermittent exercise performance in hot conditions have yet to be investigated. Methods In a randomised, counterbalanced, double-blind crossover study, 12 recreationally trained males ingested a nitrate-rich beetroot juice shot (BRJ) (6.2 mmol NO 3 − ) or a nitrate-depleted placebo (PLA) (< 0.004 mmol NO 3 − ) 3 h prior to an intermittent sprint test (IST) in temperate (22 °C, 35% RH) and hot conditions (30 °C, 70% RH). The cycle ergometer IST consisted of twenty maximal 6 s sprints interspersed by 114 s of active recovery. Work done, power output, heart rate and RPE were measured throughout; tympanic temperature was measured prior to and upon completion. Results There were no significant effects of supplement on sprint performance in either temperate or hot, humid conditions ( p > 0.05). There was a reduced peak (BRJ: 659 ± 100W vs. PLA: 693 ± 139W; p = 0.056) and mean power (BRJ: 543 ± 29W vs. PLA: 575 ± 38W; p = 0.081) following BRJ compared to PLA in the hot and humid condition, but this was not statistically significant. There was no effect of supplement on total work done irrespective of environmental condition. However, ~ 75% of participants experienced performance decreases following BRJ in the hot and humid environment. No differences were observed between trials for tympanic temperature measured at the conclusion of the exercise trial. Conclusion In conclusion, an acute dose of inorganic dietary NO 3 − does not improve repeated-sprint performance in either temperate, or hot and humid conditions.
Background There is no consensus on reporting non-mortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery, and requires adaptation to provide meaningful data for trauma patients. In particular the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and non-operatively. Methods A combined prospective and retrospective international multi-center observational study was undertaken to apply the ACDiT scale to 484 trauma patients at 3 university teaching hospitals (Birmingham, England (n=303); Houston, Texas (n=113); and Glasgow, Scotland (n=68)). These included both intensive care (ICU) and non-ICU managed patients. The Clavien-Dindo scoring system was adapted for trauma patients based on consensus amongst an international collaboration of trauma specialists at these sites. Data included whether initial patients were managed operatively or non-operatively. Complication grades were compared to hospital-free and ICU-free days as other outcome measures of patient morbidity. Results 217/484 (44.8%) patients experienced complications, of whom 61/217 (28.1%) died (Grade V). The remainder consisted of grades I (n=20), II (n=60), III (n=24) and IV (n=52). There was a strong association between higher ACDiT grade category and lower number of hospital-free and ICU-free days (p<0.01). Eighty-eight patients with complications did not require surgery, validating the score’s usefulness in patients managed non-operatively. Conclusions The ACDiT scale can be used to grade the severity of post-trauma complications in patients managed both operatively and non-operatively. It provides clinically meaningful data for morbidity and mortality meetings and other quality improvement exercises.
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