Clinical nutrition: metabolic and nutritional aspects of severe injury
digital file Black & White Sound 1976 20:06
Summary: Here, Dr. Roger Smith of the Radcliffe Infirmary, Oxford describes some of the metabolic effects of severe injury in man and attempts to assess the nutritional and therapeutic implications of recent work. A short summary accompanying the cassette reads: Injury is a complex insult which produces widespread effects on body composition, energy exchange and hormonal balance. Studies on protein and ketone body metabolism suggest that these are closely linked. The loss of muscle protein after injury may be due to failure of synthesis as well as increased breakdown. Measurement of circulating levels of branched-chain amino acids and of urinary 3-methylhistidine (as an index of muscle catabolism) provide support for these ideas. Out-standing problems include the effect of immobility on the skeleton and muscle, and the ways in which muscle protein synthesis may be stimulated. 4 segments.
Title number: 18283
Description: Segment 1 Opening credits. Dr Smith introduces his topic, beginning by discussing the composition of the human body, its energy supply and utilisation and its hormonal control. A diagram shows the composition of an ideal 70kg man. Further diagrams show the supply and use of energy in the human body, and Smith talks about the role of the liver, fat and glucose. He then compares an overweight 140kg man with the 70kg man and also discusses the role of amino acids. Time start: 00:00:00:00 Time end: 00:06:22:15 Length: 00:06:22:15 Segment 2 Diagrams show amino acid formulae and the role of hormones in metabolic processes as Smith discusses these topics. He goes on to talk about what happens to the body after an average injury. Tables and diagrams also show information on this subject. Time start: 00:06:22:15 Time end: 00:10:04:00 Length: 00:03:41:10 Segment 3 Smith discusses the effects of injury on body composition, energy exchange and on hormonal control, explaining loss of muscle protein, change in muscle protein metabolism, change in ketone body levels and decrease in insulin. Time start: 00:10:04:00 Time end: 00:15:17:00 Length: 00:05:13:00 Segment 4 Smith goes on to talk about other effects of severe injury, including immobility and sepsis, and also briefly discusses burns. He talks about previous publications that have dealt with the subject of immobility and its effect on the skeleton and muscles. A table shows the effects of burns on the metabolism. He talks about the American black bear that burns its own fat during winter as its sole source of fuel. He finishes the film by discussing new ideas in the area of injury and nutrition and three key problems in the study of metabolic effects of injury: how ketone bodies influence gluconeogenesis, the importance of branched-chain amino acids and the biochemical effects of immobility. Time start: 00:15:17:00 Time end: 00:20:06:20 Length: 00:04:49:20
Credits: Presented by Dr Roger Smith, Radcliffe Infirmary and Nuffield Orthopaedic Centre, Oxford. Produced by Trevor A. Scott. Made by University of London for British Postgraduate Medical Federation.
Further information: This video is one of more than 120 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.
Keywords: Nutritional Physiological Phenomena; Orthopedics; Wounds and Injuries; Amino Acids; Ketone Bodies; Immobilization; Metabolism;
Locations: United Kingdom; England; London; University of London