Sodium bicarbonate supplementation does not improve elite women's team sport running or field hockey skill performance

Team sports, such as field hockey, incorporate high‐intensity repeated sprints, interspersed with low‐intensity running, which can result in acidosis. The aim of the present study was to examine the effect of acute sodium bicarbonate (SB) supplementation on team sport running and skill performance. Eight elite female field hockey players (age 23 ± 5 years, body mass 62.6 ± 8.4 kg, height 1.66 ± 0.05 m) completed three Field Hockey Skill Tests (FHST) interspersed with four sets of the Loughborough Intermittent Shuttle Test (LIST). Prior to exercise, participants were supplemented with capsules equivalent to 0.2 g·kg−1 body mass (BM) of a placebo (maltodextrin) or 0.3 g·kg−1 BM SB. Field hockey skill performance incorporated overall performance time (PFT), movement time (MT), decision‐making time (DMT), and penalty time (PT). Sprint time (ST), rating of perceived exertion (RPE), blood lactate concentration, bicarbonate anion (urn:x-wiley:2051817X:media:phy213818:phy213818-math-0001) concentration, pH, and base excess were measured at various time points. Data (mean ± SD) were analyzed using a two‐way analysis of variance (ANOVA) with repeated measures, with Hedges g effect sizes used to interpret the magnitude of differences. Bicarbonate anion concentration (+5.4 ± 2.6 mmol·L−1) and pH (+0.06 ± 0.03) were greater during the bicarbonate trial compared with the placebo (P 0.30) or ST (placebo: 2.87 ± 0.12 sec; bicarbonate: 2.86 ± 0.12 sec, P = 0.893, g = −0.08). RPE was lower during the SB condition (placebo: 13 ± 2; bicarbonate: 12 ± 2, P = 0.021, g = −0.41). Acute ingestion of bicarbonate did not improve sprint or sport‐specific skill performance. Bicarbonate ingestion did result in a lower perception of effort during team‐sport running, which may have performance implications in a competitive match situation

Teaching to transform surgical culture: an educational programme and thematic analysis in a general surgery department

Introduction General surgery departments are busy, meaning educational opportunities may be sporadic. Clinical priorities can sometimes supersede teaching and trainees may feel alienated at the periphery of the working community. In this study, we demonstrate how a reflective, multidisciplinary general surgery teaching programme was established and use this to assess the impact of structured teaching on surgical doctors of all grades in the department. Methods Twelve semi-structured telephone interviews were conducted with participants of varying grades. Transcripts were analysed using a grounded theory thematic analysis, revealing four themes: the value of teaching; learning as a community; barriers to successful training; and culture of surgery. Discussion Teaching helped juniors construct healthy narratives around general surgery and encouraged a process of professional identity formation. Pairing junior and senior colleagues allowed both to develop their skills, and reflective learning revealed new learning opportunities. Transparency across the ‘community of practice’ was achieved and the programme helped juniors overcome negative stereotypes of intimidation embedded in the hidden surgical curriculum. Conclusion Reflective, multidisciplinary learning can challenge the hidden curriculum and encourage team cohesion. A commitment to critical reflective teaching will be vital in cultivating surgeons of the future

Role of the monocarboxylate transporter MCT1 in the uptake of lactate during active recovery

Purpose We assessed the role of monocarboxylate transporter 1 (MCT1) on lactate clearance during an active recovery after high-intensity exercise, by comparing genetic groups based on the T1470A (rs1049434) MCT1 polymorphism, whose influence on lactate transport has been proven. Methods Sixteen young male elite field hockey players participated in this study. All of them completed two 400 m maximal run tests performed on different days, followed by 40 min of active or passive recovery. Lactate samples were measured immediately after the tests, and at min 10, 20, 30 and 40 of the recoveries. Blood lactate decreases were calculated for each 10-min period. Participants were distributed into three groups according to the T1470A polymorphism (TT, TA and AA). Results TT group had a lower blood lactate decrease than AA group during the 10?20 min period of the active recovery (p = 0.018). This period had the highest blood lactate for the whole sample, significantly differing from the other periods (p ? 0.003). During the passive recovery, lactate declines were constant except for the 0?10-min period (p ? 0.003), suggesting that liver uptake is similar in all the genetic groups, and that the difference seen during the active recovery is mainly due to muscle lactate uptake. Conclusions These differences according to the polymorphic variant T1470A suggest that MCT1 affects the plasma lactate decrease during a crucial period of active recovery, where the maximal lactate amount is cleared (i.e. 10?20 min period)

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

There was no funding support for this study. Disclosure. The authors declare no conflict of interest.Peer reviewedPublisher PD

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic