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Exercise and Stress Response: The Role of Stress Proteins

2003; Elsevier BV; Volume: 14; Issue: 3 Linguagem: Inglês

10.1580/1080-6032(2003)14[207a

1545-1534

George W. Rodway, Matthew F. Russell, Luanne Freer, Bruce C. Paton, Michael E. Jacobs, Christopher Van Tilburg,

Muscle metabolism and nutrition

The role of stress proteins in exercise is a relatively recent area of investigation, and the development of a book on this subject is most welcome. Exercise and Stress Response: The Role of Stress Proteins, part of the CRC Press Series in Exercise Physiology, provides a current and very worthwhile review of the role of stress response to exercise and health. There is strong support for the idea that expression of stress proteins (SPs) provides protection to cells and tissues. Scientists interested in the pursuit of SPs, especially as SPs relate to exercise, will find in this book a current review of the topics necessary for an up-to-date familiarity with the field. Topics covered (to name just a few) include transcriptional regulation of the mammalian heat-shock genes, SPs and myocardial protection, heat-shock proteins and reactive oxygen species, SPs and exercise-induced muscle damage, and modulation of immune response. The editors of this book are experts in the field of SPs and have chosen leading internationally known researchers as contributors. Even though there is a very strong emphasis here on exercise physiology research as it concerns SPs, the editors have included topics of applied interest suitable for practitioners and teachers. Although long recognized as a stress, exercise has only recently been examined as a natural physiological method for inducing the protective cellular stress response. Not surprisingly, relatively few studies have examined the relationship between exercise and the stress response. The editors note that although investigation into cellular stress response, SPs, and heat-shock proteins is a well-established area of research (a PubMed search using the keywords cells and stress lists over 42 000 journal articles), the field of investigation examining how exercise alters the cellular stress response has only recently emerged (a PubMed search using the words stress proteins and exercise lists 85 papers). Because the expression of SPs has been shown to provide protection to cells and tissues, understanding the role of SPs during exercise is of considerable importance. It appears that exercise is capable of altering cellular homeostasis to such an extent that the cellular stress response is activated and SPs accumulate in certain tissues. Nonetheless, the exact significance of increased SPs, not to mention the mechanism(s) by which exercise induces SPs and confers protection at the cellular level, has not been determined. Although the physiological meaning of the SP response for exercise is far from completely understood, Exercise and Stress Response: The Role of Stress Proteins is an important contribution to the literature. Perhaps most importantly, it provides well-documented support for the use of SPs as molecular markers of cellular stress as a clear understanding of the functional importance of SPs in the muscular repair process. Do you want to read some words of wisdom regarding the practice of disaster medicine in a foreign country? Well, the authors of Conflict and Catastrophe Medicine: A Practical Guide have pooled their considerable experiences to construct an excellent handbook tailored to anyone with such an interest. The authors have collected the lessons they have learned from participating in disaster relief programs around the world—in places like Azerbaijan, Kosovo, Bosnia, Namibia, and the Falkland Islands—and have organized them in this compact and very readable volume. The authors, all from the United Kingdom, have constructed a book that is rich in specific resources for readers in the United Kingdom, yet it has broader applicability as well. According to the preface, the book is designed “as an entry-level text aimed at medical, nursing, and paramedical staff undertaking work in a hostile environment.” It lives up to this task and is easily readable by a wide audience. However, there can be no mistaking that the authors have focused their attention on a specific type of reader—the medical student and resident (“junior health professional”) who is contemplating a rotation or experience in the field. In fact, this handbook should constitute a must read for readers who fall into that category. Although the chapter titled “A Guide to the Medical Student Elective Abroad” does not appear until late in section 2, it is quite clear from beginning to end that every aspect of the book has been designed to educate the eager young professional. Despite this focus, the book still contains many useful pearls for any who are considering the field. This is true for all but the clinical sections, which come with the explicit warning that they are “not intended for the experienced senior physician … seasoned by numerous deployments.” The book is organized into 5 separate sections. The first 2 give an interesting overview to the field of “conflict and catastrophe” medicine in general. These sections start with a background of global trends regarding both conflicts and disasters, then proceed with the “process” of becoming involved in the field. They are clearly intended to help someone who is considering involvement in a deployment of any kind to better understand what he or she might be getting into. The third section is a general overview of certain clinical aspects of medical care in the field. Because this section is more of a general overview and aimed at a wide audience, it loses some practicality; diagnostic and management strategies are only cursorily addressed. To have expanded this section much more, however, would have resulted in a much longer book. Only 2 short chapters in length, the fourth section briefly discusses the aftermath of a disaster or conflict and the (hopeful) transition back to normal. The second chapter, though, titled “Hard Knocks and Hard Lessons,” is one of the best in the book and contains brief scenarios that actually occurred and the lessons that can be learned from them. The final section is devoted to resources. Although readers who are looking for extensive checklists will be disappointed, there is a tremendous amount of useful information, from publications such as clinical reference texts to collections of Internet websites related to disaster and conflict medicine. This is in addition to the intelligent design of an existing brief and focused list of additional readings and resources at the end of most chapters throughout the book. Members of the WMS should note that although the title of the book suggests an explicit focus on true disaster and conflict medicine as exemplified by events in Rwanda, Kosovo, or Afghanistan, the content is far more broadly inclusive of any sort of foreign or remote location where exposure to the environment and limited resources are factors. In fact, one of the early (and interesting) chapters is a collection of experiences by doctors who have practiced in 3 separate environments: polar medicine, cruise and expedition medicine as experienced on the Falkland Islands in recent years, and the medical environment involved in oil and gas exploration. Overall, the book is very well written. The chapters are short, focused, and about as to the point as chapters can be. At the same time, they are authored with a personable tenor. One chapter even ends, “the authors are happy to answer any specific questions from readers and can be reached via e-mail,” though no e-mail addresses are listed. The authors do an outstanding job of imparting lessons learned from often painful sounding experiences, striving to make future deployments by the reader better for everyone involved (eg, “Debriefing and post-mission health checks are vital … one of the authors of this chapter developed malaria 3 weeks after returning home from a mission in East Africa”). The character of the book is entirely one of practicality and includes a constant and somber tone regarding potential risks and hazards. Although it is mentioned on several occasions that the greatest hazard to personnel is the combination of alcohol and automobile, numerous other hazards and situations are discussed. These include physical hazards such as how to handle road blocks and what to do if you are kidnapped and held for ransom (do not try to escape). They also include less physical but equally dangerous hazards, such as cultural snafus or local politics (eg, when with local officials, “drink moderately or not at all—if necessary blame an upset stomach”). Even the problems encountered upon return home (“repatriation”) are discussed. Amazingly, even though the chapters are short, succinct, and very readable, they are also complete with specific resources, especially for readers from the United Kingdom (eg, “Been tortured? Contact the Medical Council for the Victims of Torture at 96-98 Grafton Road, London NW5 3EJ”). The book is an extremely worthwhile read for anyone considering involvement in the field of disaster medicine in a foreign country, and its value is easily doubled if you are in medical training or are from the United Kingdom. Tashi Tenzing authored this book in honor of his Sherpa people, on whose backs so many western climbers have climbed the Himalayas and achieved fame and fortune. Tenzing is the grandson of Tenzing Norgay, who, with Sir Edmund Hillary, was the first Sherpa to reach the summit of Mount Everest. Although many climbers know the Tenzing name, and some thank their Sherpa colleagues for their help on risky expeditions, very few know the history of the Sherpa people and of their supreme sacrifices for the relatively new career of high-altitude mountaineering. Far fewer climbers consider the impact that the industry has had on the Sherpa culture, from the positive effects (increases in salary, better education, and better health care) to the negative effects (westernization of their villages and the environmental degradation of their homeland). Initially, one might wonder if Tenzing has anything to share that is new on the subject. He recounts his grandfather's historic climb and his own climb to Everest's summit, but these stories can be found in several previous publications, not the least of which is his uncle Jamling Norgay's Touching My Father's Soul. However, because of his family connections and famous name, Tenzing had access to records, photographs, and personal accounts of the Sherpa pioneers of Everest. He is therefore able to recount the history of the Sherpa people in mountaineering like no other writer has done before. Forewords written by Sir Edmund Hillary and the Dalai Lama eloquently introduce the text, but the book could have stood on its own. Tenzing's work is a gift to his people (who are not known for keeping written records of their heritage) and their past, and the photographs are a precious collection for all to enjoy. Tenzing Norgay and the Sherpas of Everest is a fascinating history lesson for anyone interested in Nepali cultures and mountaineering, and it is a must-read for any mountaineer who climbs in the Khumbu region. Certain criteria are essential for a good birding guide. Some books are guides to identification, others to places. This book falls into the latter category and covers a large area, including Costa Rica—one of the favorite places for true aficionados. A birding guide of this sort should be authoritative, written by authors who are familiar with the area and the birds to be seen; it should be easy to use; its maps and illustrations should be accurate and helpful; it should be small enough to be put in a pack or pocket; and it should have a binding strong enough to withstand rough handling. This book is successful in nearly all of these categories. The authors are well-known authorities who have spent many years exploring the countries they describe. Each section is laid out according to the same pattern: a brief summary including the size of the country, how to get around, and some information about accommodation and food. Details about health and safety are included where necessary. The climate, habitats, and conservation issues are all discussed before listing the species you can expect to see and where they are likely to be seen. Each site is listed by name and is described in sufficient detail, often including a map with useful details such as a particular clump of trees where a certain bird might be seen. Throughout the book are occasional black-and-white line drawings of birds. Although the drawings are excellent, they add little but decorative value because there are so few of them. However, this book is not intended to be used for identification but as a guide to the knowledgeable birder. The 5 1/2 × 9-inch format is small enough to put in your pack, but you will also need a bird identification guide, good binoculars, and a notebook to complete your equipment. This is an excellent guide. If you are heading for the Caribbean, read it before you leave or put a copy in your pack. Of the 140 000 people who die each year in water-related incidents worldwide, few ever thought they would be in a survival situation. Most people who go to sea professionally or for recreation believe that catastrophe will never befall them. Essentials of Sea Survival is written for mariners as well as for the health care professionals and rescue personnel who may care for them when disaster strikes. This informative book examines the nature of the threats to survival in the marine environment (eg, hypothermia, drowning, cold water immersion, and dehydration) and the physiological responses of the body to these challenges. The book gives the reader a comprehensive and practical understanding of the dangers confronted by a mariner and knowledge of basic physiology, enabling him or her to formulate an informed survival strategy that will maximize the chances for open-water survival. The authors are eminent physiologists with extensive research backgrounds and experience in the medical aspects of survival at sea. The book is written for both laypeople and readers with a background in medicine and physiology. The terminology is thoroughly explained and facts are often vividly illustrated. For example, an average size man rowing leisurely would exhaust his carbohydrate stores in about 43/4 hours, whereas his fat stores would be sufficient to keep him rowing for about 121/2 days. The many citations of maritime disasters and detailed accounts of survival incidents continually remind the reader that understanding human physiology has practical applications and benefits. Many of the statistics presented emphasize the need to fully appreciate the complexity of survival issues. For example, 55% of open-water immersion deaths in the United Kingdom occur within about 3 meters (10 feet) of a safe refuge, and two thirds of those who die are regarded as good swimmers. These statistics do not suggest the cause of death to be from the protracted period of cooling required for hypothermia. “Rather, they are indicative of some incapacitating response that is rapid in onset and prevents individuals from swimming 3 meters to save their lives.” The authors then go on to describe the initial, short-term, and long-term physiological responses to cold water immersion. After reading this section, even the most competent swimmer will appreciate the nature of cold-water–induced swimming failure and his or her own vulnerability. Each chapter is followed by a summary highlighting salient points, practical recommendations for survival strategies (eg, “Body cooling during immersion can occur five times more quickly than it does in air at the same temperature. In no circumstances are you better off in the water than out of it.”), medical care of victims, and prevention of specific problems through the use of sound safety practices and equipment. The final part of the book addresses survival in open boats and life rafts and the many critical factors influencing survival: abandoning ship, life raft equipment, thermal insulation, protection from the elements, food and water rationing, watch keeping, crew discipline and morale, raft maintenance, signaling, leadership, and treating the illnesses and injuries of the crew. The section on search and rescue discusses the possible mechanisms contributing to a victim's circum-rescue collapse and demise and gives medical guidelines for the initial prehospital treatment of casualties. This book has a wealth of useful information. I strongly recommend it for all those who want to actively improve their chances for survival at sea. I loathed the read of another adventure travel narrative. But when I finally delved into Richard Bangs’ latest book, I was thrilled by a poignant standout: Bangs is a fine wordsmith—much better, in fact, than some best-selling authors. His eloquent and dynamic choice of words gives the prose excitement, fluidity, and panache. You don’t have to be a world traveler or whitewater aficionado to enjoy these brief chapters. The 16 slice-of-thrill pieces are nicely distributed among 5 continents and as many sports. With a few, I longed to hear the full-length tale. The book opens with a remote descent of the Kilombero and Rufija rivers through Tanzania's most wild Selous game reserve. The climbs include Mount Adams in Washington State and Mount Kinabalu in Malaysian Borneo (no Everest—thank you!). The obtainable: biking Burgundy and sea kayaking Newfoundland. The classics: trekking Machu Pichu via the Inca Trail and Patagonia. Bangs is no stranger to adventure travel; he was one of the founders of the genera. Bangs, along with John Yost, founded Sobek Expeditions in 1973. In 1991, Sobek merged with Mountain Travel, creating the foremost company in the business. Bangs is a veteran of more than a dozen books (many out of print) and multiple first descents of exotic rivers: Indus, Zambezi, Yangtze, Bío-Bío, Euphrates, Çoruh, and Watut. Bangs was lured into the dot.com world first with Mungo Park and later with MSNBC.com and Expedia.com, a travel Website for which he served as editor-at-large. These stories are taken from his postings.