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Sample records for exertional heat illness

  1. Backpropagation ANN-based prediction of exertional heat illness.

    PubMed

    Aggarwal, Yogender; Karan, Bhuwan Mohan; Das, Barda Nand; Aggarwal, Tarana; Sinha, Rakesh Kumar

    2007-12-01

    Exertional heat illness is primarily a multi-system disorder results from the combined effect of exertional and thermoregulation stress. The severity of exertional heat illness can be classified as mild, intermediate and severe from non-specific symptoms like thirst, myalgia, poor concentration, hysteria, vomiting, weakness, cramps, impaired judgement, headache, diarrhea, fatigue, hyperventilation, anxiety, and nausea to more severe symptoms like exertional dehydration, heat cramps, heat exhaustion, heat injury, heatstroke, rhabdomyolysis, and acute renal failure. At its early stage, it is quite difficult to find out the severity of disease with manual screening because of overlapping of symptoms. Therefore, one need to classify automatically the disease based on symptoms. The 7:10:1 backpropagation artificial neural network model has been used to predict the clinical outcome from the symptoms that are routinely available to clinicians. The model has found to be effective in differentiating the different stages of exertional heat-illness with an overall performance of 100%.

  2. Exertional heat illness: emerging concepts and advances in prehospital care.

    PubMed

    Pryor, Riana R; Roth, Ronald N; Suyama, Joe; Hostler, David

    2015-06-01

    Exertional heat illness is a classification of disease with clinical presentations that are not always diagnosed easily. Exertional heat stroke is a significant cause of death in competitive sports, and the increasing popularity of marathons races and ultra-endurance competitions will make treating many heat illnesses more common for Emergency Medical Services (EMS) providers. Although evidence is available primarily from case series and healthy volunteer studies, the consensus for treating exertional heat illness, coupled with altered mental status, is whole body rapid cooling. Cold or ice water immersion remains the most effective treatment to achieve this goal. External thermometry is unreliable in the context of heat stress and direct internal temperature measurement by rectal or esophageal probes must be used when diagnosing heat illness and during cooling. With rapid recognition and implementation of effective cooling, most patients suffering from exertional heat stroke will recover quickly and can be discharged home with instructions to rest and to avoid heat stress and exercise for a minimum of 48 hours; although, further research pertaining to return to activity is warranted.

  3. Exertional heat illness and hyponatremia in hikers.

    PubMed

    Backer, H D; Shopes, E; Collins, S L; Barkan, H

    1999-10-01

    We compared clinical presentation and course of exercise-associated hyponatremia with heat exhaustion among summertime hikers in Grand Canyon National Park. Cases were selected from among hikers who requested medical help from the National Park Service Emergency Medical Service (EMS) or who presented to the medical clinic on the rim of the canyon with complaints related to exercise in the heat. Of 44 patients who had serum samples analyzed, 7 had hyponatremia with clinically significant symptoms and serum sodium levels <130 mmol/L: 3 had grand mal seizures, 2 had other major central nervous system disorders, and 2 had minor neurological symptoms. Seizures and change of mental status distinguished hyponatremia, (P = 0.0002). Indirect evidence suggests that hyponatremic patients were hyperhydrated. Other common symptoms included nausea, vomiting, headache, and dizziness, but these symptoms did not predict the level of serum sodium. When exercise in the heat is prolonged, hyponatremia is suggested either by altered mental status or by seizures without hyperpyrexia or hypoglycemia. No mortality or long-term morbidity occurred in any of these cases of hyponatremia.

  4. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses

    PubMed Central

    Binkley, Helen M.; Beckett, Joseph; Casa, Douglas J.; Kleiner, Douglas M.; Plummer, Paul E.

    2002-01-01

    Objective: To present recommendations for the prevention, recognition, and treatment of exertional heat illnesses and to describe the relevant physiology of thermoregulation. Background: Certified athletic trainers evaluate and treat heat-related injuries during athletic activity in “safe” and high-risk environments. While the recognition of heat illness has improved, the subtle signs and symptoms associated with heat illness are often overlooked, resulting in more serious problems for affected athletes. The recommendations presented here provide athletic trainers and allied health providers with an integrated scientific and practical approach to the prevention, recognition, and treatment of heat illnesses. These recommendations can be modified based on the environmental conditions of the site, the specific sport, and individual considerations to maximize safety and performance. Recommendations: Certified athletic trainers and other allied health providers should use these recommendations to establish on-site emergency plans for their venues and athletes. The primary goal of athlete safety is addressed through the prevention and recognition of heat-related illnesses and a well-developed plan to evaluate and treat affected athletes. Even with a heat-illness prevention plan that includes medical screening, acclimatization, conditioning, environmental monitoring, and suitable practice adjustments, heat illness can and does occur. Athletic trainers and other allied health providers must be prepared to respond in an expedient manner to alleviate symptoms and minimize morbidity and mortality. PMID:12937591

  5. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses

    PubMed Central

    Casa, Douglas J.; DeMartini, Julie K.; Bergeron, Michael F.; Csillan, Dave; Eichner, E. Randy; Lopez, Rebecca M.; Ferrara, Michael S.; Miller, Kevin C.; O'Connor, Francis; Sawka, Michael N.; Yeargin, Susan W.

    2015-01-01

    Objective  To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Background  Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Recommendations  Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses. PMID:26381473

  6. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

    PubMed

    Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

    2015-09-01

    To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation. Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment of, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes. Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

  7. National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses.

    PubMed

    Casa, Douglas J; DeMartini, Julie K; Bergeron, Michael F; Csillan, Dave; Eichner, E Randy; Lopez, Rebecca M; Ferrara, Michael S; Miller, Kevin C; O'Connor, Francis; Sawka, Michael N; Yeargin, Susan W

    2015-08-18

     To present best-practice recommendations for the prevention, recognition, and treatment of exertional heat illnesses (EHIs) and to describe the relevant physiology of thermoregulation.  Certified athletic trainers recognize and treat athletes with EHIs, often in high-risk environments. Although the proper recognition and successful treatment strategies are well documented, EHIs continue to plague athletes, and exertional heat stroke remains one of the leading causes of sudden death during sport. The recommendations presented in this document provide athletic trainers and allied health providers with an integrated scientific and clinically applicable approach to the prevention, recognition, treatment, and return-to-activity guidelines for EHIs. These recommendations are given so that proper recognition and treatment can be accomplished in order to maximize the safety and performance of athletes.  Athletic trainers and other allied health care professionals should use these recommendations to establish onsite emergency action plans for their venues and athletes. The primary goal of athlete safety is addressed through the appropriate prevention strategies, proper recognition tactics, and effective treatment plans for EHIs. Athletic trainers and other allied health care professionals must be properly educated and prepared to respond in an expedient manner to alleviate symptoms and minimize the morbidity and mortality associated with these illnesses.

  8. Exertional Heat Illness and Hyponatremia: An Epidemiological Prospective

    DTIC Science & Technology

    2008-01-01

    caused, in part, by increased use of nutritional supplements. However, delayed or improper treatment is the likely major cause of many fatalities (36...Med. Sci. Sports Exerc. 38:1197Y1203, 2006. 23. Savdie, E., H. Prevedoros, A. Irish, et al. Heat stroke following Rugby League football. Med. J. Aust

  9. Risk factors predicting exertional heat illness in male Marine Corps recruits.

    PubMed

    Gardner, J W; Kark, J A; Karnei, K; Sanborn, J S; Gastaldo, E; Burr, P; Wenger, C B

    1996-08-01

    A matched population-based case-control study was conducted on exertional heat illness (EHI) in male Marine Corps recruits in basic training at Parris Island, SC. Physical fitness and anthropometric measurements were obtained for 391 of 528 cases of EHI identified in this population during 1988-1992, and 1467 of 1725 controls matched to cases by initial training platoon. The risk for developing EHI increased with increase in body mass index (BMI = weight.height-2) as measured on arrival and with increase in time to complete a 1.5-mile run conducted during the first week. Recruits at highest risk for developing exertional heat illness had a BMI of 22 or more kg.m-2 and a 1.5-mile run-time for 12 of more minutes. These recruits had an eightfold higher risk for developing exertional heat illness during basic training when compared with those with BMI less than 22 kg.m-2 and 1.5-mile run-time under 10 min (P < 10(-6). Only one-fifth (18%) of male recruits met these criteria for high risk, but they accounted for nearly half (47%) of the exertional heat illness cases occurring during the 12-wk basic training course.

  10. Environmental Conditions and the Occurrence of Exertional Heat Illnesses and Exertional Heat Stroke at the Falmouth Road Race

    PubMed Central

    DeMartini, Julie K.; Casa, Douglas J.; Belval, Luke N.; Crago, Arthur; Davis, Rob J.; Jardine, John J.; Stearns, Rebecca L.

    2014-01-01

    Context: The Falmouth Road Race is unique because of the environmental conditions and relatively short distance, which allow runners to maintain a high intensity for the duration of the event. Therefore, the occurrence of exertional heat illnesses (EHIs), especially exertional heat stroke (EHS), is 10 times higher than in other races. Objective: To summarize the occurrence and relationship of EHI and environmental conditions at the Falmouth Road Race. Design: Descriptive epidemiologic study. Setting: An 11.3-km (7-mile) road race in Falmouth, Massachusetts. Patients or Other Participants: Runners who sustained an EHI while participating in the Falmouth Road Race. Main Outcome Measure(s): We obtained 18 years of medical records and environmental conditions from the Falmouth Road Race and documented the incidence of EHI, specifically EHS, as related to ambient temperature (Tamb), relative humidity, and heat index (HI). Results: Average Tamb, relative humidity, and HI were 23.3 ± 2.5°C, 70 ± 16%, and 24 ± 3.5°C, respectively. Of the 393 total EHI cases observed, EHS accounted for 274 (70%). An average of 15.2 ± 13.0 EHS cases occurred each year; the incidence was 2.13 ± 1.62 cases per 1000 runners. Regression analysis revealed a relationship between the occurrence of both EHI and EHS and Tamb (R2 = 0.71, P = .001, and R2 = 0.65, P = .001, respectively) and HI (R2 = 0.76, P < .001, and R2 = 0.74, P < .001, respectively). Occurrences of EHS (24.2 ± 15.5 cases versus 9.3 ± 4.3 cases) and EHI (32.3 ± 16.3 versus 13.0 ± 4.9 cases) were higher when Tamb and HI were high compared with when Tamb and HI were low. Conclusions: Because of the environmental conditions and race duration, the Falmouth Road Race provides a unique setting for a high incidence of EHS. A clear relationship exists between environmental stress, especially as measured by Tamb and HI, and the occurrence of EHS or other EHI. Proper prevention and treatment strategies should be used during periods

  11. Predisposing risk factors on susceptibility to exertional heat illness: clinical decision-making considerations.

    PubMed

    Cleary, Michelle

    2007-08-01

    To present strategies for identifying predisposing conditions, susceptibility, and incidence reduction for the most common exertional heat illnesses (EHI): heat cramps, heat exhaustion, and most importantly, heat stroke. A comprehensive literature review of MEDLINE and 1996 to 2006, including all retrospective, controlled studies of EHI risk using the following keywords: exertional heat illness risk, exertional heat stroke risk, and exercise-induced dehydration risk. Search limits included the following: English language, published in the last 10 years, clinical trial, meta-analysis, practice guideline, randomized controlled trial, review, and humans. A manual review was conducted of relevant position statements and book chapters including the reference lists. To evaluate the quality of the empirical studies to be included in this review, each study must have scored at least 17/22 or 77% of items included when reporting a randomized trial using the CONSORT checklist. Many cases of EHI are preventable and can be successfully treated if the ATC identifies individuals at increased relative risk and implement appropriate prevention strategies. The ability to objectively identify individuals at increased relative risk of EHI and to provide appropriate monitoring is critical in EHI prevention and reduction of repeated incidents of EHI. For any heat illness prevention program to be effective, greater attention and continued observation is needed for athletes at high risk for EHI. For many athletic teams or programs, because of the sheer numbers and associated catastrophic injury potential, health care professionals must implement a system by which high-risk individuals are monitored during activity with the highest level of vigilance for prevention of EHI.

  12. American College of Sports Medicine position stand. Exertional heat illness during training and competition.

    PubMed

    Armstrong, Lawrence E; Casa, Douglas J; Millard-Stafford, Mindy; Moran, Daniel S; Pyne, Scott W; Roberts, William O

    2007-03-01

    Exertional heat illness can affect athletes during high-intensity or long-duration exercise and result in withdrawal from activity or collapse during or soon after activity. These maladies include exercise associated muscle cramping, heat exhaustion, or exertional heatstroke. While certain individuals are more prone to collapse from exhaustion in the heat (i.e., not acclimatized, using certain medications, dehydrated, or recently ill), exertional heatstroke (EHS) can affect seemingly healthy athletes even when the environment is relatively cool. EHS is defined as a rectal temperature greater than 40 degrees C accompanied by symptoms or signs of organ system failure, most frequently central nervous system dysfunction. Early recognition and rapid cooling can reduce both the morbidity and mortality associated with EHS. The clinical changes associated with EHS can be subtle and easy to miss if coaches, medical personnel, and athletes do not maintain a high level of awareness and monitor at-risk athletes closely. Fatigue and exhaustion during exercise occur more rapidly as heat stress increases and are the most common causes of withdrawal from activity in hot conditions. When athletes collapse from exhaustion in hot conditions, the term heat exhaustion is often applied. In some cases, rectal temperature is the only discernable difference between severe heat exhaustion and EHS in on-site evaluations. Heat exhaustion will generally resolve with symptomatic care and oral fluid support. Exercise associated muscle cramping can occur with exhaustive work in any temperature range, but appears to be more prevalent in hot and humid conditions. Muscle cramping usually responds to rest and replacement of fluid and salt (sodium). Prevention strategies are essential to reducing the incidence of EHS, heat exhaustion, and exercise associated muscle cramping.

  13. Exercise in the Heat. II. Critical Concepts in Rehydration, Exertional Heat Illnesses, and Maximizing Athletic Performance

    PubMed Central

    Casa, Douglas J.

    1999-01-01

    Objective: To acquaint athletic trainers with the numerous interrelated components that must be considered when assisting athletes who exercise in hot environments. Useful guidelines to maximize performance and minimize detrimental health consequences are presented. Data Sources: The databases MEDLINE and SPORT Discus were searched from 1980 to 1999, with the terms. “body cooling,” “dehydration,” “exercise,” “heat illnesses,” “heat,” “fluid replacement,” “acclimatization,” “hydration,” “rehydration,” “performance,” and “intravenous,” among others. Data Synthesis: This paper provides an in-depth look at issues regarding physiologic and performance considerations related to rehydration, strategies to maximize rehydration, modes of rehydration, health consequences of exercise in the heat, heat acclimatization, body cooling techniques, and practice and competition modifications. Conclusions/Recommendations: Athletic trainers have a responsibility to ensure that athletes who exercise in hot environments are prepared to do so in an optimal manner and to act properly to avoid the potentially harmful heat illnesses that can result from exercise in the heat. PMID:16558573

  14. Exertional heat illness: a review of the syndrome affecting racing Thoroughbreds in hot and humid climates.

    PubMed

    Brownlow, M A; Dart, A J; Jeffcott, L B

    2016-07-01

    Metabolic heat produced by Thoroughbred racehorses during racing can rapidly elevate core body temperature (1°C/min). When environmental conditions are hot and humid, the normal physiological cooling mechanisms become ineffective. The heat accumulated may exceed a critical thermal maximum (estimated to be 42°C), which may trigger a complex pathophysiological cascade with potentially lethal consequences. This syndrome has been labelled exertional heat illness (EHI). EHI is described in humans, but has not been well documented in Thoroughbred racehorses. The clinical signs described in racehorses would suggest that the pathophysiological events affecting the central nervous (CNS) and gastrointestinal systems are similar to those described in humans. Clinical signs are progressive and include signs of endotoxaemia and increasing levels of CNS dysfunction. Initially, horses that may be mildly irritable (agitated, randomly kicking out) may progress to unmanageable (disorientation, severe ataxia, falling) and ultimately convulsions, coma and death. Currently, the approach to treatment is largely empirical and involves rapid and effective cooling, administration of drugs to provide sedation, administration of non-steroidal anti-inflammatory drugs to ameliorate the effects of endotoxaemia and glucocorticoids to stabilise cell membranes and reduce the effects of inflammation on the CNS. This review provides an overview of the current knowledge about EHI in Thoroughbred racehorses, suggests a likely pathophysiology of the syndrome in horses based on the current literature on heat illness in humans and horses, and outlines current treatment strategies being used to treat racehorses with clinical signs of EHI. © 2016 Australian Veterinary Association.

  15. Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.

    PubMed

    Tripp, Brady L; Eberman, Lindsey E; Smith, Michael Seth

    2015-10-01

    Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Descriptive epidemiology study. For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and

  16. Exertional Heat Illness and Environmental Conditions During a Single Football Season in the Southeast

    PubMed Central

    Cooper, Earl R; Ferrara, Michael S; Broglio, Steven P

    2006-01-01

    Context: Recommendations for heat illness prevention provided by sports medicine associations do not always account for sex differences, specific age populations, regional environmental conditions, equipment worn during activity, or the athlete's size or preexisting level of fitness. Objective: To evaluate the rate of exertional heat illness (EHI) among collegiate football athletes and to monitor environmental conditions during American football practice for a 3-month period. Design: Epidemiologic study in which we reviewed the occurrence rates of EHI and wet bulb globe temperature readings during a 3-month period of American collegiate football practice sessions. Setting: Five universities in the southeastern region of the United States. Patients or Other Participants: Collegiate football players at the 5 universities. Main Outcome Measure(s): Wet bulb globe temperatures were recorded from August through October 2003, at the beginning, middle, and end of each practice session. The EHIs were identified and recorded, and athlete-exposures (AEs) were calculated. Results: A total of 139 EHIs and 33 196 AEs were reported (EHI rate = 4.19/1000 AEs). The highest incidence of EHIs was in August (88%, EHI rate = 8.95/1000 AEs) and consisted of 70% heat cramps (6.13/1000 AEs), 23% heat exhaustion (2.06/ 1000 AEs), and 7% heat syncope (0.58/1000 AEs). No cases of heat stroke or hyponatremia were identified. The highest risk of EHI occurred during the first 3 weeks of the study; mean wet bulb globe temperature declined significantly as the study continued ( P < .001). Temperatures in the final 5 weeks of the study were significantly cooler than in the first 5 weeks ( P < .05). Conclusions: Heat cramps were the most common EHI and occurred most often during the first 3 weeks of practice. Athletic trainers should take all necessary preventive measures to reduce the risk of EHI. PMID:17043703

  17. Women and exertional heat illness: identification of gender specific risk factors.

    PubMed

    Kazman, Josh B; Purvis, Dianna L; Heled, Yuval; Lisman, Peter; Atias, Danit; Van Arsdale, Stephanie; Deuster, Patricia A

    2015-01-01

    With the expanding role of women into previously closed combat military occupational specialties, women will likely be exposed more to challenging and extreme conditions. Physical work or exercise in extreme environments could increase the risk for exertional heat illness (EHI) and exertional heat stroke (EHS), the most severe type of EHI. Although men have higher rates of EHS than women, women have slightly higher rates of other EHI. Women may respond differently to exertion in the heat than men, as they typically have higher percentage of body fat (BF%) and lower aerobic power. Further, published pilot-data using the Israeli heat tolerance test (HTT) indicate that women are more likely to be classified as heat intolerant than men. The objectives of the present study were to (1) compare male and female classification patterns of heat tolerance, and (2) identify EHI risk factors that might account for the relationship between heat tolerance classification and sex. Fifty-five male and 20 female participants were recruited from military and university communities to participate in a standardized HTT. Subjects underwent measures to calculate anthropometric variables (BF%, body surface area, and waist circumference), a maximal oxygen uptake test to assess aerobic power (VO₂max), and a standardized HTT, which consisted of treadmill walking at 5 km/h at a 2% grade for 120 minutes at 40°C and 40% relative humidity. Heat intolerance was defined as attaining a maximum heart rate (HR) greater than 150 bpm or a core body temperature (Tc) more than 38.5°C. Separate hierarchical regressions were conducted using categorical (heat tolerant/intolerant) and continuous (physiological strain index, maximum HR, Tc) HTT outcomes. Risk factors were identified with and without controlling for sex. Women were 3.7 (95% CI, 1.21-11.24) times more likely to be heat intolerant than men (χ²=6.85, P<.01). Compared to men, women had significantly higher BF% and lower body surface area

  18. Exertional Heat Illness in American Football Players: When Is the Risk Greatest?

    PubMed Central

    Cooper, Earl R.; Ferrara, Michael S.; Casa, Douglas J.; Powell, John W.; Broglio, Steven P.; Resch, Jacob E.; Courson, Ronald W.

    2016-01-01

    Context: Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI). Objective: To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI. Design: Descriptive epidemiology study. Setting: Sixty colleges and universities representing 5 geographic regions of the United States. Patients or Other Participants: National Collegiate Athletic Association football players. Main Outcome Measure(s): Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs). Results: A total of 553 EHI cases and 365 810 AEs were reported for an overall EHI rate of 1.52/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0°F (27.8°C) or greater. Conclusions: We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0°F (27.8°C), the rate of EHI increased. Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT. PMID:27505271

  19. Next Generation Sequencing of RYR1 and CACNA1S in Malignant Hyperthermia and Exertional Heat Illness

    PubMed Central

    Fiszer, Dorota; Shaw, Marie-Anne; Fisher, Nickla A.; Carr, Ian M.; Gupta, Pawan K.; Watkins, Elizabeth J.; de Sa, Daniel Roiz; Kim, Jerry H.; Hopkins, Philip M.

    2015-01-01

    Background Variants in RYR1 are associated with the majority of cases of malignant hyperthermia (MH), a form of heat illness pharmacogenetically triggered by general anesthetics, and they have also been associated with exertional heat illness. CACNA1S has also been implicated in MH. We applied a targeted next generation sequencing approach to identify variants in RYR1 and CACNA1S in a cohort of unrelated patients diagnosed with MH susceptibility. We also provide the first comprehensive report of sequencing of these two genes in a cohort of survivors of exertional heat illness. Methods DNA extracted from blood was genotyped using a “long” polymerase chain reaction technique, with sequencing on the Illumina GAII® or MiSeq® platforms (Illumina Inc., San Diego, CA). Variants were assessed for pathogenicity using bioinformatic approaches. For further follow up DNA from additional family members and up to 211 MH normal and 556 MH susceptible unrelated individuals was tested. Results In 29 MH patients we identified three pathogenic and four novel RYR1 variants, with a further five RYR1 variants previously reported in association with MH. Three novel RYR1 variants were found in the exertional heat illness cohort (n = 28) along with two more previously reported in association with MH. Two other variants were reported previously associated with centronuclear myopathy. We found one and three rare variants of unknown significance in CACNA1S in the MH and exertional heat illness cohorts respectively. Conclusion Targeted next generation sequencing proved efficient at identifying diagnostically useful and potentially implicated variants in RYR1 and CACNA1S in MH and exertional heat illness. PMID:25658027

  20. Exertional Heat Illness Resulting in Acute Liver Failure and Liver Transplantation.

    PubMed

    Boni, Benjamin; Amann, Christopher Amann

    2017-01-01

    Heat illness remains a large medical burden for militaries around the world. Mitigating the incidence as well as the complications of heat illness must remain on the forefront of operational planning when operating in hot environments. We report the case of a 27-year-old male U.S. Marine who sustained a heat-related illness resulting in fulminant liver failure and permanent disability. The patient was transferred from the field to a civilian hospital. On hospital day 5, liver failure was identified. The patient was transferred to a transplant center, where he successfully received a liver transplant. 2017.

  1. Plasma and lymphocyte Hsp72 responses to exercise in athletes with prior exertional heat illness.

    PubMed

    Ruell, Patricia A; Simar, David; Périard, Julien D; Best, Stuart; Caillaud, Corinne; Thompson, Martin W

    2014-06-01

    We investigated the effect of exercise in the heat on both intracellular and extracellular Hsp72 in athletes with a prior history of exertional heat illness (EHI). Two groups of runners, one consisting of athletes who had a previous history of EHI, and a control group (CON) of similar age (29.7 ± 1.2 and 29.1 ± 2 years CON vs. EHI) and fitness [maximal oxygen consumption [Formula: see text] 65.7 ± 2 and 64.5 ± 3 ml kg(-1) min(-1) CON vs. EHI] were recruited. Seven subjects in each group ran on a treadmill for 1 h at 72 % [Formula: see text] in warm conditions (30 °C, 40 % RH) reaching rectal temperatures of ~39.3 (CON) and ~39.2 °C (EHI). Blood was collected every 10 min during exercise and plasma was analysed for extracellular Hsp72. Intracellular Hsp72 levels were measured in both monocytes and lymphocytes before and immediately after the 60-min run, and then after 1 h recovery at an ambient temperature of 24 °C. Plasma Hsp72 increased from 1.18 ± 0.14 and 0.86 ± 0.08 ng/ml (CON vs. EHI) at rest to 4.56 ± 0.63 and 4.04 ± 0.45 ng/ml (CON vs. EHI, respectively) at the end of exercise (p < 0.001), with no difference between groups. Lymphocyte Hsp72 was lower in the EHI group at 60 min of exercise (p < 0.05), while monocyte Hsp72 was not different between groups. The results of the present study suggest that the plasma Hsp72 response to exercise in athletes with a prior history of EHI remained similar to that of the CON group, while the lymphocyte Hsp72 response was reduced.

  2. Implementing exertional heat illness prevention strategies in US high school football.

    PubMed

    Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

    2014-01-01

    Approximately 6500 high school football athletes are treated annually for exertional heat illness (EHI). In 2009, the National Athletic Trainers Association (NATA)-led Inter-Association Task Force (NATA-IATF) released preseason heat acclimatization guidelines to help athletes become accustomed to environmental factors contributing to EHI. This study examines compliance with NATA-IATF guidelines and related EHI prevention strategies. The study used a cross-sectional survey completed by 1142 certified athletic trainers (AT), which captured compliance with 17 NATA-IATF guidelines and EHI prevention strategies in high school football during the 2011 preseason. On average, AT reported football programs complying with 10.4 NATA-IATF guidelines (SD = 3.2); 29 AT (2.5%) reported compliance with all 17. Guidelines with the lowest compliance were as follows: "Single-practice days consisted of practice no more than three hours in length" (39.7%); and "During days 3-5 of acclimatization, only helmets and shoulder pads should be worn" (39.0%). An average of 7.6 EHI prevention strategies (SD = 2.5) were used. Common EHI prevention strategies were as follows: having ice bags/cooler available (98.5%) and having a policy with written instructions for initiating emergency medical service response (87.8%). Programs in states with mandated guidelines had higher levels of compliance with guidelines and greater prevalence of EHI prevention strategies. A low proportion of surveyed high school football programs fully complied with all 17 NATA-IATF guidelines. However, many EHI prevention strategies were voluntarily implemented. State-level mandated EHI prevention guidelines may increase compliance with recognized best practices recommendations. Ongoing longitudinal monitoring of compliance is also recommended.

  3. Susceptibility to exertional heat illness and hospitalisation risk in UK military personnel

    PubMed Central

    Stacey, Michael J; Parsons, Iain T; Woods, David R; Taylor, Peter N; Ross, David; J Brett, Stephen

    2015-01-01

    Background Susceptibility to exertional heat illness (EHI) is considered multifactorial in nature. The aims of this study were to (1) review traditional susceptibility factors identified in cases of EHI and (2) determine how they are related to risk of hospitalisation. Methods Review of an electronic database of EHI reported in the British Army between 1 September 2007 and 31 December 2014. Cases were categorised by demographic, situational and susceptibility variables. Univariate and multivariate logistic regression was performed for the OR for hospitalisation by risk factor. Results 361 reports were included in the analysis. 33.5% of cases occurred in hot climates, 34.6% in temperate climates during summer months and 31.9% in temperate climates outside of summer months. Traditional susceptibility factors were reported in 193 but entirely absent from 168 cases. 137 cases (38.0%) were admitted to hospital. Adjusted OR for hospitalisation was lower for recruits (OR 0.42, 95% CI 0.18 to 0.99, p<0.05) and for personnel wearing occlusive dress (OR 0.56, 95% CI 0.34 to 0.93, p<0.05) or unacclimatised to heat (OR 0.31, 95% CI 0.15 to 0.66, p<0.01). Conclusions The global, year-round threat of EHI is highlighted. Absence of susceptibility factors in nearly half of reports highlights the challenge of identifying EHI-prone individuals. Paradoxical association of traditional susceptibility factors with reduced hospitalisation risk may reflect the contemporary contexts in which severe EHI occurs. These findings also suggest a need for better evidence to inform guidelines that aim to prevent severe EHI concurrent to reducing overall morbidity. PMID:27900138

  4. Mitigating Exertional Heat Illness in Military Personnel: The Science Behind a Rice-Based Electrolyte and Rehydration Drink.

    PubMed

    Moore, Brenda; O'Hara, Reginald

    Exertional heat illness continues to be prevalent among members of active duty personnel, especially those in specific military occupational specialties such as loadmasters, flight crew, flight maintainers, and Special Operations Forces. Therefore, the primary objective of this article was to elucidate the various oral rehydration solutions (ORSs) on the market that are used to mitigate exertional heat illness (EHI) in military personnel, and to focus on the science behind a ricebased electrolyte drink, CeraSport®, currently used by US military personnel in mitigating EHI during sustained training operations in high-heat environments. A search of the literature (through March 2016) was performed using PubMed and ProQuest, in addition to searching bibliographies and text books. We reviewed 63 articles and three texts. Articles were limited to those published in English and to studies that used only carbohydrates (e.g., no amino acids) and drinks reported to be used by the military in field training and deployment. Heat illness is prevalent among military personnel operating in high-heat environments and a variety of ORSs and sports drinks are available to help mitigate this. However, CeraSport, compared with other ORSs and sports drinks, may offer benefits such as faster gastric emptying rates and improved absorption from the gastrointestinal tract, which can provide rapidly available carbohydrate substrates for energy needs, and increased water retention for maintenance of blood plasma volume. 2016.

  5. Preventive measures and lifestyle habits against exertional heat illness in radiation decontamination workers.

    PubMed

    Endo, Shota; Kakamu, Takeyasu; Sato, Sei; Hidaka, Tomoo; Kumagai, Tomohiro; Nakano, Shinichi; Koyama, Kikuo; Fukushima, Tetsuhito

    2017-09-28

    The aim of this study was to reveal the current state of preventive measures and lifestyle habits against heat illness in radiation decontamination workers and to examine whether young radiation decontamination workers take less preventive measures and have worse lifestyle habits than the elder workers. This was a cross-sectional study. Self-administered questionnaires were sent to 1,505 radiation decontamination workers in Fukushima, Japan. Five hundred fifty-eight men who replied and answered all questions were included in the statistical analysis. The questionnaire included age, duration of decontamination work, previous occupation, lifestyle habit, and preventive measures for heat illness. We classified age of the respondents into five groups: <30, 30-39, 40-49, 50-59, and ≥60 years and defined the workers under 30 years of age as young workers. Logistic regression analysis was used to reveal the factors associated with each lifestyle habit and preventive measures. In comparison with young workers, 50-59-year-old workers were significantly associated with refraining from drinking alcohol. Workers 40 years of age or older were significantly associated with cooling their bodies with refrigerant. Furthermore, 30-39-year-old workers and 40-49-year-old workers were significantly associated with adequate consumption of water compared to young workers. The results of our study suggests that young decontamination workers are more likely to have worse lifestyle habits and take insufficient preventive measures for heat illness. This may be the cause of higher incidence of heat illness among young workers.

  6. National Athletic Trainers' Association Releases New Guidelines for Exertional Heat Illnesses: What School Nurses Need to Know.

    PubMed

    VanScoy, Rachel M; DeMartini, Julie K; Casa, Douglas J

    2016-05-01

    Exertional heat illnesses (EHI) occur in various populations and settings. Within a school setting, there are student athletes who take part in physical activity where the risk of EHI is increased. The National Athletic Trainers' Association (NATA) released an updated position statement on EHI in September of 2015. This article is a summary of the position statement. The sports medicine team, including school nurses and athletic trainers, provides quality health care to these physically active individuals. Thus, it is important for school nurses to understand the prevention, recognition, and treatment of EHI.

  7. Exertional Heat-Related Illnesses at the Grand Canyon National Park, 2004–2009

    PubMed Central

    Noe, Rebecca S.; Choudhary, Ekta; Cheng-Dobson, Jennifer; Wolkin, Amy F.; Newman, Sara B.

    2016-01-01

    Background The Grand Canyon National Park has approximately 4 million visitors between April and September each year. During this period, outdoor activity such as hiking is potentially hazardous owing to extreme heat, limited shade, and steep, long ascents. Given the high visitation and the public health interest in the effects of extreme heat, this study calculated morbidity rates and described heat-related illness (HRI) among visitors. Methods We conducted a retrospective cross-sectional study from April 1 through September 30, during 2004–2009. From a review of Ranger Emergency Medical Services (EMS) incident report files, we extracted information on those that met the case definition of greater than 1 hour of outdoor heat exposure with an HRI assessment or diagnosis, HRI self-report, or signs or symptoms of HRI without another etiology noted. Visitor and temperature data were obtained from respective official sources. Results Grand Canyon EMS responded to 474 nonfatal and 6 fatal HRI cases, with the majority (84%) being US residents, 29% from Western states. Of the nonfatal cases, 51% were women, the median age was 43 years (range, 11–83 years), and 18% reported a cardiovascular condition. Clinical HRI assessments included dehydration (25%), heat exhaustion (23%), and suspected hyponatremia (19%). Almost all (90%) were hiking; 40% required helicopter evacuation. The highest HRI rates were seen in May. Conclusions HRI remains a public health concern at the Grand Canyon. High-risk evacuations and life-threatening conditions were found. Majority were hikers, middle-aged adults, and US residents. These findings support the park’s hiker HRI prevention efforts and use of park EMS data to measure HRI. PMID:24119571

  8. Exertional heat-related illnesses at the Grand Canyon National Park, 2004-2009.

    PubMed

    Noe, Rebecca S; Choudhary, Ekta; Cheng-Dobson, Jennifer; Wolkin, Amy F; Newman, Sara B

    2013-12-01

    The Grand Canyon National Park has approximately 4 million visitors between April and September each year. During this period, outdoor activity such as hiking is potentially hazardous owing to extreme heat, limited shade, and steep, long ascents. Given the high visitation and the public health interest in the effects of extreme heat, this study calculated morbidity rates and described heat-related illness (HRI) among visitors. We conducted a retrospective cross-sectional study from April 1 through September 30, during 2004-2009. From a review of Ranger Emergency Medical Services (EMS) incident report files, we extracted information on those that met the case definition of greater than 1 hour of outdoor heat exposure with an HRI assessment or diagnosis, HRI self-report, or signs or symptoms of HRI without another etiology noted. Visitor and temperature data were obtained from respective official sources. Grand Canyon EMS responded to 474 nonfatal and 6 fatal HRI cases, with the majority (84%) being US residents, 29% from Western states. Of the nonfatal cases, 51% were women, the median age was 43 years (range, 11-83 years), and 18% reported a cardiovascular condition. Clinical HRI assessments included dehydration (25%), heat exhaustion (23%), and suspected hyponatremia (19%). Almost all (90%) were hiking; 40% required helicopter evacuation. The highest HRI rates were seen in May. HRI remains a public health concern at the Grand Canyon. High-risk evacuations and life-threatening conditions were found. Majority were hikers, middle-aged adults, and US residents. These findings support the park's hiker HRI prevention efforts and use of park EMS data to measure HRI. Published by Elsevier Inc.

  9. Within-year Exertional Heat Illness Incidence in U.S. Army Soldiers, 2008-2012

    DTIC Science & Technology

    2015-06-01

    follow-up” injury events, affected Soldiers were not considered at risk for “new” EHIs within 60 days of prior heat injury events. It is possible...6.1. T bl 61 D a e em oil rap! ICS 0 0 1ers 0 h" f S ld" Wh E xpenence an ’ -d EHI 2008 2012 (n=6,838) Variable Variable Level n % injured Sex Male...visit more than 60 days after the initial event, leading to over-estimation of the number of repeat EHI. There is evidence from animal models of heat

  10. Heat Illness

    MedlinePlus

    ... humidity, sweating just isn't enough. Your body temperature can rise to dangerous levels and you can ... Heatstroke - a life-threatening illness in which body temperature may rise above 106° F in minutes; symptoms ...

  11. Heat Illness - A Practical Primer.

    PubMed

    Raukar, Neha; Lemieux, Renee; Finn, George; Stearns, Rebecca; Casa, Douglas J

    2015-07-01

    Heat stroke is one of the top three causes of death for athletes. Vigilance is required to prevent these illnesses and when faced with an individual who is suffering an exertional heat stroke, the goal is to aggressively cool the patient to 102°F within 30 minutes to optimize survival. The elderly are also at risk for heat illness and physicians caring for these patients should discuss prevention and treatment plans.

  12. Treatment of suspected heat illness.

    PubMed

    Eichner, E R

    1998-06-01

    1. Despite advances in the art and science of fluid balance, exertional heat illness -- even life-threatening heat stroke -- remains a threat for some athletes today. 2. Risk factors for heat illness include: being unacclimatized, unfit, or hypohydrated; certain illnesses or drugs; not drinking in long events; and a fast finishing pace. 3. Heat cramps typically occur in conditioned athletes who compete for hours in the sun. They can be prevented by increasing dietary salt and staying hydrated. 4. Early diagnosis of heat exhaustion can be vital. Early warning signs include: flushed face, hyperventilation, headache, dizziness, nausea, tingling arms, piloerection, chilliness, incoordination, and confusion. 5. Pitfalls in the diagnosis of heat illness include: confusion preventing self-diagnosis; the lack of trained spotters; rectal temperature not taken promptly; the problem of "seek not, find not;" and the mimicry of heat illness. 6. Heat stroke is a medical emergency. Mainstays of therapy include: emergency on-site cooling; intravenous fluids; treating hypoglycemia as needed; intravenous diazepam for seizures or severe cramping or shivering; and hospitalizing if response is slow or atypical. 7. The best treatment is prevention. Tips to avoiding heat illness include: rely not on thirst; drink on schedule; favor sports drinks; monitor weight; watch urine; shun caffeine and alcohol; key on meals for fluids and salt; stay cool when you can; and know the early warning signs of heat illness.

  13. Heat illness. I. Epidemiology.

    PubMed

    Ellis, F P

    1976-01-01

    Reliable information on the epidemiology of heat illness has come, until recently, mainly from the armed forces and, to a lesser extent, from some industries and civil communities. Data from the records of the British Army, Royal Navy, Royal Air Force, Indian Armed Forces, U.S. Army and forces engaged in the Arab-Israeli wars, from the South African gold mining corporations and Persian Gulf oil tankers, and from civilian communities, mainly in the U.S.A., are reviewed and discussed with particular reference to the classification of heat illness and definition of the terms used, and the effects on acclimatized and non-acclimatized personnel and on other sections of the civilian communities most at risk, i.e. the old and very young. This section concludes with an outline of the classification of acute heat illnesses from 1899 to the eighth revision of the WHO International Classification of Diseases in 1967.

  14. Heat-related illness.

    PubMed

    Becker, Jonathan A; Stewart, Lynsey K

    2011-06-01

    Heat-related illness is a set of preventable conditions ranging from mild forms (e.g., heat exhaustion, heat cramps) to potentially fatal heat stroke. Hot and humid conditions challenge cardiovascular compensatory mechanisms. Once core temperature reaches 104°F (40°C), cellular damage occurs, initiating a cascade of events that may lead to organ failure and death. Early recognition of symptoms and accurate measurement of core temperature are crucial to rapid diagnosis. Milder forms of heat-related illness are manifested by symptoms such as headache, weakness, dizziness, and an inability to continue activity. These are managed by supportive measures including hydration and moving the patient to a cool place. Hyperthermia and central nervous system symptoms should prompt an evaluation for heat stroke. Initial treatments should focus on lowering core temperature through cold water immersion. Applying ice packs to the head, neck, axilla, and groin is an alternative. Additional measures include transporting the patient to a cool environment, removing excess clothing, and intravenous hydration. Delayed access to cooling is the leading cause of morbidity and mortality in persons with heat stroke. Identification of at-risk groups can help physicians and community health agencies provide preventive measures.

  15. Heat illness in the emergency department: keeping your cool.

    PubMed

    Santelli, Jaron; Sullivan, Julie M; Czarnik, Ann; Bedolla, John

    2014-08-01

    Heat illness spans a broad spectrum of disease, with outcomes ranging from benign rash to fatal heat stroke. Heat illness is broadly divided into 2 types: classic and exertional. Both types occur as a result of exposure to elevated temperature with inadequate thermoregulation; however, classic illness occurs without preceding physical activity. Treatment consists of rapid cooling, fluid replacement, and physiologic support. Other milder forms of heat illness include heat fatigue, heat syncope, heat edema, and heat rash. Drugs, drug combinations, drug side effects, and infections can also cause or complicate heat illness and these manifestations may not respond to standard cooling maneuvers and treatments alone; each requires specific additional therapy or antidotes to reverse the cycle of heat and organ damage. This review examines the physiology, diagnosis, and treatment of exertional, classic, and drug-induced hypothermia. Field and prehospital diagnosis and treatment are also reviewed, with recommendations for rehydration and monitoring in rhabdomyolysis.

  16. Heat Illness in Football: Current Concepts.

    PubMed

    Krohn, Austin R; Sikka, Robby; Olson, David E

    2015-01-01

    Despite growing health and safety concerns, American football remains a vastly popular sport in the United States. Unfortunately, even with increased efforts in promoting education and hydration, the incidence of death from exertional heat stroke continues to rise. General risk factors such as hydration status, obesity, fitness level, and football-specific risk factors such as timing of training camp and equipment all contribute to the development of heat illness. At the professional level, changes have been made to effectively reduce mortality from heat stroke with no deaths since August 2001. However, there have been at least 33 total deaths at the high school and collegiate levels since this time. More efforts need to be focused at these levels to mandate exertional heat illness prevention guidelines in order to reverse this trend of mortality in our younger athletes.

  17. Heat-related illness in sports and exercise.

    PubMed

    Nichols, Andrew W

    2014-12-01

    Exertional heat-related illness (EHRI) is comprised of several states that afflict physically active persons when exercising during conditions of high environmental heat stress. Certain forms of EHRI may become life threatening if not treated. Exertional heat stroke (EHS), characterized by a core body temperature of >40 ° C and mental status changes, is the most severe form of EHRI. EHS must be treated immediately with rapid body cooling to reduce morbidity and mortality. Many EHRI cases are preventable by following heat acclimatization guidelines, modifying sports and exercise sessions during conditions of high environmental heat stress, maintaining adequate hydration, avoiding exertion in the heat when ill, and by educating sports medicine personnel, coaches, parents, and athletes on the early recognition and prevention of EHRI. Heat exhaustion, exercise-associated collapse, exercise-associated muscle cramps, exercise-associated hyponatremia, and exertional rhabdomyolysis are also described.

  18. Exertional heat stroke: the runner's nemesis.

    PubMed Central

    Hart, L. E.; Egier, B. P.; Shimizu, A. G.; Tandan, P. J.; Sutton, J. R.

    1980-01-01

    Heat stroke in distance runners is increasing in frequency. A case is reported of a 41-year-old man who collapsed during a 10-km "fun run" held when the temperature was 31.6 degrees C and the humidity 80%. Acute renal failure (serum creatinine level 1530 mumol/l [17.3 mg/dl]), rhabdomyolysis, disseminated intravascular coagulation and hepatic damage complicated the clinical picture. Repeated peritoneal dialysis and one cycle of hemodialysis because of a very high serum level of uric acid (1.23 mmol/l [20.7 mg/dl]) were required. Although the illness was prolonged, recovery was almost complete, and 4 months after the man's collapse the serum creatinine level had fallen to 133 mumol/l (1.5 mg/dl). PMID:7388706

  19. Heat-related illness.

    PubMed

    Atha, Walter F

    2013-11-01

    Environmental exposure to high temperatures can result in abnormalities ranging from mild heat exhaustion to heat stroke with multiorgan system failure. An understanding of the mechanisms of thermoregulation and how those mechanisms fail with extreme heat stress is critical for management of the patient with elevated body temperature in the emergency department.

  20. [Pathophysiology of heat illness].

    PubMed

    Aruga, Tohru; Miyake, Yasufumi

    2012-06-01

    Human core temperature is strictly controlled by mechanism of radiation, conduction, convection, and evaporation from skin surface. Serial hot and humid climate induces dehydration which interferes heat pump-out from the body. Heart dysfunction is the third factor to rise body temperature. Hyperthermia and hypo-perfusion caused by dehydration and heart failure deteriorate specific organ functions, i.e. central nervous system, liver and renal functions and coagulation system. Disseminated intravascular coagulopathy is one of the standard indicators of severity and mortality of heat stroke.

  1. Exertional heat stroke, rhabdomyolysis and susceptibility to malignant hyperthermia.

    PubMed

    Thomas, J; Crowhurst, T

    2013-09-01

    Unexpectedly severe exertional heat stroke and rhabdomyolysis should prompt a clinician to look for susceptibility to malignant hyperthermia. We report a case of exertional heat stroke and rhabdomyolysis in a man later determined to have the malignant hyperthermia phenotype. We review the existing literature regarding this association and suggest future research that could address areas of remaining clinical uncertainty. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  2. Epidemiology of Hospitalizations and Deaths from Heat Illness in Soldiers

    DTIC Science & Technology

    2005-01-01

    compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval , 0.71-0.82]; greater rates of hospitalizations and heat strokes among...recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval , 1.42-1 .90]; and greater rates of hospitalizations...and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval , 1.09-1.27]). Exertional heat illness continues to be a

  3. Heat-Related Illness among Oregon Farmworkers

    PubMed Central

    Bethel, Jeffrey W.; Harger, Renee

    2014-01-01

    Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI) given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1) describe symptoms of HRI experienced by farmworkers and (2) explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0%) and 15.6% of participants reported being “very concerned” about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be “very concerned” about HRI but less likely to be “very comfortable” taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI. PMID:25198688

  4. Heat-related illness among Oregon farmworkers.

    PubMed

    Bethel, Jeffrey W; Harger, Renee

    2014-09-05

    Farmworkers are particularly vulnerable to climate-sensitive health outcomes such as heat-related illness (HRI) given their tasks involve heavy exertion in an outdoor setting. The objectives of the study were to: (1) describe symptoms of HRI experienced by farmworkers and (2) explore factors associated with heat knowledge, level of concern regarding HRI, and comfort level taking breaks at work. Bilingual research staff conducted personal interviews of 100 farmworkers during July and August 2013. Data collected included demographics, work history and current work practices, trainings received, HRI symptoms experienced, health status, and health behaviors. Nearly 30% of participants reported experiencing ≥ 2 HRI symptoms during the previous work. Few participants had high level of heat knowledge (21.0%) and 15.6% of participants reported being "very concerned" about the health effects of working in hot conditions. Participants who were paid by the piece were more likely to have a high heat knowledge score and be "very concerned" about HRI but less likely to be "very comfortable" taking a break compared to workers paid by the hour than those who had not received HRI training. Results suggest several areas in which employers and agencies conducting outreach and education to the workers about HRI can change their practices including providing cooling measures and HRI training about risk factors for HRI.

  5. Heat Illness among North Carolina Latino Farmworkers

    PubMed Central

    Arcury, Thomas A.; Summers, Phillip; Talton, Jennifer W.; Chen, Haiying; Sandberg, Joanne C.; Spears Johnson, Chaya R.; Quandt, Sara A.

    2015-01-01

    Objective Heat exposure is an important hazard for workers in manual occupations, including farmworkers. This analysis delineates the prevalence of heat illness among farmworkers, and the factors associated with heat illness. Methods North Carolina Latino male farmworkers completed interviews in August, 2013. They reported on heat exposure and behaviors over the previous 3 months while working both outdoors and indoors. Results A third (35.6%) of the participants reported heat illness while working outside, and 13.9% while working inside. Factors associated with heat illness while working outside included working in wet clothes and shoes, harvesting and topping tobacco, and spending after-work time in an extremely hot house. Conclusions Policy addressing heat illness is needed, as is more detailed research on occupational heat exposure that uses common measures. PMID:26641825

  6. American College of Sports Medicine Roundtable on Exertional Heat Stroke - Return to Duty/Return to Play: Conference Proceedings

    DTIC Science & Technology

    2010-01-01

    in physical activity and exposure to heat stress (35). Although current American College of Sports Medicine (ACSM) recommendations suggest EHS...D, Punnett L, et al. The effects of continuous hot weather training on risk of exertional heat illness. Med. Sci. Sports Exerc. 2005; 37:84Y90. 66... Sports Med. 1986; 3:346Y56. 68. Wilkinson DA, Burholt DR, Shrivastava PN. Hypothermia following whole-body heating of mice: effect of heating time

  7. A virtual rat for simulating environmental and exertional heat stress.

    PubMed

    Rakesh, Vineet; Stallings, Jonathan D; Reifman, Jaques

    2014-12-01

    Severe cases of environmental or exertional heat stress can lead to varying degrees of organ dysfunction. To understand heat-injury progression and develop efficient management and mitigation strategies, it is critical to determine the thermal response in susceptible organs under different heat-stress conditions. To this end, we used our previously published virtual rat, which is capable of computing the spatiotemporal temperature distribution in the animal, and extended it to simulate various heat-stress scenarios, including 1) different environmental conditions, 2) exertional heat stress, 3) circadian rhythm effect on the thermal response, and 4) whole body cooling. Our predictions were consistent with published in vivo temperature measurements for all cases, validating our simulations. We observed a differential thermal response in the organs, with the liver experiencing the highest temperatures for all environmental and exertional heat-stress cases. For every 3°C rise in the external temperature from 40 to 46°C, core and organ temperatures increased by ∼0.8°C. Core temperatures increased by 2.6 and 4.1°C for increases in exercise intensity from rest to 75 and 100% of maximal O2 consumption, respectively. We also found differences as large as 0.8°C in organ temperatures for the same heat stress induced at different times during the day. Even after whole body cooling at a relatively low external temperature (1°C for 20 min), average organ temperatures were still elevated by 2.3 to 2.5°C compared with normothermia. These results can be used to optimize experimental protocol designs, reduce the amount of animal experimentation, and design and test improved heat-stress prevention and management strategies.

  8. Preventing heat-related illness among agricultural workers.

    PubMed

    Jackson, Larry L; Rosenberg, Howard R

    2010-07-01

    Hyperthermia from exertion and environmental conditions during agricultural work manifests itself by various symptoms and may lead to death. From 1992 through 2006, 68 workers employed in crop production and related services died from heat-related illness. The crop worker fatality rate averaged 4 heat-related deaths per one million workers per year-20 times higher than the 0.2 rate for US civilian workers overall. Many of the agricultural workers who died were foreign-born. Foreign-born workers tend to have limited English language skills and often are not acclimatized to exertion in hot weather when beginning seasonal jobs. Increased recognition of heat hazards to agricultural workers, in particular, has stimulated concern among employers, workers, and public policy makers. California and Washington have led the nation in adopting workplace safety standards designed to prevent heat-related illnesses. These state regulations include new specific requirements for employer provision of drinking water, shade for rest or other sufficient means to recover from heat, worker and supervisor training, and written heat safety plans. Agricultural employers face practical challenges in fulfilling the purpose and complying with these standards. By their very nature the standards impose generic requirements in a broad range of circumstances and may not be equally protective in all agricultural work settings. It is vital that employers and supervisors have a thorough knowledge of heat illness prevention to devise and implement safety measures that suit local conditions. Ongoing risk-based assessment of current heat conditions by employers is important to this safety effort. Workers need training to avoid heat illness and recognize the symptoms in themselves and coworkers. Innovative management practices are joining time-honored approaches to controlling heat stress and strain. Research targeted to answer questions about heat accumulation and dissipation during agricultural work

  9. Exertional rhabdomyolysis and heat stroke: Beware of volatile anesthetic sedation

    PubMed Central

    Heytens, Karel; De Bleecker, Jan; Verbrugghe, Walter; Baets, Jonathan; Heytens, Luc

    2017-01-01

    In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units (ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique. As illustrated by the three case studies we elaborate upon, a thorough diagnostic work-up is needed to clarify the subsequent risk of strenuous exercise, and the anesthetic exposure to volatile agents in these patients and their families. Other contraindications for the use of volatile intensive care sedation consist of known malignant hyperthermia susceptibility, congenital myopathies, Duchenne muscular dystrophy, and intracranial hypertension. PMID:28224104

  10. Heat Illness: A Handbook for Medical Officers

    DTIC Science & Technology

    1991-06-03

    should be done early. The oliguric patient with a casts, piggmenturia or red celis a i a urine [Na] greater thanl 30 1iieq/l (btefore diulletics) has a...Heat Illnesses 1. Miliaxia RubrgýJ~tiarja Profunda aind AnhidrotIc Heat Exhaustion Mliliaria rubra is a subacute pruritic, inflameid papuloveslc-ular...epidermis, which takes 7 to 10 days. Miiliaza that becomes generplized and prolonged (miltaria profunda ) can c~ause an uncomnmon but disab~ling dit

  11. Challenging Return to Play Decisions: Heat Stroke, Exertional Rhabdomyolysis, and Exertional Collapse Associated With Sickle Cell Trait.

    PubMed

    Asplund, Chad A; O'Connor, Francis G

    2016-01-01

    Sports medicine providers frequently return athletes to play after sports-related injuries and conditions. Many of these conditions have guidelines or medical evidence to guide the decision-making process. Occasionally, however, sports medicine providers are challenged with complex medical conditions for which there is little evidence-based guidance and physicians are instructed to individualize treatment; included in this group of conditions are exertional heat stroke (EHS), exertional rhabdomyolysis (ER), and exertional collapse associated with sickle cell trait (ECAST). The MEDLINE (2000-2015) database was searched using the following search terms: exertional heat stroke, exertional rhabdomyolysis, and exertional collapse associated with sickle cell trait. References from consensus statements, review articles, and book chapters were also utilized. Clinical review. Level 4. These entities are unique in that they may cause organ system damage capable of leading to short- or long-term detriments to physical activity and may not lend to complete recovery, potentially putting the athlete at risk with premature return to play. With a better understanding of the pathophysiology of EHS, ER, and ECAST and the factors associated with recovery, better decisions regarding return to play may be made. © 2015 The Author(s).

  12. American football and fatal exertional heat stroke: a case study of Korey Stringer

    NASA Astrophysics Data System (ADS)

    Grundstein, Andrew; Knox, John A.; Vanos, Jennifer; Cooper, Earl R.; Casa, Douglas J.

    2017-03-01

    On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.

  13. American football and fatal exertional heat stroke: a case study of Korey Stringer.

    PubMed

    Grundstein, Andrew; Knox, John A; Vanos, Jennifer; Cooper, Earl R; Casa, Douglas J

    2017-03-17

    On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.

  14. American football and fatal exertional heat stroke: a case study of Korey Stringer

    NASA Astrophysics Data System (ADS)

    Grundstein, Andrew; Knox, John A.; Vanos, Jennifer; Cooper, Earl R.; Casa, Douglas J.

    2017-08-01

    On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.

  15. The effect of passive heating and face cooling on perceived exertion during exercise in the heat.

    PubMed

    Armada-da-Silva, P A S; Woods, J; Jones, D A

    2004-05-01

    Increased body temperature is thought to be an important component of the higher perception of exertion that is a feature of fatigue during exercise in the heat but a causal relationship has yet to be demonstrated. We have investigated the effect of passive heating on the perception of exertion during a standard bout of exercise and also assessed the effect of cooling the head on compensating for the increased body temperature on the feelings of exertion. Ten male subjects performed a 14-min cycling exercise [average power approximately 63% of maximum power output ( W(max))] at an ambient temperature of 35 degrees C at resting rectal temperature [mean (SD): 37.49 (0.27) degrees C; control (CON) trial] on one occasion, and after sitting in a sauna to raise rectal temperature [mean (SD): 38.95(0.13) degrees C; sauna (SAU) trial]. During the exercise, subjects reported their ratings of overall perceived exertion (RPE), perceived exertion of the legs (RPE(legs)) and thermal comfort (TC). A blood sample was collected by the end of the exercise for determination of plasma glucose, lactate and prolactin and haematocrit. RPE values were significantly elevated after passive heating [mean (SE): 14.5 (0.7) units in CON and 17.2 (0.5) units in SAU, at the end of exercise; P<0.001] as were the RPE(legs) ( P<0.01), while ratings of TC were similar in CON and SAU trials. Passive heating increased blood glucose ( P<0.05) but had no effect on lactate at the end of the exercise. Plasma prolactin was markedly elevated as a result of the sauna exposure [mean (SE): 1598 (152) versus 225 (31) mU l(-1) in SAU and CON trials, respectively; P<0.001]. Six of the subjects repeated the two trials but with the face cooled during exercise (trials CON(FAN) and SAU(FAN)) that was achieved by combining face fanning and spraying the face with a mist of cooled water. Face cooling decreased RPE values after sauna to a point that no differences between the two conditions existed. RPE(legs) scores and

  16. Effects of partial sleep restriction and subsequent daytime napping on prolonged exertional heat strain.

    PubMed

    Tokizawa, Ken; Sawada, Shin-Ichi; Tai, Tetsuo; Lu, Jian; Oka, Tatsuo; Yasuda, Akinori; Takahashi, Masaya

    2015-07-01

    It is considered that sleep restriction is one of the risk factors for the development of exertional heat stroke and illness. However, how sleep restriction affects exertional heat strain and the nature of the coping strategy involved in this phenomenon remain unclear. Fourteen healthy subjects were studied on four occasions: after a night of normal sleep (NS, 7-8 h) and after a night of partial sleep restriction (PSR, 4 h), each with or without taking a daytime nap during the subsequent experimental day. The laboratory test consisted of two 40 min periods of moderate walking in a hot room in the morning and the afternoon. The increase in rectal temperature during walking was significantly greater in PSR than in NS in the afternoon. The rating scores for physical and psychological fatigue and sleepiness were significantly greater in PSR than in NS, both in the morning and in the afternoon. The reaction times and lapses in the psychomotor vigilance task (PVT) after walking were significantly worse in PSR than in NS in the morning and after lunch. The nap intervention attenuated significantly the scores for fatigue and sleepiness in PSR. Furthermore, the decreased PVT response in PSR was significantly reversed by the nap. These results suggest that PSR augments physiological and psychological strain and reduces vigilance in the heat. Taking a nap seemed to be effective in reducing psychological strain and inhibiting the decrease in vigilance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Estimating core temperature with external devices after exertional heat stress in thermal protective clothing.

    PubMed

    Pryor, Riana R; Seitz, Jennifer R; Morley, Julia; Suyama, Joe; Guyette, Francis X; Reis, Steven E; Hostler, David

    2012-01-01

    Temperature measurement is important for emergency medical services (EMS) providers when identifying and treating heat illness or infection. Direct measures of body core temperature (T(c)) are often expensive (ingestible capsules) or impractical (rectal probes) in the field. Multiple devices for estimating T(c) have been adopted by EMS providers, with little understanding of the agreement between these devices and T(c). To examine the agreement between the results of five external thermometers and T(c) after subjects experienced physical exertion while wearing protective clothing. Fifty firefighters completed treadmill walking in thermal protective clothing in a hot environment. Measurements of core, temporal, tympanic, forehead, and skin temperatures were obtained during a 20-minute recovery period simulating emergency incident rehabilitation. The mean bias of external thermometers ranged from -1.31°C to -3.28°C when compared with T(c) and exceeded the predetermined clinical cutoff of ±0.5°C from T(c). The 95% limits of agreement ranged from 2.75°C to 5.00°C. External measuring devices failed to accurately predict T(c) in hyperthermic individuals following exertion. Confidence intervals around the bias were too large to allow for reasonable estimation of T(c). EMS providers should exercise caution when using any of these temperature estimation techniques.

  18. Exertional heat stroke management strategies in United States high school football.

    PubMed

    Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

    2014-01-01

    The 5-year period of 2005-2009 saw more exertional heat stroke-related deaths in organized sports than any other 5-year period in the past 35 years. The risk of exertional heat stroke appears highest in football, particularly during the preseason. To estimate the incidence of exertional heat stroke events and assess the utilization of exertional heat stroke management strategies during the 2011 preseason in United States high school football programs. Cross-sectional study; Level of evidence, 3. A self-administered online questionnaire addressing the incidence of exertional heat stroke events and utilization of exertional heat stroke management strategies (eg, removing athlete's football equipment, calling Emergency Medical Services [EMS]) was completed in May to June 2012 by 1142 (18.0%) athletic trainers providing care to high school football athletes during the 2011 preseason. Among all respondents, 20.3% reported treating at least 1 exertional heat stroke event. An average of 0.50 ± 1.37 preseason exertional heat stroke events were treated per program. Athletic trainers responding to exertional heat stroke reported using an average of 6.6 ± 1.8 management strategies. The most common management strategies were low-level therapeutic interventions such as removing the athlete's football equipment (98.2%) and clothing (77.8%) and moving the athlete to a shaded area (91.6%). Few athletic trainers reported active management strategies such as calling EMS (29.3%) or using a rectal thermometer to check core body temperature (0.9%). Athletic trainers in states with mandated preseason heat acclimatization guidelines reported a higher utilization of management strategies such as cooling the athlete through air conditioning (90.1% vs 65.0%, respectively; P < .001), immersion in ice water (63.0% vs 45.4%, respectively; P = .01), or fans (54.3% vs 42.0%, respectively; P = .06) and monitoring the athlete's temperature (60.5% vs 46.2%, respectively; P = .04). Preseason

  19. A bibliometric analysis of exertional heat stroke research in Web of Science.

    PubMed

    Mao, Zhi; Liu, Chao; Chen, Shuo; Zhu, Zheng-Guo; Kang, Hong-Jun; Zhou, Fei-Hu

    2016-01-01

    Exertional heat stroke is a fatal condition and remains a health problem. This paper evaluates the publication trend regarding exertional heat stroke research between 1996 and 2015 using a bibliometric method. Articles regarding exertional heat stroke research published between 1996 and December 2015 were searched for in the SCI-EXPANDED database of Web of Science. The search results were analyzed with regard to publication year; publication quantity regarding countries/regions, and authors; citation frequency; and journal distribution. CiteSpace (v3.6) was used for a document co-citation visualization analysis. In total, 289 publications on heat stroke were located. After selection, 209 original articles conducted across 28 countries/regions and published in 83 journals were included in the analysis. The USA, Isreal, and France were the most common locations for exertional heat stroke studies. The CiteSpace visualization cluster analysis showed that exertional heat stroke-related mortality and protective measures were constant concerns of research. Research related to exertional heat stroke has been continuous concerned. USA is still the leading country in this field.

  20. A Virtual Rat for Simulating Environmental and Exertional Heat Stress

    DTIC Science & Technology

    2014-10-02

    handle, and they demonstrate certain similarities to humans during thermoregulation (7, 11). Several studies have used experimental rat models to...during thermoregulation (22, 25). However, due to their inability to measure the spatiotemporal temperature distribution in vivo throughout the animal...description of the rat obtained from medical imaging and incorporates the major heat transfer mechanisms involved during thermoregulation (see Ref

  1. Gastrointestinal temperature trends in football linemen during physical exertion under heat stress.

    PubMed

    Coris, Eric E; Mehra, Shabnam; Walz, Stephen M; Duncanson, Robert; Jennings, Jason; Nugent, Dylan; Zwygart, Kira; Pescasio, Michele

    2009-06-01

    Exertional heat stroke is the third leading cause of death in US athletes. Elevations in core temperature in the digestive tract (TGI) have correlated with core temperature and are possible indicators of those at increased risk of heat stroke. The primary objective was to compare a.m. vs. p.m. TGI variation in collegiate football linemen during intense "two-a-day" preseason practice. A secondary objective was to compare longitudinal TGI in offensive and defensive linemen. Cross-sectional observational study. Division I Intercollegiate Athletics Football Program. TGI was monitored during consecutive preseason sessions. TGI, heat illness, weight changes, environmental stress, and subjective symptoms. Mean TGI were 37.8°C and 38.3°C during a.m. and p.m. practices, respectively. The a.m. practices revealed higher TGI gain (1.8°C) compared to p.m. (1.4°C). The p.m. practices had higher maximum TGI than a.m. practices (39.1°C versus 38.8, P=0.0001). Mean time to maximum temperature (Tmax) was 1 hr and 30 min for a.m. and 1 hr and 22 min for p.m. practices. Offensive linemen trended toward higher mean TGI than defensive players (38.0°C vs. 36.7°C, P = 0.069). The rate of rise in TGI was significantly greater in a.m. practices. A decrease in rate of TGI rise was seen from the first to last a.m. practices of the week (P = 0.004). Significant TGI elevations in asymptomatic athletes are common in extreme heat during football practice. Intense a.m. practices in full gear result in higher net temperature gain and rate of temperature gain than p.m. practices. Offensive linemen trended toward higher TGI than defensive linemen. As players acclimatized, a decrease in the rate of TGI increase was appreciable, particularly in a.m. practices. Appreciating cumulative heat stress and variations in heat stress related to scheduling of practice is critical.

  2. Solar Injury and Heat Illness. Treatment and Prevention in Children.

    ERIC Educational Resources Information Center

    Gutierrez, Greg

    1995-01-01

    Children are especially vulnerable to solar injury and heat illness. Physicians can lower children's risk through education about short-term and long-term sequelae and through various prevention efforts. The paper discusses how to screen for risk factors and how to prevent and treat heat illness and solar injury. (SM)

  3. Exertional heat stroke in navy and marine personnel: a hot topic.

    PubMed

    Goforth, Carl W; Kazman, Josh B

    2015-02-01

    Although exertional heat stroke is considered a preventable condition, this life-threatening emergency affects hundreds of military personnel annually. Because heat stroke is preventable, it is important that Navy critical care nurses rapidly recognize and treat heat stroke casualties. Combined intrinsic and extrinsic risk factors can quickly lead to heat stroke if not recognized by deployed critical care nurses and other first responders. In addition to initial critical care nursing interventions, such as establishing intravenous access, determining body core temperature, and assessing hemodynamic status, aggressive cooling measures should be initiated immediately. The most important determinant in heat stroke outcome is the amount of time that patients sustain hyperthermia. Heat stroke survival approaches 100% when evidence-based cooling guidelines are followed, but mortality from heat stroke is a significant risk when care is delayed. Navy critical care and other military nurses should be aware of targeted assessments and cooling interventions when heat stroke is suspected during military operations.

  4. Promoting Best Practices regarding Exertional Heat Stroke: A Perspective from the Team Physician

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie M.; Pagnotta, Kelly D.; McDowell, Lindsey; Casa, Douglas J.; Armstrong, Lawrence

    2012-01-01

    Context: Knowing the team physician's perspective regarding the use of evidence-based practice (EBP) for treatment of exertional heat stroke (EHS) may help increase the number of athletic trainers (ATs) implementing best practices and avoiding the use of improper assessment tools and treatment methods. Objective: To ascertain team physicians'…

  5. Professional Preparation regarding the Recognition and Treatment of Exertional Heat Stroke: The Student Perspective

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie M.; Pagnotta, Kelly D.; Casa, Douglas J.; Armstrong, Lawrence; Maresh, Carl

    2011-01-01

    Context: Current evidence suggests rectal temperature(T[subscript re] and cold-water immersion (CWI) are the most effective means to diagnose and treat exertional heat stroke (EHS), respectively. Educators, clinicians, and students should be apprised of this evidence to guide their practice. Objective: Investigate what athletic training students…

  6. Professional Preparation regarding the Recognition and Treatment of Exertional Heat Stroke: The Student Perspective

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie M.; Pagnotta, Kelly D.; Casa, Douglas J.; Armstrong, Lawrence; Maresh, Carl

    2011-01-01

    Context: Current evidence suggests rectal temperature(T[subscript re] and cold-water immersion (CWI) are the most effective means to diagnose and treat exertional heat stroke (EHS), respectively. Educators, clinicians, and students should be apprised of this evidence to guide their practice. Objective: Investigate what athletic training students…

  7. Promoting Best Practices regarding Exertional Heat Stroke: A Perspective from the Team Physician

    ERIC Educational Resources Information Center

    Mazerolle, Stephanie M.; Pagnotta, Kelly D.; McDowell, Lindsey; Casa, Douglas J.; Armstrong, Lawrence

    2012-01-01

    Context: Knowing the team physician's perspective regarding the use of evidence-based practice (EBP) for treatment of exertional heat stroke (EHS) may help increase the number of athletic trainers (ATs) implementing best practices and avoiding the use of improper assessment tools and treatment methods. Objective: To ascertain team physicians'…

  8. The effects of acclimatization on blood clotting parameters in exertional heat stress.

    PubMed

    Vesić, Zoran; Vukasinović-Vesić, Milica; Dincić, Dragan; Surbatović, Maja; Radaković, Sonja S

    2013-07-01

    Exertional heat stress is a common problem in military services. Considering the coagulation abnormalities are of major importance in development of severe heat stroke, we wanted to examine changes in hemostatic parameters in soldiers during exertional heat stress test as well as the effects of a 10-day passive or active acclimatization in a climatic chamber. A total of 40 male soldiers with high aerobic capacity performed exertional heat stress test (EHST) either in cool [20 degrees C, 16 degrees C wet bulb globe temperature (WBGT)], or hot (40 degrees C, 29 degrees C, (WBGT) environment, unacclimatized (U) or after 10 days of passive (P) or active (A) acclimatization. Physiological strain was measured by tympanic temperatures (Tty) and heart rates (HR). Platelet count (PC), antithrombin III (AT), and prothrombin time (PT) were assessed in blood samples collected before and immediately after the EHST. EHST in hot conditions induced physiological heat stress (increase in Tty and HR), with a significant increase in prothrombin time in the groups U and A. Platelet counts were significantly higher after the EHST compared to the basic levels in all the investigated groups, regardless environmental conditions and acclimatization state. Antithrombin levels were not affected by EHST whatsoever. In the trained soldiers, physiological heat stress caused mild changes in some serum parameters of blood clotting such as prothrombin time, while others such as antithrombin levels were not affected. Platelet counts were increased after EHST in all groups. A 10-day passive or active acclimatization in climatic chamber showed no effect on parameters investigated.

  9. Symptoms of Heat Illness Among Latino Farmworkers in North Carolina

    PubMed Central

    Mirabelli, Maria C.; Quandt, Sara A.; Crain, Rebecca; Grzywacz, Joseph G.; Robinson, Erin N.; Vallejos, Quirina M.; Arcury, Thomas A.

    2010-01-01

    Background Symptoms of occupational heat illness provide an early warning that workers are in potentially life-threatening environmental conditions. Purpose This analysis was designed to assess the extent to which strategies to reduce the health impact of extreme heat were associated with the prevalence of heat illness among Latino farmworkers. Methods Between June and September 2009, 300 Latino men and women participated in a cross-sectional survey about farmworker health. Participants reported whether they were employed through the H-2A temporary agricultural worker program and whether they had ever worked in conditions of extreme heat during their work in the U.S. agricultural industry. Workers who had worked in extreme heat also responded to questions about selected activities and behaviors and whether they experienced symptoms of heat illness. Data analysis was conducted in 2009 to assess associations of altering work hours and activities, drinking more water, resting in shaded areas, and going to air-conditioned places during or after work, with the prevalence of symptoms of heat illness among H-2A and non–H-2A workers. Results Working in extreme heat was reported by 281 respondents (94%), among whom 112 (40%) reported symptoms of heat illness. Changes in work hours and activities during hot conditions were associated with a lower prevalence of heat illness among H-2A workers, but not among non–H-2A workers. Conclusions These findings suggest the need to improve the understanding of working conditions for farmworkers and to assess strategies to reduce agricultural workers’ environmental heat exposure. PMID:20965386

  10. Heat-related illness in China, summer of 2013

    NASA Astrophysics Data System (ADS)

    Gu, Shaohua; Huang, Cunrui; Bai, Li; Chu, Cordia; Liu, Qiyong

    2016-01-01

    Extreme heat events have occurred more frequently in China in recent years, leading to serious impacts on human life and the health care system. To identify the characteristics of individuals with heat-related illnesses in China during the summer of 2013, we collected the data from the Heat-related Illness Surveillance System in Chinese Center for Disease Control and Prevention (China CDC). A total of 5758 cases were reported in the summer of 2013, mostly concentrated in urban areas around the middle and lower reaches of the Yangtze River. We found a difference in age distribution of percentage of deaths from heat-related illness between males and females. Severe cases in males mostly occurred in the age group 45-74 years but in females mostly in the age group over 75. A distributed lag non-linear model had been used to identify population vulnerabilities in Ningbo and Chongqing. The results show that there was a clear positive relationship between maximum temperature and heat-related illness, and the heat effect was nonlinear and could last for 3 days. The elderly and males in the range of 45-64 years old might be the most vulnerable people of heat-related illness in China. We also highlighted some deficiencies of the surveillance system, such that the reported data were not accurate, comprehensive, or timely enough at this stage.

  11. [Influence of acclimatization on serum enzyme changes in soldiers during exertional heat stress].

    PubMed

    Radaković, Sonja; Marić, Jelena; Surbatović, Maja; Vasiljević, Nada; Milivojević, Mladen

    2009-05-01

    Exertional heat stress is common problem in military services. The aim was to exemine changes in serum concentrations of some enzymes in soldiers during exertional heat stress test (EHST) as well as the effects of 10-days passive or active acclimatization in climatic chamber. Forty male soldiers with high aerobic capacity, performed EHST either in cool (20 degrees C, 16 degrees C Wet bulb globe temperature--WBGT), or hot (40 degrees C, 25 degrees C WBGT) environment, unacclimatized, or after 10 days of passive or active acclimation. Physiological strain was measured by tympanic temperatures (Tty) and heart rates (HR). Concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and creatine-kinase (CK) were measured in blood samples collected before and immediately after EHST. Exertional heat stress test in hot conditions induced physiological heat stress (increase in Tty and HR), with significant increase in concentrations of all enzymes in unacclimatized group: ALT (42.5 +/- 4.2 before vs 48.1 +/- 3.75 U/L after EHST, p < 0.01), AST (24.9 +/- 5.1 vs 33.4 +/- 4.48 U/L, p < 0.01), LDH (160.6 +/- 20.2 vs 195.7 +/- 22.6 U/L, p < 0.001) and CK (215.5 +/- 91.2 vs 279.1 +/- 117.5 U/L, p < 0.05). In acclimatized soldiers there were no significant changes in concentrations of ALT and AST, while concentration of CK was significantly higher. Concentrations of LDH were significantly higher in all investigated groups, regardless of temperature conditions. In trained soldiers, 10-days passive or active acclimatization in climatic chamber can prevent increase in serum concentrations of ALT and AST, induced by exertional heat stress. Increase of serum concentrations of CK and LDH was induced by physical strain itself, with no additional effect of heat stress.

  12. Heat illness in athletes: the dangerous combination of heat, humidity and exercise.

    PubMed

    Coris, Eric E; Ramirez, Arnold M; Van Durme, Daniel J

    2004-01-01

    In 1980, 1700 people died during a prolonged heat wave in a region under-prepared for heat illness prevention. Dramatically underreported, heat-related pathology contributes to significant morbidity as well as occasional mortality in athletic, elderly, paediatric and disabled populations. Among US high school athletes, heat illness is the third leading cause of death. Significant risk factors for heat illness include dehydration, hot and humid climate, obesity, low physical fitness, lack of acclimatisation, previous history of heat stroke, sleep deprivation, medications (especially diuretics or antidepressants), sweat gland dysfunction, and upper respiratory or gastrointestinal illness. Many of these risk factors can be addressed with education and awareness of patients at risk. Dehydration, with fluid loss occasionally as high as 6-10% of bodyweight, appears to be one of the most common risk factors for heat illness in patients exercising in the heat. Core body temperature has been shown to rise an additional 0.15-0.2 degrees C for every 1% of bodyweight lost to dehydration during exercise. Identifying athletes at risk, limiting environmental exposure, and monitoring closely for signs and symptoms are all important components of preventing heat illness. However, monitoring hydration status and early intervention may be the most important factors in preventing severe heat illness.

  13. Extreme heat and occupational heat illnesses in South Australia, 2001-2010.

    PubMed

    Xiang, Jianjun; Hansen, Alana; Pisaniello, Dino; Bi, Peng

    2015-08-01

    This study aims to examine the epidemiological characteristics of occupational heat illnesses in South Australia, to quantify the association between ambient temperature and occupational heat illnesses, and to investigate the impact of heatwaves on occupational heat illnesses. Workers' compensation claims data and weather data were obtained from SafeWork South Australia and the Bureau of Meteorology, respectively, for 2001-2010. Time series analysis with generalised estimation equation models and linear spline functions was used to quantify the temperature-heat illness claims association. A case-crossover design was applied to investigate the impact of heatwaves on occupational heat illnesses. There were 306 heat illness claims during the study period, with an incidence rate of 4.5 per 100,000 employees. The overall risk of occupational heat illness was positively associated with maximum temperature (Tmax), especially when Tmax was over the threshold of 35.5 °C. One degree increase of Tmax was associated with a 12.7% (incidence rate ratio 1.127, 95% CI 1.067 to 1.190) increase of occupational heat illness claims. During heatwave periods, the risk of occupational heat illness was about 4-7 times higher than that of non-heatwave periods. There is a need to develop or refine current heat-related regulations and guidelines to minimise the risk of occupational heat illnesses in vulnerable workers in a warming climate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Pediatric heat-related illness: recommendations for prevention and management

    PubMed

    Dunn, Roberta J.; Kim, Tommy Y.

    2017-08-01

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. Copyright © 2017 EB Medicine

  15. Heat Illness - Multiple Languages: MedlinePlus

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Arabic (العربية) Bosnian (Bosanski) Somali (af Soomaali) Spanish (español) Arabic (العربية) Heat Waves English (Arabic) الموجات الحارة - العربية ...

  16. Aural Canal, Esophageal, and Rectal Temperatures During Exertional Heat Stress and the Subsequent Recovery Period

    PubMed Central

    Gagnon, Daniel; Lemire, Bruno B.; Jay, Ollie; Kenny, Glen P.

    2010-01-01

    Abstract Context: The measurement of body temperature is crucial for the initial diagnosis of exertional heat injury and for monitoring purposes during a subsequent treatment strategy. However, little information is available about how different measurements of body temperature respond during and after exertional heat stress. Objective: To present the temporal responses of aural canal (Tac), esophageal (Tes), and rectal (Tre) temperatures during 2 different scenarios (S1, S2) involving exertional heat stress and a subsequent recovery period. Design: Randomized controlled trial. Setting: University research laboratory. Patients or Other Participants: Twenty-four healthy volunteers, with 12 (5 men, 7 women) participating in S1 and 12 (7 men, 5 women) participating in S2. Intervention(s): The participants exercised in the heat (42°C, 30% relative humidity) until they reached a 39.5°C cut-off criterion, which was determined by Tre in S1 and by Tes in S2. As such, participants attained different levels of hyperthermia (as determined by Tre) at the end of exercise. Participants in S1 were subsequently immersed in cold water (2°C) until Tre reached 37.5°C, and participants in S2 recovered in a temperate environment (30°C, 30% relative humidity) for 60 minutes. Main Outcome Measure(s): We measured Tac, Tes, and Tre throughout both scenarios. Results: The Tes (S1  =  40.19 ± 0.41°C, S2  =  39.50 ± 0.02°C) was higher at the end of exercise compared with both Tac (S1  =  39.74 ± 0.42°C, S2  =  38.89 ± 0.32°C) and Tre (S1  =  39.41 ± 0.04°C, S2  =  38.74 ± 0.28°C) (for both comparisons in each scenario, P < .001). Conversely, Tes (S1  =  36.26 ± 0.74°C, S2  =  37.36 ± 0.34°C) and Tac (S1  =  36.48 ± 1.07°C, S2  =  36.97 ± 0.38°C) were lower compared with Tre (S1  =  37.54 ± 0.04°C, S2  =  37.78 ± 0.31°C) at the end of both scenarios (for both comparisons in each scenario, P < .001). Conclusions: We

  17. Effectiveness of cold water immersion for treating exertional heat stress when immediate response is not possible.

    PubMed

    Flouris, A D; Friesen, B J; Carlson, M J; Casa, D J; Kenny, G P

    2015-06-01

    Immediate treatment with cold water immersion (CWI) is the gold standard for exertional heatstroke. In the field, however, treatment is often delayed due to delayed paramedic response and/or inaccurate diagnosis. We examined the effect of treatment (reduction of rectal temperature to 37.5 °C) delays of 5, 20, and 40 min on core cooling rates in eight exertionally heat-stressed (40.0 °C rectal temperature) individuals. We found that rectal temperature was elevated above baseline (P < 0.05) at the end of all delay periods (5 min: 40.08 ± 0.32; 20 min: 39.92 ± 0.40; 40 min: 39.57 ± 0.29 °C). Mean arterial pressure was reduced (P < 0.05) below baseline (92 ± 1.8 mm Hg) after all delay periods (5 min: 75 ± 2.6; 20 min: 74 ± 1.7; 40 min: 70 ± 2.1 mm Hg; P > 0.05). Rectal core cooling rates were similar among conditions (5 min: 0.20 ± 0.01; 20 min: 0.17 ± 0.02; 40 min: 0.17 ± 0.01 °C/min; P > 0.05). The rectal temperature afterdrop following CWI was similar across conditions (5 min: 35.95; 20 min: 35.61; 40 min: 35.87 °C; P > 0.05). We conclude that the effectiveness of 2 °C CWI as a treatment for exertional heat stress remains high even when applied with a delay of 40 min. Therefore, our results support that CWI is the most appropriate treatment for exertional heatstroke as it is capable of quickly reversing hyperthermia even when treatment is commenced with a significant delay.

  18. A randomized controlled trial of aspirin and exertional heat stress activation of platelets in firefighters during exertion in thermal protective clothing.

    PubMed

    Hostler, David; Suyama, Joe; Guyette, Francis X; Moore, Charity G; Pryor, Riana R; Khorana, Priya; McEntire, Serina J; Comer, Diane; Reis, Steven E

    2014-01-01

    Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation. In a double-blind, placebo-controlled study, 102 firefighters were randomized to receive daily therapy (81 mg aspirin or placebo) for 14 days before and a single dose (325 mg aspirin or placebo) following exercise in TPC resulting in four potential assignments: aspirin before and after exercise (AA), placebo before and after exercise (PP), aspirin before and placebo after exercise (AP), and placebo before and aspirin after exercise (PA). Platelet closure time (PCT) was measured with a platelet function analyzer before the 2-week treatment, after the 2 week treatment period, immediately after exercise, and 30, 60, and 90 minutes later. Baseline PCT did not differ between groups. PCT changed over time in all four groups (p < 0.001) rising to a median of >300 seconds [IQR 99, 300] in AA and >300 [92, 300] in AP prior to exercise. Following exercise, median PCT decreased to in all groups. Median PCT returned to >300 seconds 30 minutes later in AA and AP and rose to 300 seconds in PA 60 minutes after exercise. Daily aspirin therapy blunts platelet activation during exertional heat stress and single-dose aspirin therapy following exertional heat stress reduces platelet activation within 60 minutes.

  19. Heat-related illnesses. When are they a true emergency?

    PubMed

    Scott, J

    1989-06-01

    During the hot, humid months of summer, heat-related illnesses are common. Many of these are minor and self-limited, but heatstroke is a true emergency because the body's cooling mechanisms have been overwhelmed. The condition must be recognized rapidly and treated immediately with fluid replacement and cooling. The most effective and accessible technique for cooling involves the use of cool mist and fans directed across the patient's body to promote rapid evaporation. With aggressive management, the effects of heatstroke are almost uniformly reversible. With proper precautions, its occurrence is universally preventable.

  20. Effectiveness of exercise-heat acclimation for preventing heat illness in the workplace.

    PubMed

    Yamazaki, Fumio

    2013-09-01

    The incidence of heat-related illness in the workplace is linked to whether or not workers have acclimated to a hot environment. Heat acclimation improves endurance work performance in the heat and thermal comfort at a given work rate. These improvements are achieved by increased sweating and skin blood flow responses, better fluid balance and cardiovascular stability. As a practical means of acclimatizing the body to heat stress, daily aerobic exercise training is recommended since thermoregulatory capacity and blood volume increase with physical fitness. In workers wearing personal protective suits in hot environments, however, little psychophysiological benefit is received from short-term exercise training and/or heat acclimation because of the ineffectiveness of sweating for heat dissipation and the aggravation of thermal discomfort with the accumulation of sweat within the suit. For a manual laborer who works under uncompensable heat stress, better management of the work rate, the work environment and health is required.

  1. Current Knowledge, Attitudes, and Practices of Certified Athletic Trainers Regarding Recognition and Treatment of Exertional Heat Stroke

    PubMed Central

    Mazerolle, Stephanie M.; Scruggs, Ian C.; Casa, Douglas J.; Burton, Laura J.; McDermott, Brendon P.; Armstrong, Lawrence E.; Maresh, Carl M.

    2010-01-01

    Abstract Context: Previous research has indicated that despite awareness of the current literature on the recommended prevention and care of exertional heat stroke (EHS), certified athletic trainers (ATs) acknowledge failure to follow those recommendations. Objective: To investigate the current knowledge, attitudes, and practices of ATs regarding the recognition and treatment of EHS. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: We obtained a random sample of e-mail addresses for 1000 high school and collegiate ATs and contacted these individuals with invitations to participate. A total of 498 usable responses were received, for a 25% response rate. Main Outcome Measure(s): The survey instrument evaluated ATs' knowledge and actual practice regarding EHS and included 29 closed-ended Likert scale questions (1  =  strongly disagree, 7  =  strongly agree), 2 closed-ended questions rated on a Likert scale (1  =  lowest value, 9  =  greatest value), 8 open-ended questions, and 7 demographic questions. We focused on the open-ended and demographic questions. Results: Although most ATs (77.1%) have read the current National Athletic Trainers' Association position statement on heat illness, only 18.6% used rectal thermometers to assess core body temperature to recognize EHS, and 49.7% used cold-water immersion to treat EHS. Athletic trainers perceived rectal thermometers as the most valid temperature assessment device when compared with other assessment devices (P ≤ .05), but they used oral thermometers as the primary assessment tool (49.1%). They identified cold-water immersion as the best cooling method (P ≤ .05), even though they used other means to cool a majority of the time (50.3%). Conclusions: The ATs surveyed have sound knowledge of the correct means of EHS recognition and treatment. However, a significant portion of these ATs reported using temperature assessment devices that are invalid with athletes

  2. The Secondary School Football Coach's Relationship With the Athletic Trainer and Perspectives on Exertional Heat Stroke

    PubMed Central

    Adams, William M.; Mazerolle, Stephanie M.; Casa, Douglas J.; Huggins, Robert A.; Burton, Laura

    2014-01-01

    Context: Prior researchers have examined the first-aid knowledge and decision making among high school coaches, but little is known about their perceived knowledge of exertional heat stroke (EHS) or their relationships with an athletic trainer (AT). Objective: To examine secondary school football coaches' perceived knowledge of EHS and their professional relationship with an AT. Design: Qualitative study. Setting: Web-based management system. Patients or Other Participants: Thirty-eight secondary school head football coaches (37 men, 1 woman) participated in this study. Their average age was 47 ± 10 years old, and they had 12 ± 9 years' experience as a head football coach. Data Collection and Analysis: Participants responded to a series of online questions that were focused on their perceived knowledge of EHS and professional relationships with ATs. Data credibility was established through multiple-analyst triangulation and peer review. We analyzed the data by borrowing from the principles of a general inductive approach. Results: Two dominant themes emerged from the data: perceived self-confidence of the secondary school coach and the influence of the AT. The first theme highlighted the perceived confidence, due to basic emergency care training, of the coach regarding management of an emergency situation, despite a lack of knowledge. The second theme illustrated the secondary school coach's positive professional relationships with ATs regarding patient care and emergency procedures. Of the coaches who participated, 89% (34 out of 38) indicated positive interactions with their ATs. Conclusions: These secondary school coaches were unaware of the potential causes of EHS or the symptoms associated with EHS, and they had higher perceived levels of self-confidence in management abilities than indicated by their perceived knowledge level. The secondary school football coaches valued and understood the role of the AT regarding patient and emergency care. PMID:24933433

  3. Enzyme-treated asparagus extract promotes expression of heat shock protein and exerts antistress effects.

    PubMed

    Ito, Tomohiro; Maeda, Takahiro; Goto, Kazunori; Miura, Takehito; Wakame, Koji; Nishioka, Hiroshi; Sato, Atsuya

    2014-03-01

    A novel enzyme-treated asparagus extract (ETAS) has been developed as a functional material produced from asparagus stem. Studies were conducted to determine the effect of ETAS on heat shock protein 70 (HSP70) expression and alleviation of stress. HeLa cells were treated with ETAS, and HSP70 mRNA and protein levels were measured using a reverse transcription-polymerase chain reaction (RT-PCR) assay and an enzyme-linked immunosorbent assay (ELISA), respectively. ETAS showed significant increases in HSP70 mRNA at more than 0.125 mg/mL and the protein at more than 1.0 mg/mL. The antistress effect was evaluated in a murine sleep-deprivation model. A sleep-deprivation stress load resulted in elevation of blood corticosterone and lipid peroxide concentrations, while supplementation with ETAS at 200 and 1000 mg/kg body weight was associated with significantly reduced levels of both stress markers, which were in the normal range. The HSP70 protein expression level in mice subjected to sleep-deprivation stress and supplemented with ETAS was significantly enhanced in stomach, liver, and kidney, compared to ETAS-untreated mice. A preliminary and small-sized human study was conducted among healthy volunteers consuming up to 150 mg/d of ETAS daily for 7 d. The mRNA expression of HSP70 in peripheral leukocytes was significantly elevated at intakes of 100 or 150 mg/d, compared to their baseline levels. Since HSP70 is known to be a stress-related protein and its induction leads to cytoprotection, the present results suggest that ETAS might exert antistress effects under stressful conditions, resulting from enhancement of HSP70 expression. © 2014 Institute of Food Technologists®

  4. Identification of Risk Factors for Exertional Heat Illness: A Brief Commentary on Genetic Testing

    DTIC Science & Technology

    2007-01-01

    RYR1 ) gene and other genes related to disorders of skeletal muscle. Data Synthesis: EHI is a complex disorder wherein physiological, environmental, and...due to mutations in the calcium release channel, type 1 ryanodine receptor ( RYR1 ). The RYR1 belongs to a class of calcium ion channels located in the...Muscle fibers from MH susceptible individuals are markedly more sensitive to RYR1 agonists halothane, caffeine, and 4-chloro-m-cresol. A reproducible

  5. Heat illnesses: a hot topic in the setting of global climate change.

    PubMed

    Sankoff, Jeffrey

    2015-01-01

    Heat illnesses affect a large number of people every year and are becoming an increasing cause of pathology as climate change results in increasing global temperatures. This article will review the physiological responses to heat, as well as the pathophysiological processes that result in heat illnesses. The emphasis will be on providing general practitioners (GPs) with an understanding of how to prevent heat illness in their patients and how to predict who is most at risk. Heat illnesses may be thought of as minor or major illnesses, any of which may present to the GP. Consideration must be given to identifying those who need more critical intervention and on when to transfer for higher-level of care.

  6. Occupational heat illness in Washington State, 1995-2005.

    PubMed

    Bonauto, David; Anderson, Robert; Rauser, Edmund; Burke, Brian

    2007-12-01

    Little information exists describing the incidence of heat-related illness (HRI) among non-military working populations. An analysis of HRI cases utilizing workers' compensation data has not been previously reported. We used both ICD-9 and ANSI Z16.2 codes with subsequent medical record review to identify accepted Washington State Fund workers' compensation claims for HRI over the 11-year time period from 1995-2005. There were 480 Washington workers' compensation claims for HRI during the 11-year study period. NAICS industries with the highest workers' compensation HRI average annual claims incidence rate were Fire Protection 80.8/100,000 FTE, Roofing Construction 59.0/100,000 FTE, and Highway, Bridge and Street Construction 44.8/100,000 FTE. HRI claims were associated with high outdoor ambient temperatures. Medical risk factors for HRI were present in some cases. HRI cases occur in employed populations. HRI rates vary by industry and are comparable to those previously published for the mining industry.

  7. A Heat Warning System to Reduce Heat Illness in San Diego County

    NASA Astrophysics Data System (ADS)

    Tardy, A. O.; Corcus, I.; Guirguis, K.; Gershunov, A.; Basu, R.; Stepanski, B.

    2016-12-01

    The National Weather Service (NWS) has issued official heat alerts to the public and decision making partners for many years by developing a single criterion or regional criteria from heat indices which combine temperature and humidity. The criteria have typically relied on fixed thresholds and did not consider impact from a particular heat episode, nor did it factor seasonality, population acclimatization, or impacts on the most vulnerable subgroups. In 2013, the NWS San Diego office began modifying their criteria to account for local climatology with much less dependence on humidity or the heat index. These local changes were based on initial findings from the California Department of Public Health, EpiCenter California Injury Data Online system (EPIC), which document heat health impacts. The Scripps Institution of Oceanography (SIO) in collaboration with the California Environmental Protection Agency's Office of Environmental Health Hazard Assessment and the NWS completed a study of hospital visits during heat waves in California showing significant health impacts occurred in the past when no regional heat warning was issued. Therefore, the results supported the need for an exploratory project to implement significant modification of the traditional local criteria. To understand the impacts of heat on community health, medical outcome data were provided by the County of San Diego Emergency Medical Services Branch (EMS), which is provided by the County's Public Health Officer to monitor heat-related illness and injury daily during specific heat episodes. The data were combined with SIO research to inform the modification of local NWS heat criteria and establish trigger points to pilot new procedures for the issuance of heat alerts. Finally, procedures were customized for each of the county health departments in the NWS area of responsibility across extreme southwest California counties in collaboration with their Office of Emergency Services (OES). The

  8. Preservation of cognitive performance with age during exertional heat stress under low and high air velocity.

    PubMed

    Wright Beatty, Heather E; Keillor, Jocelyn M; Hardcastle, Stephen G; Boulay, Pierre; Kenny, Glen P

    2015-01-01

    Older adults may be at greater risk for occupational injuries given their reduced capacity to dissipate heat, leading to greater thermal strain and potentially cognitive decrements. To examine the effects of age and increased air velocity, during exercise in humid heat, on information processing and attention. Nine young (24 ± 1 years) and 9 older (59 ± 1 years) males cycled 4 × 15 min (separated by 15 min rest) at a fixed rate of heat production (400 W) in humid heat (35°C, 60% relative humidity) under 0.5 (low) and 3.0 (high) m·s(-1) air velocity wearing coveralls. At rest, immediately following exercise (end exercise), and after the final recovery, participants performed an abbreviated paced auditory serial addition task (PASAT, 2 sec pace). PASAT numbers of correct responses at end exercise were similar for young (low = 49 ± 3; high = 51 ± 3) and older (low = 46 ± 5; high = 47 ± 4) males and across air velocity conditions, and when scored relative to age norms. Psychological sweating, or an increased sweat rate with the administration of the PASAT, was observed in both age groups in the high condition. No significant decrements in attention and speeded information processing were observed, with age or altered air velocity, following intermittent exercise in humid heat.

  9. Preservation of Cognitive Performance with Age during Exertional Heat Stress under Low and High Air Velocity

    PubMed Central

    Wright Beatty, Heather E.; Keillor, Jocelyn M.; Hardcastle, Stephen G.; Boulay, Pierre; Kenny, Glen P.

    2015-01-01

    Older adults may be at greater risk for occupational injuries given their reduced capacity to dissipate heat, leading to greater thermal strain and potentially cognitive decrements. Purpose. To examine the effects of age and increased air velocity, during exercise in humid heat, on information processing and attention. Methods. Nine young (24 ± 1 years) and 9 older (59 ± 1 years) males cycled 4 × 15 min (separated by 15 min rest) at a fixed rate of heat production (400 W) in humid heat (35°C, 60% relative humidity) under 0.5 (low) and 3.0 (high) m·s−1 air velocity wearing coveralls. At rest, immediately following exercise (end exercise), and after the final recovery, participants performed an abbreviated paced auditory serial addition task (PASAT, 2 sec pace). Results. PASAT numbers of correct responses at end exercise were similar for young (low = 49 ± 3; high = 51 ± 3) and older (low = 46 ± 5; high = 47 ± 4) males and across air velocity conditions, and when scored relative to age norms. Psychological sweating, or an increased sweat rate with the administration of the PASAT, was observed in both age groups in the high condition. Conclusion. No significant decrements in attention and speeded information processing were observed, with age or altered air velocity, following intermittent exercise in humid heat. PMID:25874223

  10. [Sports and extreme conditions. Cardiovascular incidence in long term exertion and extreme temperatures (heat, cold)].

    PubMed

    Melin, B; Savourey, G

    2001-06-30

    During ultra-endurance exercise, both increase in body temperature and dehydration due to sweat losses, lead to a decrease in central blood volume. The heart rate drift allows maintaining appropriate cardiac output, in order to satisfy both muscle perfusion and heat transfer requirements by increasing skin blood flow. The resulting dehydration can impair thermal regulation and increase the risks of serious accidents as heat stroke. Endurance events, lasting more than 8 hours, result in large sweat sodium chloride losses. Thus, ingestion of large amounts of water with poor salt intake can induce symptomatic hyponatremia (plasma sodium < 130 mEq/L) which is also a serious accident. Heat environment increases the thermal constraint and when the air humidity is high, evaporation of sweat is compromise. Thus, thermal stress becomes uncompensable which increases the risk of cardiovascular collapse. Cold exposure induces physiological responses to maintain internal temperature by both limiting thermal losses and increasing metabolic heat production. Cold can induce accidental hypothermia and local frost-bites; moreover, it increases the risk of arrhythmia during exercise. Some guidelines (cardiovascular fitness, water and electrolyte intakes, protective clothing) are given for each extreme condition.

  11. Symptoms of heat illness among Latino farm workers in North Carolina.

    PubMed

    Mirabelli, Maria C; Quandt, Sara A; Crain, Rebecca; Grzywacz, Joseph G; Robinson, Erin N; Vallejos, Quirina M; Arcury, Thomas A

    2010-11-01

    Symptoms of occupational heat illness provide an early warning that workers are in potentially life-threatening environmental conditions. This analysis was designed to assess the extent to which strategies to reduce the health impact of extreme heat were associated with the prevalence of heat illness among Latino farm workers. Between June and September 2009, a total of 300 Latino men and women participated in a cross-sectional survey about farm worker health. Participants reported whether they were employed through the H-2A temporary agricultural worker program and whether they had ever worked in conditions of extreme heat during their work in the U.S. agricultural industry. Workers who had worked in extreme heat also responded to questions about selected activities and behaviors and whether they experienced symptoms of heat illness. Data analysis was conducted in 2009 to assess associations of altering work hours and activities, drinking more water, resting in shaded areas, and going to air-conditioned places during or after work, with the prevalence of symptoms of heat illness among H-2A and non-H-2A workers. Working in extreme heat was reported by 281 respondents (94%), among whom 112 (40%) reported symptoms of heat illness. Changes in work hours and activities during hot conditions were associated with a lower prevalence of heat illness among H-2A workers but not among non-H-2A workers. These findings suggest the need to improve the understanding of working conditions for farm workers and to assess strategies to reduce agricultural workers' environmental heat exposure. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. Estimating the burden of heat illness in England during the 2013 summer heatwave using syndromic surveillance

    PubMed Central

    Smith, Sue; Elliot, Alex J; Hajat, Shakoor; Bone, Angie; Smith, Gillian E; Kovats, Sari

    2016-01-01

    Background The burden of heat illness on health systems is not well described in the UK. Although the UK generally experiences mild summers, the frequency and intensity of hot weather is likely to increase due to climate change, particularly in Southern England. We investigated the impact of the moderate heatwave in 2013 on primary care and emergency department (ED) visits using syndromic surveillance data in England. Methods General practitioner in hours (GPIH), GP out of hours (GPOOH) and ED syndromic surveillance systems were used to monitor the health impact of heat/sun stroke symptoms (heat illness). Data were stratified by age group and compared between heatwave and non-heatwave years. Incidence rate ratios were calculated for GPIH heat illness consultations. Results GP consultations and ED attendances for heat illness increased during the heatwave period; GPIH consultations increased across all age groups, but the highest rates were in school children and those aged ≥75 years, with the latter persisting beyond the end of the heatwave. Extrapolating to the English population, we estimated that the number of GPIH consultations for heat illness during the whole summer (May to September) 2013 was 1166 (95% CI 1064 to 1268). This was double the rate observed during non-heatwave years. Conclusions These findings support the monitoring of heat illness (symptoms of heat/sun stroke) as part of the Heatwave Plan for England, but also suggest that specifically monitoring heat illness in children, especially those of school age, would provide additional early warning of, and situation awareness during heatwaves. PMID:26873949

  13. Exertional Heat Injury: Effects of Adding Cold (4°C) Intravenous Saline to Prehospital Protocol.

    PubMed

    Mok, Gordon; DeGroot, David; Hathaway, Nathanael E; Bigley, Daniel P; McGuire, Christopher S

    This article reviews current prehospital treatment for heat casualties and introduces a retrospective study on the addition of cold (4 °C) intravenous (IV) saline to prehospital treatment and its effect on morbidity. The study is a retrospective cohort reviewing electronic medical records of 290 heat casualties admitted to Martin Army Community Hospital, Ft. Benning, GA, comparing two treatment groups; U.S. Army Training and Doctrine Command (ice-sheeting and ambient temperature IV saline) versus Benning (ice-sheeting and cold IV saline). U.S. Army Training and Doctrine Command group significantly differed from Benning group on a number of measures, the median length of stay in the hospital was 3 and 2 d, respectively (P < 0.0001); pCr were 1.8 to 1.4 mg·dL, respectively (difference of 0.4 mg·dL pCr, P < 0.0001). However, creatine phosphokinase, aspartate aminotransferase, and alanine aminotransferase were not significantly different across groups. Findings demonstrate that adding cold IV saline to ice-sheeting as a protocol reduces the length of hospitalization of heat casualties and lowers their peak creatinine values.

  14. Development of a Heat-Illness Screening Instrument Using the Delphi Panel Technique

    PubMed Central

    Eberman, Lindsey E.; Cleary, Michelle A.

    2011-01-01

    Abstract Context: Exertional heat illness (EHI) is the third leading cause of death among athletes, but with preparticipation screening, risk factors can be identified, and some EHIs can be prevented. Objective: To establish content validity of the Heat Illness Index Score (HIIS), a 10-item screening instrument designed to identify athletes at risk for EHI during a preparticipation examination. Design: Delphi study. Setting: The Delphi technique included semistructured face-to-face or telephone interviews and included electronic questionnaires administered via e-mail. Patients or Other Participants: Six individuals with extensive research experience and/or clinical expertise in EHI participated as expert panelists. Main Outcome Measure(s): We used a Delphi panel technique (3 rounds) to evaluate the HIIS with the consensus of expert opinions. For round 1, we conducted face-to-face interviews with the panelists. For round 2, we solicited panelists' feedback of the transcribed data to ensure trustworthiness, then provided the participants with the revised HIIS and a questionnaire eliciting their levels of agreement for each revision from the previous round on a visual analog scale (11.4 cm) with extreme indicators of strongly disagree and strongly agree. We calculated the mean and SD for each revision and accepted when the mean was greater than 7.6 cm (agree) and the SD still permitted a positive response (>5.7 cm), suggesting consensus. For round 3, we instructed participants to indicate their levels of agreement with each final, revised item and their levels of agreement with the entire instrument on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree). Results: In round 1, panelists supported all 10 items but requested various revisions. In round 2, 16.3% (7 of 43) revisions were rejected, and 2 revisions were modified. In round 3, 100% of panelists reported agreeing (n = 3 of 6) or strongly agreeing (n = 3 of 6) with the final instrument

  15. Heat illness during working and preventive considerations from body fluid homeostasis.

    PubMed

    Kamijo, Yoshi-ichiro; Nose, Hiroshi

    2006-07-01

    The purposes of this review are to show pathophysiological mechanisms for heat illness during working in a hot environment and accordingly provide some preventive considerations from a viewpoint of body fluid homeostasis. The incidence of the heat illness is closely associated with body temperature regulation, which is much affected by body fluid state in humans. Heat generated by contracting muscles during working increases body temperature, which, in a feedback manner, drives heat-dissipation mechanisms of skin blood flow and sweating to prevent a rise in body temperature. However, the impairment of heat-dissipation mechanisms caused by hard work in hot, humid, and dehydrated conditions accelerates the increase in body temperature, and, if not properly treated, leads to heat illness. First, we overviewed thermoregulation during working (exercising) in a hot environment, describe the effects of dehydration on skin blood flow and sweating, and then explained how they contributes to the progression toward heat illness. Second, we described the advantageous effects of blood volume expansion after heat acclimatization on temperature regulation during exercise as well as those of restitution from dehydration by supplementation of carbohydrate-electrolyte solution. Finally, we described that the deteriorated thermoregulation in the elderly is closely associated with the impaired body fluid regulation and that blood volume expansion by exercise training with protein supplementation improves thermoregulation.

  16. Risk factors for heat illness among British soldiers in the hot Collective Training Environment

    PubMed Central

    Moore, Alice C; Stacey, M J; Bailey, K G H; Bunn, R J; Woods, D R; Haworth, K J; Brett, S J; Folkes, S E F

    2016-01-01

    Background Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops. Objective To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses. Methods An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation). Results The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation. Conclusions Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of ‘marginal gains’ is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE. PMID:26036822

  17. Preventing Heat-Related Illness or Death of Outdoor Workers

    MedlinePlus

    ... physical labor) and environ- mental heat arising from work- ing conditions. Moderate to high air temperature, particularly with high ... with proper amounts and types of fluids Establishing work/rest schedules appropriate for the current heat stress conditions (an industrial hygien- ist may need to be ...

  18. The descriptive epidemiology of sports/leisure-related heat illness hospitalisations in New South Wales, Australia.

    PubMed

    Finch, Caroline F; Boufous, Soufiane

    2008-01-01

    Sport-related heat illness has not been commonly studied from an epidemiological perspective. This study presents the descriptive epidemiology of sports/leisure-related heat illness hospitalisations in New South Wales, Australia. All in-patient separations from all acute hospitals in NSW during 2001-2004, with an International Classification of Diseases external cause of injury code indicating "exposure to excessive natural heat (X30)" or any ICD-10 diagnosis code in the range: "effects of heat and light (T67.0-T67.9)", were analysed. The sport/leisure relatedness of cases was defined by ICD-10-AM activity codes indicating involvement in sport/leisure activities. Cases of exposure to heat while engaged in sport/leisure were described by gender, year, age, principal diagnosis, type of activity/sport and length of stay. There were 109 hospital separations for exposure to heat while engaging in sport/leisure activity, with the majority occurring during the hottest months. The number of male cases significantly increased over the 4-year period and 45+ -year olds had the largest number of cases. Heat exhaustion was the leading cause of hospital separation (40% of cases). Marathon running, cricket and golf were the activities most commonly associated with heat-related hospitalisation. Ongoing development and refinement of expert position statements regarding heat illnesses need to draw on both epidemiological and physiological evidence to ensure their relevance to all levels of risk from the real world sport training and competition contexts.

  19. Warning Signs and Symptoms of Heat-Related Illness

    MedlinePlus

    ... continues, seek medical attention immediately. Heat Stroke High body temperature (above 103°F)* Hot, red, dry or moist ... person to a cooler environment. Reduce the person's body temperature with cool cloths or even a bath. Do ...

  20. Evaluation of a Novel Syndromic Surveillance Query for Heat-Related Illness Using Hospital Data From Maricopa County, Arizona, 2015.

    PubMed

    White, Jessica R; Berisha, Vjollca; Lane, Kathryn; Ménager, Henri; Gettel, Aaron; Braun, Carol R

    We evaluated a novel syndromic surveillance query, developed by the Council of State and Territorial Epidemiologists (CSTE) Heat Syndrome Workgroup, for identifying heat-related illness cases in near real time, using emergency department and inpatient hospital data from Maricopa County, Arizona, in 2015. The Maricopa County Department of Public Health applied 2 queries for heat-related illness to area hospital data transmitted to the National Syndromic Surveillance Program BioSense Platform: the BioSense "heat, excessive" query and the novel CSTE query. We reviewed the line lists generated by each query and used the diagnosis code and chief complaint text fields to find probable cases of heat-related illness. For each query, we calculated positive predictive values (PPVs) for heat-related illness. The CSTE query identified 674 records, of which 591 were categorized as probable heat-related illness, demonstrating a PPV of 88% for heat-related illness. The BioSense query identified 791 patient records, of which 589 were probable heat-related illness, demonstrating a PPV of 74% for heat-related illness. The PPV was substantially higher for the CSTE novel and BioSense queries during the heat season (May 1 to September 30; 92% and 85%, respectively) than during the cooler seasons (55% and 29%, respectively). A novel query for heat-related illness that combined diagnosis codes, chief complaint text terms, and exclusion criteria had a high PPV for heat-related illness, particularly during the heat season. Public health departments can use this query to meet local needs; however, use of this novel query to substantially improve public health heat-related illness prevention remains to be seen.

  1. Heat-related illnesses: the role of the occupational and environmental health nurse.

    PubMed

    Rogers, Bonnie; Stiehl, Kristin; Borst, Jennifer; Hess, Andrea; Hutchins, Shauna

    2007-07-01

    Heat-related illnesses can occur in workplaces where hot environments pose a threat to at-risk workers. Operations involving high air temperatures and humidity, radiant heat sources, direct physical contact with hot objects, or strenuous physical activities have potential for inducing heat stress in employees engaged in job functions in specific industries. Exposure to high temperatures can lead to a progression of symptoms in the body, which can result in widespread tissue damage, organ damage, and even death if not treated in a timely and effective manner. Strategies to reduce the effects of heat in the workplace include engineering controls, administrative controls, and personal protective equipment. Occupational and environmental health nurses must be able to recognize and treat the broad range of symptoms that can result from exposure to high temperatures. They must work together with interdisciplinary teams to provide training and education to the work force so that workers are able to take appropriate measures to prevent the onset of a heat-related illness, recognize the early symptoms, and seek treatment. Interdisciplinary teams must ensure that appropriate controls in the work environment reduce the risk of heat exposure and related heat stress disorders. Education and early intervention are key to avoiding heat-induced illness and eliminating or minimizing the effects of high temperature environments.

  2. Pediatric heat-related illness: recommendations for prevention and management [digest].

    PubMed

    Dunn, Roberta J; Kim, Tommy Y; Chaudhari, Pradip

    2017-08-22

    Infants, children, and adolescents are at increased risk for heat-related illness due to their inability to remove themselves from dangerous environments. Evidence shows that morbidity and mortality from heat illness is related to the length of time core temperature is elevated, so rapid reduction and accurate serial measurements are crucial to prevention of organ system damage and death. The primary methods of patient cooling are conduction (ice-water immersion, cold packs) and convection (moisture and moving air). The choice of method used may depend on availability of equipment, but there is evidence that can guide optimal use of resources. This issue presents evidence-based recommendations and best practices in heat-illness resuscitation, including managing children who are obese, have special needs or take medications, and advocacy for prevention strategies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  3. Numerical Solution of an Ill-Posed Problem Arising in Wind Tunnel Heat Transfer Data Reduction,

    DTIC Science & Technology

    1981-12-04

    Solutions of Ill - Posed Problems , A. H. Winston and Sons, 1977 . 6. Widder, D. V., The Heat Equation, Academic Press. 7. Richtmyer, R. D. and...DEC Al J B BELL. A B WAROLAW UNCLASSI ESWC WC/TR2l3lSBI.ADF5 046NL U" ~ a5 11111.5 N NSWC TR 82-32 cNUMERICAL SOLUTION OF AN ILL - POSED PROBLEM ...is ill - posed . A Tikhonov regularization procedure5 is then used to compute stable approximate solutions to the integral equation. In the

  4. Thermoregulatory disorders and illness related to heat and cold stress.

    PubMed

    Cheshire, William P

    2016-04-01

    Thermoregulation is a vital function of the autonomic nervous system in response to cold and heat stress. Thermoregulatory physiology sustains health by keeping body core temperature within a degree or two of 37°C, which enables normal cellular function. Heat production and dissipation are dependent on a coordinated set of autonomic responses. The clinical detection of thermoregulatory impairment provides important diagnostic and localizing information in the evaluation of disorders that impair thermoregulatory pathways, including autonomic neuropathies and ganglionopathies. Failure of neural thermoregulatory mechanisms or exposure to extreme or sustained temperatures that overwhelm the body's thermoregulatory capacity can also result in potentially life-threatening departures from normothermia. Hypothermia, defined as a core temperature of <35.0°C, may present with shivering, respiratory depression, cardiac dysrhythmias, impaired mental function, mydriasis, hypotension, and muscle dysfunction, which can progress to cardiac arrest or coma. Management includes warming measures, hydration, and cardiovascular support. Deaths from hypothermia are twice as frequent as deaths from hyperthermia. Hyperthermia, defined as a core temperature of >40.5°C, may present with sweating, flushing, tachycardia, fatigue, lightheadedness, headache, and paresthesia, progressing to weakness, muscle cramps, oliguria, nausea, agitation, hypotension, syncope, confusion, delirium, seizures, and coma. Mental status changes and core temperature distinguish potentially fatal heat stroke from heat exhaustion. Management requires the immediate reduction of core temperature. Ice water immersion has been shown to be superior to alternative cooling measures. Avoidance of thermal risk and early recognition of cold or heat stress are the cornerstones of preventive therapy. Copyright © 2016 The Author. Published by Elsevier B.V. All rights reserved.

  5. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness.

    PubMed

    Lipman, Grant S; Eifling, Kurt P; Ellis, Mark A; Gaudio, Flavio G; Otten, Edward M; Grissom, Colin K

    2013-12-01

    The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat-related illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best-practice recommendations for both field- and hospital-based therapeutic management of heat-related illness. These recommendations are graded based on the quality of supporting evidence and the balance between the benefits and risks or burdens for each modality. © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  6. The effects of summer temperature and heat waves on heat-related illness in a coastal city of China, 2011-2013.

    PubMed

    Bai, Li; Ding, Gangqiang; Gu, Shaohua; Bi, Peng; Su, Buda; Qin, Dahe; Xu, Guozhang; Liu, Qiyong

    2014-07-01

    Devastating health effects from recent heat waves in China have highlighted the importance of understanding health consequences from extreme heat stress. Despite the increasing mortality from extreme heat, very limited studies have quantified the effects of summer extreme temperature on heat-related illnesses in China. The associations between extreme heat and daily heat-related illnesses that occurred in the summers of 2011-2013 in Ningbo, China, have been examined, using a distributed lag non-linear model (DLNM) based on 3862 cases. The excess morbidities of heat-related illness during each heat wave have been calculated separately and the cumulative heat wave effects on age-, sex-, and cause-specific illnesses in each year along lags have been estimated as well. After controlling the effect of relative humidity, it is found that maximum temperature, rather than heat index, was a better predictor of heat-related illnesses in summers. A positive association between maximum temperatures and occurrence of heat-related diseases was apparent, especially at short lag effects. Six heat waves during the period of 2011-2013 were identified and all associated with excess heat-related illnesses. Relative to the average values for the corresponding periods in 2011 and 2012, a total estimated 679 extra heat-related illnesses occurred during three heat waves in 2013. The significant prolonged heat wave effects on total heat-related illnesses during heat waves in three study years have also been identified. The strongest cumulative effect of heat waves was on severe heat diseases in 2013, with a 10-fold increased risk. More males than females, individuals with more severe forms of illness, were more affected by the heat. However, all age groups were vulnerable. Recent heat waves had a substantial and delayed effect on heat illnesses in Ningbo. Relevant active well-organized public health initiatives should be implemented to reduce the adverse effects of heat extremes on the

  7. Relationships between maximum temperature and heat-related illness across North Carolina, USA

    NASA Astrophysics Data System (ADS)

    Sugg, Margaret M.; Konrad, Charles E.; Fuhrmann, Christopher M.

    2016-05-01

    Heat kills more people than any other weather-related event in the USA, resulting in hundreds of fatalities each year. In North Carolina, heat-related illness accounts for over 2,000 yearly emergency department admissions. In this study, data on emergency department (ED) visits for heat-related illness (HRI) were obtained from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool to identify spatiotemporal relationships between temperature and morbidity across six warm seasons (May-September) from 2007 to 2012. Spatiotemporal relationships are explored across different regions (e.g., coastal plain, rural) and demographics (e.g., gender, age) to determine the differential impact of heat stress on populations. This research reveals that most cases of HRI occur on days with climatologically normal temperatures (e.g., 31 to 35 °C); however, HRI rates increase substantially on days with abnormally high daily maximum temperatures (e.g., 31 to 38 °C). HRI ED visits decreased on days with extreme heat (e.g., greater than 38 °C), suggesting that populations are taking preventative measures during extreme heat and therefore mitigating heat-related illness.

  8. Relationships between maximum temperature and heat-related illness across North Carolina, USA.

    PubMed

    Sugg, Margaret M; Konrad, Charles E; Fuhrmann, Christopher M

    2016-05-01

    Heat kills more people than any other weather-related event in the USA, resulting in hundreds of fatalities each year. In North Carolina, heat-related illness accounts for over 2,000 yearly emergency department admissions. In this study, data on emergency department (ED) visits for heat-related illness (HRI) were obtained from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool to identify spatiotemporal relationships between temperature and morbidity across six warm seasons (May-September) from 2007 to 2012. Spatiotemporal relationships are explored across different regions (e.g., coastal plain, rural) and demographics (e.g., gender, age) to determine the differential impact of heat stress on populations. This research reveals that most cases of HRI occur on days with climatologically normal temperatures (e.g., 31 to 35 °C); however, HRI rates increase substantially on days with abnormally high daily maximum temperatures (e.g., 31 to 38 °C). HRI ED visits decreased on days with extreme heat (e.g., greater than 38 °C), suggesting that populations are taking preventative measures during extreme heat and therefore mitigating heat-related illness.

  9. Climatic and psychosocial risks of heat illness incidents on construction site.

    PubMed

    Jia, Yunyan Andrea; Rowlinson, Steve; Ciccarelli, Marina

    2016-03-01

    The study presented in this paper aims to identify prominent risks leading to heat illness in summer among construction workers that can be prioritised for developing effective interventions. Samples are 216 construction workers' cases at the individual level and 26 construction projects cases at the organisation level. A grounded theory is generated to define the climatic heat and psychosocial risks and the relationships between risks, timing and effectiveness of interventions. The theoretical framework is then used to guide content analysis of 36 individual onsite heat illness cases to identify prominent risks. The results suggest that heat stress risks on construction site are socially constructed and can be effectively managed through elimination at supply chain level, effective engineering control, proactive control of the risks through individual interventions and reactive control through mindful recognition and response to early symptoms. The role of management infrastructure as a base for effective interventions is discussed.

  10. A retrospective study of clinical profile and outcomes of critically ill patients with heat-related illness.

    PubMed

    Kalaiselvan, M S; Renuka, M K; Arunkumar, A S

    2015-11-01

    Heat-related illness (HRI) due to high ambient temperatures is a common feature during the Indian summer. HRI often results in Intensive Care Unit (ICU) admissions and are associated with significant morbidity and mortality. However, published report on the effects of HRI among the Indian population is lacking. This study was undertaken to identify the profile of patients admitted to ICU with clinical features of HRI and study their clinical outcomes. This was a retrospective case series of patients admitted with features of HRI during the summer of 2012 in our multidisciplinary ICU. Data on demographics, co-morbid illness, admission severity of illness (Acute Physiology and Chronic Health Evaluation II [APACHE II]), organ failure scores (Sequential Organ Failure Assessment [SOFA]) and neuroimaging studies were collected. Outcome data studied included mortality, ICU length of stay (LOS), ventilator days and hospital LOS. Statistical analysis was performed using Student's t-test, Chi-square test and multivariate analysis. Twenty-six patients met the diagnostic criteria for HRI. Fifteen were males. The mean age was 53.12 ± 18.6 years. Mean APACHE II score was 19.6 ± 7.7 and mean SOFA score was 7.5 ± 2.6. The common presenting symptoms were fever with neurological impairment (100%) and gastrointestinal symptoms (30%). Major organ systems involvement include neurological (100%), renal (57%), hepatic (34%) and coagulation abnormalities (26%). Most common metabolic abnormality noted was hyponatraemia (73%). Magnetic resonance imaging findings suggestive of heat stroke were seen in 5 of 26 patients. Mortality rate was 34%. 8 of 17 survivors had residual neurological impairment. HRI carries a high mortality and significant neurological morbidity.

  11. A retrospective study of clinical profile and outcomes of critically ill patients with heat-related illness

    PubMed Central

    Kalaiselvan, MS; Renuka, MK; Arunkumar, AS

    2015-01-01

    Background and Aims: Heat-related illness (HRI) due to high ambient temperatures is a common feature during the Indian summer. HRI often results in Intensive Care Unit (ICU) admissions and are associated with significant morbidity and mortality. However, published report on the effects of HRI among the Indian population is lacking. This study was undertaken to identify the profile of patients admitted to ICU with clinical features of HRI and study their clinical outcomes. Methods: This was a retrospective case series of patients admitted with features of HRI during the summer of 2012 in our multidisciplinary ICU. Data on demographics, co-morbid illness, admission severity of illness (Acute Physiology and Chronic Health Evaluation II [APACHE II]), organ failure scores (Sequential Organ Failure Assessment [SOFA]) and neuroimaging studies were collected. Outcome data studied included mortality, ICU length of stay (LOS), ventilator days and hospital LOS. Statistical analysis was performed using Student's t-test, Chi-square test and multivariate analysis. Results: Twenty-six patients met the diagnostic criteria for HRI. Fifteen were males. The mean age was 53.12 ± 18.6 years. Mean APACHE II score was 19.6 ± 7.7 and mean SOFA score was 7.5 ± 2.6. The common presenting symptoms were fever with neurological impairment (100%) and gastrointestinal symptoms (30%). Major organ systems involvement include neurological (100%), renal (57%), hepatic (34%) and coagulation abnormalities (26%). Most common metabolic abnormality noted was hyponatraemia (73%). Magnetic resonance imaging findings suggestive of heat stroke were seen in 5 of 26 patients. Mortality rate was 34%. 8 of 17 survivors had residual neurological impairment. Conclusion: HRI carries a high mortality and significant neurological morbidity. PMID:26755836

  12. Risk and preventive factors for heat illness in radiation decontamination workers after the Fukushima Daiichi Nuclear Power Plant accident.

    PubMed

    Kakamu, Takeyasu; Hidaka, Tomoo; Hayakawa, Takehito; Kumagai, Tomohiro; Jinnouchi, Takanobu; Tsuji, Masayoshi; Nakano, Shinichi; Koyama, Kikuo; Fukushima, Tetsuhito

    2015-01-01

    The aim of this study was to reveal factors related to heat illness in radiation decontamination workers and determine effective preventive measures. A self-administered questionnaire was sent to 1,505 radiation decontamination workers. The questionnaire included age, sex, duration of decontamination work, previous occupation, education provided by employers regarding heat illness, preventive action against heat illness, and subjective symptoms of heat illness during work. We included 528 men, who replied and answered all questions, in the statistical analysis. Subjective symptoms of heat illness were categorized as "no symptoms", "Grade I" and "Grade II" according to severity. A multiple linear regression model was used to determine the factors associated with the severity of heat illness. The mean age of the subjects was 47.6 years old (standard deviation: 13.4). Of the 528 workers, 316 (59.8%) experienced heat illness symptoms (213 at Grade I and 103 at Grade II). The results of the stepwise selection revealed that age, outdoor manual labor, adequate sleep, use of a cool vest, and salt intake were selected as preventive factors, whereas living in a company dormitory or temporary housing, wearing light clothing, and consuming breakfast were selected as risk factors for heat illness. Both working conditions and living environment are associated with heat illness in radiation decontamination workers. Type of housing and sleep are also strongly related to heat illness during work. Employers should consider not only the working conditions of the employee but also the employee's daily living conditions, in order to prevent heat illness.

  13. An Exertional Heat Stroke Survivor's Return to Running: An Integrated Approach on the Treatment, Recovery, and Return to Activity.

    PubMed

    Adams, William M; Hosokawa, Yuri; Huggins, Robert A; Mazerolle, Stephanie M; Casa, Douglas J

    2016-08-01

    Evidence-based best practices for the recognition and treatment of exertional heat stroke (EHS) indicate that rectal thermometry and immediate, aggressive cooling via cold-water immersion ensure survival from this medical condition. However, little is known about the recovery, medical follow-up, and return to activity after an athlete has suffered EHS. To highlight the transfer of evidenced-based research into clinical practice by chronicling the treatment, recovery, and return to activity of a runner who suffered an EHS during a warm-weather road race. Case study. Warm-weather road race. 53-y-old recreationally active man. A runner's treatment, recovery, and return to activity from EHS and 2014 Falmouth Road Race performance. Runner's perceptions and experiences with EHS, body temperature, heart rate, hydration status, exercise intensity. The runner successfully completed the 2014 Falmouth Road Race without incident of EHS. Four dominant themes emerged from the data: predisposing factors, ideal treatment, lack of medical follow-up, and patient education. The first theme identified 3 predisposing factors that contributed to the runner's EHS: hydration, sleep loss, and lack of heat acclimatization. The runner received ideal treatment using evidence-based best practices. A lack of long-term medical care following the EHS with no guidance on the runner's return to full activity was observed. The runner knew very little about EHS before the 2013 race, which drove him to seek knowledge as to why he suffered EHS. Using this newly learned information, he successfully completed the 2014 Falmouth Road Race without incident. This case supports prior literature examining the factors that predispose individuals to EHS. Although evidence-based best practices regarding prompt recognition and treatment of EHS ensure survival, this case highlights the lack of medical follow-up and physician-guided return to activity after EHS.

  14. Hypothesis: exertional heat stroke-induced myopathy and genetically inherited malignant hyperthermia represent the same disorder, the human stress syndrome.

    PubMed

    Zhao, Xuesheng; Song, Qing; Gao, Yan

    2014-11-01

    Exertional heat stroke is usually experienced as a result of a prolonged and intensive exercise. It is a life-threatening condition that is characterized by an increase in core body temperature and rhabdomyolysis. The associated hyperkalemia and metabolic acidosis may lead to an acute renal, cardiac, and hemostatic failure. Exactly, the same symptoms are noticed in case of the anesthesia-induced malignant hyperthermia (MH), an inherited disorder of the skeletal muscle ryanodine receptor. This receptor is a Ca(2+) channel that is activated by the volatile anesthetic agents and depolarizing muscle relaxant. The presence of MH-associated ryanodine receptor variant in the individuals who suffered from EH and improvement of the symptoms with dantrolene has frequently raised the question as to whether the two disorders actually represent one and the same disease. Nevertheless, an exact explanation of the susceptibility of the genetically predisposed MH individuals to ER remains elusive. We have attempted to review the published clinical reports to explore the possibility that ER and EH represent one and the same disorder.

  15. Community Trial on Heat Related-Illness Prevention Behaviors and Knowledge for the Elderly

    PubMed Central

    Takahashi, Noriko; Nakao, Rieko; Ueda, Kayo; Ono, Masaji; Kondo, Masahide; Honda, Yasushi; Hashizume, Masahiro

    2015-01-01

    This study aims to explore whether broadcasting heat health warnings (HHWs), to every household and whether the additional home delivery of bottled water labeled with messages will be effective in improving the behaviors and knowledge of elderly people to prevent heat-related illness. A community trial on heat-related-illness-prevention behaviors and knowledge for people aged between 65 and 84 years was conducted in Nagasaki, Japan. Five hundred eight subjects were selected randomly from three groups: heat health warning (HHW), HHW and water delivery (HHW+W), and control groups. Baseline and follow-up questionnaires were conducted in June and September 2012, respectively. Of the 1524 selected subjects, the 1072 that completed both questionnaires were analyzed. The HHW+W group showed improvements in nighttime AC use (p = 0.047), water intake (p = 0.003), cooling body (p = 0.002) and reduced activities in heat (p = 0.047) compared with the control, while the HHW group improved hat or parasol use (p = 0.008). An additional effect of household water delivery was observed in water intake (p = 0.067) and cooling body (p = 0.095) behaviors. HHW and household bottled water delivery improved heat-related-illness-prevention behaviors. The results indicate that home water delivery in addition to a HHW may be needed to raise awareness of the elderly. PMID:25789456

  16. Survey Instrument Validity Part II: Validation of a Survey Instrument Examining Athletic Trainers' Knowledge and Practice Beliefs Regarding Exertional Heat Stroke

    ERIC Educational Resources Information Center

    Burton, Laura J.; Mazerolle, Stephanie M.

    2011-01-01

    Objective: The purpose of this article is to discuss the process of developing and validating an instrument to investigate an athletic trainer's attitudes and behaviors regarding the recognition and treatment of exertional heat stroke. Background: Following up from our initial paper, which discussed the process of survey instrument design and…

  17. Survey Instrument Validity Part II: Validation of a Survey Instrument Examining Athletic Trainers' Knowledge and Practice Beliefs Regarding Exertional Heat Stroke

    ERIC Educational Resources Information Center

    Burton, Laura J.; Mazerolle, Stephanie M.

    2011-01-01

    Objective: The purpose of this article is to discuss the process of developing and validating an instrument to investigate an athletic trainer's attitudes and behaviors regarding the recognition and treatment of exertional heat stroke. Background: Following up from our initial paper, which discussed the process of survey instrument design and…

  18. Summer outdoor temperature and occupational heat-related illnesses in Quebec (Canada)

    SciTech Connect

    Adam-Poupart, Ariane; Smargiassi, Audrey; Busque, Marc-Antoine; Duguay, Patrice; Fournier, Michel; Zayed, Joseph; Labrèche, France

    2014-10-15

    Background: Predicted rise in global mean temperature and intensification of heat waves associated with climate change present an increasing challenge for occupational health and safety. Although important scientific knowledge has been gathered on the health effects of heat, very few studies have focused on quantifying the association between outdoor heat and mortality or morbidity among workers. Objective: To quantify the association between occupational heat-related illnesses and exposure to summer outdoor temperatures. Methods: We modeled 259 heat-related illnesses compensated by the Workers' Compensation Board of Quebec between May and September, from 1998 to 2010, with maximum daily summer outdoor temperatures in 16 health regions of Quebec (Canada) using generalized linear models with negative binomial distributions, and estimated the pooled effect sizes for all regions combined, by sex and age groups, and for different time lags with random-effect models for meta-analyses. Results: The mean daily compensation count was 0.13 for all regions of Quebec combined. The relationship between daily counts of compensations and maximum daily temperatures was log-linear; the pooled incidence rate ratio (IRR) of daily heat-related compensations per 1 °C increase in daily maximum temperatures was 1.419 (95% CI 1.326 to 1.520). Associations were similar for men and women and by age groups. Increases in daily maximum temperatures at lags 1 and 2 and for two and three-day lag averages were also associated with increases in daily counts of compensations (IRRs of 1.206 to 1.471 for every 1 °C increase in temperature). Conclusion: This study is the first to quantify the association between occupational heat-related illnesses and exposure to summer temperatures in Canada. The model (risk function) developed in this study could be useful to improve the assessment of future impacts of predicted summer outdoor temperatures on workers and vulnerable groups, particularly in colder

  19. Predictive Factors for Hospitalization of Patients with Heat Illness in Yamaguchi, Japan.

    PubMed

    Yamamoto, Takahiro; Todani, Masaki; Oda, Yasutaka; Kaneko, Tadashi; Kaneda, Kotaro; Fujita, Motoki; Miyauchi, Takashi; Tsuruta, Ryosuke

    2015-09-18

    The objective of the study was to investigate the predictive factors for the hospitalization of patients who presented with mild to moderate heat illness at an emergency department. We conducted a retrospective survey of hospitals with an emergency department in Yamaguchi Prefecture, Japan. The survey questionnaire entries included patient age, sex, use of an ambulance, vital signs, blood examination conducted at the emergency department, the length of hospitalization, and outcome. We analyzed the predictive factors for hospitalization in patients with heat illness. A total of 127 patients were analyzed. Of these, 49 (37%) were admitted, with 59% discharged on the day following admission. In univariate analysis, the following inpatient characteristics were predictive for hospitalization: old age, low Glasgow Coma Scale score, elevated body temperature, increased serum C-reactive protein, and increased blood urea nitrogen. In logistic regression multivariate analysis, the following were predictive factors for hospitalization: age of ≥ 65 years (odds ratio (OR) 4.91; 95% confidence interval (CI) 1.42-17.00), body temperature (OR 1.97; 95% CI 1.14-3.41), Glasgow Coma Scale (OR 0.40; 95% CI 0.16-0.98), and creatinine (OR 2.92; 95% CI 1.23-6.94). The results suggest that the elderly with hyperthermia, disturbance of consciousness, and elevated serum creatinine have an increased risk for hospitalization with heat illness.

  20. Sickle Cell Trait and Fatal Exertional Heat Illness: Implications for Exercise-Related Death of Young Ddults

    DTIC Science & Technology

    2008-10-22

    pneumonia, Osteomyelitis (Salmonella, Staph aureus), Urinary tract infections , port infections Vaso-occlusive pain episodes Cholelithiasis: salmonella...8 g/dL w intra-vascular component, Acute anemia: folate depletion, Parvovirus B19 & other infection , splenic sequestration, high rate of delayed

  1. The rate of heat storage mediates an anticipatory reduction in exercise intensity during cycling at a fixed rating of perceived exertion.

    PubMed

    Tucker, Ross; Marle, Trevor; Lambert, Estelle V; Noakes, Timothy D

    2006-08-01

    The aim of the present study was to examine the regulation of exercise intensity in hot environments when exercise is performed at a predetermined, fixed subjective rating of perceived exertion (RPE). Eight cyclists performed cycling trials at 15 degrees C (COOL), 25 degrees C (NORM) and 35 degrees C (HOT) (65% humidity throughout), during which they were instructed to cycle at a Borg rating of perceived exertion (RPE) of 16, increasing or decreasing their power output in order to maintain this RPE. Power output declined linearly in all three trials and the rate of decline was significantly higher in HOT than in NORM and COOL (2.35 +/- 0.73 W min(-1), 1.63 +/- 0.70 and 1.61 +/- 0.80 W min(-1), respectively, P < 0.05). The rate of heat storage was significantly higher in HOT for the first 4 min of the trials only, as a result of increasing skin temperatures. Thereafter, no differences in heat storage were found between conditions. We conclude that the regulation of exercise intensity is controlled by an initial afferent feedback regarding the rate of heat storage, which is used to regulate exercise intensity and hence the rate of heat storage for the remainder of the anticipated exercise bout. This regulation maintains thermal homeostasis by reducing the exercise work rate and utilizing the subjective RPE specifically to ensure that excessive heat accumulation does not occur and cellular catastrophe is avoided.

  2. Females exposed to 24 h of sleep deprivation do not experience greater physiological strain, but do perceive heat illness symptoms more severely, during exercise-heat stress.

    PubMed

    Relf, Rebecca; Willmott, Ashley; Mee, Jessica; Gibson, Oliver; Saunders, Arron; Hayes, Mark; Maxwell, Neil

    2017-03-24

    There is limited and inconclusive evidence surrounding the physiological and perceptual responses to heat stress while sleep deprived, especially for females. This study aimed to quantify the effect of 24 h sleep deprivation on physiological strain and perceptual markers of heat-related illness in females. Nine females completed two 30-min heat stress tests (HST) separated by 48 h in 39°C, 41% relative humidity at a metabolic heat production of 10 W · kg(-1). The non-sleep deprived HST was followed by the sleep deprivation (SDHST) trial for all participants during the follicular phase of the menstrual cycle. Physiological and perceptual measures were recorded at 5 min intervals during the HSTs. On the cessation of the HSTs, heat illness symptom index (HISI) was completed. HISI scores increased after sleep deprivation by 28 ± 16 versus 20 ± 16 (P = 0.01). Peak (39.40 ± 0.35°C vs. 39.35 ± 0.33°C) and change in rectal temperature (1.91 ± 0.21 vs. 1.93 ± 0.34°C), and whole body sweat rate (1.08 ± 0.31 vs. 1.15 ± 0.36 L · h(-1)) did not differ (P > 0.05) between tests. No difference was observed in peak, nor rise in: heart rate, mean skin temperature, perceived exertion or thermal sensation during the HSTs. Twenty-four hours sleep deprivation increased perceptual symptoms associated with heat-related illness; however, no thermoregulatory alterations were observed.

  3. Safety in the Heat: A Comprehensive Program for Prevention of Heat Illness Among Workers in Abu Dhabi, United Arab Emirates

    PubMed Central

    Thomsen, Jens; Harrison, Oliver

    2011-01-01

    The Safety in the Heat program was developed in response to the extreme heat stress conditions experienced by workers in the United Arab Emirates and other Middle Eastern countries each summer, where ambient air temperatures often reach 45°C (135°F) and higher with 90% humidity. A comprehensive, multimedia, economical education and awareness program targeting companies in the region was developed; 465 companies employing 814 996 heat-exposed workers across 6254 work and labor residence sites were reached. Feedback from program participants indicated a high level of support and satisfaction. Results indicated a marked reduction in heat related illness over a period of 2 years (2008–2009) at 2 companies, one of which reported a combined 79.5% decrease in cases (15.3 vs 1.16 cases per 1000 workers) while the other experienced a 50% reduction in serious cases (0.08–0.04 cases per 100 000 work hours). PMID:21307373

  4. Heat-Related Illness in Washington State Agriculture and Forestry Sectors

    PubMed Central

    Spector, June T.; Krenz, Jennifer; Rauser, Edmund; Bonauto, David K.

    2017-01-01

    Background We sought to describe heat-related illness (HRI) in agriculture and forestry workers in Washington State. Methods Demographic and clinical Washington State Fund workers’ compensation agriculture and forestry HRI claims data (1995–2009) and Washington Agriculture Heat Rule citations (2009–2012) were accessed and described. Maximum daily temperature (Tmax) and Heat Index (HImax) were estimated by claim date and location using AgWeatherNet’s weather station network. Results There were 84 Washington State Fund agriculture and forestry HRI claims and 60 Heat Rule citations during the study period. HRI claims and citations were most common in crop production and support subsectors. The mean Tmax (HImax) was 95°F (99°F) for outdoor HRI claims. Potential HRI risk factors and HRI-related injuries were documented for some claims. Conclusions Agriculture and forestry HRI cases are characterized by potential work-related, environmental, and personal risk factors. Further work is needed to elucidate the relationship between heat exposure and occupational injuries. PMID:24953344

  5. Heat-related illness in Washington State agriculture and forestry sectors.

    PubMed

    Spector, June T; Krenz, Jennifer; Rauser, Edmund; Bonauto, David K

    2014-08-01

    We sought to describe heat-related illness (HRI) in agriculture and forestry workers in Washington State. Demographic and clinical Washington State Fund workers' compensation agriculture and forestry HRI claims data (1995-2009) and Washington Agriculture Heat Rule citations (2009-2012) were accessed and described. Maximum daily temperature (Tmax) and Heat Index (HImax) were estimated by claim date and location using AgWeatherNet's weather station network. There were 84 Washington State Fund agriculture and forestry HRI claims and 60 Heat Rule citations during the study period. HRI claims and citations were most common in crop production and support subsectors. The mean Tmax (HImax) was 95°F (99°F) for outdoor HRI claims. Potential HRI risk factors and HRI-related injuries were documented for some claims. Agriculture and forestry HRI cases are characterized by potential work-related, environmental, and personal risk factors. Further work is needed to elucidate the relationship between heat exposure and occupational injuries. © 2014 Wiley Periodicals, Inc.

  6. Increased Air Velocity Reduces Thermal and Cardiovascular Strain in Young and Older Males during Humid Exertional Heat Stress.

    PubMed

    Wright Beatty, Heather E; Hardcastle, Stephen G; Boulay, Pierre; Flouris, Andreas D; Kenny, Glen P

    2015-01-01

    Older adults have been reported to have a lower evaporative heat loss capacity than younger adults during exercise when full sweat evaporation is permitted. However, it is unclear how conditions of restricted evaporative and convective heat loss (i.e., high humidity, clothing insulation) alter heat stress. to the purpose of this study was to examine the heat stress responses of young and older males during and following exercise in a warm/humid environment under two different levels of air velocity. Ten young (YOUNG: 24±2 yr) and 10 older (OLDER: 59±3 yr) males, matched for body surface area performed 4×15-min cycling bouts (15-min rest) at a fixed rate of heat production (400 W) in warm/humid conditions (35°C, 60% relative humidity) under 0.5 (Low) and 3.0 (High) m·s(-1) air velocity while wearing work coveralls. Rectal (Tre) and mean skin (MTsk) temperatures, heart rate (HR), local sweat rate, % max skin blood flow (SkBF) (recovery only), and blood pressure (recovery only) were measured. High air velocity reduced core and skin temperatures (p < 0.05) equally in YOUNG and OLDER males (p > 0.05) but was more effective in reducing cardiovascular strain (absolute and % max HR; p < 0.05) in YOUNG males (p < 0.05). Greater increases in local dry heat loss responses (% max SkBF and cutaneous vascular conductance) were detected across time in OLDER than YOUNG males in both conditions (p < 0.05). Local dry heat loss responses and cardiovascular strain were attenuated during the High condition in YOUNG compared to OLDER (p < 0.05). High air velocity reduced the number of males surpassing the 38.0°C Tre threshold from 90% (Low) to 50% (High). Despite age-related local heat loss differences, YOUNG and OLDER males had similar levels of heat stress during intermittent exercise in warm and humid conditions while wearing work coveralls. Increased air velocity was effective in reducing heat stress equally, and cardiovascular strain to a greater extent, in YOUNG and OLDER

  7. Medicines can affect thermoregulation and accentuate the risk of dehydration and heat-related illness during hot weather.

    PubMed

    Westaway, K; Frank, O; Husband, A; McClure, A; Shute, R; Edwards, S; Curtis, J; Rowett, D

    2015-08-01

    Hot days are increasingly common and are often associated with increased morbidity and mortality, especially in the elderly. Most heat-related illness and heat-related deaths are preventable. Medicines may accentuate the risk of dehydration and heat-related illness, especially in elderly people taking multiple medicines, through the following mechanisms: diuresis and electrolyte imbalance, sedation and cognitive impairment, changed thermoregulation, reduced thirst recognition, reduced sweat production, and hypotension and reduced cardiac output. Commonly used medicines that may significantly increase the risk include diuretics, especially when combined with an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), anticholinergics and psychotropics. Initiation of individualized preventive measures prior to the start of the hot weather season, which includes a review of the patient and their medicines to identify thermoregulatory issues, may reduce the risk of heat-related illness or death. © 2015 John Wiley & Sons Ltd.

  8. Economic Burden of Hospitalizations for Heat-Related Illnesses in the United States, 2001–2010

    PubMed Central

    Schmeltz, Michael T.; Petkova, Elisaveta P.; Gamble, Janet L.

    2016-01-01

    Understanding how heat waves affect morbidity and mortality, as well as the associated economic costs, is essential for characterizing the human health impacts of extreme heat under a changing climate. Only a handful of studies have examined healthcare costs associated with exposures to high temperatures. This research explores costs associated with hospitalizations for heat-related illness (HRI) in the United States using the 2001 to 2010 Nationwide Inpatient Sample (NIS). Descriptive statistics of patient data for HRI hospitalizations were examined and costs of hospitalizations were reported using the all-payer inpatient cost-to-charge ratio. Costs were examined using a log-gamma model with patient and hospital characteristics included as fixed effects. Adjusted mean costs were then compared across racial groups. The mean costs of HRI hospitalizations were higher among racial/ethnic minorities compared to Whites, who accounted for almost 65% of all HRI hospitalizations. Observed differences in costs based on income, insurance, and gender were also significant. These results suggest that these populations are suffering disproportionately from health inequity, thus, they could shoulder greater disease and financial burdens due to climate change. These findings may have important implications in understanding the economic impact public health planning and interventions will have on preventing hospitalizations related to extreme heat. PMID:27618079

  9. Exertion-induced heat exhaustion and other medical aspects of the City-to-Surf fun runs, 1978-1984.

    PubMed

    Richards, R; Richards, D

    During the years 1978 to 1984, only 197 (0.14%) of 144 950 starters in a 14-km road race had suffered from heat exhaustion; of these, only three (1.5%) required admission to hospital. The effectiveness of treatment in medical centres was indicated by the fact that the mean time taken for the body temperature to fall to 38 degrees C was 31 +/- 12 minutes in all heat-exhaustion casualties, and 49 +/- 14 minutes in 41 subjects who had rectal temperatures of 42 degrees C and higher. When disaster teams from metropolitan hospitals were introduced in 1983, it became apparent that skilled staff members, despite their lack of experience in the resuscitation of combative heat casualties, could carry out the established procedures and protocols effectively and efficiently.

  10. Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness: 2014 update.

    PubMed

    Lipman, Grant S; Eifling, Kurt P; Ellis, Mark A; Gaudio, Flavio G; Otten, Edward M; Grissom, Colin K

    2014-12-01

    The Wilderness Medical Society (WMS) convened an expert panel to develop a set of evidence-based guidelines for the recognition, prevention, and treatment of heat illness. We present a review of the classifications, pathophysiology, and evidence-based guidelines for planning and preventive measures as well as best practice recommendations for both field and hospital-based therapeutic management of heat illness. These recommendations are graded on the basis of the quality of supporting evidence, and balance between the benefits and risks or burdens for each modality. This is an updated version of the original WMS Practice Guidelines for the Prevention and Treatment of Heat-Related Illness published in Wilderness & Environmental Medicine 2013;24(4):351-361. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  11. Temporal and spatial variation of heat-related illness using 911 medical dispatch data.

    PubMed

    Bassil, Kate L; Cole, Donald C; Moineddin, Rahim; Craig, Alan M; Lou, W Y Wendy; Schwartz, Brian; Rea, Elizabeth

    2009-07-01

    The adverse effect of hot weather on health in urban communities is of increasing public health concern, particularly given trends in climate change. To demonstrate the potential public health applications of monitoring 911 medical dispatch data for heat-related illness (HRI), using historical data for the summer periods (June 1-August 31) during 2002-2005 in Toronto, Ontario, Canada. The temporal distribution of the medical dispatch calls was described in relation to a current early warning system and emergency department data from the National Ambulatory Care Reporting System (NACRS). Geospatial methods were used to map the percentage of heat-related calls in each Toronto neighborhood over the study period. The temporal pattern of 911 calls for HRI was similar, and sometimes peaked earlier, than current heat health warning systems (HHWS). The pattern of calls was similar to NACRS HRI visits, with the exception of 2005 where 911 calls peaked earlier. Areas of the city with a relatively higher burden of HRI included low income inner-city neighborhoods, areas with high rates of street-involved individuals, and areas along the waterfront which include summer outdoor recreational activities. Identifying the temporal trends and geospatial patterns of these important environmental health events has the potential to direct targeted public health interventions to mitigate associated morbidity and mortality.

  12. Summertime Acute Heat Illness in U.S. Emergency Departments from 2006 through 2010: Analysis of a Nationally Representative Sample

    PubMed Central

    Saha, Shubhayu; Luber, George

    2014-01-01

    Background: Patients with acute heat illness present primarily to emergency departments (EDs), yet little is known regarding these visits. Objective: We aimed to describe acute heat illness visits to U.S. EDs from 2006 through 2010 and identify factors associated with hospital admission or with death in the ED. Methods: We extracted ED case-level data from the Nationwide Emergency Department Sample (NEDS) for 2006–2010, defining cases as ED visits from May through September with any heat illness diagnosis (ICD-9-CM 992.0–992.9). We correlated visit rates and temperature anomalies, analyzed demographics and ED disposition, identified risk factors for adverse outcomes, and examined ED case fatality rates (CFR). Results: There were 326,497 (95% CI: 308,372, 344,658) cases, with 287,875 (88.2%) treated and released, 38,392 (11.8%) admitted, and 230 (0.07%) died in the ED. Heat illness diagnoses were first-listed in 68%. 74.7% had heat exhaustion, 5.4% heat stroke. Visit rates were highly correlated with annual temperature anomalies (Pearson correlation coefficient 0.882, p = 0.005). Treat-and-release rates were highest for younger adults (26.2/100,000/year), whereas hospitalization and death-in-the-ED rates were highest for older adults (6.7 and 0.03/100,000/year, respectively); all rates were highest in rural areas. Heat stroke had an ED CFR of 99.4/10,000 (95% CI: 78.7, 120.1) visits and was diagnosed in 77.0% of deaths. Adjusted odds of hospital admission or death in the ED were higher among elders, males, urban and low-income residents, and those with chronic conditions. Conclusions: Heat illness presented to the ED frequently, with highest rates in rural areas. Case definitions should include all diagnoses. Visit rates were correlated with temperature anomalies. Heat stroke had a high ED CFR. Males, elders, and the chronically ill were at greatest risk of admission or death in the ED. Chronic disease burden exponentially increased this risk. Citation: Hess JJ

  13. Modeling and syndromic surveillance for estimating weather-induced heat-related illness.

    PubMed

    Perry, Alexander G; Korenberg, Michael J; Hall, Geoffrey G; Moore, Kieran M

    2011-01-01

    This paper compares syndromic surveillance and predictive weather-based models for estimating emergency department (ED) visits for Heat-Related Illness (HRI). A retrospective time-series analysis of weather station observations and ICD-coded HRI ED visits to ten hospitals in south eastern Ontario, Canada, was performed from April 2003 to December 2008 using hospital data from the National Ambulatory Care Reporting System (NACRS) database, ED patient chief complaint data collected by a syndromic surveillance system, and weather data from Environment Canada. Poisson regression and Fast Orthogonal Search (FOS), a nonlinear time series modeling technique, were used to construct models for the expected number of HRI ED visits using weather predictor variables (temperature, humidity, and wind speed). Estimates of HRI visits from regression models using both weather variables and visit counts captured by syndromic surveillance as predictors were slightly more highly correlated with NACRS HRI ED visits than either regression models using only weather predictors or syndromic surveillance counts.

  14. Exertional thermal strain, protective clothing and auxiliary cooling in dry heat: evidence for physiological but not cognitive impairment.

    PubMed

    Caldwell, Joanne N; Patterson, Mark J; Taylor, Nigel A S

    2012-10-01

    Individuals exposed to extreme heat may experience reduced physiological and cognitive performance, even during very light work. This can have disastrous effects on the operational capability of aircrew, but such impairment could be prevented by auxiliary cooling devices. This hypothesis was tested under very hot-dry conditions, in which eight males performed 2 h of low-intensity exercise (~30 W) in three trials, whilst wearing biological and chemical protective clothing: temperate (control: 20°C, 30% relative humidity) and two hot-dry trials (48°C, 20% relative humidity), one without (experimental) and one with liquid cooling (water at 15°C). Physiological strain and six cognitive functions were evaluated (MiniCog Rapid Assessment Battery), and participants drank to sustain hydration state. Maximal core temperatures averaged 37.0°C (±0.1) in the control trial, and were significantly elevated in the experimental trial (38.9°C ± 0.3; P < 0.05). Similarly, heart rates peaked at 92 beats min(-1) (±7) and 133 beats min(-1) (±4; P < 0.05), respectively. Liquid cooling reduced maximal core temperatures (37.3°C ± 0.1; P < 0.05) and heart rates 87 beats min(-1) (±3; P < 0.05) in the heat, such that neither now differed significantly from the control trial (P > 0.05). However, despite inducing profound hyperthermia and volitional fatigue, no cognitive degradation was evident in the heat (P > 0.05). Since extensive dehydration was prevented, it appears that thermal strain in the absence of dehydration may have minimal impact upon cognitive function, at least as evaluated within this experiment.

  15. Development of a surveillance case definition for heat-related illness using 911 medical dispatch data.

    PubMed

    Bassil, Kate L; Cole, Donald C; Moineddin, Rahim; Gournis, Effie; Schwartz, Brian; Craig, Alan M; Lou, W Y Wendy; Rea, Elizabeth

    2008-01-01

    The adverse effects of hot weather on public health are of increasing concern. A surveillance system using 911 medical dispatch data for the detection of heat-related illness (HRI) could provide new information on the impact of excessive heat on the population. This paper describes how we identified medical dispatch call codes, called "determinants", that could represent HRI events. Approximately 500 medical dispatch determinants were reviewed in focus groups composed of Emergency Medical Services (EMS) paramedics, dispatchers, physicians, and public health epidemiologists. Each group was asked to select those determinants that might adequately represent HRI. Selections were then assessed empirically using correlations with daily mean temperature over the study period (June 1-August 31,2005). The focus groups identified 12 determinant groupings and ranked them according to specificity for HRI. Of these, "Heat/cold exposure" was deemed the most specific. The call determinant groupings with the clearest positive associations with daily mean temperature empirically were "Heat/cold exposure" (Spearman's correlation coefficient (SCC) 0.71, p < 0.0001) and "Unknown problem (man down)" (SCC 0.21, p = 0.04). Within each grouping, the determinant "Unknown status (3rd party caller)" showed significant associations, SCC = 0.34 (p = 0.001) and SCC = 0.22 (p = 0.03) respectively. Clinically-informed expertise and empirical evidence both contributed to identification of a group of 911 medical dispatch call determinants that plausibly represent HRI events. Once evaluated prospectively, these may be used in public health surveillance to better understand environmental health impacts on human populations and inform targeted public health interventions.

  16. Bacterial Heat Shock Protein GroEL (Hsp64) Exerts Immunoregulatory Effects on T Cells by Utilizing Apoptosis.

    PubMed

    Nalbant, Ayten; Kant, Melis

    2016-01-01

    Aggregatibacter actinomycetemcomitans (Aa) expresses a 64-kDa GroEL protein belonging to the heat shock family of proteins. This protein has been shown to influence human host cells, but the apoptotic capacity of the GroEL protein regarding T cells is not yet known. The purpose of this study was to investigate the ability of A. actinomycetemcomitans GroEL (AaGroEL) protein to induce human peripheral blood T-cell apoptosis. Endogenous, purified AaGroEL protein was used as an antigen. In AaGroEL-treated T cells, the data indicated that phosphatidylserine exposure, an early apoptotic event, was dose- and time-dependent. The AaGroEL-treated T cells were also positive for active caspase-3 in a dose-dependent manner. The rate of AaGroEL-induced apoptosis was suppressed by the addition of the general caspase inhibitor Z-VAD-FMK. Furthermore, cleaved caspase-8 bands (40/36 kDa and 23 kDa) were identified in cells responding to AaGroEL. DNA fragmentation was also detected in the AaGroEL-treated T cells. Overall, we demonstrated that the endogenous GroEL from A. actinomycetemcomitans has the capacity to induce T-cell apoptosis.

  17. Hansenula polymorpha expressed heat shock protein gp96 exerts potent T cell activation activity as an adjuvant.

    PubMed

    Li, Yang; Song, Haolei; Li, Jin; Wang, Yanzhong; Yan, Xiaoli; Zhao, Bao; Zhang, Xiaojun; Wang, Saifeng; Chen, Lizhao; Qiu, Bingsheng; Meng, Songdong

    2011-02-20

    Previous studies together with ours showed that heat shock protein gp96 as an adjuvant induces antigen specific T cell responses against cancer and infectious diseases. However, at present there is no efficient method to obtain high amount of full-length gp96 by in vitro expression. Here, we used the yeast Hansenula polymorpha as an efficient host for gp96 recombinant protein production. The transformant clones with highly expressed recombinant proteins were screened and selected by measuring the halo size which indicates enzymatic hydrolysis of starch in the medium. High-level production of gp96 (around 150mg/mL) was achieved by using high-cell density fed-batch cultivations. We showed that peptide binding of the recombinant protein has similar specificity and intrinsic binding parameters as that of the native gp96. We next examined the self-assembly properties and high-order structures of the recombinant protein. Moreover, the H. polymorpha expressed recombinant gp96 can effectively induce HBV-specific CTL response in immunized mice while Escherichia coli-expressed gp96 cannot. Our results therefore may provide bases for structure and functional studies of gp96 and thereby potentially expedite the development of gp96-based vaccines for immunotherapy of cancer or infectious diseases.

  18. Bacterial Heat Shock Protein GroEL (Hsp64) Exerts Immunoregulatory Effects on T Cells by Utilizing Apoptosis

    PubMed Central

    Nalbant, Ayten; Kant, Melis

    2016-01-01

    Aggregatibacter actinomycetemcomitans (Aa) expresses a 64-kDa GroEL protein belonging to the heat shock family of proteins. This protein has been shown to influence human host cells, but the apoptotic capacity of the GroEL protein regarding T cells is not yet known. The purpose of this study was to investigate the ability of A. actinomycetemcomitans GroEL (AaGroEL) protein to induce human peripheral blood T-cell apoptosis. Endogenous, purified AaGroEL protein was used as an antigen. In AaGroEL-treated T cells, the data indicated that phosphatidylserine exposure, an early apoptotic event, was dose- and time-dependent. The AaGroEL-treated T cells were also positive for active caspase-3 in a dose-dependent manner. The rate of AaGroEL-induced apoptosis was suppressed by the addition of the general caspase inhibitor Z-VAD-FMK. Furthermore, cleaved caspase-8 bands (40/36 kDa and 23 kDa) were identified in cells responding to AaGroEL. DNA fragmentation was also detected in the AaGroEL-treated T cells. Overall, we demonstrated that the endogenous GroEL from A. actinomycetemcomitans has the capacity to induce T-cell apoptosis. PMID:27736933

  19. Summertime acute heat illness in U.S. emergency departments from 2006 through 2010: analysis of a nationally representative sample.

    PubMed

    Hess, Jeremy J; Saha, Shubhayu; Luber, George

    2014-11-01

    Patients with acute heat illness present primarily to emergency departments (EDs), yet little is known regarding these visits. We aimed to describe acute heat illness visits to U.S. EDs from 2006 through 2010 and identify factors associated with hospital admission or with death in the ED. We extracted ED case-level data from the Nationwide Emergency Department Sample (NEDS) for 2006-2010, defining cases as ED visits from May through September with any heat illness diagnosis (ICD-9-CM 992.0-992.9). We correlated visit rates and temperature anomalies, analyzed demographics and ED disposition, identified risk factors for adverse outcomes, and examined ED case fatality rates (CFR). There were 326,497 (95% CI: 308,372, 344,658) cases, with 287,875 (88.2%) treated and released, 38,392 (11.8%) admitted, and 230 (0.07%) died in the ED. Heat illness diagnoses were first-listed in 68%. 74.7% had heat exhaustion, 5.4% heat stroke. Visit rates were highly correlated with annual temperature anomalies (Pearson correlation coefficient 0.882, p = 0.005). Treat-and-release rates were highest for younger adults (26.2/100,000/year), whereas hospitalization and death-in-the-ED rates were highest for older adults (6.7 and 0.03/100,000/year, respectively); all rates were highest in rural areas. Heat stroke had an ED CFR of 99.4/10,000 (95% CI: 78.7, 120.1) visits and was diagnosed in 77.0% of deaths. Adjusted odds of hospital admission or death in the ED were higher among elders, males, urban and low-income residents, and those with chronic conditions. Heat illness presented to the ED frequently, with highest rates in rural areas. Case definitions should include all diagnoses. Visit rates were correlated with temperature anomalies. Heat stroke had a high ED CFR. Males, elders, and the chronically ill were at greatest risk of admission or death in the ED. Chronic disease burden exponentially increased this risk.

  20. Risk Factors for Heat-Related Illness in Washington Crop Workers.

    PubMed

    Spector, June T; Krenz, Jennifer; Blank, Kristina N

    2015-01-01

    Crop workers are at high risk of heat-related illness (HRI) from internal heat generated by heavy physical work, particularly when laboring in hot and humid conditions. The aim of this study was to identify risk factors for HRI symptoms in Washington crop workers using an audio computer-assisted self-interview (A-CASI) instrument that has undergone reliability and validity evaluation. A cross-sectional A-CASI survey of 97 crop workers in Washington State was conducted during the summer of 2013. Potential HRI risk factors in demographic, training, work, hydration, clothing, health, and environmental domains were selected a priori for evaluation. Mixed-effects logistic regression was used to identify risk factors for self-reported symptoms associated with heat strain and HRI (dizziness/light-headedness or heavy sweating) experienced at work in hot conditions. An increase in age was associated with a lower odds of HRI symptoms (odds ratio [OR] = 0.92; 95% confidence interval [CI] = 0.87-0.98). Piece rate compared with hourly payment (OR = 6.20; 95% CI = 1.11-34.54) and needing to walk for more than 3 minutes to get to the toilet, compared with less than 3 minutes (OR = 4.86; 95% CI = 1.18-20.06), were associated with a higher odds of HRI symptoms. In this descriptive study of risk factors for HRI symptoms in Washington crop workers, decreased age (and less work experience), piece rate pay, and longer distance to the toilet were associated with self-reported HRI symptoms. Modifiable workplace factors should be considered in HRI prevention efforts that are evaluated using objective measures in representative working populations.

  1. Numerical approximation of null controls for the heat equation: Ill-posedness and remedies

    NASA Astrophysics Data System (ADS)

    Münch, Arnaud; Zuazua, Enrique

    2010-08-01

    The numerical approximation of exact or trajectory controls for the wave equation is known to be a delicate issue, since the pioneering work of Glowinski-Lions in the nineties, because of the anomalous behavior of the high-frequency spurious numerical waves. Various efficient remedies have been developed and analyzed in the last decade to filter out these high-frequency components: Fourier filtering, Tychonoff's regularization, mixed finite-element methods, multi-grid strategies, etc. Recently convergence rate results have also been obtained. This work is devoted to analyzing this issue for the heat equation, which is the opposite paradigm because of its strong dissipativity and smoothing properties. The existing analytical results guarantee that, at least in some simple situations, as in the finite-difference scheme in 1 - d, the null or trajectory controls for numerical approximation schemes converge. This is due to the intrinsic high-frequency damping of the heat equation that is inherited by its numerical approximation schemes. But when developing numerical simulations the topic appears to be much more subtle and difficult. In fact, efficiently computing the null control for a numerical approximation scheme of the heat equation is a difficult problem in itself. The difficulty is strongly related to the regularizing effect of the heat kernel. The controls of minimal L2-norm are characterized as minima of quadratic functionals on the solutions of the adjoint heat equation, or its numerical versions. These functionals are shown to be coercive in very large spaces of solutions, sufficient to guarantee the L2 character of controls, but very far from being identifiable as energy spaces for the adjoint system. The very weak coercivity of the functionals under consideration makes the approximation problem exponentially ill-posed and the functional framework far from being well adapted to standard techniques in numerical analysis. In practice, the controls of the

  2. Mitigation and prevention of exertional heat stress in firefighters: a review of cooling strategies for structural firefighting and hazardous materials responders.

    PubMed

    McEntire, Serina J; Suyama, Joe; Hostler, David

    2013-01-01

    Most duties performed by firefighters require the use of personal protective equipment, which inhibits normal thermoregulation during exertion, creating an uncompensable heat stress. Structured rest periods are required to correct the effects of uncompensable heat stress and ensure that firefighter safety is maintained and that operations can be continued until their conclusion. While considerable work has been done to optimize firefighter cooling during fireground operations, there is little consensus on when or how cooling should be deployed. A systematic review of cooling techniques and practices among firefighters and hazardous materials operators was conducted to describe the state of the science and provide recommendations for deploying resources for fireground rehab (i.e., structured rest periods during an incident). Five electronic databases were searched using a selected combination of key words. One hundred forty publications were found in the initial search, with 27 meeting all the inclusion criteria. Two independent reviewers performed a qualitative assessment of each article based on nine specific questions. From the selected literature, the efficacy of multiple cooling strategies was compared during exertion and immediately following exertion under varying environmental conditions. When considering the literature available for cooling firefighters and hazardous materials technicians during emergency incident rehabilitation, widespread use of cooling devices does not appear to be warranted if ambient temperature and humidity approximate room temperature and protective garments can be removed. When emergency incident rehabilitation must be conducted in hot or humid conditions, active cooling devices are needed. Hand/forearm immersion is likely the best modality for cooling during rehab under hot, humid conditions; however, this therapy has a number of limitations. Cooling during work thus far has been limited primarily to cooling vests and liquid- or

  3. Heat or Cold: Which One Exerts Greater Deleterious Effects on Health in a Basin Climate City? Impact of Ambient Temperature on Mortality in Chengdu, China.

    PubMed

    Cui, Yan; Yin, Fei; Deng, Ying; Volinn, Ernest; Chen, Fei; Ji, Kui; Zeng, Jing; Zhao, Xing; Li, Xiaosong

    2016-12-10

    Background: Although studies from many countries have estimated the impact of ambient temperature on mortality, few have compared the relative impacts of heat and cold on health, especially in basin climate cities. We aimed to quantify the impact of ambient temperature on mortality, and to compare the contributions of heat and cold in a large basin climate city, i.e., Chengdu (Sichuan Province, China); Methods: We estimated the temperature-mortality association with a distributed lag non-linear model (DLNM) with a maximum lag-time of 21 days while controlling for long time trends and day of week. We calculated the mortality risk attributable to heat and cold, which were defined as temperatures above and below an "optimum temperature" that corresponded to the point of minimum mortality. In addition, we explored effects of individual characteristics; Results: The analysis provides estimates of the overall mortality burden attributable to temperature, and then computes the components attributable to heat and cold. Overall, the total fraction of deaths caused by both heat and cold was 10.93% (95%CI: 7.99%-13.65%). Taken separately, cold was responsible for most of the burden (estimate 9.96%, 95%CI: 6.90%-12.81%), while the fraction attributable to heat was relatively small (estimate 0.97%, 95%CI: 0.46%-2.35%). The attributable risk (AR) of respiratory diseases was higher (19.69%, 95%CI: 14.45%-24.24%) than that of cardiovascular diseases (11.40%, 95%CI: 6.29%-16.01%); Conclusions: In Chengdu, temperature was responsible for a substantial fraction of deaths, with cold responsible for a higher proportion of deaths than heat. Respiratory diseases exert a larger effect on death than other diseases especially on cold days. There is potential to reduce respiratory-associated mortality especially among the aged population in basin climate cities when the temperature deviates beneath the optimum. The result may help to comprehensively assess the impact of ambient temperature

  4. Heat or Cold: Which One Exerts Greater Deleterious Effects on Health in a Basin Climate City? Impact of Ambient Temperature on Mortality in Chengdu, China

    PubMed Central

    Cui, Yan; Yin, Fei; Deng, Ying; Volinn, Ernest; Chen, Fei; Ji, Kui; Zeng, Jing; Zhao, Xing; Li, Xiaosong

    2016-01-01

    Background: Although studies from many countries have estimated the impact of ambient temperature on mortality, few have compared the relative impacts of heat and cold on health, especially in basin climate cities. We aimed to quantify the impact of ambient temperature on mortality, and to compare the contributions of heat and cold in a large basin climate city, i.e., Chengdu (Sichuan Province, China); Methods: We estimated the temperature-mortality association with a distributed lag non-linear model (DLNM) with a maximum lag-time of 21 days while controlling for long time trends and day of week. We calculated the mortality risk attributable to heat and cold, which were defined as temperatures above and below an “optimum temperature” that corresponded to the point of minimum mortality. In addition, we explored effects of individual characteristics; Results: The analysis provides estimates of the overall mortality burden attributable to temperature, and then computes the components attributable to heat and cold. Overall, the total fraction of deaths caused by both heat and cold was 10.93% (95%CI: 7.99%–13.65%). Taken separately, cold was responsible for most of the burden (estimate 9.96%, 95%CI: 6.90%–12.81%), while the fraction attributable to heat was relatively small (estimate 0.97%, 95%CI: 0.46%–2.35%). The attributable risk (AR) of respiratory diseases was higher (19.69%, 95%CI: 14.45%–24.24%) than that of cardiovascular diseases (11.40%, 95%CI: 6.29%–16.01%); Conclusions: In Chengdu, temperature was responsible for a substantial fraction of deaths, with cold responsible for a higher proportion of deaths than heat. Respiratory diseases exert a larger effect on death than other diseases especially on cold days. There is potential to reduce respiratory-associated mortality especially among the aged population in basin climate cities when the temperature deviates beneath the optimum. The result may help to comprehensively assess the impact of ambient

  5. Case ascertainment of heat illness in the British Army: evidence of under-reporting from analysis of Medical and Command notifications, 2009–2013

    PubMed Central

    Stacey, Michael J; Brett, S; Woods, D; Jackson, S; Ross, D

    2016-01-01

    Background Heat illness in the Armed Forces is considered preventable. The UK military relies upon dual Command and Medical reporting for case ascertainment, investigation of serious incidents and improvement of preventive practices and policy. This process could be vulnerable to under-reporting. Objectives To establish whether heat illness in the British Army has been under-reported, by reviewing concordance of reporting to the Army Incident Notification Cell (AINC) and the Army Health Unit (AHU) and to characterise the burden of heat illness reported by these means. Methods Analysis of anonymised reporting databases held by the AHU and AINC, for the period 2009–2013. Results 565 unique cases of heat illness were identified. Annual concordance of reporting ranged from 9.6% to 16.5%. The overall rate was 13.3%. July was the month with the greatest number of heat illness reports (24.4% of total reporting) and the highest concordance rate (30%). Reports of heat illness from the UK (n=343) exceeded overseas notifications (n=221) and showed better concordance (17.1% vs 12.8%). The annual rate of reported heat illness varied widely, being greater in full-time than reservist personnel (87 vs 23 per100 000) and highest in full-time untrained personnel (223 per100 000). Conclusions The risk of heat illness was global, year-round and showed dynamic local variation. Failure to dual-report casualties impaired case ascertainment of heat illness across Command and Medical chains. Current preventive guidance, as applied in training and on operations, should be critically evaluated to ensure that risk of heat illness is reduced as low as possible. Clear procedures for casualty notification and surveillance are required in support of this and should incorporate communication within and between the two reporting chains. PMID:25717054

  6. Modeling and Syndromic Surveillance for Estimating Weather-Induced Heat-Related Illness

    PubMed Central

    Perry, Alexander G.; Korenberg, Michael J.; Hall, Geoffrey G.; Moore, Kieran M.

    2011-01-01

    This paper compares syndromic surveillance and predictive weather-based models for estimating emergency department (ED) visits for Heat-Related Illness (HRI). A retrospective time-series analysis of weather station observations and ICD-coded HRI ED visits to ten hospitals in south eastern Ontario, Canada, was performed from April 2003 to December 2008 using hospital data from the National Ambulatory Care Reporting System (NACRS) database, ED patient chief complaint data collected by a syndromic surveillance system, and weather data from Environment Canada. Poisson regression and Fast Orthogonal Search (FOS), a nonlinear time series modeling technique, were used to construct models for the expected number of HRI ED visits using weather predictor variables (temperature, humidity, and wind speed). Estimates of HRI visits from regression models using both weather variables and visit counts captured by syndromic surveillance as predictors were slightly more highly correlated with NACRS HRI ED visits than either regression models using only weather predictors or syndromic surveillance counts. PMID:21647355

  7. From agricultural fields to urban asphalt: the role of worker education to promote California's heat illness prevention standard.

    PubMed

    Riley, Kevin; Delp, Linda; Cornelio, Deogracia; Jacobs, Sarah

    2012-01-01

    This article describes an innovative approach to reach and educate workers and worker advocates about California's outdoor heat illness prevention standard. In 2010, Cal/OSHA initiated a statewide education campaign to reduce heat-related illnesses and fatalities and increase awareness of the standard's requirements. In Southern California, the UCLA Labor Occupational Safety and Health Program (LOSH) focused on three principal strategies of community-based outreach, popular education, and organizational capacity building. Central to the LOSH approach was the integration of health promotores into core program planning and training activities and the expansion of campaign activities to a wide variety of rural and urban workers. We describe each of these strategies and analyze the possibilities and constraints of worker education to support implementation of this standard, particularly given the vulnerabilities of the impacted workforce, the often precarious nature of employment arrangements for these workers, and the resource limitations of Cal/OSHA.

  8. Heat Stress Illness Emergency Department Visits in National Environmental Public Health Tracking States, 2005-2010.

    PubMed

    Fechter-Leggett, Ethan D; Vaidyanathan, Ambarish; Choudhary, Ekta

    2016-02-01

    Variability of heat stress illness (HSI) by urbanicity and climate region has rarely been considered in previous HSI studies. We investigated temporal and geographic trends in HSI emergency department (ED) visits in CDC Environmental Public Health Tracking Network (Tracking) states for 2005-2010. We obtained county-level HSI ED visit data for 14 Tracking states. We used the National Center for Health Statistics Urban-Rural Classification Scheme to categorize counties by urbanicity as (1) large central metropolitan (LCM), (2) large fringe metropolitan, (3) small-medium metropolitan, or (4) nonmetropolitan (NM). We also assigned counties to one of six US climate regions. Negative binomial regression was used to examine trends in HSI ED visits over time across all counties and by urbanicity for each climate region, adjusting for pertinent variables. During 2005-2010, there were 98,462 HSI ED visits in the 14 states. ED visits for HSI decreased 3.0% (p < 0.01) per year. Age-adjusted incidence rates of HSI ED visits increased from most urban to most rural. Overall, ED visits were significantly higher for NM areas (IRR = 1.41, p < 0.01) than for LCM areas. The same pattern was observed in all six climate regions; compared with LCM, NM areas had from 14 to 90% more ED visits for HSI. These findings of significantly increased HSI ED visit rates in more rural settings suggest a need to consider HSI ED visit variability by county urbanicity and climate region when designing and implementing local HSI preventive measures and interventions.

  9. Heat Stress Illness Emergency Department Visits in National Environmental Public Health Tracking States, 2005–2010

    PubMed Central

    Fechter-Leggett, Ethan D.; Vaidyanathan, Ambarish; Choudhary, Ekta

    2015-01-01

    Variability of heat stress illness (HSI) by urbanicity and climate region has rarely been considered in previous HSI studies. We investigated temporal and geographic trends in HSI emergency department (ED) visits in CDC Environmental Public Health Tracking Network (Tracking) states for 2005–2010. We obtained county-level HSI ED visit data for 14 Tracking states. We used the National Center for Health Statistics Urban-Rural Classification Scheme to categorize counties by urbanicity as 1) large central metropolitan (LCM), 2) large fringe metropolitan (LFM), 3) small–medium metropolitan (SMM), or 4) nonmetropolitan (NM). We also assigned counties to one of six US climate regions. Negative binomial regression was used to examine trends in HSI ED visits over time across all counties and by urbanicity for each climate region, adjusting for pertinent variables. During 2005–2010, there were 98,462 HSI ED visits in the 14 states. ED visits for HSI decreased 3.0 % (p < 0.01) per year. Age-adjusted incidence rates of HSI ED visits increased from most urban to most rural. Overall, ED visits were significantly higher for NM areas (IRR = 1.41, p < 0.01) than for LCM areas. The same pattern was observed in all six climate regions; compared with LCM, NM areas had from 14 % to 90 % more ED visits for HSI. These findings of significantly increased HSI ED visit rates in more rural settings suggest a need to consider HSI ED visit variability by county urbanicity and climate region when designing and implementing local HSI preventive measures and interventions. PMID:26205070

  10. Medical Evaluation for Exposure Extremes: Heat.

    PubMed

    Pryor, Riana R; Bennett, Brad L; OʼConnor, Francis G; Young, Justin M J; Asplund, Chad A

    2015-09-01

    Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.

  11. Medical Evaluation for Exposure Extremes: Heat.

    PubMed

    Pryor, Riana R; Bennett, Brad L; O'Connor, Francis G; Young, Justin M J; Asplund, Chad A

    2015-12-01

    Exertional heat illness can be a serious consequence of sports or exercise in hot environments. Participants can possess intrinsic or face extrinsic risk factors that may increase their risk for heat-related illness. Knowledge of the physiology and pathology of heat illness, identification of risk factors, and strategies to combat heat accumulation will aid both the practitioner and the participant in preparing for activities that occur in hot environments. Through preparation and mitigation of risk, safe and enjoyable wilderness adventure can be pursued.

  12. Evidence-based practice and the recognition and treatment of exertional heat stroke, part I: a perspective from the athletic training educator.

    PubMed

    Mazerolle, Stephanie M; Ruiz, Roberto C; Casa, Douglas J; Pagnotta, Kelly D; Pinkus, Danielle E; Armstrong, Lawrence E; Maresh, Carl M

    2011-01-01

    Athletic trainers (ATs) know to diagnose exertional heat stroke (EHS) via rectal thermometry (T(re)) and to treat EHS via cold-water immersion (CWI) but do not implement these recommendations in clinical practice. To gain an understanding of educational techniques used to deliver content regarding EHS. Qualitative study. In-person focus groups at the National Athletic Trainers' Association (NATA) Annual Meeting in June 2009 and 2 follow-up telephone interviews to confirm emergent themes. Thirteen AT educators (11 men, 2 women) from programs accredited by the Commission on Accreditation of Athletic Training Education, with an average of 22 ± 9 years of clinical experience and 16 ± 10 years of experience as educators. Five NATA districts were represented. Data were analyzed using inductive content analysis. Peer review and data source triangulation also were conducted to establish trustworthiness. Four themes emerged from the analysis: educational techniques, educational competencies, previous educational training, and privacy/public opinion. Educational techniques highlighted the lack of hands-on training for T(re) and CWI. Educational competencies referred to the omission of T(re) and CWI as psychomotor skills. Previous educational training addressed educators not having the skills or comfort with the skills necessary to properly educate students. Privacy/public opinion comprised external inputs from various groups (parents and coaches), legal considerations, and social bias. Educators supplied students with the appropriate didactic knowledge about EHS, but their lack of training and misgivings about T(re) prevented them from allowing students to gain competence with this skill. Until the NATA competencies state the need to teach T(re) and CWI and until educators are provided with their own learning opportunities, evidence-based practice regarding EHS will be lacking.

  13. Evidence-Based Medicine and the Recognition and Treatment of Exertional Heat Stroke, Part II: A Perspective From the Clinical Athletic Trainer

    PubMed Central

    Mazerolle, Stephanie M.; Pinkus, Danielle E.; Casa, Douglas J.; McDermott, Brendon P.; Pagnotta, Kelly D.; Ruiz, Roberto C.; Armstrong, Lawrence E.; Maresh, Carl M.

    2011-01-01

    Context: Exertional heat stroke (EHS) is one of the leading causes of death in athletes. Certified athletic trainers (ATs) demonstrate strong knowledge of recommended practices with EHS but are apprehensive in implementing 2 basic procedures: rectal temperature assessment and cold water immersion. This apprehension might lead to deaths from EHS that could have been prevented. Objective: To investigate why collegiate and high school ATs do not implement best practices for the recognition and treatment of EHS. Design: Qualitative study. Setting: In-person focus groups consisting of 3 to 6 collegiate or high school ATs. Patients or Other Participants: A total of 19 ATs (9 men, 10 women; age = 36 ± 10 years, length of certification = 12 ± 9 years) employed at either the collegiate (n = 10) or high school (n = 9) level participated in the study. Data Collection and Analysis: Interviews were transcribed verbatim, and data were analyzed using deductive data analysis. Peer review and multiple-analyst data triangulation were conducted to establish trustworthiness of the data. Results: Five emergent themes explained the lack of evidence-based practice (EBP) regarding recognition and treatment of EHS. Three themes (lack of knowledge, comfort level, lack of initiative) were common in both the collegiate and high school settings, and 2 separate themes (liability concerns, lack of resources) were present in the high school setting. Conclusions: Our findings are consistent with those in the literature on EBP and EHS. Regardless of clinical setting, ATs have basic information on recognition and treatment of EHS, but 5 themes act as barriers to implementing proper management in the clinical setting. Workshops or hands-on training sessions need to be made available to improve students' comfort levels so ATs will implement EBP into everyday settings. PMID:22488141

  14. Evidence-Based Practice and the Recognition and Treatment of Exertional Heat Stroke, Part I: A Perspective From the Athletic Training Educator

    PubMed Central

    Mazerolle, Stephanie M.; Ruiz, Roberto C.; Casa, Douglas J.; Pagnotta, Kelly D.; Pinkus, Danielle E.; Armstrong, Lawrence E.; Maresh, Carl M.

    2011-01-01

    Context: Athletic trainers (ATs) know to diagnose exertional heat stroke (EHS) via rectal thermometry (Tre) and to treat EHS via cold-water immersion (CWI) but do not implement these recommendations in clinical practice. Objective: To gain an understanding of educational techniques used to deliver content regarding EHS. Design: Qualitative study. Setting: In-person focus groups at the National Athletic Trainers' Association (NATA) Annual Meeting in June 2009 and 2 follow-up telephone interviews to confirm emergent themes. Patients or Other Participants: Thirteen AT educators (11 men, 2 women) from programs accredited by the Commission on Accreditation of Athletic Training Education, with an average of 22 ± 9 years of clinical experience and 16 ± 10 years of experience as educators. Five NATA districts were represented. Data Collection and Analysis: Data were analyzed using inductive content analysis. Peer review and data source triangulation also were conducted to establish trustworthiness. Results: Four themes emerged from the analysis: educational techniques, educational competencies, previous educational training, and privacy/public opinion. Educational techniques highlighted the lack of hands-on training for Tre and CWI. Educational competencies referred to the omission of Tre and CWI as psychomotor skills. Previous educational training addressed educators not having the skills or comfort with the skills necessary to properly educate students. Privacy/public opinion comprised external inputs from various groups (parents and coaches), legal considerations, and social bias. Conclusions: Educators supplied students with the appropriate didactic knowledge about EHS, but their lack of training and misgivings about Tre prevented them from allowing students to gain competence with this skill. Until the NATA competencies state the need to teach Tre and CWI and until educators are provided with their own learning opportunities, evidence-based practice regarding EHS

  15. Cost of preventing workplace heat-related illness through worker breaks and the benefit of climate-change mitigation

    NASA Astrophysics Data System (ADS)

    Takakura, Jun'ya; Fujimori, Shinichiro; Takahashi, Kiyoshi; Hijioka, Yasuaki; Hasegawa, Tomoko; Honda, Yasushi; Masui, Toshihiko

    2017-06-01

    The exposure of workers to hot environments is expected to increase as a result of climate change. In order to prevent heat-related illness, it is recommended that workers take breaks during working hours. However, this would lead to reductions in worktime and labor productivity. In this study, we estimate the economic cost of heat-related illness prevention through worker breaks associated with climate change under a wide range of climatic and socioeconomic conditions. We calculate the worktime reduction based on the recommendation of work/rest ratio and the estimated future wet bulb glove temperature, which is an index of heat stresses. Corresponding GDP losses (cost of heat-related illness prevention through worker breaks) are estimated using a computable general equilibrium model throughout this century. Under the highest emission scenario, GDP losses in 2100 will range from 2.6 to 4.0% compared to the current climate conditions. On the other hand, GDP losses will be less than 0.5% if the 2.0 °C goal is achieved. The benefit of climate-change mitigation for avoiding worktime loss is comparable to the cost of mitigation (cost of the greenhouse gas emission reduction) under the 2.0 °C goal. The relationship between the cost of heat-related illness prevention through worker breaks and global average temperature rise is approximately linear, and the difference in economic loss between the 1.5 °C goal and the 2.0 °C goal is expected to be approximately 0.3% of global GDP in 2100. Although climate mitigation and socioeconomic development can limit the vulnerable regions and sectors, particularly in developing countries, outdoor work is still expected to be affected. The effectiveness of some adaptation measures such as additional installation of air conditioning devices or shifting the time of day for working are also suggested. In order to reduce the economic impacts, adaptation measures should also be implemented as well as pursing ambitious climate change

  16. Circulatory endotoxin concentration and cytokine profile in response to exertional-heat stress during a multi-stage ultra-marathon competition.

    PubMed

    Gill, Samantha K; Teixeira, Ana; Rama, Luis; Prestes, Jonato; Rosado, Fatima; Hankey, Joanne; Scheer, Volker; Hemmings, Krystal; Ansley-Robson, Paula; Costa, Ricardo J S

    2015-01-01

    Exertional-heat stress has the potential to disturb intestinal integrity, leading to enhanced permeability of enteric pathogenic micro-organisms and associated clinical manifestations. The study aimed to determine the circulatory endotoxin concentration and cytokine profile of ultra-endurance runners (UER, n=19) and a control group (CON, n=12) during a five stage 230km ultra-marathon (mean ± SD: 27h38min ± 3h55min) conducted in hot and dry environmental conditions (30ºC to 40ºC and 31% to 40% relative humidity). Body mass and tympanic temperature were measured, and venous blood samples were taken before (pre-stage) and immediately after (post-stage) each stage of the ultra-marathon for the analysis of gram-negative bacterial endotoxin, C-reactive protein, cytokine profile (IL-6, IL-1β, TNF-α, IFN-γ, IL-10, and IL- 1ra), and plasma osmolality. Gastrointestinal symptoms and perceptive thermal tolerance rating were also monitored throughout competition. Mean exercise-induced body mass loss over the five stages ranged 1.0% to 2.5%. Pre- and poststage plasma osmolality in UER ranged277 to 282mOsmol/kg and 286 to 297 mOsmol/kg, respectively. Pre-stage concentrations of endotoxin (peak: 21% at Stage 5), C-reactive protein (889% at Stage 3), IL-6 (152% at Stage 2), IL-1β (95% at Stage 5), TNF-α (168% at Stage 5), IFN-γ (102% at Stage 5),IL-10 (1271% at Stage 3), and IL-1ra (106% at Stage 5) increased as the ultra-marathon progressed in UER; while no changes in CON were observed (except for IL-1β, 71% at Stage 5). Pre- to post-stage increases were observed for endotoxin (peak: 22% at Stage 3), C-reactive protein (25% at Stage 1), IL-6 (238% at Stage 1), IL-1β (64% at Stage 1), TNF-α (101% at Stage 1), IFN-γ (39% at Stage 1), IL-10 (1100% at Stage 1), and IL-1ra(207% at Stage 1) concentrations in UER. Multi-stage ultra-marathon competition in the heat resulted in a modest circulatory endotoxaemia accompanied by a pronounced pro-inflammatory cytokinaemia by post

  17. Ambient temperature and emergency department visits for heat-related illness in North Carolina, 2007-2008.

    PubMed

    Lippmann, Steven J; Fuhrmann, Christopher M; Waller, Anna E; Richardson, David B

    2013-07-01

    To estimate the association between environmental temperatures and the occurrence of emergency department visits for heat-related illness in North Carolina, a large Southern state with 85 rural and 15 urban counties; approximately half the state's population resides in urban counties. County-level daily emergency department visit counts and daily mean temperatures for the period 1/1/2007-12/31/2008 were merged to form a time-series data structure. Incidence rates were calculated by sex, age group, region, day of week, and month. Incidence rate ratios were estimated using categorical and linear spline Poisson regression models and heterogeneity of the temperature-emergency department visit association was assessed using product interaction terms in the Poisson models. In 2007-2008, there were 2539 emergency department visits with heat-related illness as the primary diagnosis. Incidence rates were highest among young adult males (19-44 year age group), in rural counties, and in the Sandhills region. Incidence rates increased exponentially with temperatures over 15.6 °C (60 °F). The overall incidence rate ratio for each 1 °C increase over 15.6 °C in daily mean temperature was 1.43 (95%CI: 1.41, 1.45); temperature effects were greater for males than females, for 45-64 year olds, and for residents of rural counties than residents of urban counties. As heat response plans are developed, they should incorporate findings on climate effects for both mortality and morbidity. While forecast-triggered heat health warning systems are essential to mitigate the effects of extreme heat events, public health preparedness plans should not ignore the effects of more persistently observed high environmental temperatures like those that occur throughout the warm season in North Carolina. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Heat illness surveillance in schoolboys participating in physical education class in tropical climate: an analytical prospective descriptive study

    PubMed Central

    Sanguanrungsirikul, Sompol; Pitayanon, Chatchatchai

    2012-01-01

    Objectives This study aimed to determine thermoregulatory and cardiovascular responses as well as the occurrence of heat illness in children exercising outdoors in physical education class under hot and humid climate. Little information regarding this issue under real-life situation is available, especially in the Southeast Asia. Design Analytical, prospective descriptive study. Setting A primary school in Bangkok, Thailand. Participants A total of 457 schoolboys (aged 5.5–12 years) were observed while exercising outdoors during their physical education classes throughout the academic year of 2009, including semester 1 (between July and September 2009) and semester 2 (between November 2009 and February 2010). Primary and secondary outcome measures Primary outcome measure was tympanic temperature. Secondary outcome measures included blood pressure, heart rate, hydration status and the occurrence of heat-related illness. Results Outdoor physical activity consisted of skill practice (duration 24.11±11.04 min, intensity <3 metabolic equivalent of tasks) and playing sports (duration 11.48±5.53 min, intensity 2.6–8.8 metabolic equivalent of tasks). After exercise, tympanic temperature increased by 0.66±0.41°C. There were 20 (4.4%) students whose ear temperature exceeded 38°C, 18 of whom did not consume water. The RR of increasing body temperature up to 38°C in overweight students was 2.1-fold higher than normal-weight students. The per cent change in mean arterial pressure and heart rate increased by 20.16±15.34% and 23.94±19.78%, respectively. Sweat and dehydration rates were 391.16±186.75 ml/h and 0.63±0.26%, respectively. No evidence of heat illness was found. Wet bulb globe temperatures of semesters 1 and 2 were 29.95±1.87°C and 28.32±2.39°C, respectively. Conclusions There is an increased risk for heat illness during outdoor activities in physical education class in primary school children, especially those who are overweight and have poor

  19. Heat illness surveillance in schoolboys participating in physical education class in tropical climate: an analytical prospective descriptive study.

    PubMed

    Somboonwong, Juraiporn; Sanguanrungsirikul, Sompol; Pitayanon, Chatchatchai

    2012-01-01

    This study aimed to determine thermoregulatory and cardiovascular responses as well as the occurrence of heat illness in children exercising outdoors in physical education class under hot and humid climate. Little information regarding this issue under real-life situation is available, especially in the Southeast Asia. Analytical, prospective descriptive study. A primary school in Bangkok, Thailand. A total of 457 schoolboys (aged 5.5-12 years) were observed while exercising outdoors during their physical education classes throughout the academic year of 2009, including semester 1 (between July and September 2009) and semester 2 (between November 2009 and February 2010). Primary outcome measure was tympanic temperature. Secondary outcome measures included blood pressure, heart rate, hydration status and the occurrence of heat-related illness. Outdoor physical activity consisted of skill practice (duration 24.11±11.04 min, intensity <3 metabolic equivalent of tasks) and playing sports (duration 11.48±5.53 min, intensity 2.6-8.8 metabolic equivalent of tasks). After exercise, tympanic temperature increased by 0.66±0.41°C. There were 20 (4.4%) students whose ear temperature exceeded 38°C, 18 of whom did not consume water. The RR of increasing body temperature up to 38°C in overweight students was 2.1-fold higher than normal-weight students. The per cent change in mean arterial pressure and heart rate increased by 20.16±15.34% and 23.94±19.78%, respectively. Sweat and dehydration rates were 391.16±186.75 ml/h and 0.63±0.26%, respectively. No evidence of heat illness was found. Wet bulb globe temperatures of semesters 1 and 2 were 29.95±1.87°C and 28.32±2.39°C, respectively. There is an increased risk for heat illness during outdoor activities in physical education class in primary school children, especially those who are overweight and have poor hydration status.

  20. The rate and risk of heat-related illness in hospital emergency departments during the 1995 Chicago heat disaster.

    PubMed

    Rydman, R J; Rumoro, D P; Silva, J C; Hogan, T M; Kampe, L M

    1999-02-01

    To conduct an Emergency Department (ED)-based treated prevalence study of heat morbidity and to estimate the rate and risk of heat morbid events for all Chicago MSA EDs (N = 95; 2.7 million visits per year). ED patient log data were compiled from 13 randomly selected hospitals located throughout the Chicago MSA during the 2 weeks of the 1995 heat disaster and from the same 2-week period in 1994 (controls). Measurements included: age, sex, date, and time of ED service, up to three ICD-9 diagnoses, and disposition. Heat morbidity for Chicago MSA hospital EDs was calculated at 4,224 (95% CI = 2964-5488) cases. ED heat morbidity increased significantly 5 days prior to the first heat-related death. In 1995, there was an increase in the estimated relative risk for the city = 3.85 and suburbs = 1.89 over the control year of 1994. Real time ED-based computer automated databanks should be constructed to improve public health response to infectious or noninfectious outbreaks. Rapid area-wide M&M tabulations can be used for advancing the effectiveness of community-based prevention programs, and anticipating hospital ED resource allocation.

  1. Symptoms of respiratory illness in young children and the use of wood-burning stoves for indoor heating.

    PubMed

    Honicky, R E; Osborne, J S; Akpom, C A

    1985-03-01

    The occurrence of symptoms of respiratory illness among preschool children living in homes heated by wood-burning stoves was examined by conducting an historical prospective study (n = 62) with an internal control group (matched for age, sex, and town of residence). Exposures of subjects were not significantly different (P greater than .05) with respect to parental smoking, urea-formaldehyde foam insulation, and use of humidifiers. The control group made significantly greater use of gas stoves for cooking whereas the study group made greater use of electric stoves for cooking and of air filters (P less than .05). Only one home used a kerosene space heater. During the winter of 1982, moderate and severe symptoms in all categories were significantly greater for the study group compared with the control group (P less than .001). These differences could not be accounted for by medical histories (eg, allergies, asthma), demographic or socioeconomic characteristics, or by exposure to sources of indoor air pollution other than wood-burning stoves. Present findings suggest that indoor heating with wood-burning stoves may be a significant etiologic factor in the occurrence of symptoms of respiratory illness in young children.

  2. A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness.

    PubMed

    Cox, Andrew T; Schoonbaert, I; Trinick, T; Phillips, A; Marion, D

    2016-06-01

    We present a 27-year old British nurse admitted to the Kerry Town Ebola Treatment Unit, Sierra Leone, with symptoms fitting suspect-Ebola virus disease (EVD) case criteria. A diagnosis of Plasmodium falciparum malaria and heat illness was ultimately made, both of which could have been prevented through employing simple measures not utilised in this case. The dual pathology of her presentation was atypical for either disease meaning EVD could not be immediately excluded. She remained isolated in the red zone until 72 h from symptom onset. This case highlights why force protection measures are important to reduce the incidence of both malaria and heat illness in deployed military and civilian populations. These prevention measures are particularly pertinent during the current EVD epidemic where presenting with these pathologies requires clinical assessment in the 'red zone' of an Ebola treatment unit. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Symptoms of respiratory illness in young children and the use of wood-burning stoves for indoor heating

    SciTech Connect

    Honicky, R.E.; Osborne, J.S.; Akpom, C.A.

    1985-03-01

    The occurrence of symptoms of respiratory illness among preschool children living in homes heated by wood-burning stoves was examined by conducting an historical prospective study (n . 62) with an internal control group (matched for age, sex, and town of residence). Exposures of subjects were not significantly different (P greater than .05) with respect to parental smoking, urea-formaldehyde foam insulation, and use of humidifiers. The control group made significantly greater use of gas stoves for cooking whereas the study group made greater use of electric stoves for cooking and of air filters (P less than .05). Only one home used a kerosene space heater. During the winter of 1982, moderate and severe symptoms in all categories were significantly greater for the study group compared with the control group (P less than .001). These differences could not be accounted for by medical histories (eg, allergies, asthma), demographic or socioeconomic characteristics, or by exposure to sources of indoor air pollution other than wood-burning stoves. Present findings suggest that indoor heating with wood-burning stoves may be a significant etiologic factor in the occurrence of symptoms of respiratory illness in young children.

  4. Effect of aspirin on acute changes in peripheral arterial stiffness and endothelial function following exertional heat stress in firefighters: The factorial group results of the Enhanced Firefighter Rehab Trial.

    PubMed

    Olafiranye, Oladipupo; Hostler, David; Winger, Daniel G; Wang, Li; Reis, Steven E

    2015-06-01

    Peripheral arterial stiffness and endothelial function, which are independent predictors of cardiac events, are abnormal in firefighters. We examined the effects of aspirin on peripheral arterial stiffness and endothelial function in firefighters. Fifty-two firefighters were randomized to receive daily 81 mg aspirin or placebo for 14 days before treadmill exercise in thermal protection clothing, and a single dose of 325 mg aspirin or placebo immediately following exertion. Peripheral arterial augmentation index adjusted for a heart rate of 75 (AI75) and reactive hyperemia index (RHI) were determined immediately before, and 30, 60, and 90 minutes after exertion. Low-dose aspirin was associated with lower AI75 (-15.25±9.25 vs -8.08±10.70, p=0.014) but not RHI. On repeated measures analysis, treatment with low-dose aspirin before, but not single-dose aspirin after exertion, was associated with lower AI75 following exertional heat stress (p=0.018). Low-dose aspirin improved peripheral arterial stiffness and wave reflection but not endothelial function in firefighters. © The Author(s) 2015.

  5. Heat Stress Illness in a Mechanized Infantry Brigade During Simulated Combat at Fort Irwin

    DTIC Science & Technology

    1994-05-01

    Soldiers carry with them casualty cards in the event they are hit in a MILES engagement. These casualty cards are small preprinted Graphic Training...Aids (GTA 8-11-5) that assign soldiers an injury or disease and designate whether they will be a liter case or ambulatory. The casualty card also gives...the data balanced positive correlations in other data segments. There are plausible explanations for the principal features of the heat stress incident

  6. Phosgene Poisoning Caused by the Use of Chemical Paint Removers Containing Methylene Chloride in Ill-Ventilated Rooms Heated by Kerosene Stoves

    PubMed Central

    Gerritsen, W. B.; Buschmann, C. H.

    1960-01-01

    Two cases resembling poisoning by phosgene following the use of a paint remover containing methylene chloride in ill-ventilated rooms heated by an oil stove are described. Experiments carried out under similar conditions demonstrated the production of phosgene in toxic concentrations. The potential hazards from non-inflammable solvents are discussed. PMID:13827592

  7. Chronic Exertional Compartment Syndrome

    MedlinePlus

    ... through the pain; that can lead to permanent muscle or nerve damage. Sometimes chronic exertional compartment syndrome is mistaken for shin splints, a more common cause of leg pain in young people who do a lot of vigorous weight- ...

  8. Identifying Individual Risk Factors and Documenting the Pattern of Heat-Related Illness through Analyses of Hospitalization and Patterns of Household Cooling

    PubMed Central

    Schmeltz, Michael T.; Sembajwe, Grace; Marcotullio, Peter J.; Grassman, Jean A.; Himmelstein, David U.; Woolhandler, Stephanie

    2015-01-01

    Background As climate change increases the frequency and intensity of extreme heat events researchers and public health officials must work towards understanding the causes and outcomes of heat-related morbidity and mortality. While there have been many studies on both heat-related illness (HRI), there are fewer on heat-related morbidity than on heat-related mortality. Objective To identify individual and environmental risk factors for hospitalizations and document patterns of household cooling. Methods We performed a pooled cross-sectional analysis of secondary U.S. data, the Nationwide Inpatient Sample. Risk ratios were calculated from multivariable models to identify risk factors for hospitalizations. Hierarchical modeling was also employed to identify relationships between individual and hospital level predictors of hospitalizations. Patterns of air conditioning use were analyzed among the vulnerable populations identified. Results Hospitalizations due to HRI increased over the study period compared to all other hospitalizations. Populations at elevated risk for HRI hospitalization were blacks, males and all age groups above the age of 40. Those living in zip-codes in the lowest income quartile and the uninsured were also at an increased risk. Hospitalizations for HRI in rural and small urban clusters were elevated, compared to urban areas. Conclusions Risk factors for HRI include age greater than 40, male gender and hospitalization in rural areas or small urban clusters. Our analysis also revealed an increasing pattern of HRI hospitalizations over time and decreased association between common comorbidities and heat illnesses which may be indicative of underreporting. PMID:25742021

  9. Policy statement—Climatic heat stress and exercising children and adolescents.

    PubMed

    Bergeron, Michael F; Devore, Cynthia; Rice, Stephen G

    2011-09-01

    Results of new research indicate that, contrary to previous thinking, youth do not have less effective thermoregulatory ability, insufficient cardiovascular capacity, or lower physical exertion tolerance compared with adults during exercise in the heat when adequate hydration is maintained. Accordingly, besides poor hydration status, the primary determinants of reduced performance and exertional heat-illness risk in youth during sports and other physical activities in a hot environment include undue physical exertion, insufficient recovery between repeated exercise bouts or closely scheduled same-day training sessions or rounds of sports competition, and inappropriately wearing clothing, uniforms, and protective equipment that play a role in excessive heat retention. Because these known contributing risk factors are modifiable, exertional heat illness is usually preventable. With appropriate preparation, modifications, and monitoring, most healthy children and adolescents can safely participate in outdoor sports and other physical activities through a wide range of challenging warm to hot climatic conditions.

  10. Heat shock protein 90 inhibition results in altered downstream signaling of mutant KIT and exerts synergistic effects on Kasumi-1 cells when combining with histone deacetylase inhibitor.

    PubMed

    Yu, Wenjuan; Wang, Jianxiang; Jin, Jie; Qian, Wenbin; Qian, Jiejing; Cheng, Yizhi; Wang, Lei

    2011-09-01

    KIT mutations may be associated with a poor prognosis in t(8;21) AML. Heat shock protein 90 (Hsp90) is a molecular chaperone frequently used by cancer cells to stabilize mutant oncoproteins. Inhibition of Hsp90 by 17-allylamino-17-demethoxygeldanamycin (17-AAG) disrupted downstream signaling pathways of mutant KIT in Kasumi-1 cells. AML1-ETO fusion gene and mutated KIT act as "two-hit" factors in Kasumi-1 cells. Histone deacetylation (HDAC) inhibitors sodium phenylbutyrate (PB) and valproic acid (VPA) block AML1-ETO. Co-treatment with 17-AAG and PB or 17-AAG and VPA resulted in a synergistic effect in Kasumi-1 cells. Our results confirmed that Hsp90 and mutated KIT were valid molecular targets in the therapy of AML. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Ergonomics and Beyond: Understanding How Chemical and Heat Exposures and Physical Exertions at Work Affect Functional Ability, Injury, and Long-Term Health.

    PubMed

    Ross, Jennifer A; Shipp, Eva M; Trueblood, Amber B; Bhattacharya, Amit

    2016-08-01

    To honor Tom Waters's work on emerging occupational health issues, we review the literature on physical along with chemical exposures and their impact on functional outcomes. Many occupations present the opportunity for exposure to multiple hazardous exposures, including both physical and chemical factors. However, little is known about how these different factors affect functional ability and injury. The goal of this review is to examine the relationships between these exposures, impairment of the neuromuscular and musculoskeletal systems, functional outcomes, and health problems with a focus on acute injury. Literature was identified using online databases, including PubMed, Ovid Medline, and Google Scholar. References from included articles were searched for additional relevant articles. This review documented the limited existing literature that discussed cognitive impairment and functional disorders via neurotoxicity for physical exposures (heat and repetitive loading) and chemical exposures (pesticides, volatile organic compounds [VOCs], and heavy metals). This review supports that workers are exposed to physical and chemical exposures that are associated with negative health effects, including functional impairment and injury. Innovation in exposure assessment with respect to quantifying the joint exposure to these different exposures is especially needed for developing risk assessment models and, ultimately, preventive measures. Along with physical exposures, chemical exposures need to be considered, alone and in combination, in assessing functional ability and occupationally related injuries. © 2016, Human Factors and Ergonomics Society.

  12. A Comprehensive Evaluation of the Burden of Heat-Related Illness and Death within the Florida Population

    PubMed Central

    Harduar Morano, Laurel; Watkins, Sharon; Kintziger, Kristina

    2016-01-01

    The failure of the human body to thermoregulate can lead to severe outcomes (e.g., death) and lasting physiological damage. However, heat-related illness (HRI) is highly preventable via individual- and community-level modification. A thorough understanding of the burden is necessary for effective intervention. This paper describes the burden of severe HRI morbidity and mortality among residents of a humid subtropical climate. Work-related and non-work-related HRI emergency department (ED) visits, hospitalizations, and deaths among Florida residents during May to October (2005–2012) were examined. Sub-groups susceptible to HRI were identified. The age-adjusted rates/100,000 person-years for non-work-related HRI were 33.1 ED visits, 5.9 hospitalizations, and 0.2 deaths, while for work-related HRI/100,000 worker-years there were 8.5 ED visits, 1.1 hospitalizations, and 0.1 deaths. The rates of HRI varied by county, data source, and work-related status, with the highest rates observed in the panhandle and south central Florida. The sub-groups with the highest relative rates regardless of data source or work-relatedness were males, minorities, and rural residents. Those aged 15–35 years had the highest ED visit rates, while for non-work-related hospitalizations and deaths the rates increased with age. The results of this study can be used for targeted interventions and evaluating changes in the HRI burden over time. PMID:27258296

  13. Heat-Related Illnesses

    MedlinePlus Videos and Cool Tools

    ... cool place and give small amounts of cool water, juice or a commercial sports liquid. (Do not ... non-caffeinated fluids. Apply cool, wet cloths or water mist while fanning the person. Seek immediate medical ...

  14. Heat-Related Illnesses

    DTIC Science & Technology

    1988-04-01

    is a major site of electrolyte resorbtion; heatstroke related to fluid and electrolyte loss from gastroenteritis has been reported. 7 7 Virtually any...restoration of plasma tonicity to normal animals previously chronically hypernatramic. Pediatrica , 43:54- 63, 1969. 65. Holmes, S.W., Horton, E.W.: The

  15. KU135, a Novel Novobiocin-Derived C-Terminal Inhibitor of the 90-kDa Heat Shock Protein, Exerts Potent Antiproliferative Effects in Human Leukemic Cells

    PubMed Central

    Shelton, Shary N.; Shawgo, Mary E.; Matthews, Shawna B.; Lu, Yuanming; Donnelly, Alison C.; Szabla, Kristen; Tanol, Mehmet; Vielhauer, George A.; Rajewski, Roger A.; Matts, Robert L.; Blagg, Brian S. J.

    2009-01-01

    The 90-kDa heat shock protein (Hsp90) assists in the proper folding of numerous mutated or overexpressed signal transduction proteins that are involved in cancer. Consequently, there is considerable interest in developing chemotherapeutic drugs that specifically disrupt the function of Hsp90. Here, we investigated the extent to which a novel novobiocin-derived C-terminal Hsp90 inhibitor, designated KU135, induced antiproliferative effects in Jurkat T-lymphocytes. The results indicated that KU135 bound directly to Hsp90, caused the degradation of known Hsp90 client proteins, and induced more potent antiproliferative effects than the established N-terminal Hsp90 inhibitor 17-allylamino-demethoxygeldanamycin (17-AAG). Closer examination of the cellular response to KU135 and 17-AAG revealed that only 17-AAG induced a strong up-regulation of Hsp70 and Hsp90. In addition, KU135 caused wild-type cells to undergo G2/M arrest, whereas cells treated with 17-AAG accumulated in G1. Furthermore, KU135 but not 17-AAG was found to be a potent inducer of mitochondria-mediated apoptosis as evidenced, in part, by the fact that cell death was inhibited to a similar extent by Bcl-2/Bcl-xL overexpression or the depletion of apoptotic protease-activating factor-1 (Apaf-1). Together, these data suggest that KU135 inhibits cell proliferation by regulating signaling pathways that are mechanistically different from those targeted by 17-AAG and as such represents a novel opportunity for Hsp90 inhibition. PMID:19741006

  16. Heat shock protein 90 inhibitor NVP-AUY922 exerts potent activity against adult T-cell leukemia–lymphoma cells

    PubMed Central

    Taniguchi, Hiroaki; Hasegawa, Hiroo; Sasaki, Daisuke; Ando, Koji; Sawayama, Yasushi; Imanishi, Daisuke; Taguchi, Jun; Imaizumi, Yoshitaka; Hata, Tomoko; Tsukasaki, Kunihiro; Uno, Naoki; Morinaga, Yoshitomo; Yanagihara, Katsunori; Miyazaki, Yasushi

    2014-01-01

    Adult T-cell leukemia–lymphoma (ATL), an aggressive neoplasm etiologically associated with HTLV-1, is a chemoresistant malignancy. Heat shock protein 90 (HSP90) is involved in folding and functions as a chaperone for multiple client proteins, many of which are important in tumorigenesis. In this study, we examined NVP-AUY922 (AUY922), a second generation isoxazole-based non-geldanamycin HSP90 inhibitor, and confirmed its effects on survival of ATL-related cell lines. Analysis using FACS revealed that AUY922 induced cell-cycle arrest and apoptosis; it also inhibited the growth of primary ATL cells, but not of normal PBMCs. AUY922 caused strong upregulation of HSP70, a surrogate marker of HSP90 inhibition, and a dose-dependent decrease in HSP90 client proteins associated with cell survival, proliferation, and cell cycle in the G1 phase, including phospho-Akt, Akt, IKKα, IKKβ, IKKγ, Cdk4, Cdk6, and survivin. Interestingly, AUY922 induced downregulation of the proviral integration site for Moloney murine leukemia virus (PIM) in ATL cells. The PIM family (PIM-1, -2, -3) is made up of oncogenes that encode a serine/threonine protein kinase family. As PIM kinases have multiple functions involved in cell proliferation, survival, differentiation, apoptosis, and tumorigenesis, their downregulation could play an important role in AUY922-induced death of ATL cells. In fact, SGI-1776, a pan-PIM kinase inhibitor, successfully inhibited the growth of primary ATL cells as well as ATL-related cell lines. Our findings suggest that AUY922 is an effective therapeutic agent for ATL, and PIM kinases may be a novel therapeutic target. PMID:25263741

  17. Perceptions of risks to children's health from indoor air pollution and an investigation of respiratory illness symptoms from indoor heating with a woodburning stove

    SciTech Connect

    Osborne, J.S. III

    1986-01-01

    This study explores perceptions of risks to health (POR), risk taking behavior (RTB), and associated illness from the perspectives of medical anthropology and epidemiology. Specific objectives included investigation of the following: (1) general POR: (2) POR from indoor air pollution (IAP) and parental usage of IAP sources; (3) the relationship between POR and RTB; factors affecting POR and RTB; (4) the construction of risk domains; (5) sources of intracultural variation in POR, RTB, and the partitioning of risk domains; (6) patterns of indoor heating in central Michigan; and (7) respiratory illness symptoms (RIS) in children from exposure to indoor heating with a woodburning stove (WBS). POR and RTB were investigated in random and ethnographic samples, RIS in a random sample with an internal comparison group, and indoor heating in a random sample. Interview schedules were developed for each phase of inquiry. The instrument used to investigate POR and RTB includes both qualitative and quantitative scales for POR assessment. Findings of this study provide an ethnography of risk, an inferential analysis of POR/RTB, and a preliminary assessment of risks of RIS from heating with WBS.

  18. Integrated Physiological Mechanisms of Exercise Performance, Adaptation, and Maladaptation to Heat Stress

    DTIC Science & Technology

    2011-10-01

    number of heat exposures (359, 424). Heat acclimatization is specific to the environment (hot/dry vs. hot/ wet ) and physical activity level, however...Comprehensive Physiology Table 1 Risk of Hyperthermia (and Possible Exertional Heat Illness) for a Typical Marathon Racer Based on Wet Bulb Globe...clothing during activities in hot weather, and performing firefighting near the active fire. Environmental heat stress and exchange Wet Bulb Globe

  19. Exertional Rhabdomyolysis after Spinning

    PubMed Central

    Jeong, Youjin; Oh, Eun-Jung; Ahn, Ah-Leum; Choi, Jae-Kyung; Cho, Dong-Yung

    2016-01-01

    Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24–48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered. PMID:27900075

  20. Exertional Rhabdomyolysis after Spinning.

    PubMed

    Jeong, Youjin; Kweon, Hyuk-Jung; Oh, Eun-Jung; Ahn, Ah-Leum; Choi, Jae-Kyung; Cho, Dong-Yung

    2016-11-01

    Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24-48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.

  1. Chronic Exertional Compartment Syndrome.

    PubMed

    Braver, Richard T

    2016-04-01

    Increased tissue pressure within a fascial compartment may be the result from any increase in volume within its contents, or any decrease in size of the fascial covering or its distensibility. This may lead to symptoms of leg tightness, pain or numbness brought about by exercise. There are multiple differential diagnoses of exercise induced leg pain and the proper diagnoses of chronic exertional compartment syndrome (CECS) is made by a careful history and by exclusion of other maladies and confirmed by compartment syndrome testing as detailed in this text. Surgical fasciotomies for the anterior, lateral, superficial and deep posterior compartments are described in detail along with ancillary procedures for chronic shin splints that should allow the athlete to return to competitive activity. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Coal home heating and environmental tobacco smoke in relation to lower respiratory illness in Czech children, from birth to 3 years of age

    SciTech Connect

    Baker, R.J.; Hert-Picciotto, I.; Dostal, M.; Keller, J.A.; Nozicka, J.; Kotesovec, F.; Dejmek, J.; Loomis, D.; Sram, R.J.

    2006-07-15

    The objective of this study was to evaluate how indoor pollution from tobacco and home heating may adversely affect respiratory health in young children. A total of 452 children born 1994-1996 in two districts in the Czech Republic participated. Lower respiratory illness (LRI) diagnoses occurred more frequently in children from homes heated by coal (vs. other energy sources or distant furnaces; rate ratio (RR) = 1.45; 95% confidence interval (CI), 1.07-1.97). Maternal prenatal smoking and other adult smokers also increased LRI rates (respectively: RR = 1.48; 95% CI, 1.10-2.01; and RR = 1.29; 95% CI, 1.01-1.65). Cooking fuels (primarily electricity, natural gas, or propane) were not associated with LRI incidence. For children never breast-fed, coal home heating and mother's smoking conferred substantially greater risks: RR = 2.77 (95% CI, 1.45-5.27) and RR = 2.52 (95% CI, 1.31-4.85), respectively. This maternal smoking and coal home heating increased risk for LRI in the first 3 years of life, particularly in children not breast-fed.

  3. Coal Home Heating and Environmental Tobacco Smoke in Relation to Lower Respiratory Illness in Czech Children, from Birth to 3 Years of Age

    PubMed Central

    Baker (posthumous), Rebecca J.; Hertz-Picciotto, Irva; Dostál, Miroslav; Keller, Jean A.; Nožička, Jiři; Kotìšovec, František; Dejmek (posthumous), Jan; Loomis, Dana; Šrám, Radim J.

    2006-01-01

    Objective The objective of this study was to evaluate how indoor pollution from tobacco and home heating may adversely affect respiratory health in young children. Design A birth cohort was followed longitudinally for 3 years to determine incidence of lower respiratory illness (LRI). Participants A total of 452 children born 1994–1996 in two districts in the Czech Republic participated. Evaluations Indoor combustion exposures were home heating and cooking fuel, mother’s smoking during pregnancy, and other adult smokers in the household. Diagnoses of LRI (primarily acute bronchitis) from birth to 3 years of age were abstracted from pediatric records. Questionnaires completed at delivery and at 3-year follow-up provided covariate information. LRI incidence rates were modeled with generalized linear models adjusting for repeated measures and for numerous potential confounders. Results LRI diagnoses occurred more frequently in children from homes heated by coal [vs. other energy sources or distant furnaces; rate ratio (RR) = 1.45; 95% confidence interval (CI), 1.07–1.97]. Maternal prenatal smoking and other adult smokers also increased LRI rates (respectively: RR = 1.48; 95% CI, 1.10–2.01; and RR = 1.29; 95% CI, 1.01–1.65). Cooking fuels (primarily electricity, natural gas, or propane) were not associated with LRI incidence. For children never breast-fed, coal home heating and mother’s smoking conferred substantially greater risks: RR = 2.77 (95% CI, 1.45–5.27) and RR = 2.52 (95% CI, 1.31–4.85), respectively. Conclusions Maternal smoking and coal home heating increased risk for LRI in the first 3 years of life, particularly in children not breast-fed. Relevance Few studies have described effects of coal heating fuel on children’s health in a Western country. Breast-feeding may attenuate adverse effects of prenatal and childhood exposures to combustion products. PMID:16835069

  4. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods

    PubMed Central

    2013-01-01

    Background Heat-related illness (HRI) is an important cause of non-fatal illness and death in farmworkers. We sought to identify potential barriers to HRI prevention and treatment in Latino farmworkers. Methods We conducted three semi-structured focus group discussions with 35 Latino farmworkers in the Central Washington, USA area using participatory rural appraisal techniques. Interviews were audio taped and transcribed in Spanish. Three researchers reviewed and coded transcripts and field notes, and investigator triangulation was used to identify relevant themes and quotes. Results Although the majority of participants in our study reported never receiving formal HRI training, most participants were aware that extreme heat can cause illness and were able to accurately describe HRI symptoms, risk factors, and certain prevention strategies. Four main observations regarding farmworkers’ HRI-relevant beliefs and attitudes were identified: 1) farmworkers subscribe to varying degrees to the belief that cooling treatments should be avoided after heat exposure, with some believing that such treatments should be avoided after heat exposure, and others encouraging the use of such treatments; 2) the desire to lose weight may be reflected in behaviors that promote increased sweating; 3) highly caffeinated energy drinks are preferred to increase work efficiency and maintain alertness; and 4) the location of drinking water at work (e.g. next to restrooms) and whether water is clean, but not necessarily chemically-treated, are important considerations in deciding whether to drink the water provided at worksites. Conclusions We identified potential barriers to HRI prevention and treatment related to hydration, certain HRI treatments, clothing use, and the desire to lose weight among Latino farmworkers. Strategies to address potential barriers to HRI prevention and treatment in this population may include engineering, administrative, and health education and health promotion

  5. Identification of barriers to the prevention and treatment of heat-related illness in Latino farmworkers using activity-oriented, participatory rural appraisal focus group methods.

    PubMed

    Lam, Michelle; Krenz, Jennifer; Palmández, Pablo; Negrete, Maria; Perla, Martha; Murphy-Robinson, Helen; Spector, June T

    2013-10-24

    Heat-related illness (HRI) is an important cause of non-fatal illness and death in farmworkers. We sought to identify potential barriers to HRI prevention and treatment in Latino farmworkers. We conducted three semi-structured focus group discussions with 35 Latino farmworkers in the Central Washington, USA area using participatory rural appraisal techniques. Interviews were audio taped and transcribed in Spanish. Three researchers reviewed and coded transcripts and field notes, and investigator triangulation was used to identify relevant themes and quotes. Although the majority of participants in our study reported never receiving formal HRI training, most participants were aware that extreme heat can cause illness and were able to accurately describe HRI symptoms, risk factors, and certain prevention strategies. Four main observations regarding farmworkers' HRI-relevant beliefs and attitudes were identified: 1) farmworkers subscribe to varying degrees to the belief that cooling treatments should be avoided after heat exposure, with some believing that such treatments should be avoided after heat exposure, and others encouraging the use of such treatments; 2) the desire to lose weight may be reflected in behaviors that promote increased sweating; 3) highly caffeinated energy drinks are preferred to increase work efficiency and maintain alertness; and 4) the location of drinking water at work (e.g. next to restrooms) and whether water is clean, but not necessarily chemically-treated, are important considerations in deciding whether to drink the water provided at worksites. We identified potential barriers to HRI prevention and treatment related to hydration, certain HRI treatments, clothing use, and the desire to lose weight among Latino farmworkers. Strategies to address potential barriers to HRI prevention and treatment in this population may include engineering, administrative, and health education and health promotion strategies at individual, workplace

  6. Cold thermoregulatory responses following exertional fatigue.

    PubMed

    Castellani, John W; Sawka, Michael N; DeGroot, David W; Young, Andrew J

    2010-06-01

    Participants in prolonged, physically demanding cold-weather activities are at risk for a condition called "thermoregulatory fatigue". During cold exposure, the increased gradient favoring body heat loss to the environment is opposed by physiological responses and clothing and behavioral strategies that conserve body heat stores to defend body temperature. The primary human physiological responses elicited by cold exposure are shivering and peripheral vasoconstriction. Shivering increases thermogenesis and replaces body heat losses, while peripheral vasoconstriction improves thermal insulation of the body and retards the rate of heat loss. A body of scientific literature supports the concept that prolonged and/or repeated cold exposure, fatigue induced by sustained physical exertion, or both together, can impair the shivering and vasoconstrictor responses to cold ("thermoregulatory fatigue"). The mechanisms accounting for this thermoregulatory impairment are not clear, but there is evidence to suggest that changes in central thermoregulatory control or peripheral sympathetic responsiveness to cold lead to thermoregulatory fatigue and increased susceptibility to hypothermia.

  7. [Nonthyroidal illness (NTI)].

    PubMed

    Murakami, Masami

    2012-11-01

    Thyroxine (T4), a major secretory product of thyroid gland, needs to be converted to 3,5,3'-triiodothyronine (T3) by iodothyronine deiodinases to exert its biological effect. Nonthyroidal illness, also known as low T3 syndrome, is associated with low serum T3 concentrations, which are inversely correlated to the severity of the illness. The patients with nonthyroidal illness do not show compensatory rise in serum TSH concentrations, and sometimes develop low serum T4 and TSH concentrations. It has been postulated that decreased extrathyroidal conversion of T4 to T3 is a responsible mechanism underlying low T3 syndrome. The roles of three types of iodothyronine deiodinases (D1, D2, D3) in the pathophysiology of nonthyroidal illness are discussed.

  8. Mental Illness

    MedlinePlus

    ... questionnaire to help answer these questions. Determining which mental illness you have Sometimes it's difficult to find out ... insurance companies to reimburse for treatment. Classes of mental illness The main classes of mental illness are: Neurodevelopmental ...

  9. Predicting hospitalization for heat-related illness at the census-tract level: accuracy of a generic heat vulnerability index in Phoenix, Arizona (USA).

    PubMed

    Chuang, Wen-Ching; Gober, Patricia

    2015-06-01

    Vulnerability mapping based on vulnerability indices is a pragmatic approach for highlighting the areas in a city where people are at the greatest risk of harm from heat, but the manner in which vulnerability is conceptualized influences the results. We tested a generic national heat-vulnerability index, based on a 10-variable indicator framework, using data on heat-related hospitalizations in Phoenix, Arizona. We also identified potential local risk factors not included in the generic indicators. To evaluate the accuracy of the generic index in a city-specific context, we used factor scores, derived from a factor analysis using census tract-level characteristics, as independent variables, and heat hospitalizations (with census tracts categorized as zero-, moderate-, or high-incidence) as dependent variables in a multinomial logistic regression model. We also compared the geographical differences between a vulnerability map derived from the generic index and one derived from actual heat-related hospitalizations at the census-tract scale. We found that the national-indicator framework correctly classified just over half (54%) of census tracts in Phoenix. Compared with all census tracts, high-vulnerability tracts that were misclassified by the index as zero-vulnerability tracts had higher average income and higher proportions of residents with a duration of residency < 5 years. The generic indicators of vulnerability are useful, but they are sensitive to scale, measurement, and context. Decision makers need to consider the characteristics of their cities to determine how closely vulnerability maps based on generic indicators reflect actual risk of harm.

  10. Current and future cooling technologies used in preventing heat illness and improving work capacity for battlefield soldiers: review of the literature.

    PubMed

    O'Hara, Reginald; Eveland, Ed; Fortuna, Sarah; Reilly, Patricia; Pohlman, Roberta

    2008-07-01

    The goals were to review the effectiveness of current cooling technologies used on the battlefield to reduce or to prevent heat illness in soldiers and to discuss possible alternative or improved cooling methods. A search of the literature for 1990-2007 was performed by using the Air Force Institute of Technology and Air Force Research Laboratory search engines. Several current cooling technologies are modestly effective in attenuating brain and core body temperatures, but the cooling effects are not sustained and the devices present operational problems. This review indicates that some current cooling devices are effective in lowering perceived efforts and lengthening maximal exercise time but are incompatible with current demands. Many of the cooling methods and devices detailed in the literature are impractical for use in the field. Future research should focus on cooling technologies that are practical in the battlefield and have sustainable cooling effects.

  11. Heat Exhaustion in a Rat Model: Lithium as a Biochemical Probe.

    DTIC Science & Technology

    1988-11-08

    thought to predispose to heat-induced illness include amount of exertion, prior conditioning, pre-existing cardiovascular disease, diabetes mellitus...and to employ the methods of Durkot, et. al. (33). 14C- inulin will replace 35S04 as the ECFV marker, and 3H20 will be allowed to equilibrate for at

  12. Effectiveness of Ice-Sheet Cooling Following Exertional Hyperthermia.

    PubMed

    Butts, Cory L; Spisla, Debora L; Adams, J D; Smith, Cody R; Paulsen, Kathleen M; Caldwell, Aaron R; Ganio, Matthew S; McDermott, Brendon P

    2017-09-01

    = 0.051). Thermal sensation was reduced from 3 minutes of treatment (ISC 3.5 ± 0.9 vs. CON 4.5 ± 0.6, p = 0.002) through 15 minutes (ISC 2.8 ± 1.0 vs. CON 3.9 ± 0.4, p = 0.005). ISC does not provide effective reduction in Tre following exertional hyperthermia compared to no treatment. However, perceptual benefits may warrant the use of ISC in settings where rapid reductions in core temperature are not a concern (i.e., recovery from exercise). Thus, clinicians should continue to utilize validated techniques (i.e., cold-water immersion) for the treatment of exertional heat illnesses. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  13. Cooling Methods in Heat Stroke.

    PubMed

    Gaudio, Flavio G; Grissom, Colin K

    2016-04-01

    Heat stroke is an illness with a high risk of mortality or morbidity, which can occur in the young and fit (exertional heat stroke) as well as the elderly and infirm (nonexertional heat stroke). In the United States, from 2006 to 2010, there were at least 3332 deaths attributed to heat stroke. To summarize the available evidence on the principal cooling methods used in the treatment of heat stroke. Although it is generally agreed that rapid, effective cooling increases survival in heat stroke, there continues to be debate on the optimal cooling method. Large, controlled clinical trials on heat stroke are lacking. Cooling techniques applied to healthy volunteers in experimental models of heat stroke have not worked as rapidly in actual patients with heat stroke. The best available evidence has come from large case series using ice-water immersion or evaporation plus convection to cool heat-stroke patients. Ice-water immersion has been shown to be highly effective in exertional heat stroke, with a zero fatality rate in large case series of younger, fit patients. In older patients with nonexertional heat stroke, studies have more often promoted evaporative plus convective cooling. Evaporative plus convective cooling may be augmented by crushed ice or ice packs applied diffusely to the body. Chilled intravenous fluids may also supplement primary cooling. Based on current evidence, ice packs applied strategically to the neck, axilla, and groin; cooling blankets; and intravascular or external cooling devices are not recommended as primary cooling methods in heat stroke. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. The force exerted by a fireball

    SciTech Connect

    Makrinich, G.; Fruchtman, A.

    2014-02-15

    The force exerted by a fireball was deduced both from the change of the equilibrium position of a pendulum and from the change in the pendulum oscillation period. That measured force was found to be several times larger than the force exerted by the ions accelerated across the double layer that is assumed to surround the fireball. The force enhancement that is expected by ion-neutral collisions in the fireball is evaluated to be too small to explain the measured enhanced force. Gas pressure increase, due to gas heating through electron-neutral collisions, as recently suggested [Stenzel et al., J. Appl. Phys. 109, 113305 (2011)], is examined as the source for the force enhancement.

  15. Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients.

    PubMed

    Auxiliadora-Martins, M; Menegueti, M G; Nicolini, E A; Alkmim-Teixeira, G C; Bellissimo-Rodrigues, F; Martins-Filho, O A; Basile-Filho, A

    2012-12-01

    Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP, the duration of mechanical ventilation, or the length of stay in the ICU in the study population.

  16. Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

    PubMed Central

    Auxiliadora-Martins, M.; Menegueti, M.G.; Nicolini, E.A.; Alkmim-Teixeira, G.C.; Bellissimo-Rodrigues, F.; Martins-Filho, O.A.; Basile-Filho, A.

    2012-01-01

    Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP, the duration of mechanical ventilation, or the length of stay in the ICU in the study population. PMID:23044627

  17. Glutamine effects on heat shock protein 70 and interleukines 6 and 10: Randomized trial of glutamine supplementation versus standard parenteral nutrition in critically ill children.

    PubMed

    Jordan, Iolanda; Balaguer, Mònica; Esteban, M Esther; Cambra, Francisco José; Felipe, Aida; Hernández, Lluïsa; Alsina, Laia; Molero, Marta; Villaronga, Miquel; Esteban, Elisabeth

    2016-02-01

    To determine whether glutamine (Gln) supplementation would have a role modifying both the oxidative stress and the inflammatory response of critically ill children. Prospective, randomized, double-blind, interventional clinical trial. Selection criteria were children requiring parenteral nutrition for at least 5 days diagnosed with severe sepsis or post major surgery. Patients were randomly assigned to standard parenteral nutrition (SPN, 49 subjects) or standard parenteral nutrition with glutamine supplementation (SPN + Gln, 49 subjects). Glutamine levels failed to show statistical differences between groups. At day 5, patients in the SPN + Gln group had significantly higher levels of HSP-70 (heat shock protein 70) as compared with the SPN group (68.6 vs 5.4, p = 0.014). In both groups, IL-6 (interleukine 6) levels showed a remarkable descent from baseline and day 2 (SPN: 42.24 vs 9.39, p < 0.001; SPN + Gln: 35.20 vs 13.80, p < 0.001) but only the treatment group showed a statistically significant decrease between day 2 and day 5 (13.80 vs 10.55, p = 0.013). Levels of IL-10 (interleukine 10) did not vary among visits except in the SPN between baseline and day 2 (9.55 vs 5.356, p < 0.001). At the end of the study, no significant differences between groups for PICU and hospital stay were observed. No adverse events were detected in any group. Glutamine supplementation in critically-ill children contributed to maintain high HSP-70 levels for longer. Glutamine supplementation had no influence on IL-10 and failed to show a significant reduction of IL-6 levels. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Total exertion: zen, psychoanalysis, life.

    PubMed

    Cooper, Paul C

    2011-09-01

    This paper integrates Zen and psychoanalytic concepts; introduces the Zen concept of total exertion; elaborates the profound implications that the notion of total exertion has for the psychoanalytic encounter and the psychotherapist's capacity for maintaining an optimal attentional stance; addresses anxiety-driven interferences to both the psychoanalytic process and deepened Zen practice. Clinical vignettes, personal experiences, poetry and psychoanalytic theory serve to demonstrate the abstract aspects of the discussion.

  19. When exercise causes exertional rhabdomyolysis.

    PubMed

    Furman, Janet

    2015-04-01

    Exertional rhabdomyolysis is a clinical condition caused by intense, repetitive exercise or a sudden increase in exercise in an untrained person, although rhabdomyolysis can occur in trained athletes. In many cases, the presentation of early, uncomplicated rhabdomyolysis is subtle, but serious complications such as renal failure, compartment syndrome, and dysrhythmias may arise if severe exertional rhabdomyolysis is undiagnosed or untreated. Management is further complicated by the lack of concrete management guidelines for treating rhabdomyolysis and returning patients to activity.

  20. Exertional Rhabdomyolysis in the Athlete

    PubMed Central

    Tietze, David C.; Borchers, James

    2014-01-01

    Context: Exertional rhabdomyolysis is a relatively uncommon but potentially fatal condition affecting athletes that requires prompt recognition and appropriate management. Evidence Acquisition: A search of the PubMed database from 2003 to 2013 using the term exertional rhabdomyolysis was performed. Further evaluation of the bibliographies of articles expanded the evidence. Study Design: Clinical review. Level of Evidence: Level 3. Results: Exertional rhabdomyolysis (ER) is a relatively uncommon condition with an incidence of approximately 29.9 per 100,000 patient years but can have very serious consequences of muscle ischemia, cardiac arrhythmia, and death. The athlete will have pain, weakness, and swelling in the muscles affected as well as significantly elevated levels of creatine kinase (CK). Hydration is the foundation for any athlete with ER; management can also include dialysis or surgery. Stratifying the athlete into high- or low-risk categories can determine if further workup is warranted. Conclusion: Exertional rhabdomyolysis evaluation requires a history, physical examination, and serology for definitive diagnosis. Treatment modalities should include rest and hydration. Return to play and future workup should be determined by the risk stratification of the athlete. Strength-of-Recommendation Taxonomy (SORT): C. PMID:24982707

  1. Update: Exertional hyponatremia, active component, U.S. Armed Forces, 1999-2013.

    PubMed

    2014-03-01

    From 1999 through 2013, there were 1,406 incident diagnoses of exertional hyponatremia among active component members of the U.S. Armed Forces. Annual incidence rates rose sharply from 2008 to 2010 but decreased by 59 percent from 2010 to 2013. In 2013, there were fewer incident cases (n=73) than in any of the previous 9 years. The recent decrease in overall rates reflects sharply declining rates in the Marine Corps and slight decreases in the other Services. Relative to their respective counterparts, crude incidence rates of exertional hyponatremia for the entire 15-year surveillance period were higher among females, those in the youngest age group, Marines, recruit trainees, and "other" military occupations. Service members (particularly recruit trainees) and their supervisors must be vigilant for early signs of heat-related illnesses and must be knowledgeable of the dangers of excessive water consumption and the prescribed limits for water intake during prolonged physical activity (e.g., field training exercises, personal fitness training, recreational activities) in hot, humid weather.

  2. Voodoo illness.

    PubMed

    Campinha-Bacote, J

    1992-01-01

    Healthcare providers must familiarize themselves with specific culture-bound syndromes and their manifestations in order to provide quality care to culturally diverse clients seeking healthcare services. Voodoo illness is one of several culture-bound syndromes that nurses need to be familiar with, for an inability to understand voodoo illness may result in the client's death (voodoo death).

  3. Foodborne illness.

    PubMed

    Pigott, David C

    2008-05-01

    While few patients with foodborne illness present with life-threatening symptoms, there are a number of foodborne infectious diseases and toxins that the emergency physician or other health care provider must consider in the evaluation of these patients. Given the frequency of international travel, as well as the risk associated with recurrent outbreaks of foodborne illness from commercial food sources, it is important to recognize various syndromes of foodborne illness, including those which may require specific evaluation and management strategies. This article reviews a number of the most common causes of foodborne illness, as well as several less common pathogens with the potential for causing significant morbidity and mortality if not promptly identified and treated.

  4. Foodborne Illness

    MedlinePlus

    ... get sick from contaminated food. Common culprits include bacteria, parasites and viruses. Symptoms range from mild to ... cramps Nausea and vomiting Diarrhea Fever Dehydration Harmful bacteria are the most common cause of foodborne illness. ...

  5. Foodborne Illnesses

    MedlinePlus

    ... Some parasites and chemicals also cause foodborne illnesses. Bacteria Bacteria are tiny organisms that can cause infections of the GI tract. Not all bacteria are harmful to humans. Some harmful bacteria may ...

  6. Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing.

    PubMed

    Li, Mian; Xu, Changqing; Yao, Wenguo; Mahan, Clare M; Kang, Han K; Sandbrink, Friedhelm; Zhai, Ping; Karasik, Pamela A

    2014-01-07

    To determine if objective evidence of autonomic dysfunction exists from a group of Gulf War veterans with self-reported post-exertional fatigue, we evaluated 16 Gulf War ill veterans and 12 Gulf War controls. Participants of the ill group had self- reported, unexplained chronic post-exertional fatigue and the illness symptoms had persisted for years until the current clinical study. The controls had no self-reported post-exertional fatigue either at the time of initial survey nor at the time of the current study. We intended to identify clinical autonomic disorders using autonomic and neurophysiologic testing in the clinical context. We compared the autonomic measures between the 2 groups on cardiovascular function at both baseline and head-up tilt, and sudomotor function. We identified 1 participant with orthostatic hypotension, 1 posture orthostatic tachycardia syndrome, 2 distal small fiber neuropathy, and 1 length dependent distal neuropathy affecting both large and small fiber in the ill group; whereas none of above definable diagnoses was noted in the controls. The ill group had a significantly higher baseline heart rate compared to controls. Compound autonomic scoring scale showed a significant higher score (95% CI of mean: 1.72-2.67) among ill group compared to controls (0.58-1.59). We conclude that objective autonomic testing is necessary for the evaluation of self-reported, unexplained post-exertional fatigue among some Gulf War veterans with multi-symptom illnesses. Our observation that ill veterans with self-reported post-exertional fatigue had objective autonomic measures that were worse than controls warrants validation in a larger clinical series.

  7. Acute Exertional Rhabdomyolysis and Triceps Compartment Syndrome During a High School Football Camp

    PubMed Central

    Oh, John Y.; Laidler, Matthew; Fiala, Steven C.; Hedberg, Katrina

    2012-01-01

    Background: Acute exertional rhabdomyolysis has been infrequently reported among adolescents. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. Purpose: To confirm the diagnoses, characterize the spectrum of illnesses, and determine the factors contributing to rhabdomyolysis and triceps compartment syndromes. Study Design: Descriptive epidemiology study. Methods: The authors reviewed hospital medical records and interviewed players, coaches, school administrators, and hospital staff, using a standardized questionnaire that assessed symptoms, exposures, and activities. Results: Among 43 players, 22 (51%) experienced rhabdomyolysis (peak creatine kinase range, 2434-42 000 U/L): 22 patients had upper arm myalgia; 12 were hospitalized; 3 experienced triceps compartment syndrome; none experienced renal failure. Illnesses started 1 to 3 days after the triceps exercise. Forty players (93%) completed questionnaires. Among 19 players receiving at least 1 vote from a teammate as 1 of the 3 hardest working players, 13 (68%) experienced rhabdomyolysis versus 7 (33%) of 21 not considered hardest working (relative risk, 2.1; 95% confidence interval, 1.04-4.0). Of 40 players, 10 (25%) reported creatine supplement use, which was not associated with rhabdomyolysis. No player acknowledged use of alcohol, illicit drugs, or performance-enhancing drugs; results of performance-enhancing drug tests on the 4 players tested were negative. Environmental investigation did not identify additional factors contributing to illness. Conclusions: The upper arm exercise, possibly exacerbated by heat, led to rhabdomyolysis and compartment syndrome. Greater awareness of specific exercise hazards and prevention strategies can minimize risk for clinically significant muscle injury. PMID:23016070

  8. Acute exertional rhabdomyolysis and triceps compartment syndrome during a high school football cAMP.

    PubMed

    Oh, John Y; Laidler, Matthew; Fiala, Steven C; Hedberg, Katrina

    2012-01-01

    Acute exertional rhabdomyolysis has been infrequently reported among adolescents. In August 2010, several high school football players from one team developed rhabdomyolysis and triceps compartment syndrome following an upper arm exercise held in a non-air-conditioned wrestling room. To confirm the diagnoses, characterize the spectrum of illnesses, and determine the factors contributing to rhabdomyolysis and triceps compartment syndromes. Descriptive epidemiology study. The authors reviewed hospital medical records and interviewed players, coaches, school administrators, and hospital staff, using a standardized questionnaire that assessed symptoms, exposures, and activities. Among 43 players, 22 (51%) experienced rhabdomyolysis (peak creatine kinase range, 2434-42 000 U/L): 22 patients had upper arm myalgia; 12 were hospitalized; 3 experienced triceps compartment syndrome; none experienced renal failure. Illnesses started 1 to 3 days after the triceps exercise. Forty players (93%) completed questionnaires. Among 19 players receiving at least 1 vote from a teammate as 1 of the 3 hardest working players, 13 (68%) experienced rhabdomyolysis versus 7 (33%) of 21 not considered hardest working (relative risk, 2.1; 95% confidence interval, 1.04-4.0). Of 40 players, 10 (25%) reported creatine supplement use, which was not associated with rhabdomyolysis. No player acknowledged use of alcohol, illicit drugs, or performance-enhancing drugs; results of performance-enhancing drug tests on the 4 players tested were negative. Environmental investigation did not identify additional factors contributing to illness. The upper arm exercise, possibly exacerbated by heat, led to rhabdomyolysis and compartment syndrome. Greater awareness of specific exercise hazards and prevention strategies can minimize risk for clinically significant muscle injury.

  9. The role of exercise in the etiology of exertional heatstroke.

    PubMed

    Hubbard, R W

    1990-02-01

    Exertional heatstroke usually occurs among healthy, fit individuals who are motivated to perform strenuous exercise because of peer pressure, discipline, or athletic competition. In fact, exertional heatstroke deaths among high school athletes in the United States (ranked third only to head and neck injuries and heart failures), and the reluctance of race directors to cancel or postpone mass participation road races during periods of severe heat and humidity, emphasize a continuing need for widespread dissemination of information. The purposes of this symposium are 1) to convey essential information to the members of ACSM who are involved in exercise prescription, patient care, or athletic training; and 2) to disseminate recent scientific theories and research concerning exertional heatstroke.

  10. Exertional Rhabdomyolysis in a Collegiate American Football Player After Preventive Cold-Water Immersion: A Case Report

    PubMed Central

    Kahanov, Leamor; Eberman, Lindsey E.; Wasik, Mitchell; Alvey, Thurman

    2012-01-01

    Objective: To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive cold-water immersion. Background: A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated post-practice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45–260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal < 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%– 30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids. Differential Diagnosis: Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis. Treatment: The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L). Uniqueness: The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis. Conclusions: In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after

  11. Exertional rhabdomyolysis in a collegiate american football player after preventive cold-water immersion: a case report.

    PubMed

    Kahanov, Leamor; Eberman, Lindsey E; Wasik, Mitchell; Alvey, Thurman

    2012-01-01

    To describe a case of exertional rhabdomyolysis in a collegiate American football player after preventive coldwater immersion. A healthy man (19 years old) participated in full-contact football practice followed by conditioning (2.5 hours). After practice, he entered a coach-mandated postpractice cold-water immersion and had no signs of heat illness before developing leg cramps, for which he presented to the athletic training staff. After 10 minutes of repeated stretching, massage, and replacement of electrolyte-filled fluids, he was transported to the emergency room. Laboratory tests indicated a creatine kinase (CK) level of 2545 IU/L (normal range, 45-260 IU/L), CK-myoglobin fraction of 8.5 ng/mL (normal < 6.7 ng/mL), and CK-myoglobin relative index of 30% (normal range, 25%-30%). Myoglobin was measured at 499 ng/mL (normal = 80 ng/mL). The attending physician treated the athlete with intravenous fluids. Exercise-associated muscle cramps, dehydration, exertional rhabdomyolysis. The patient was treated with rest and rehydration. One week after the incident, he began biking and swimming. Eighteen days later, the patient continued to demonstrate elevated CK levels (527 IU/L) but described no other symptoms and was allowed to return to football practice as tolerated. Two months after the incident, his CK level remained high (1900 IU/L). The athlete demonstrated no signs of heat illness upon entering the cold-water immersion but experienced severe leg cramping after immersion, resulting in a diagnosis of exertional rhabdomyolysis. Previously described cases have not linked cold-water immersion with the pathogenesis of rhabdomyolysis. In this football player, CK levels appeared to be a poor indicator of rhabdomyolysis. Our patient demonstrated no other signs of the illness weeks after the incident, yet his elevated CK levels persisted. Cold-water immersion immediately after exercise should be monitored by the athletic training staff and may not be appropriate to

  12. Y-632 inhibits heat shock protein 90 (Hsp90) function by disrupting the interaction between Hsp90 and Hsp70/Hsp90 organizing protein, and exerts antitumor activity in vitro and in vivo.

    PubMed

    Wang, Wenqian; Liu, Yang; Zhao, Zhixin; Xie, Chengying; Xu, Yongping; Hu, Youhong; Quan, Haitian; Lou, Liguang

    2016-06-01

    Heat shock protein 90 (Hsp90) stabilizes a variety of proteins required for cancer cell survival and has been identified as a promising drug target for cancer treatment. To date, several Hsp90 inhibitors have entered into clinical trials, but none has been approved for cancer therapy yet. Thus, exploring new Hsp90 inhibitors with novel mechanisms of action is urgent. In the present study, we show that Y-632, a novel pyrimidine derivative, inhibited Hsp90 in a different way from the conventional Hsp90 inhibitor geldanamycin. Y-632 induced degradation of diverse Hsp90 client proteins through the ubiquitin-proteasome pathway, as geldanamycin did; however, it neither directly bound to Hsp90 nor inhibited Hsp90 ATPase activity. Y-632 inhibited Hsp90 function mainly through inducing intracellular thiol oxidation, which led to disruption of the Hsp90-Hsp70/Hsp90 organizing protein complex and further induced cell adhesion inhibition, G0 /G1 cell cycle arrest, and apoptosis. Moreover, Y-632 efficiently overcame imatinib resistance mediated by Bcr-Abl point mutations both in vitro and in vivo. We believe that Y-632, acting as a novel small-molecule inhibitor of the Hsp90-Hsp70/Hsp90 organizing protein complex, has great potential to be a promising Hsp90 inhibitor for cancer therapy, such as for imatinib-resistant leukemia. © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  13. Reflections on the Institute of Medicine's systemic exertion intolerance disease.

    PubMed

    Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; McManimen, Stephanie; Furst, Jacob

    2015-01-01

    The Institute of Medicine (IOM) in the United States has recently proposed that the term systemic exertion intolerance disease (SEID) replace chronic fatigue syndrome. In addition, the IOM proposed a new case definition for SEID, which includes substantial reductions or impairments in the ability to engage in pre‑illness activities, unrefreshing sleep, postexertional malaise, and either cognitive impairment or orthostatic intolerance. Unfortunately, these recommendations for a name change were not vetted with patient and professional audiences, and the new criteria were not evaluated with data sets of patients and controls. A recent poll suggests that the majority of patients reject this new name. In addition, studies have found that prevalence rates will dramatically increase with the new criteria, particularly due to the ambiguity revolving around exclusionary illnesses. Findings suggest that the new criteria select more patients who have less impairment and fewer symptoms than several other criteria. The implications of these findings are discussed in the current review.

  14. Foodborne Illness

    DTIC Science & Technology

    1983-02-01

    be subdivided into three major categories. The first category includes the traditional forms of food poisoning caused by preformed toxins that may...Infectious not all, kinds of food poisoning. In other forms, Diseases section. neurotoxicity may be the principal manifestation, and respiratory...foodborne illnesses PRINCIPLES OF MANAGEMENT. Principles i’, are relatively innocuous and of short duration. A the overall management of food poisoning

  15. Update: Exertional hyponatremia, active component, U.S. Army, Navy, Air Force, and Marine Corps, 2000-2015.

    PubMed

    Armed Forces Health Surveillance Branch

    2016-03-01

    From 2000 through 2015, there were 1,542 incident diagnoses of exertional hyponatremia among active component members of the U.S. Army, Navy, Air Force, and Marine Corps. Annual incidence rates rose sharply from 2008 through 2010 but then decreased by more than 50% from 2010 through 2013. In 2015, the number of cases (n=116) increased by approximately 20% from the previous year. The recent increase in rates overall reflects increased rates in the Army and the Marine Corps. Relative to their respective counterparts, crude incidence rates of exertional hyponatremia for the entire 16-year surveillance period were higher among females, those in the youngest age group, Marines, and recruit trainees. Service members (particularly recruit trainees) and their supervisors must be vigilant for early signs of heat-related illnesses and must be knowledgeable of the dangers of excessive water consumption and the prescribed limits for water intake during prolonged physical activity (e.g., field training exercises, personal fitness training, recreational activities) in hot, humid weather.

  16. Muscle-damaging exercise increases heat strain during subsequent exercise heat stress.

    PubMed

    Fortes, Matthew Benjamin; Di Felice, Umberto; Dolci, Alberto; Junglee, Naushad A; Crockford, Michael J; West, Liam; Hillier-Smith, Ryan; Macdonald, Jamie Hugo; Walsh, Neil Peter

    2013-10-01

    It remains unclear whether exercise-induced muscle damage (EIMD) increases heat strain during subsequent exercise heat stress, which in turn may increase the risk of exertional heat illness. We examined heat strain during exercise heat stress 30 min after EIMD to coincide with increases in circulating pyrogens (e.g., interleukin-6 [IL-6]) and 24 h after EIMD to coincide with the delayed muscle inflammatory response when a higher rate of metabolic energy expenditure (M˙) and thus decreased economy might also increase heat strain. Thirteen non-heat-acclimated males (mean ± SD, age = 20 ± 2 yr) performed exercise heat stress tests (running for 40 min at 65% V˙O2max in 33°C, 50% humidity) 30 min (HS1) and 24 h (HS2) after treatment, involving running for 60 min at 65% V˙O2max on either -10% gradient (EIMD) or +1% gradient (CON) in a crossover design. Rectal (Tre) and skin (Tsk) temperature, local sweating rate, and M˙ were measured throughout HS tests. Compared with CON, EIMD evoked higher circulating IL-6 pre-HS1 (P < 0.01) and greater plasma creatine kinase and muscle soreness pre-HS2 (P < 0.01). The ΔTre was greater after EIMD than CON during HS1 (0.35°C, 95% confidence interval = 0.11°C-0.58°C, P < 0.01) and HS2 (0.17°C, 95% confidence interval = 0.07°C-0.28°C, P < 0.01). M˙ was higher on EIMD throughout HS1 and HS2 (P < 0.001). Thermoeffector responses (Tsk, sweating rate) were not altered by EIMD. Thermal sensation and RPE were higher on EIMD after 25 min during HS1 (P < 0.05). The final Tre during HS1 correlated with the pre-HS1 circulating IL-6 concentration (r = 0.67). Heat strain was increased during endurance exercise in the heat conducted 30 min after and, to a much lesser extent, 24 h after muscle-damaging exercise. These data indicate that EIMD is a likely risk factor for exertional heat illness particularly during exercise heat stress when behavioral thermoregulation cues are ignored.

  17. Reflections on the Design of Exertion Games.

    PubMed

    Mueller, Florian Floyd; Altimira, David; Khot, Rohit Ashot

    2015-02-01

    The design of exertion games (i.e., digital games that require physical effort from players) is a difficult intertwined challenge of combining digital games and physical effort. To aid designers in facing this challenge, we describe our experiences of designing exertion games. We outline personal reflections on our design processes and articulate analyses of players' experiences. These reflections and analyses serve to highlight the unique opportunities of combining digital games and physical effort. The insights we seek aim to enhance the understanding of exertion game design, contributing to the advancement of the field, and ultimately resulting in better games and associated player experiences.

  18. Hydration and thermal strain during tennis in the heat

    PubMed Central

    Bergeron, Michael F

    2014-01-01

    Competitive tennis in the heat can prompt substantial sweat losses and extensive consequent body water and electrolyte deficits, as well as a level of thermal strain that considerably challenges a player's physiology, perception of effort, and on-court well-being and performance. Adequate hydration and optimal performance can be notably difficult to maintain when multiple same-day matches are played on successive days in hot weather. Despite the recognised effects of the heat, much more research needs to be carried out to better appreciate the broader scope and full extent of the physiological demands and hydration and thermal strain challenges facing junior and adult players in various environments, venues and competition scenarios. However, certain recommendations of best practices should be emphasised to minimise exertional heat illness risk and improve player safety, well-being and on-court performance. PMID:24668373

  19. Hydration and thermal strain during tennis in the heat.

    PubMed

    Bergeron, Michael F

    2014-04-01

    Competitive tennis in the heat can prompt substantial sweat losses and extensive consequent body water and electrolyte deficits, as well as a level of thermal strain that considerably challenges a player's physiology, perception of effort, and on-court well-being and performance. Adequate hydration and optimal performance can be notably difficult to maintain when multiple same-day matches are played on successive days in hot weather. Despite the recognised effects of the heat, much more research needs to be carried out to better appreciate the broader scope and full extent of the physiological demands and hydration and thermal strain challenges facing junior and adult players in various environments, venues and competition scenarios. However, certain recommendations of best practices should be emphasised to minimise exertional heat illness risk and improve player safety, well-being and on-court performance.

  20. Nutritional support of the critically ill child.

    PubMed

    Huddleston, K C; Ferraro-McDuffie, A; Wolff-Small, T

    1993-03-01

    There is a growing awareness that the nutrition an individual receives as a child may exert significant consequences later in life. The successful treatment of critically ill children influences their potential for full recovery and optimal outcome. This requires an understanding of how the child responds to stress and starvation. Daily energy needs of the child in the intensive care unit are highly variable. Specific knowledge of the nutritional assessment of these children, whether sustaining an acute or chronic illness, is required, as is an understanding of how the disease process affects the child. Further work needs to be done to evaluate how chronic illness affects the growth, development, and maturation of the child. Assessment parameters remain somewhat controversial, and recent studies indicate that, indeed, critically ill children may be overfed if standard equations are used to calculate needs. Poor clinical outcomes can occur if the child is underfed or overfed. The long-term results of specific diets, micronutrients, glutamine, and new access routes into the infant are not yet known. Research in these areas is rapidly growing, and the new knowledge will provide a greater ability to meet the individual needs of the critically ill child. Perhaps in the future the treatment of choice in patients with organ failure will involve specific micronutrients that influence the immune status and cellular degradation. In the meantime, critically ill children deserve to have their basic nutritional needs met, and nurses can do much to individualize the nutritional support required to produce optimal patient outcomes.

  1. Exertional leg pain: teasing out arterial entrapments.

    PubMed

    Pham, Thomas T; Kapur, Rahul; Harwood, Marc I

    2007-12-01

    Vascular causes of exertional lower extremity pain are relatively rare, but may be the answer in athletes refractory to treatment for the more common overuse syndromes of the lower extremities. It is important to differentiate these vascular causes from chronic exertional compartment syndrome (CECS), medial tibial stress syndrome (MTSS), and stress fractures in order to develop appropriate treatment plans, avoid complications, and return athletes to play expeditiously. Important vascular etiologies to be considered are popliteal artery entrapment syndrome (PAES), endofibrotic disease, popliteal artery aneurysm, cystic adventitial disease, and peripheral arterial dissections. The diagnostic workup involves angiography or noninvasive vascular studies such as Doppler ultrasound or magnetic resonance angiography in both the neutral and provocative positions. Treatment of these vascular abnormalities typically involves surgical correction of the vascular anomaly.

  2. Myeloperoxidase Exerts Microbicidal Activity against Mycobacterium tuberculosis

    PubMed Central

    Borelli, Violetta; Banfi, Elena; Perrotta, Maria Giovanna; Zabucchi, Giuliano

    1999-01-01

    We investigated the antimycobacterial role of myeloperoxidase (MPO), one of the most abundant granule proteins in human neutrophils. Our data indicate that purified MPO, in the presence of hydrogen peroxide, exerts a consistent killing activity against Mycobacterium tuberculosis H37Rv and against a clinical isolate. The activity is time and dose dependent and requires the presence of chloride ions in the assay medium. PMID:10417186

  3. Illness as Teacher: Learning from Illness

    ERIC Educational Resources Information Center

    Yoo, Joanne

    2017-01-01

    This article is a conceptual exploration into the value of illness, bodies and embodied practice in teacher education. It draws on my reflections and practitioner accounts of poor health to investigate the potential to learn from illness. I position myself in this discussion as a non-tenured academic who experiences the challenges of her uncertain…

  4. Forces exerted during microneurosurgery: a cadaver study

    PubMed Central

    Marcus, Hani J; Zareinia, Kourosh; Gan, Liu Shi; Yang, Fang Wei; Lama, Sanju; Yang, Guang-Zhong; Sutherland, Garnette R

    2014-01-01

    Background A prerequisite for the successful design and use of robots in neurosurgery is knowledge of the forces exerted by surgeons during neurosurgical procedures. The aim of the present cadaver study was to measure the surgical instrument forces exerted during microneurosurgery. Methods An experimental apparatus was set up consisting of a platform for human cadaver brains, a Leica microscope to provide illumination and magnification, and a Quanser 6 Degrees-Of-Freedom Telepresence System for tissue manipulation and force measurements. Results The measured forces varied significantly depending on the region of the brain (P = 0.016) and the maneuver performed (P < 0.0001). Moreover, blunt arachnoid dissection was associated with greater force exertion than sharp dissection (0.22 N vs. 0.03 N; P = 0.001). Conclusions The forces necessary to manipulate brain tissue were surprisingly low and varied depending on the anatomical structure being manipulated, and the maneuver performed. Knowledge of such forces could well increase the safety of microsurgery. © 2014 The Authors. The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons, Ltd. PMID:24431265

  5. Extreme Heat: A Prevention Guide to Promote Your Personal Health and Safety

    MedlinePlus

    ... in your office, school, or home. Related Links Climate Change- Extreme Heat Heat Stress Illness Search Heat Stress Illness Data Temperature Extremes- Climate and Health Language: English (US) Español (Spanish) ...

  6. Protecting Workers from Heat Stress

    MedlinePlus

    ... temperatures are high and the job involves physical work. Risk Factors for Heat Illness • High temperature and humidity, ... heat or those that have been away from work to adapt to working in the heat (acclimatization). • Routinely check workers who are at risk of heat stress due to protective clothing and ...

  7. Working safely in summertime heat

    Treesearch

    Robert B. Rummer

    1997-01-01

    As logging operations continue in the hotter months of he year, the safety hazard of heat stress appears. Loggers are particularly at risk, because the combination of hard physical work and outdoor conditions puts high demands on the body. While loggers rarely die from heat stress, they may suffer heat illness symptoms ranging from the discomfort of heat rash to nausea...

  8. Illness anxiety disorder

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001236.htm Illness anxiety disorder To use the sharing features on this page, please enable JavaScript. Illness anxiety disorder (IAD) is a preoccupation that physical symptoms ...

  9. Help for Mental Illnesses

    MedlinePlus

    ... If you or someone you know has a mental illness, there are ways to get help. Use these ... Support Alliance Mental Health America National Alliance on Mental Illness University or medical school-affiliated programs may offer ...

  10. Pathophysiology of Heat-Related Illnesses

    DTIC Science & Technology

    2012-01-01

    authors has rewarmed frozen fluorescein stain , oxybupro- caine hydrochloride 0.4%, ophthalmic local anesthetic, cortico- steroid creams, antifungal...exposure to lipopolysaccharide (LPS), a cell wall component of gram -negative bacteria, exacerbated inflam- mation, coagulation, and multiorgan system...NK cells TLR2 Lipopolysaccharide Peptidoglycan Lipoteichoic acid Measles virus Human cytomegalovirus Hepatitis C virus Zymosan Necrotic cells

  11. Clinical Management of Heat-Related Illnesses

    DTIC Science & Technology

    2012-01-01

    temperature measurement can be obtained. Cooling measures should only be minimally delayed for vital resuscitation measures. Nevertheless, it is... resuscitative measures.49 In the field, the sick individual should be placed in the shade, and any restrictive clothing should be removed. There are mul- tiple...positive-pressure ventilation—should be provided. Overly vigorous fluid resuscitation may precipitate pul- monary edema, so careful monitoring is

  12. Water Replacement Schedules in Heat Stress

    ERIC Educational Resources Information Center

    Londeree, Ben R.; and others

    1969-01-01

    Although early ingestion of cold water appears to lead to greater relief from heat stress during physical exertion than late ingestion, this difference is reduced toward the end of an hour's work in high heat and humidity. (CK)

  13. Water Replacement Schedules in Heat Stress

    ERIC Educational Resources Information Center

    Londeree, Ben R.; and others

    1969-01-01

    Although early ingestion of cold water appears to lead to greater relief from heat stress during physical exertion than late ingestion, this difference is reduced toward the end of an hour's work in high heat and humidity. (CK)

  14. Coping with Chronic Illness

    MedlinePlus

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  15. Carbohydrate exerts a mild influence on fluid retention following exercise-induced dehydration.

    PubMed

    Osterberg, Kristin L; Pallardy, Shannon E; Johnson, Richard J; Horswill, Craig A

    2010-02-01

    Rapid and complete rehydration, or restoration of fluid spaces, is important when acute illness or excessive sweating has compromised hydration status. Many studies have investigated the effects of graded concentrations of sodium and other electrolytes in rehydration solutions; however, no study to date has determined the effect of carbohydrate on fluid retention when electrolyte concentrations are held constant. The purpose of this study was to determine the effect of graded levels of carbohydrate on fluid retention following exercise-induced dehydration. Fifteen heat-acclimatized men exercised in the heat for 90 min with no fluid to induce 2-3% dehydration. After a 30-min equilibration period, they received, over the course of 60 min, one of five test beverages equal to 100% of the acute change in body mass. The experimental beverages consisted of a flavored placebo with no electrolytes (P), placebo with electrolytes (P + E), 3%, 6%, and 12% carbohydrate solutions with electrolytes. All beverages contained the same type and concentration of electrolytes (18 meq/l Na(+), 3 meq/l K(+), 11 meq/l Cl(-)). Subjects voided their bladders at 60, 90, 120, 180, and 240 min, and urine specific gravity and urine volume were measured. Blood samples were taken before exercise and 30, 90, 180, and 240 min following exercise and were analyzed for glucose, sodium, hemoglobin, hematocrit, renin, aldosterone, and osmolality. Body mass was measured before and after exercise and a final body mass was taken at 240 min. There were no differences in percent dehydration, sweat loss, or fluid intake between trials. Fluid retention was significantly greater for all carbohydrate beverages compared with P (66.3 +/- 14.4%). P + E (71.8 +/- 9.9%) was not different from water, 3% (75.4 +/- 7.8%) or 6% (75.4 +/- 16.4%) but was significantly less than 12% (82.4 +/- 9.2%) retention of the ingested fluid. No difference was found between the carbohydrate beverages. Carbohydrate at the levels

  16. Experimental approaches to therapy and prophylaxis for heat stress and heatstroke.

    PubMed

    Gaffin, S L; Hubbard, R

    1996-11-01

    New developments in the fields of biochemistry, physiology, sepsis, cancer therapy, and molecular genetics have led to opportunities for the development of new therapies and prophylaxes for heat illnesses and for improving human performance during conditions of environmental stress. These include antilipopolysaccharide agents, anticytokines, potassium channel agents, a diet rich in omega-3 fatty acids, and psychological conditioning. This review summarizes the backgrounds and recent findings in the above fields and provides specific suggestions for potential therapy and prophylaxis for classic and exertional heatstroke and for improving athletic performance.

  17. Virtual exertions: evoking the sense of exerting forces in virtual reality using gestures and muscle activity.

    PubMed

    Chen, Karen B; Ponto, Kevin; Tredinnick, Ross D; Radwin, Robert G

    2015-06-01

    This study was a proof of concept for virtual exertions, a novel method that involves the use of body tracking and electromyography for grasping and moving projections of objects in virtual reality (VR). The user views objects in his or her hands during rehearsed co-contractions of the same agonist-antagonist muscles normally used for the desired activities to suggest exerting forces. Unlike physical objects, virtual objects are images and lack mass. There is currently no practical physically demanding way to interact with virtual objects to simulate strenuous activities. Eleven participants grasped and lifted similar physical and virtual objects of various weights in an immersive 3-D Cave Automatic Virtual Environment. Muscle activity, localized muscle fatigue, ratings of perceived exertions, and NASA Task Load Index were measured. Additionally, the relationship between levels of immersion (2-D vs. 3-D) was studied. Although the overall magnitude of biceps activity and workload were greater in VR, muscle activity trends and fatigue patterns for varying weights within VR and physical conditions were the same. Perceived exertions for varying weights were not significantly different between VR and physical conditions. Perceived exertion levels and muscle activity patterns corresponded to the assigned virtual loads, which supported the hypothesis that the method evoked the perception of physical exertions and showed that the method was promising. Ultimately this approach may offer opportunities for research and training individuals to perform strenuous activities under potentially safer conditions that mimic situations while seeing their own body and hands relative to the scene. © 2014, Human Factors and Ergonomics Society.

  18. Update: Exertional rhabdomyolysis, active component, U.S. Army, Navy, Air Force, and Marine Corps, 2011-2015.

    PubMed

    Armed Forces Health Surveillance Branch

    2016-03-01

    Among active component members of the U.S. Army, Navy, Air Force, and Marine Corps in 2015, there were 456 incident episodes of rhabdomyolysis likely due to physical exertion or heat stress ("exertional rhabdomyolysis"). Annual rates of incident diagnoses of exertional rhabdomyolysis increased 17% between 2014 and 2015. In 2015, the highest incidence rates occurred in service members who were male; younger than 20 years of age; black, non-Hispanic; members of the Marine Corps and Army; recruit trainees; and in combat-specific occupations. Most cases of exertional rhabdomyolysis were diagnosed at installations that support basic combat/recruit training or major ground combat units of the Army or Marine Corps. Medical care providers should consider exertional rhabdomyolysis in the differential diagnosis when service members (particularly recruits) present with muscular pain and swelling, limited range of motion, or the excretion of dark urine (e.g., myoglobinuria) after strenuous physical activity, particularly in hot, humid weather.

  19. Traction forces exerted by epithelial cell sheets

    NASA Astrophysics Data System (ADS)

    Saez, A.; Anon, E.; Ghibaudo, M.; du Roure, O.; Di Meglio, J.-M.; Hersen, P.; Silberzan, P.; Buguin, A.; Ladoux, B.

    2010-05-01

    Whereas the adhesion and migration of individual cells have been well described in terms of physical forces, the mechanics of multicellular assemblies is still poorly understood. Here, we study the behavior of epithelial cells cultured on microfabricated substrates designed to measure cell-to-substrate interactions. These substrates are covered by a dense array of flexible micropillars whose deflection enables us to measure traction forces. They are obtained by lithography and soft replica molding. The pillar deflection is measured by video microscopy and images are analyzed with home-made multiple particle tracking software. First, we have characterized the temporal and spatial distributions of traction forces of cellular assemblies of various sizes. The mechanical force balance within epithelial cell sheets shows that the forces exerted by neighboring cells strongly depend on their relative position in the monolayer: the largest deformations are always localized at the edge of the islands of cells in the active areas of cell protrusions. The average traction stress rapidly decreases from its maximum value at the edge but remains much larger than the inherent noise due to the force resolution of our pillar tracking software, indicating an important mechanical activity inside epithelial cell islands. Moreover, these traction forces vary linearly with the rigidity of the substrate over about two decades, suggesting that cells exert a given amount of deformation rather than a force. Finally, we engineer micropatterned substrates supporting pillars with anisotropic stiffness. On such substrates cellular growth is aligned with respect to the stiffest direction in correlation with the magnitude of the applied traction forces.

  20. Traction forces exerted by epithelial cell sheets.

    PubMed

    Saez, A; Anon, E; Ghibaudo, M; du Roure, O; Di Meglio, J-M; Hersen, P; Silberzan, P; Buguin, A; Ladoux, B

    2010-05-19

    Whereas the adhesion and migration of individual cells have been well described in terms of physical forces, the mechanics of multicellular assemblies is still poorly understood. Here, we study the behavior of epithelial cells cultured on microfabricated substrates designed to measure cell-to-substrate interactions. These substrates are covered by a dense array of flexible micropillars whose deflection enables us to measure traction forces. They are obtained by lithography and soft replica molding. The pillar deflection is measured by video microscopy and images are analyzed with home-made multiple particle tracking software. First, we have characterized the temporal and spatial distributions of traction forces of cellular assemblies of various sizes. The mechanical force balance within epithelial cell sheets shows that the forces exerted by neighboring cells strongly depend on their relative position in the monolayer: the largest deformations are always localized at the edge of the islands of cells in the active areas of cell protrusions. The average traction stress rapidly decreases from its maximum value at the edge but remains much larger than the inherent noise due to the force resolution of our pillar tracking software, indicating an important mechanical activity inside epithelial cell islands. Moreover, these traction forces vary linearly with the rigidity of the substrate over about two decades, suggesting that cells exert a given amount of deformation rather than a force. Finally, we engineer micropatterned substrates supporting pillars with anisotropic stiffness. On such substrates cellular growth is aligned with respect to the stiffest direction in correlation with the magnitude of the applied traction forces.

  1. 20 CFR 220.132 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Physical exertion requirements. 220.132... ACT DETERMINING DISABILITY Vocational Considerations § 220.132 Physical exertion requirements. To determine the physical exertion requirements of work in the national economy, jobs are classified as...

  2. Differentiated Ratings of Perceived Exertion during Physical Exercise

    DTIC Science & Technology

    1982-01-01

    MEDICINE AND SCIENCE IN SPORTS AND EXERCISE VOl 14, No 5. Pp 397-405. 1982 -1982 Differentiated ratings of perceived exertion during physical ...that PANDOLF, KENT B. Differentiated ratings of perceived exertion utilizes differentiated ratings of perceived exertion (RPE) during physical exercise ...in the eval- Specific instructions and procedures for the utilization uation of effort sensations during physical exercise . Ekblom and Goldbarg (17

  3. Perceived Exertion of the PACER in High School Students

    ERIC Educational Resources Information Center

    Smith, John D.; Holmes, Patricia A.

    2013-01-01

    The purpose of this study was to explore high school students' perceived exertion after participating in the Progressive Aerobic Cardiovascular Endurance Run (PACER). Immediately after completing the PACER, students (N = 792) indicated their perceived exertion on the OMNI rating of perceived exertion (RPE) for children (1-10 scale). All students,…

  4. Repeated muscle damage blunts the increase in heat strain during subsequent exercise heat stress.

    PubMed

    Dolci, A; Fortes, M B; Walker, F S; Haq, A; Riddle, T; Walsh, N P

    2015-07-01

    Exercise-induced muscle damage (EIMD) has recently been shown to increase heat strain during exercise heat stress (HS), and represents a risk factor for exertional heat illness (EHI). We hypothesised that a repeated bout of EIMD blunts the increase in rectal temperature (T re) during subsequent endurance exercise in the heat. Sixteen non-heat-acclimated males were randomly allocated to EIMD (n = 9) or control (CON, n = 7). EIMD performed a downhill running treatment at -10 % gradient for 60 min at 65 % [Formula: see text]O2max in 20 °C, 40 % RH. CON participants performed the same treatment but at +1 % gradient. Following treatment, participants rested for 30 min, then performed HS (+1 % gradient running for 40 min at 65 % [Formula: see text]O2max in 33 °C, 50 % RH) during which thermoregulatory measures were assessed. Both groups repeated the treatment and subsequent HS 14 days later. Isometric quadriceps strength was assessed at baseline, and 48 h post-treatment. The decrease in leg strength 48 h post-EIMD trial 1 (-7.5 %) was absent 48 h post-EIMD trial 2 (+2.9 %) demonstrating a repeated bout effect. Final T re during HS was lower following EIMD trial 2 (39.25 ± 0.47 °C) compared with EIMD trial 1 (39.59 ± 0.49 °C, P < 0.01), with CON showing no difference. Thermal sensation and the T re threshold for sweating onset were also lower during HS on EIMD trial 2. The repeated bout effect blunted the increase in heat strain during HS conducted after EIMD. Incorporating a muscle-damaging bout into training could be a strategy to reduce the risk of EHI and improve endurance performance in individuals undertaking heavy exercise with an eccentric component in the heat.

  5. The definition of exertion-related cardiac events.

    PubMed

    Rai, M; Thompson, P D

    2011-02-01

    Vigorous physical activity increases the risk of sudden cardiac death (SCD) and acute myocardial infarction (AMI) but there is no standard definition as to what constitutes an exertion-related cardiac event, specifically the time interval between physical exertion and cardiac event. A systematic review of studies related to exertion-related cardiac events was performed and the time interval between exertion and the event or the symptoms leading to the event was looked for in all the articles selected for inclusion. A total of 12 of 26 articles "suggested" or "defined" exertion-related events as those events whose symptoms started during or within 1 h of exertion. Others used definitions of 0.5 h, 2 h, "during exertion", "during or immediately post exertion" and "during or within several hours after exertion". It is suggested, therefore, that the definition of an exertion-related cardiac event be established as a cardiac event in which symptoms started during or within 1 h of physical exertion.

  6. Negative radiation pressure exerted on kinks

    NASA Astrophysics Data System (ADS)

    Forgács, Péter; Lukács, Árpád; Romańczukiewicz, Tomasz

    2008-06-01

    The interaction of a kink and a monochromatic plane wave in one dimensional scalar field theories is studied. It is shown that in a large class of models the radiation pressure exerted on the kink is negative, i.e. the kink is pulled towards the source of the radiation. This effect has been observed by numerical simulations in the ϕ4 model, and it is explained by a perturbative calculation assuming that the amplitude of the incoming wave is small. Quite importantly the effect is shown to be robust against small perturbations of the ϕ4 model. In the sine-Gordon (SG) model the time-averaged radiation pressure acting on the kink turns out to be zero. The results of the perturbative computations in the SG model are shown to be in full agreement with an analytical solution corresponding to the superposition of a SG kink with a cnoidal wave. It is also demonstrated that the acceleration of the kink satisfies Newton’s law.

  7. Exercise Device Would Exert Selectable Constant Resistance

    NASA Technical Reports Server (NTRS)

    Smith, Damon C.

    2003-01-01

    An apparatus called the resistive exercise device (RED) has been proposed to satisfy a requirement for exercise equipment aboard the International Space Station (ISS) that could passively exert a selectable constant load on both the outward and return strokes. The RED could be used alone; alternatively, the RED could be used in combination with another apparatus called the treadmill with vibration isolation and stabilization (TVIS), in which case the combination would be called the subject load device (SLD). The basic RED would be a passive device, but it could incorporate an electric motor to provide eccentric augmentation (augmentation to make the load during inward movement greater than the load during outward movement). The RED concept represents a unique approach to providing a constant but selectable resistive load for exercise for the maintenance and development of muscles. Going beyond the original ISS application, the RED could be used on Earth as resistive weight training equipment. The advantage of the RED over conventional weight-lifting equipment is that it could be made portable and lightweight.

  8. Negative radiation pressure exerted on kinks

    SciTech Connect

    Forgacs, Peter; Lukacs, Arpad; Romanczukiewicz, Tomasz

    2008-06-15

    The interaction of a kink and a monochromatic plane wave in one dimensional scalar field theories is studied. It is shown that in a large class of models the radiation pressure exerted on the kink is negative, i.e. the kink is pulled towards the source of the radiation. This effect has been observed by numerical simulations in the {phi}{sup 4} model, and it is explained by a perturbative calculation assuming that the amplitude of the incoming wave is small. Quite importantly the effect is shown to be robust against small perturbations of the {phi}{sup 4} model. In the sine-Gordon (SG) model the time-averaged radiation pressure acting on the kink turns out to be zero. The results of the perturbative computations in the SG model are shown to be in full agreement with an analytical solution corresponding to the superposition of a SG kink with a cnoidal wave. It is also demonstrated that the acceleration of the kink satisfies Newton's law.

  9. Travelers' Health: Problems with Heat and Cold

    MedlinePlus

    ... predisposing factor in heat illness. Dehydration also reduces exercise performance, decreases time to exhaustion, and increases internal heat load. Temperature and heart rate increase in direct proportion to the level of ...

  10. A Critical Review of OSHA Heat Enforcement Cases: Lessons Learned.

    PubMed

    Arbury, Sheila; Lindsley, Matthew; Hodgson, Michael

    2016-04-01

    The aim of the study was to review the Occupational Safety and Health Administration's (OSHA) 2012 to 2013 heat enforcement cases, using identified essential elements of heat illness prevention to evaluate employers' programs and make recommendations to better protect workers from heat illness. (1) Identify essential elements of heat illness prevention; (2) develop data collection tool; and (3) analyze OSHA 2012 to 2013 heat enforcement cases. OSHA's database contains 84 heat enforcement cases in 2012 to 2013. Employer heat illness prevention programs were lacking in essential elements such as providing water and shade; adjusting the work/rest proportion to allow for workload and effective temperature; and acclimatizing and training workers. In this set of investigations, most employers failed to implement common elements of illness prevention programs. Over 80% clearly did not rely on national standard approaches to heat illness prevention.

  11. Perception of and attitude towards mental illness in Oman.

    PubMed

    Al-Adawi, Samir; Dorvlo, Atsu S S; Al-Ismaily, Suad S; Al-Ghafry, Dalal A; Al-Noobi, Balquis Z; Al-Salmi, Ahmed; Burke, David T; Shah, Mrugeshkumar K; Ghassany, Harith; Chand, Suma P

    2002-12-01

    As conceptions of mental illness are often dictated by prevailing socio-cultural factors and the philosophy of the time, there is little research to substantiate how mental illness is perceived in the Arab world in the light of both traditional and more recent modernization and acculturation processes. To examine whether social factors exert an influence on a person's attitude towards people with mental illness (PWMI) in the rapidly changing country of Oman. This study compares the response elicited from medical students, relatives of psychiatric patients and the general Omani public on the causes of mental illness, attitudes toward PWMI and the care and management of people with mental illness. This study found no relationship between attitudes towards PWMI, and demographic variables such as age, educational level, marital status, sex and personal exposure to people with mental illness. Both medical students and the public rejected a genetic factor as the cause of mental illness; instead they favoured the role of spirits as the aetiological factor for mental illness. There were favourable responses on statements regarding value of life, family life, decision-making ability, and the management and care of mental illness. However, both medical students and the public thought that PWMI tend to have peculiar and stereotypical appearances and the majority preferred that facilities for psychiatric care should be located away from the community. Although the relatives of psychiatric patients were concerned about the welfare of mental patients, their responses varied and were often contingent upon their expectations. The data suggest that neither socio-demographic factors nor previous exposure to PWMI was related to attitudes towards PWMI. Although the attitudes of Omanis toward PWMI appear to fluctuate in complex ways, traditional beliefs on mental illness have yet to be eroded by exposure to a biomedical model of mental illness. This study largely supports the view that

  12. Critical illness myopathy.

    PubMed

    Latronico, Nicola; Tomelleri, Giuliano; Filosto, Massimiliano

    2012-11-01

    To describe the incidence, major risk factors, and the clinical, electrophysiological, and histological features of critical illness myopathy (CIM). Major pathogenetic mechanisms and long-term consequences of CIM are also reviewed. CIM is frequently associated with critical illness polyneuropathy (CIP), and may have a relevant impact on patients' outcome. CIM has an earlier onset than CIP, and recovery is faster. Loss of myosin filaments on muscle biopsy is important to diagnose CIM, and has a good prognosis. Critical illness, use of steroids, and immobility concur in causing CIM. A rationale diagnostic approach to CIM using clinical, electrophysiological, and muscle biopsy investigations is important to plan adequate therapy and to predict recovery.

  13. Abandoning the mentally ill.

    PubMed

    Barton, R

    1975-12-01

    Mentally ill people have been avoided and abandoned by their families and public authorities for hundreds of years. Present day abandonment includes the deployment of professionals from patients to paper; the destruction of availability and effectiveness of institutional facilities; the obfuscation of mental illness by captious, sematic criticism; the aspirations of paramedical and paraprofessional groups; and the subordination of the primary purpose of institutions and physicians to other objectives. The nature of authority is discussed and the need for the treatment of mentally ill people to be based on the art and science of medicine, rather than the pretension and advocacy of the gullible, unqualified or unscrupulous, is noted.

  14. The Effect of Exertion on Heart Rate and Rating of Perceived Exertion in Acutely Concussed Individuals.

    PubMed

    Hinds, Andrea; Leddy, John; Freitas, Michael; Czuczman, Natalie; Willer, Barry

    2016-08-01

    Research suggests that one physiological effect of concussion is a disruption in regulation of autonomic nervous system control that affects the balance between parasympathetic and sympathetic output. While changes in heart rate after concussion have been observed, the nature of the heart rate change during progressive exercise has not been well evaluated in acutely symptomatic patients. Additionally, little is known about the relationship between HR and RPE in this population. We compared changes in heart rate and perceived effort during graded treadmill exertion in recently concussed patients to elucidate the effect of brain injury on cardiovascular response to exercise. Resting HR, HR on exercise initiation, and changes in HR and RPE during the Buffalo Concussion Treadmill Test (BCTT) were compared on two test visits: When patients were symptomatic (acute) and after recovery. Results were compared with the test-retest results obtained from a control group consisting of healthy, non-concussed individuals. Patients had a significantly lower HR at onset of exercise when acutely concussed as compared to when recovered and reported greater perceived exertion at every exercise intensity level when symptomatic, despite exercising at lower workloads, than when recovered. Sympathetic response to increased exertion was not affected by concussion - HR increased in response to exercise at a comparable rate in both tests. These differences observed in response to exercise between the first BCTT and follow-up evaluation in initially concussed patients were not present in non-concussed individuals. Our results suggest that during the acute phase after concussion, acutely concussed patients demonstrated an impaired ability to shift from parasympathetic to sympathetic control over heart rate at the onset of exercise. Changes in the autonomic nervous system after concussion may be more complex than previously reported. Continued evaluation of autonomic regulatory effects in the

  15. The Effect of Exertion on Heart Rate and Rating of Perceived Exertion in Acutely Concussed Individuals

    PubMed Central

    Hinds, Andrea; Leddy, John; Freitas, Michael; Czuczman, Natalie; Willer, Barry

    2016-01-01

    Objective Research suggests that one physiological effect of concussion is a disruption in regulation of autonomic nervous system control that affects the balance between parasympathetic and sympathetic output. While changes in heart rate after concussion have been observed, the nature of the heart rate change during progressive exercise has not been well evaluated in acutely symptomatic patients. Additionally, little is known about the relationship between HR and RPE in this population. Methods We compared changes in heart rate and perceived effort during graded treadmill exertion in recently concussed patients to elucidate the effect of brain injury on cardiovascular response to exercise. Resting HR, HR on exercise initiation, and changes in HR and RPE during the Buffalo Concussion Treadmill Test (BCTT) were compared on two test visits: When patients were symptomatic (acute) and after recovery. Results were compared with the test-retest results obtained from a control group consisting of healthy, non-concussed individuals. Results Patients had a significantly lower HR at onset of exercise when acutely concussed as compared to when recovered and reported greater perceived exertion at every exercise intensity level when symptomatic, despite exercising at lower workloads, than when recovered. Sympathetic response to increased exertion was not affected by concussion - HR increased in response to exercise at a comparable rate in both tests. These differences observed in response to exercise between the first BCTT and follow-up evaluation in initially concussed patients were not present in non-concussed individuals. Conclusion Our results suggest that during the acute phase after concussion, acutely concussed patients demonstrated an impaired ability to shift from parasympathetic to sympathetic control over heart rate at the onset of exercise. Changes in the autonomic nervous system after concussion may be more complex than previously reported. Continued evaluation of

  16. Burden of Mental Illness

    MedlinePlus

    ... this? Submit What's this? Submit Button Burden of Mental Illness Recommend on Facebook Tweet Share Compartir Depression: According ... anxiety disorder, are the most common class of mental disorders present in the general population. 5 The estimated ...

  17. Serious Illnesses and Breastfeeding

    MedlinePlus

    ... Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Breastfeeding > Serious Illnesses and Breastfeeding Ages & Stages ...

  18. Giardia: Illness & Symptoms

    MedlinePlus

    ... The CDC Cancel Submit Search The CDC Parasites - Giardia Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Giardia General Information Illness & Symptoms Diagnosis & Detection Treatment Sources ...

  19. Mass Psychogenic Illness

    MedlinePlus

    ... been exposed to something harmful.An outbreak of mass psychogenic illness is a time of anxiety and worry. During an outbreak, a lot of media coverage and the presence of ambulances or emergency ...

  20. Symptoms of Tickborne Illness

    MedlinePlus

    ... symptoms include headache, fatigue, and muscle aches. With Lyme disease you may also experience joint pain. The severity ... disease and the patient's personal tolerance level. Rash: Lyme disease , southern tick-associated rash illness (STARI) , Rocky Mountain ...

  1. Vaccines Stop Illness

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Vaccines Stop Illness Past Issues / Spring 2008 Table of ... meningitis won't infect, cripple, or kill children. Vaccine Safety In light of recent questions about vaccine ...

  2. Chronic Illness & Mental Health

    MedlinePlus

    ... your overall health and treatment issues. Recovery from depression takes time, but treatment can improve the quality of life even if you have a medical illness. Treatments for depression include: Cognitive behavioral therapy (CBT), or talk therapy, ...

  3. Absence of Exertional Hyperthermia in a 17 Year Old with Severe Burns

    PubMed Central

    McEntire, Serina J.; Lee, Jong O.; Herndon, David N.; Suman, Oscar E.

    2014-01-01

    Objective An important safety concern when exercising burned patients is the potential for an excessive increase in core body temperature (hyperthermia = body core temperature > 39°C) during exercise. Methods We examined the thermoregulatory response to exercise in the heat (31°C, relative humidity 40%) in a 17 year old with a 99% total body surface area burn. A 30 minute exercise test was performed at an intensity of 75% of his peak aerobic capacity. Intestinal temperature was assessed via telemetry with an ingestible capsule. Intestinal temperature was measured pre-exercise, during, and post-exercise. Results The patient completed 12 minutes of the 30 minute exercise test. Starting core temperature was 36.98 °C and increased 0.69 °C during exercise. After excercise, intestinal temperature continued to increase, but no hyperthermia was noted. Conclusion It has been reported that burned children can safely exercise at room temperature, however, the response in the heat is unknown. This patient did not develop exertional hyperthermia, which we propose is due to his low fitness level and heat intolerance. However, the potential for hyperthermia would be increased if he were forced to maintain a high relative workload in the heat. We propose that severely burned individuals should be able to safely participate in physical activities. However, the decision to stop exercising should be accepted to avoid development of exertional hyperthermia. PMID:19506510

  4. The effects of ice slurry ingestion before exertion in Wildland firefighting gear.

    PubMed

    Pryor, Riana R; Suyama, Joe; Guyette, Francis X; Reis, Steven E; Hostler, David

    2015-01-01

    To investigate the effect of ice slurry ingestion precooling on body core temperature (Tc) during exertion in wildland firefighting garments in uncompensable heat stress. On two separate trials, 10 males ingested 7.5 g·kg(-1) of either an ice slurry (0.1°C) or control beverage (20°C) during seated rest for 30 minutes prior to simulating the U.S. Forest Service Pack Test on a treadmill in wildland firefighting garments in a hot environment (38.8 ± 1.2°C, 17.5 ± 1.4% relative humidity). Deep gastric temperature, mean skin temperature (Tsk), and heart rate (HR) were recorded. Ratings of perceived exertion, thermal sensation, comfort, and sweating were assessed. Compared with ingestion of a temperate beverage, precooling with ice slurry before exertion in a hot environment reduced Tc during the first 30 minutes of the exercise bout. Exercise time and distance completed were not different between treatments. Skin temperature, heart rate, and perceptual responses rose in both conditions during exercise but did not differ by condition. Pretreatment with ice slurry prior to exertion in wildland firefighting garments results in a modest reduction in Tc during the first 30 minutes of exercise when compared to pretreatment with control beverage but the ice slurry precooling advantage did not persist throughout the 45-minute exercise protocol.

  5. Temperature-Related Death and Illness. Chapter 2

    NASA Technical Reports Server (NTRS)

    Sarofim, Marcus C.; Saha, Shubhayu; Hawkins, Michelle D.; Mills, David M.; Hess, Jeremy; Horton, Radley; Kinney, Patrick; Schwartz, Joel; St. Juliana, Alexis

    2016-01-01

    Based on present-day sensitivity to heat, an increase of thousands to tens of thousands of premature heat-related deaths in the summer and a decrease of premature cold-related deaths in the winter are projected each year as a result of climate change by the end of the century. Future adaptation will very likely reduce these impacts (see Changing Tolerance to Extreme Heat Finding). The reduction in cold-related deaths is projected to be smaller than the increase in heat-related deaths in most regions. Days that are hotter than usual in the summer or colder than usual in the winter are both associated with increased illness and death. Mortality effects are observed even for small differences from seasonal average temperatures. Because small temperature differences occur much more frequently than large temperature differences, not accounting for the effect of these small differences would lead to underestimating the future impact of climate change. An increase in population tolerance to extreme heat has been observed over time. Changes in this tolerance have been associated with increased use of air conditioning, improved social responses, and or physiological acclimatization, among other factors. Expected future increases in this tolerance will reduce the projected increase in deaths from heat. Older adults and children have a higher risk of dying or becoming ill due to extreme heat. People working outdoors, the socially isolated and economically disadvantaged, those with chronic illnesses, as well as some communities of color, are also especially vulnerable to death or illness.

  6. Force Exertion Capacity Measurements in Haptic Virtual Environments

    ERIC Educational Resources Information Center

    Munih, Marko; Bardorfer, Ales; Ceru, Bojan; Bajd, Tadej; Zupan, Anton

    2010-01-01

    An objective test for evaluating functional status of the upper limbs (ULs) in patients with muscular distrophy (MD) is presented. The method allows for quantitative assessment of the UL functional state with an emphasis on force exertion capacity. The experimental measurement setup and the methodology for the assessment of maximal exertable force…

  7. Exertional Rhabdomyolysis: What Is It and Why Should We Care?

    ERIC Educational Resources Information Center

    Thomas, David Q.; Carlson, Kelli A.; Marzano, Amy; Garrahy, Deborah

    2012-01-01

    Exertional rhabdomyolysis gained increased attention recently when 13 football players from the University of Iowa developed this condition after an especially demanding practice session and were hospitalized. Exertional rhabdomyolysis may lead to severe kidney stress, kidney failure, and even sudden death. Anyone who does physical exercise at a…

  8. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  9. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  10. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  11. 20 CFR 220.135 - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... limitations. (a) General. The claimant's impairment(s) and related symptoms, such as pain, may cause... as pain, are exertional, nonexertional, or a combination of both. (b) Exertional limitations. When... pain, affect only the claimant's ability to meet the strength demands of jobs (sitting,...

  12. Using Ratings of Perceived Exertion in Physical Education

    ERIC Educational Resources Information Center

    Lagally, Kristen M.

    2013-01-01

    Ratings of perceived exertion have been shown to be a valid method of monitoring physical activity intensity for both adults and children. As such, this subjective method may serve as an alternative to objective measurements for assessing students' performance on national standards 2 and 4. The OMNI-Child perceived exertion scales were…

  13. Exertional Rhabdomyolysis: What Is It and Why Should We Care?

    ERIC Educational Resources Information Center

    Thomas, David Q.; Carlson, Kelli A.; Marzano, Amy; Garrahy, Deborah

    2012-01-01

    Exertional rhabdomyolysis gained increased attention recently when 13 football players from the University of Iowa developed this condition after an especially demanding practice session and were hospitalized. Exertional rhabdomyolysis may lead to severe kidney stress, kidney failure, and even sudden death. Anyone who does physical exercise at a…

  14. Using Ratings of Perceived Exertion in Physical Education

    ERIC Educational Resources Information Center

    Lagally, Kristen M.

    2013-01-01

    Ratings of perceived exertion have been shown to be a valid method of monitoring physical activity intensity for both adults and children. As such, this subjective method may serve as an alternative to objective measurements for assessing students' performance on national standards 2 and 4. The OMNI-Child perceived exertion scales were…

  15. The illness/non-illness model: hypnotherapy for physically ill patients.

    PubMed

    Navon, Shaul

    2014-07-01

    This article proposes a focused, novel sub-set of the cognitive behavioral therapy approach to hypnotherapy for physically ill patients, based upon the illness/non-illness psychotherapeutic model for physically ill patients. The model is based on three logical rules used in differentiating illness from non-illness: duality, contradiction, and complementarity. The article discusses the use of hypnotic interventions to help physically ill and/or disabled patients distinguish between illness and non-illness in their psychotherapeutic themes and attitudes. Two case studies illustrate that patients in this special population group can be taught to learn the language of change and to use this language to overcome difficult situations. The model suggests a new clinical mode of treatment in which individuals who are physically ill and/or disabled are helped in coping with actual motifs and thoughts related to non-illness or non-disability.

  16. Acute exertional anterior compartment syndrome in an adolescent female.

    PubMed

    Fehlandt, A; Micheli, L

    1995-01-01

    Acute compartment syndromes usually occur as a complication of major trauma. While the chronic exertional anterior tibial compartment syndrome is well described in the sports medicine literature, reports of acute tibial compartment syndromes due to physical exertion, or repetitive microtrauma, are rare. The case of an adolescent female who developed an acute anterior compartment syndrome from running in a soccer game is described in this report. Failure to recognize the onset of an acute exertional compartment syndrome may lead to treatment delay and serious complications. Whereas the chronic exertional anterior compartment syndrome is characterized by pain that diminishes with the cessation of exercise, the onset of the acute exertional anterior compartment syndrome is heralded by pain that continues, or increases, after exercise has stopped. Compartment pressure measurement confirms the clinical diagnosis and helps guide treatment. True compartment syndromes require urgent fasciotomy.

  17. Exertional myopathy in whooping cranes (Grus americana) with prognostic guidlelines

    USGS Publications Warehouse

    Hanley, C.S.; Thomas, N.J.; Paul-Murphy, P.; Hartup, B.K.

    2005-01-01

    Exertional myopathy developed in three whooping cranes (Grus americana) secondary to routine capture, handling, and trauma. Presumptive diagnosis of exertional myopathy was based on history of recent capture or trauma, clinical signs, and elevation of aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, and serum potassium. Treatments were attempted in each case, but ultimately were not successful. Gross and microscopic lesions at necropsy confirmed the diagnosis in each case, with the leg musculature most severely affected. Guidelines for determining prognosis of exertional myopathy in cranes have been included based on the analysis of these cases and others in the literature. As treatment is largely unrewarding, prevention remains the key in controlling exertional myopathy. Identification of predisposing factors and proper handling, immobilization, and transportation techniques can help prevent development of exertional myopathy in cranes.

  18. Exertional myopathy in whooping cranes (Grus americana) with prognostic guidelines.

    PubMed

    Hanley, Christopher S; Thomas, Nancy J; Paul-Murphy, Joanne; Hartup, Barry K

    2005-09-01

    Exertional myopathy developed in three whooping cranes (Grus americana) secondary to routine capture, handling, and trauma. Presumptive diagnosis of exertional myopathy was based on history of recent capture or trauma, clinical signs, and elevation of aspartate aminotransferase, alanine aminotransferase, creatine kinase, lactate dehydrogenase, and serum potassium. Treatments were attempted in each case, but ultimately were not successful. Gross and microscopic lesions at necropsy confirmed the diagnosis in each case, with the leg musculature most severely affected. Guidelines for determining prognosis of exertional myopathy in cranes have been included based on the analysis of these cases and others in the literature. As treatment is largely unrewarding, prevention remains the key in controlling exertional myopathy. Identification of predisposing factors and proper handling, immobilization, and transportation techniques can help prevent development of exertional myopathy in cranes.

  19. [Mental illness and media].

    PubMed

    Magli, Erica; Buizza, Chiara; Pioli, Rosaria

    2004-06-01

    Many knowledges on the mental disease that the community possesses are turning out of information disclosed from the media. It's common in the press to connect actions of violence and murders to the mental diseases. For this reason, the reader is induced to infer that murders and other violent actions are more frequent in people who have suffered from mentally ill, than in the general population. The mystifying impression provided by media accrues from the fact that these reports are rarely compensated from positive reports. Objective of the present study is to characterize the type of information concerning mental illness diffused from the local daily paper "Giornale di Brescia" in the year 2001. The results show that many articles connote negatively the mental disease. The journalistic sensationalism, denounced facing the speech of the prejudgment in the comparisons of the mentally ill people, seems to still remain, in the considered year of publication, one unchanging tendency.

  20. [Creativity and mental illness].

    PubMed

    Rihmer, Zoltán; Gonda, Xénia; Rihmer, Annamária

    2006-01-01

    It has been known for a long time that people with salient social and artistic creativity suffer more frequently from psychiatric illnesses than the average population. In their review paper, the authors assess the Hungarian and international scientific literature regarding the association of creativity and psychopathology. They conclude that contrary to the concept prevailing in the first part of the 20th century about the strong association between schizophrenia and creativity, the results of empirical research now unambiguously suggest that prominent social and artistic creativity is associated primarily with affective, and more specifically with bipolar affective illnesses. In addition, we already know that as regards the development of creativity, it is not the given affective (depressive, manic, hypomanic) episode which is important, but the hyperthymic or cyclothymic temperament structure which also predisposes for affective illness.

  1. Prior Acute Mental Exertion in Exercise and Sport

    PubMed Central

    Silva-Júnior, Fernando Lopes e; Emanuel, Patrick; Sousa, Jordan; Silva, Matheus; Teixeira, Silmar; Pires, Flávio; Machado, Sérgio; Arias-Carrion, Oscar

    2016-01-01

    Introduction: Mental exertion is a psychophysiological state caused by sustained and prolonged cognitive activity. The understanding of the possible effects of acute mental exertion on physical performance, and their physiological and psychological responses are of great importance for the performance of different occupations, such as military, construction workers, athletes (professional or recreational) or simply practicing regular exercise, since these occupations often combine physical and mental tasks while performing their activities. However, the effects of implementation of a cognitive task on responses to aerobic exercise and sports are poorly understood. Our narrative review aims to provide information on the current research related to the effects of prior acute mental fatigue on physical performance and their physiological and psychological responses associated with exercise and sports. Methods: The literature search was conducted using the databases PubMed, ISI Web of Knowledge and PsycInfo using the following terms and their combinations: “mental exertion”, “mental fatigue”, “mental fatigue and performance”, “mental exertion and sports” “mental exertion and exercise”. Results: We concluded that prior acute mental exertion affects effectively the physiological and psychophysiological responses during the cognitive task, and performance in exercise. Conclusion: Additional studies involving prior acute mental exertion, exercise/sports and physical performance still need to be carried out in order to analyze the physiological, psychophysiological and neurophysiological responses subsequently to acute mental exertion in order to identify cardiovascular factors, psychological, neuropsychological associates. PMID:27867415

  2. Understanding the Mismatch Between Coaches' and Players' Perceptions of Exertion.

    PubMed

    Brink, Michel S; Kersten, Anna W; Frencken, Wouter G P

    2017-04-01

    A mismatch between the training exertion intended by a coach and the exertion perceived by players is well established in sports. However, it is unknown whether coaches can accurately observe exertion of individual players during training. Furthermore, the discrepancy in coaches' and players' perceptions has not been explained. To determine the relation between intended and observed training exertion by the coach and perceived training exertion by the players and establish whether on-field training characteristics, intermittent endurance capacity, and maturity status explain the mismatch. During 2 mesocycles of 4 wk (in November and March), rating of intended exertion (RIE), rating of observed exertion (ROE), and rating of perceived exertion (RPE) were monitored in 31 elite young soccer players. External and internal training loads were objectively quantified with accelerometers (PlayerLoad) and heart-rate monitors (TRIMPmod). Results of an interval shuttle-run test (ISRT) and age at peak height velocity (APHV) were determined for all players. RIE, ROE, and RPE were monitored in 977 training sessions. The correlations between RIE and RPE (r = .58; P < .01) and between ROE and RPE (r = .64; P < .01) were moderate. The mean difference between RIE and RPE was -0.31 ± 1.99 and between ROE and RPE was -0.37 ± 1.87. Multilevel analyses showed that PlayerLoad and ISRT predicted RIE and ROE. Coaches base their intended and observed exertion on what they expect players will do and what they actually did on the field. When doing this, they consider the intermittent endurance capacity of individual players.

  3. [Acute cardiovascular complications of vigorous physical exertion by untrained persons].

    PubMed

    Hart, H Ch; Hart, W

    2002-08-10

    Physical exertion has paradoxical effects: regular physical activity offers protection against cardiovascular diseases, but, on the other hand, it has been shown that strenuous exercise can provoke coronary heart disease and sudden death. The risks of vigorous exertion apply particularly to untrained individuals and persons with a sedentary lifestyle. Physical exertion can cause a myocardial infarction or sudden death in people who were considered perfectly healthy before this event. In most cases, the mechanism of this is probably a rupture at the site of a vulnerable atherosclerotic plaque, with local activation of coagulation. Disturbances in cardiac rhythm may also be a cause of these complications.

  4. Relieving thermal discomfort: Effects of sprayed L-menthol on perception, performance, and time trial cycling in the heat.

    PubMed

    Barwood, M J; Corbett, J; Thomas, K; Twentyman, P

    2015-06-01

    L-menthol stimulates cutaneous thermoreceptors and induces cool sensations improving thermal comfort, but has been linked to heat storage responses; this could increase risk of heat illness during self-paced exercise in the heat. Therefore, L-menthol application could lead to a discrepancy between behavioral and autonomic thermoregulatory drivers. Eight male participants volunteered. They were familiarized and then completed two trials in hot conditions (33.5 °C, 33% relative humidity) where their t-shirt was sprayed with CONTROL-SPRAY or MENTHOL-SPRAY after 10 km (i.e., when they were hot and uncomfortable) of a 16.1-km cycling time trial (TT). Thermal perception [thermal sensation (TS) and comfort (TC)], thermal responses [rectal temperature (Trec ), skin temperature (Tskin )], perceived exertion (RPE), heart rate, pacing (power output), and TT completion time were measured. MENTHOL-SPRAY made participants feel cooler and more comfortable and resulted in lower RPE (i.e., less exertion) yet performance was unchanged [TT completion: CONTROL-SPRAY 32.4 (2.9) and MENTHOL-SPRAY 32.7 (3.0) min]. Trec rate of increase was 1.40 (0.60) and 1.45 (0.40) °C/h after CONTROL-SPRAY and MENTHOL-SPRAY application, which were not different. Spraying L-menthol toward the end of self-paced exercise in the heat improved perception, but did not alter performance and did not increase heat illness risk. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Mental Illness And Brain Disease.

    PubMed

    Bedrick, Jeffrey D

    2014-01-01

    It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.

  6. Mozart's illnesses and death.

    PubMed Central

    Davies, P J

    1983-01-01

    Throughout his life Mozart suffered frequent attacks of tonsillitis. In 1784 he developed post-streptococcal Schönlein-Henoch syndrome which caused chronic glomerular nephritis and chronic renal failure. His fatal illness was due to Schönlein-Henoch purpura, with death from cerebral haemorrhage and bronchopneumonia. Venesection(s) may have contributed to his death. PMID:6352940

  7. Platelets in Critical Illness.

    PubMed

    Levi, Marcel

    2016-04-01

    In patients with critical illness, thrombocytopenia is a frequent laboratory abnormality. However frequent this may occur, a low platelet count is not an epiphenomenon, but a marker with further significance. It is always important to assess the proper cause for thrombocytopenia in critically ill patients because different underlying disorders may precipitate different diagnostic and therapeutic management strategies. Platelets are part of the first-line defense of the body against bleeding; hence, thrombocytopenia may increase the risk of hemorrhage. In case of systemic inflammatory syndromes, such as the response to sepsis, disseminated intravascular platelet activation may occur. This will contribute to microvascular failure and thereby play a role in the development of organ dysfunction. Platelets are circulating blood cells that will normally not interact with the intact vessel wall but that may swiftly respond to endothelial disruption (which is often part of the pathogenesis of critical illness) by adhering to subendothelial structures, followed by interaction with each other, thereby forming a platelet aggregate. The activated platelet (phospholipid) membrane may form a suitable surface on which further coagulation activation may occur. A low platelet count is a strong and independent predictor of an adverse outcome in critically ill patients, thereby facilitating a simple and practically risk assessment in these patients and potentially guiding the use of complex or expensive treatment strategies.

  8. Alienation and Illness.

    ERIC Educational Resources Information Center

    Kobasa, Suzanne C.

    Reviews of studies of four groups (business executives, lawyers, Army officers, and working women) which demonstrate the health-damaging effects of alienation in certain life situations show that, when under stress, members of these groups who feel alienated fall ill, medically and/or psychiatrically. Three models are described which may explain…

  9. Mentally Ill Children.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    Estimates suggest that about 15% of all children have some form of mental disturbance. Potential causes can be of a physical, psychological, or environmental origin. Symptoms which indicate that a child needs professional help usually involve emotional overreaction to changes. Diagnosis of a child evidencing symptoms of mental illness should take…

  10. Mentally Ill Children.

    ERIC Educational Resources Information Center

    Blai, Boris, Jr.

    Estimates suggest that about 15% of all children have some form of mental disturbance. Potential causes can be of a physical, psychological, or environmental origin. Symptoms which indicate that a child needs professional help usually involve emotional overreaction to changes. Diagnosis of a child evidencing symptoms of mental illness should take…

  11. Aerobic Fitness and Risk of Ventricular Arrhythmia Following Physical Exertion.

    PubMed

    Chahal, Harpreet S; Mostofsky, Elizabeth; Mittleman, Murray A; Suskin, Neville; Speechley, Mark; Skanes, Allan C; Leong-Sit, Peter; Manlucu, Jaimie; Yee, Raymond; Klein, George J; Gula, Lorne J

    2016-04-01

    Brief episodes of physical exertion are associated with an immediately greater risk of cardiovascular events. Previous studies on the risk of ventricular arrhythmia (VA) shortly after exertion have not assessed if this risk differs according to the level of aerobic fitness or sedentary behaviour. Therefore, we conducted a prospective cohort study of patients with implantable cardioverter-defibrillators (ICDs) with a nested case-crossover analysis to examine the risk of VA shortly after exertion and whether this risk is modified by aerobic fitness and sedentary behaviour. Ninety-seven consecutive patients were recruited at the time of ICD implantation and 30 confirmed events occurred among patients who completed interviews about physical exertion preceding ICD therapy. We compared the frequency of exertion within an hour of ICD discharge to each patient's usual frequency of exertion reported at the time of ICD implantation. Within an hour of episodes of exertion, the risk of VA was 5.3 (95% confidence interval [CI], 2.7-10.6) times greater compared with periods of rest. The association was higher among patients with aerobic fitness below the median (relative risk [RR] = 17.5; 95% CI, 5.2-58.5) than for patients with aerobic fitness above the median (RR, 1.2; 95% CI, 0.4-4.2; P homogeneity = 0.002) and higher among patients who were sedentary (RR, 52.8; 95% CI, 10.1-277) compared with individuals who were not sedentary (RR, 3.2; 95% CI, 1.3-7.6; P homogeneity = 0.0002). Within 1 hour of episodes of exertion, there is an increased risk of VA, especially among individuals with lower levels of aerobic fitness and with sedentary behaviour. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  12. Do placebo expectations influence perceived exertion during physical exercise?

    PubMed

    Mothes, Hendrik; Leukel, Christian; Seelig, Harald; Fuchs, Reinhard

    2017-01-01

    This study investigates the role of placebo expectations in individuals' perception of exertion during acute physical exercise. Building upon findings from placebo and marketing research, we examined how perceived exertion is affected by expectations regarding a) the effects of exercise and b) the effects of the exercise product worn during the exercise. We also investigated whether these effects are moderated by physical self-concept. Seventy-eight participants conducted a moderate 30 min cycling exercise on an ergometer, with perceived exertion (RPE) measured every 5 minutes. Beforehand, each participant was randomly assigned to 1 of 4 conditions and watched a corresponding film clip presenting "scientific evidence" that the exercise would or would not result in health benefits and that the exercise product they were wearing (compression garment) would additionally enhance exercise benefits or would only be worn for control purposes. Participants' physical self-concept was assessed via questionnaire. Results partially demonstrated that participants with more positive expectations experienced reduced perceived exertion during the exercise. Furthermore, our results indicate a moderator effect of physical self-concept: Individuals with a high physical self-concept benefited (in terms of reduced perceived exertion levels) in particular from an induction of generally positive expectations. In contrast, individuals with a low physical self-concept benefited when positive expectations were related to the exercise product they were wearing. In sum, these results suggest that placebo expectations may be a further, previously neglected class of psychological factors that influence the perception of exertion.

  13. Musical agency reduces perceived exertion during strenuous physical performance.

    PubMed

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-10-29

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting.

  14. Musical agency reduces perceived exertion during strenuous physical performance

    PubMed Central

    Fritz, Thomas Hans; Hardikar, Samyogita; Demoucron, Matthias; Niessen, Margot; Demey, Michiel; Giot, Olivier; Li, Yongming; Haynes, John-Dylan; Villringer, Arno; Leman, Marc

    2013-01-01

    Music is known to be capable of reducing perceived exertion during strenuous physical activity. The current interpretation of this modulating effect of music is that music may be perceived as a diversion from unpleasant proprioceptive sensations that go along with exhaustion. Here we investigated the effects of music on perceived exertion during a physically strenuous task, varying musical agency, a task that relies on the experience of body proprioception, rather than simply diverting from it. For this we measured psychologically indicated exertion during physical workout with and without musical agency while simultaneously acquiring metabolic values with spirometry. Results showed that musical agency significantly decreased perceived exertion during workout, indicating that musical agency may actually facilitate physically strenuous activities. This indicates that the positive effect of music on perceived exertion cannot always be explained by an effect of diversion from proprioceptive feedback. Furthermore, this finding suggests that the down-modulating effect of musical agency on perceived exertion may be a previously unacknowledged driving force for the development of music in humans: making music makes strenuous physical activities less exhausting. PMID:24127588

  15. Heat tolerance testing: association between heat intolerance and anthropometric and fitness measurements.

    PubMed

    Lisman, Peter; Kazman, Josh B; O'Connor, Francis G; Heled, Yuval; Deuster, Patricia A

    2014-11-01

    This study investigated associations between heat intolerance, as determined by performance on a heat tolerance test (HTT), and anthropometric measurements (body surface-to-mass ratio, percent body fat, body mass index, and waist circumference) and cardiorespiratory fitness (maximal oxygen uptake [VO2max]). Relationships between predictive variables and specific physiological measurements recorded during the HTT were examined. A total of 34 male and 12 female participants, recruited from the military community, underwent anthropometric measurements, a maximal aerobic exercise test, and a standardized HTT, which consisted of walking on a treadmill at 5 km/h at 2% grade for 120 minutes at 40°C and 40% relative humidity. VO2max negatively correlated with maximum core temperature (r = -0.30, p < 0.05) and heart rate (HR) (r = -0.48, p < 0.01) although percent body fat showed a positive correlation with maximum HR (r = 0.36, p < 0.05). VO2max was the only independent attribute that significantly influenced both the maximum HR and core temperature attained during HTT. Logistic regression analyses indicated that VO2max was the only independent parameter (OR = 0.89, p = 0.026) that significantly contributed to overall HTT performance. Low cardiorespiratory fitness was associated with heat intolerance, as defined by HTT performance, and can be addressed as a preventative measure for exertional heat illness. This study provides further evidence that the HTT can be an effective tool for assessment of thermoregulatory patterns. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  16. Darwin's illness revealed

    PubMed Central

    Campbell, A.; Matthews, S.

    2005-01-01

    After returning from the Beagle in 1836, Charles Darwin suffered for over 40 years from long bouts of vomiting, gut pain, headaches, severe tiredness, skin problems, and depression. Twenty doctors failed to treat him. Many books and papers have explained Darwin's mystery illness as organic or psychosomatic, including arsenic poisoning, Chagas' disease, multiple allergy, hypochondria, or bereavement syndrome. None stand up to full scrutiny. His medical history shows he had an organic problem, exacerbated by depression. Here we show that all Darwin's symptoms match systemic lactose intolerance. Vomiting and gut problems showed up two to three hours after a meal, the time it takes for lactose to reach the large intestine. His family history shows a major inherited component, as with genetically predisposed hypolactasia. Darwin only got better when, by chance, he stopped taking milk and cream. Darwin's illness highlights something else he missed—the importance of lactose in mammalian and human evolution. PMID:15811889

  17. Mental illness: psychiatry's phlogiston

    PubMed Central

    Szasz, T

    2001-01-01

    In physics, we use the same laws to explain why airplanes fly, and why they crash. In psychiatry, we use one set of laws to explain sane behaviour, which we attribute to reasons (choices), and another set of laws to explain insane behaviour, which we attribute to causes (diseases). God, man's idea of moral perfection, judges human deeds without distinguishing between sane persons responsible for their behaviour and insane persons deserving to be excused for their evil deeds. It is hubris to pretend that the insanity defence is compassionate, just, or scientific. Mental illness is to psychiatry as phlogiston was to chemistry. Establishing chemistry as a science of the nature of matter required the recognition of the non-existence of phlogiston. Establishing psychiatry as a science of the nature of human behaviour requires the recognition of the non-existence of mental illness. Key Words: Agency • alchemy • behaviour • cause • chemistry • dignity PMID:11579183

  18. An anatomy of illness.

    PubMed

    Biro, David

    2012-03-01

    Because it focuses primarily on the sick body (disease), medicine ignores many of the concerns and needs of sick people. By listening to the stories of patients in the clinic, on the Internet, and in published book form, health care providers could gain a better understanding of the impact of disease on the person (illness), what it means to patients over and above their physical symptoms and what they might require over and above surgery or chemotherapy. Only by familiarizing themselves with the entire emotional landscape of illness, which includes fear, anger, shame, guilt, and above all loneliness, can the healthy--medicine as well as society in general--hope to heal in a comprehensive manner.

  19. Violence and Mental Illness

    PubMed Central

    Rueve, Marie E.; Welton, Randon S.

    2008-01-01

    Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients’ lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, including etiology, comorbidity, risk factor management, and treatment. A psychiatrist who is well versed in the recognition and management of violence can contribute to the appropriate management of dangerous behaviors and minimize risk to patients, their families, mental health workers, and the community as a whole. PMID:19727251

  20. High altitude illness

    PubMed

    Hartman-Ksycińska, Anna; Kluz-Zawadzka, Jolanta; Lewandowski, Bogumił

    High-altitude illness is a result of prolonged high-altitude exposure of unacclimatized individuals. The illness is seen in the form of acute mountain sickness (AMS) which if not treated leads to potentially life-threatening high altitude pulmonary oedema and high-altitude cerebral oedema. Medical problems are caused by hypobaric hypoxia stimulating hypoxia-inducible factor (HIF) release. As a result, the central nervous system, circulation and respiratory system function impairment occurs. The most important factor in AMS treatment is acclimatization, withdrawing further ascent and rest or beginning to descent; oxygen supplementation, and pharmacological intervention, and, if available, a portable hyperbaric chamber. Because of the popularity of high-mountain sports and tourism better education of the population at risk is essential.

  1. Images of Illness

    PubMed Central

    Longhurst, Mark F.

    1992-01-01

    The images we as physicians retain of our patients have a bearing on the evolution of our clinical behaviour and attributes. These images can enhance our diagnostic and therapeutic skills, increase our capacity to care for people with incurable diseases, and offer insights into our own emotional response. A recollection of five people with Parkinson's disease offers a college of images to give us further insights into the meaning of illness-for the patient and the physician. PMID:20469529

  2. Parasites and Foodborne Illness

    MedlinePlus

    ... Administrative Forms Standard Forms Skip Navigation Z7_0Q0619C0JGR010IFST1G5B10H1 Web Content Viewer (JSR 286) Actions ${title} Loading... / Topics / ... and Disease / Parasites and Foodborne Illness Z7_0Q0619C0JGR010IFST1G5B10H3 Web Content Viewer (JSR 286) Actions ${title} Loading... Z7_ ...

  3. Suicide in the Medically Ill.

    ERIC Educational Resources Information Center

    Hughes, Douglas; Kleespies, Phillip

    2001-01-01

    The relationship between medical illness and suicide seems to be multi-faceted. While medical illness is not the sole determinant of suicide, certain illnesses, such as HIV/AIDS and brain cancers, do appear to elevate the risk of suicide. Possible effective prevention efforts include education of primary care providers, and improved medication…

  4. The Stigma of Mental Illness

    ERIC Educational Resources Information Center

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  5. Suicide in the Medically Ill.

    ERIC Educational Resources Information Center

    Hughes, Douglas; Kleespies, Phillip

    2001-01-01

    The relationship between medical illness and suicide seems to be multi-faceted. While medical illness is not the sole determinant of suicide, certain illnesses, such as HIV/AIDS and brain cancers, do appear to elevate the risk of suicide. Possible effective prevention efforts include education of primary care providers, and improved medication…

  6. The Stigma of Mental Illness

    ERIC Educational Resources Information Center

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  7. Food-borne illnesses during pregnancy

    PubMed Central

    Tam, Carolyn; Erebara, Aida; Einarson, Adrienne

    2010-01-01

    ABSTRACT QUESTION After hearing about outbreaks of illness resulting from Listeria and Salmonella, many of my patients are wondering about the risks of food-borne illnesses during pregnancy and what they can do to reduce their chances of contracting them. ANSWER Although heating or cooking food is the best way to inactivate food-borne pathogens, improved standards and surveillance have reduced the prevalence of contaminated foods at grocery stores. Therefore, it is no longer necessary for pregnant women to avoid foods like deli meats and soft cheeses (associated with Listeria); soft-cooked eggs (associated with Salmonella); or sushi and sashimi. Regardless of whether seafood is raw or cooked, pregnant women should choose low mercury seafood (eg, salmon and shrimp) over higher mercury varieties (eg, fresh tuna). Pregnant women should ensure that their food is obtained from reputable establishments; stored, handled, and cooked properly; and consumed within a couple of days of purchasing. PMID:20393091

  8. Heat strain during military training activities: The dilemma of balancing force protection and operational capability.

    PubMed

    Hunt, Andrew P; Billing, Daniel C; Patterson, Mark J; Caldwell, Joanne N

    2016-01-01

    Military activities in hot environments pose 2 competing demands: the requirement to perform realistic training to develop operational capability with the necessity to protect armed forces personnel against heat-related illness. To ascertain whether work duration limits for protection against heat-related illness restrict military activities, this study examined the heat strain and risks of heat-related illness when conducting a military activity above the prescribed work duration limits. Thirty-seven soldiers conducted a march (10 km; ∼5.5 km h(-1)) carrying 41.8 ± 3.6 kg of equipment in 23.1 ± 1.8°C wet-bulb globe temperature. Body core temperature was recorded throughout and upon completion, or withdrawal, participants rated their severity of heat-related symptoms. Twenty-three soldiers completed the march in 107 ± 6.4 min (Completers); 9 were symptomatic for heat exhaustion, withdrawing after 71.6 ± 10.1 min (Symptomatic); and five were removed for body core temperature above 39.0°C (Hyperthermic) after 58.4 ± 4.5 min. Body core temperature was significantly higher in the Hyperthermic (39.03 ± 0.26°C), than Symptomatic (38.34 ± 0.44°C; P = 0.007) and Completers (37.94 ± 0.37°C; P<0.001) after 50 min. Heat-related symptom severity was significantly higher among Symptomatic (28.4 ± 11.8) compared to Completers (15.0 ± 9.8, P = 0.006) and Hyperthermic (13.0 ± 9.6, P = 0.029). The force protection provided by work duration limits may be preventing the majority of personnel from conducting activities in hot environments, thereby constraining a commander's mandate to develop an optimised military force. The dissociation between heat-related symptoms and body core temperature elevation suggests that the physiological mechanisms underpinning exhaustion during exertional heat stress should be re-examined to determine the most appropriate physiological criteria for prescribing work duration limits.

  9. Exercise Prevents Mental Illness

    NASA Astrophysics Data System (ADS)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  10. [Enigma of Lenin's illness].

    PubMed

    Witztum, E; Lerner, V

    2002-04-01

    A difficult problem that arises periodically involves the physical and psychological problems of political leaders. Unlike the ordinary person, where the presence of physical or psychiatric disability that interferes with functioning will be revealed and will result in suspension from work responsibilities (e.g. pilot, bus driver, physician), the situation is different with regard to political leaders. Concerning the latter, the information may remain concealed because it is conceived of as stigmatizing, e.g., mental illness, and sexual disorder. The result of hiding such information is that sick leaders may continue to hold their positions of vast power in spite of their disability. Examples of world leaders who suffered from sustained disability as a result of incapacitating neurological or psychiatric illnesses, physical problems or medication effects include Woodrow Wilson, Franklin Roosevelt, Dwight Eisenhower, Winston Churchill and Conrad Adenauer. In the present article we will discuss in detail Lenins severe illness--whose differential diagnosis and real facts were kept hidden from the public--and the consequences of this cover-up.

  11. Heat pipe array heat exchanger

    DOEpatents

    Reimann, Robert C.

    1987-08-25

    A heat pipe arrangement for exchanging heat between two different temperature fluids. The heat pipe arrangement is in a ounterflow relationship to increase the efficiency of the coupling of the heat from a heat source to a heat sink.

  12. Exertional rhabdomyolysis: physiological response or manifestation of an underlying myopathy?

    PubMed Central

    Scalco, Renata S; Snoeck, Marc; Quinlivan, Ros; Treves, Susan; Laforét, Pascal; Jungbluth, Heinz; Voermans, Nicol C

    2016-01-01

    Exertional rhabdomyolysis is characterised by muscle breakdown associated with strenuous exercise or normal exercise under extreme circumstances. Key features are severe muscle pain and sudden transient elevation of serum creatine kinase (CK) levels with or without associated myoglobinuria. Mild cases may remain unnoticed or undiagnosed. Exertional rhabdomyolysis is well described among athletes and military personnel, but may occur in anybody exposed to unaccustomed exercise. In contrast, exertional rhabdomyolysis may be the first manifestation of a genetic muscle disease that lowers the exercise threshold for developing muscle breakdown. Repeated episodes of exertional rhabdomyolysis should raise the suspicion of such an underlying disorder, in particular in individuals in whom the severity of the rhabdomyolysis episodes exceeds the expected response to the exercise performed. The present review aims to provide a practical guideline for the acute management and postepisode counselling of patients with exertional rhabdomyolysis, with a particular emphasis on when to suspect an underlying genetic disorder. The pathophysiology and its clinical features are reviewed, emphasising four main stepwise approaches: (1) the clinical significance of an acute episode, (2) risks of renal impairment, (3) clinical indicators of an underlying genetic disorders and (4) when and how to recommence sport activity following an acute episode of rhabdomyolysis. Genetic backgrounds that appear to be associated with both enhanced athletic performance and increased rhabdomyolysis risk are briefly reviewed. PMID:27900193

  13. Advances in understanding illness anxiety.

    PubMed

    Harding, Kelli J; Skritskaya, Natalia; Doherty, Emily; Fallon, Brian A

    2008-08-01

    Illness anxiety, also known in its more severe form as hypochondriasis, is a debilitating and chronic condition in which normal bodily symptoms are misinterpreted as signs of serious medical illness. Patients suffer with the fear that they are ill despite reassurance to the contrary and often overuse medical services in the process. This article critically evaluates the recent literature on illness anxiety and related, medically unexplained symptoms, highlighting new and interesting findings in the areas of prevalence, classification/diagnosis, management, and evidence-based treatment and new frontiers in understanding illness anxiety, such as brain imaging, neuroimmunology, and cyberchondria.

  14. Paracetamol in critical illness: a review.

    PubMed

    Jefferies, Sarah; Saxena, Manoj; Young, Paul

    2012-03-01

    Paracetamol is one of the commonest medications used worldwide. This review was conceived as a consequence of evaluating the literature in the protocol development of two randomised, controlled clinical trials investigating the safety and efficacy of paracetamol in ICU patients (the HEAT [Permissive HyperthErmiA Through Avoidance of Paracetamol in Known or Suspected Infection in the Intensive Care Unit] study; the Paracetamol After traumatic Brain Injury [PARITY] Study). To provide a historical perspective on the introduction of paracetamol into clinical practice, to present the pharmacology of paracetamol in critical illness, and evaluate the current evidence for its use as an antipyretic and analgesic in intensive care. Literature searches were performed using keywords: "paracetamol", "acetaminophen", "critical illness", "intensive care", "history", "pharmacology", "antipyre*", "analgesi*", "adverse effect*", "administration and dosage", "toxicity", "animals" and "humans". Embase, MEDLINE, PubMed (1947/1950 to July 2011). The authors examined each article's title and abstract, fully reviewing relevant articles, with searching of reference lists and additional hand-searching. The most recent and highest quality available evidence was included. Limited data are available on the pharmacology of paracetamol in the critically ill. Among patients with sepsis, paracetamol may inhibit the immunological response. Among patients with neurological injury paracetamol can reduce temperature but appears not to improve outcome. When administered with opioids after major surgery, paracetamol does not reduce the incidence of pain or opioid related side-effects. Despite the widespread use of paracetamol in critical illness, there is a paucity of data supporting its utility in this setting. Further research is required to determine how paracetamol should be used in the critically ill.

  15. Illness, phenomenology, and philosophical method.

    PubMed

    Carel, Havi Hannah

    2013-08-01

    In this article, I propose that illness is philosophically revealing and can be used to explore human experience. I suggest that illness is a limit case of embodied experience. By pushing embodied experience to its limit, illness sheds light on normal experience, revealing its ordinary and thus overlooked structure. Illness produces a distancing effect, which allows us to observe normal human behavior and cognition via their pathological counterpart. I suggest that these characteristics warrant illness a philosophical role that has not been articulated. Illness can be used as a philosophical tool for the study of normally tacit aspects of human existence. I argue that illness itself can be integral to philosophical method, insofar as it facilitates a distancing from everyday practices. This method relies on pathological or limit cases to illuminate normally overlooked aspects of human perception and action. I offer Merleau-Ponty's analysis of the case of Schneider as an example of this method.

  16. A case of mitochondrial cytopathy with exertion induced dystonia

    PubMed Central

    Chandra, Sadanandavalli Retnaswami; Issac, Thomas Gregor

    2015-01-01

    Paroxysmal dystonias are a group of relatively benign hyperkinetic childhood movement disorders of varied etiology. Mitochondrial diseases are well known to produce persistent dystonias as sequelae, but paroxysmal exertion induced dystonia has been reported in only one case to the best of our knowledge. Two siblings born to consanguineous parents presented with early-onset exertion induced dystonia, which was unresponsive to diphenylhydantoin and carbamazepine. A trial with valproate in one of the siblings turned fatal within 24 h. Based on this clue, the second child was investigated and found to suffer from complex I deficiency with a paternally inherited dominant nuclear DNA mutation, which is responsive to the mitochondrial cocktail. Exertion induced dystonia can be a rare manifestation of complex I deficiency. PMID:26557169

  17. A Technique for Establishing True Levels of Muscle Strength Exertion

    DTIC Science & Technology

    1980-01-01

    performed -"aximal or submaximal isometric strength exertions. The exertions tested were elbow flexion, finger flexion, knee flexion and knee...190.1 167.11 17.3350 Buttock-Knee Length (cm) 54.1 66.7 59.29 3.2106 Knee Height, sitting (cm) 46.5 58.7 52.91 2.8737 Shoulder- Elbow Length (cm) 29.3...propped the elbow of the right arm on the arm rest, extended the fore- arm directly forward so that the cuff was exactly above the load cell, with

  18. Portraits of an illness

    PubMed Central

    Duffy, Thomas P.

    2009-01-01

    Access to patients' inner lives can be expanded and enriched by incorporating the arts and humanities into the clinical encounter. A series of self-portraits created by an artist undergoing induction chemotherapy for leukemia afforded a unique opportunity to concentrate one's gaze upon the patient as a stimulus for reflection on suffering and isolation of patients. Poetry and theater were also invaluable in expanding the physician's awareness of the shared experience of illness. The process highlights the central role of the “New Humanities” in modern medicine, where science informs the arts and the arts inform science and medicine. PMID:19768179

  19. Gaius Caligula's mental illness.

    PubMed

    Sidwell, Barbara

    2010-01-01

    The strange behavior of emperor Gaius has been the subject of debate for many historians. Some charge him with madness and attribute it to his illness in A.D. 37, whereas others believe it occurred later, or else had nothing to do with his sickness.We have no real evidence to reconstruct his mental state. Therefore speculations about madness are fruitless, as they can't be proven. Also, his madness belongs to a discourse which originates mainly from the senatorial narrative that sought to discredit him through any means possible. Thus, his acts should be seen from other angles, and the search for "mad Caligula" abandoned.

  20. Chronically Critically Ill Patients

    PubMed Central

    Douglas, Sara L.; Daly, Barbara J.; Kelley, Carol Genet; O’Toole, Elizabeth; Montenegro, Hugo

    2007-01-01

    Background Chronically critically ill patients often have high costs of care and poor outcomes and thus might benefit from a disease management program. Objectives To evaluate how adding a disease management program to the usual care system affects outcomes after discharge from the hospital (mortality, health-related quality of life, resource use) in chronically critically ill patients. Methods In a prospective experimental design, 335 intensive care patients who received more than 3 days of mechanical ventilation at a university medical center were recruited. For 8 weeks after discharge, advanced practice nurses provided an intervention that focused on case management and interdisciplinary communication to patients in the experimental group. Results A total of 74.0% of the patients survived and completed the study. Significant predictors of death were age (P = .001), duration of mechanical ventilation (P = .001), and history of diabetes (P = .04). The disease management program did not have a significant impact on health-related quality of life; however, a greater percentage of patients in the experimental group than in the control group had “improved” physical health-related quality of life at the end of the intervention period (P = .02). The only significant effect of the intervention was a reduction in the number of days of hospital readmission and thus a reduction in charges associated with readmission. Conclusion The intervention was not associated with significant changes in any outcomes other than duration of readmission, but the supportive care coordination program could be provided without increasing overall charges. PMID:17724242

  1. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....969a Section 416.969a Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME... of jobs by various exertional levels (sedentary, light, medium, heavy, and very heavy) in terms of... assessment along with your age, education, and work experience to decide if you can adjust to any other...

  2. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS... of jobs by various exertional levels (sedentary, light, medium, heavy, and very heavy) in terms of... assessment along with your age, education, and work experience to decide if you can adjust to any other...

  3. Perception of Forces Exerted by Objects in Collision Events

    ERIC Educational Resources Information Center

    White, Peter A.

    2009-01-01

    Impressions of force are commonplace in the visual perception of objects interacting. It is proposed that these impressions have their source in haptically mediated experiences of exertion of force in actions on objects. Visual impressions of force in interactions between objects occur by a kind of generalization of the proprioceptive impression…

  4. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  5. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  6. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  7. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  8. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  9. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  10. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404.1567...

  11. 20 CFR 404.1569a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Exertional and nonexertional limitations. 404.1569a Section 404.1569a Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Vocational Considerations § 404...

  12. Perception of Forces Exerted by Objects in Collision Events

    ERIC Educational Resources Information Center

    White, Peter A.

    2009-01-01

    Impressions of force are commonplace in the visual perception of objects interacting. It is proposed that these impressions have their source in haptically mediated experiences of exertion of force in actions on objects. Visual impressions of force in interactions between objects occur by a kind of generalization of the proprioceptive impression…

  13. Perceived Exertion: An Old Exercise Tool Finds New Applications.

    ERIC Educational Resources Information Center

    Monahan, Terry

    1988-01-01

    Perceived exertion scales, based on subjective perception of energy output, are gaining respect as prescribing and monitoring tools for individual exercise programs. A review of recent literature indicates growing research interest in applications for individuals who are elderly, inactive, or subject to medical conditions such as angina. (IAH)

  14. Perceived Exertion: An Old Exercise Tool Finds New Applications.

    ERIC Educational Resources Information Center

    Monahan, Terry

    1988-01-01

    Perceived exertion scales, based on subjective perception of energy output, are gaining respect as prescribing and monitoring tools for individual exercise programs. A review of recent literature indicates growing research interest in applications for individuals who are elderly, inactive, or subject to medical conditions such as angina. (IAH)

  15. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., such as pain, may cause limitations of function or restrictions which limit your ability to meet... or restrictions imposed by your impairment(s) and related symptoms, such as pain, are exertional... imposed by your impairment(s) and related symptoms, such as pain, affect only your ability to meet...

  16. 20 CFR 416.969a - Exertional and nonexertional limitations.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., such as pain, may cause limitations of function or restrictions which limit your ability to meet... or restrictions imposed by your impairment(s) and related symptoms, such as pain, are exertional... imposed by your impairment(s) and related symptoms, such as pain, affect only your ability to meet...

  17. 20 CFR 404.1567 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Physical exertion requirements. 404.1567 Section 404.1567 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... economy, we classify jobs as sedentary, light, medium, heavy, and very heavy. These terms have the same...

  18. 20 CFR 416.967 - Physical exertion requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Physical exertion requirements. 416.967 Section 416.967 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE... economy, we classify jobs as sedentary, light, medium, heavy, and very heavy. These terms have the same...

  19. Are the Measurements of Attention Allocation and Perceived Exertion Trustworthy?

    ERIC Educational Resources Information Center

    Meir, Gily; Hutchinson, Jasmin C.; Habeeb, Christine M.; Boiangin, Nataniel M.; Shaffer, Cory; Basevitch, Itay; Tenenbaum, Gershon

    2015-01-01

    Two studies examined the trustworthiness of commonly used measurement scales for ratings of perceived exertion (RPE) and state attentional focus (SAF) during exercise. In Study 1, participants (N = 24, 14 female) performed a treadmill graded-exercise test. The order of scale presentation during the task was manipulated (i.e., RPE followed by SAF…

  20. Are the Measurements of Attention Allocation and Perceived Exertion Trustworthy?

    ERIC Educational Resources Information Center

    Meir, Gily; Hutchinson, Jasmin C.; Habeeb, Christine M.; Boiangin, Nataniel M.; Shaffer, Cory; Basevitch, Itay; Tenenbaum, Gershon

    2015-01-01

    Two studies examined the trustworthiness of commonly used measurement scales for ratings of perceived exertion (RPE) and state attentional focus (SAF) during exercise. In Study 1, participants (N = 24, 14 female) performed a treadmill graded-exercise test. The order of scale presentation during the task was manipulated (i.e., RPE followed by SAF…

  1. The microbiome and critical illness

    PubMed Central

    Dickson, Robert P

    2016-01-01

    The central role of the microbiome in critical illness is supported by a half century of experimental and clinical study. The physiological effects of critical illness and the clinical interventions of intensive care substantially alter the microbiome. In turn, the microbiome predicts patients’ susceptibility to disease, and manipulation of the microbiome has prevented or modulated critical illness in animal models and clinical trials. This Review surveys the microbial ecology of critically ill patients, presents the facts and unanswered questions surrounding gut-derived sepsis, and explores the radically altered ecosystem of the injured alveolus. The revolution in culture-independent microbiology has provided the tools needed to target the microbiome rationally for the prevention and treatment of critical illness, holding great promise to improve the acute and chronic outcomes of the critically ill. PMID:26700442

  2. Defining Occupational Illnesses and Injuries

    DTIC Science & Technology

    1990-11-01

    This technical report will discuss the definitions of occupational illnesses and injuries as established by the Occupational Safety and Health...Administration (OSHA). A systematic method for classifying an occupational event as either an illness or an injury will be presented. The Air Force is...required to collect occupational injury and illness data, to analyze collected data, and to establish preventive programs based upon any identified unsafe

  3. Protein requirement in critical illness.

    PubMed

    Hoffer, Leonard John

    2016-05-01

    How much protein do critically ill patients require? For the many decades that nutritional support has been used there was a broad consensus that critically ill patients need much more protein than required for normal health. Now, however, some clinical investigators recommend limiting all macronutrient provision during the early phase of critical illness. How did these conflicting recommendations emerge? Which of them is correct? This review explains the longstanding recommendation for generous protein provision in critical illness, analyzes the clinical trials now being claimed to refute it, and concludes with suggestions for clinical investigation and practice.

  4. Treating foodborne illness.

    PubMed

    Steiner, Theodore

    2013-09-01

    In healthy adults and children in developed countries, most foodborne and water-borne infections are short-lived and resolve without specific treatment. In developing areas, these infections may produce acute mortality and chronic morbidity caused by developmental impairment. Immune-compromised hosts are at increased risk of life-threatening complications. This article reviews recommendations for the treatment of the most common and important foodborne illnesses, focusing on those caused by infections or toxins of microbial origin. The cornerstone of life-saving treatment remains oral rehydration therapy, although the use of other supportive measures as well as antibiotics for certain infections is also recommended. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. [Nutrition in critical illness].

    PubMed

    Ökrös, Ilona

    2014-12-21

    Critically ill patients are often unable to eat by themselves over a long period of time, sometimes for weeks. In the acute phase, serious protein-energy malnutrition may develop with progressive muscle weakness, which may result in assisted respiration of longer duration as well as longer stay in intensive care unit and hospital. In view of the metabolic processes, energy and protein intake targets should be defined and the performance of metabolism should be monitored. Enteral nutrition is primarily recommended. However, parenteral supplementation is often necessary because of the disrupted tolerance levels of the gastrointestinal system. Apparently, an early parenteral supplementation started within a week would be of no benefit. Some experts believe that muscle loss can be reduced by increased target levels of protein. Further studies are needed on the effect of immune system feeding, fatty acids and micronutrients.

  6. Neuroinflammation and psychiatric illness

    PubMed Central

    2013-01-01

    Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence supporting the pathogenic role of neuroinflammation in selected classical psychiatric disorders. Understanding how psychosocial, genetic, immunological and neurotransmitter systems interact can reveal pathogenic clues and help target new preventive and symptomatic therapies. PMID:23547920

  7. Exertional Heatstroke in Soldiers: An Analysis of Predisposing Factors, Recovery Rates and Residual Heat Intolerance

    DTIC Science & Technology

    1989-11-20

    was resolved five months after the second heatstroke episode. Bianchi et al. (8) found a variety of histological abnormalities in the liver tissue of...or if Tr. increased > 0.60C during any five min period. HR was recorded continuously using an electrocardiographic telemetry system (Hewlett-Packard...PH (22.48 + 0.87 ml-kg’-"min -1) than in C (26.11 + 0.93 ml’kg-’"min-’); the corresponding mean respiratory exchange ratios were higher (p < .025) in

  8. Wall pressure exerted by hydrogenation of sodium aluminum hydride.

    SciTech Connect

    Perras, Yon E.; Dedrick, Daniel E.; Zimmerman, Mark D.

    2009-06-01

    Wall pressure exerted by the bulk expansion of a sodium aluminum hydride bed was measured as a function of hydrogen content. A custom apparatus was designed and loaded with sodium alanates at densities of 1.0, 1.1, and 1.16 g/cc. Four complete cycles were performed to identify variations in measured pressure. Results indicated poor correlation between exerted pressure and hydrogen capacity of the sodium alanate beds. Mechanical pressure due to the hydrogenation of sodium alanates does not influence full-scale system designs as it falls within common design factors of safety. Gas pressure gradients within the porous solid were identified and may limit reaction rates, especially for high aspect ratio beds.

  9. Exertional dyspnea as a symptom of infrarenal aortic occlusive disease.

    PubMed

    Schott, Stacey L; Carreiro, Fernanda Porto; Harkness, James R; Malas, Mahmoud B; Sozio, Stephen M; Zakaria, Sammy

    2014-06-01

    Advanced atherosclerosis of the aorta can cause severe ischemia in the kidneys, refractory hypertension, and claudication. However, no previous reports have clearly associated infrarenal aortic stenosis with shortness of breath. A 77-year-old woman with hypertension and hyperlipidemia presented with exertional dyspnea. Despite extensive testing and observation, no apparent cause for this patient's dyspnea was found. Images revealed severe infrarenal aortic stenosis. After the patient underwent stenting of the aortic occlusion, she had immediate symptomatic improvement and complete resolution of her dyspnea within one month. Twelve months after vascular intervention, the patient remained asymptomatic. In view of the distinct and lasting elimination of dyspnea after angioplasty and stenting of a nearly occluded infrarenal aortic lesion, we hypothesize that infrarenal aortic stenosis might be a treatable cause of exertional dyspnea. Clinicians should consider infrarenal aortic stenosis as a possible cause of dyspnea. Treatment of the stenosis might relieve symptoms.

  10. Endoscopic Thermal Fasciotomy for Chronic Exertional Compartment Syndrome

    PubMed Central

    Voleti, Pramod B.; Lebrun, Drake G.; Roth, Cameron A.; Kelly, John D.

    2015-01-01

    Chronic exertional compartment syndrome is an activity-induced condition that occurs when intracompartmental pressures within an osteofascial envelope increase during exercise, leading to reversible ischemic symptoms such as pain, cramping, numbness, or weakness. Nonoperative treatment options for this condition have shown limited success and are often undesirable for the patient given the requirement for activity modification. Traditional surgical treatment options involving open or subcutaneous fasciotomies have more favorable results, but these techniques are associated with significant morbidity. Endoscopically assisted fasciotomy techniques afford the advantages of being minimally invasive, providing excellent visualization, and allowing accelerated rehabilitation. The purpose of this article is to describe a technique for performing endoscopically assisted fasciotomies for chronic exertional compartment syndrome of the lower leg using an entirely endoscopic thermal ablating device. The endoscopic thermal fasciotomy technique is associated with minimal morbidity, ensures excellent hemostasis, and affords an early return to sports. PMID:26900549

  11. Recreational water–related illness

    PubMed Central

    Sanborn, Margaret; Takaro, Tim

    2013-01-01

    Abstract Objective To review the risk factors, management, and prevention of recreational water–related illness in family practice. Sources of information Original and review articles from January 1998 to February 2012 were identified using PubMed and the search terms water-related illness, recreational water illness, and swimmer illness. Main message There is a 3% to 8% risk of acute gastrointestinal illness (AGI) after swimming. The high-risk groups for AGI are children younger than 5 years, especially if they have not been vaccinated for rotavirus, and elderly and immunocompromised patients. Children are at higher risk because they swallow more water when swimming, stay in the water longer, and play in the shallow water and sand, which are more contaminated. Participants in sports with a lot of water contact like triathlon and kite surfing are also at high risk, and even activities involving partial water contact like boating and fishing carry a 40% to 50% increase in risk of AGI compared with nonwater recreational activities. Stool cultures should be done when a recreational water illness is suspected, and the clinical dehydration scale is a useful clinical tool for assessing the treatment needs of affected children. Conclusion Recreational water illness is the main attributable cause of AGI during swimming season. Recognition that swimming is a substantial source of illness can help prevent recurrent and secondary cases. Rotavirus vaccine is highly recommended for children who will swim frequently. PMID:23673583

  12. Water Recreation and Illness Severity

    EPA Science Inventory

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  13. Water Recreation and Illness Severity

    EPA Science Inventory

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  14. Responding to Students' Chronic Illnesses

    ERIC Educational Resources Information Center

    Shaw, Steven R.; Glaser, Sarah E.; Stern, Melissa; Sferdenschi, Corina; McCabe, Paul C.

    2010-01-01

    Chronic illnesses are long-term or permanent medical conditions that have recurring effects on everyday life. Large and growing number of students have chronic illnesses that affect their emotional development, physical development, academic performance, and family interactions. The primary error in educating those students is assuming that the…

  15. Children Coping with Chronic Illness.

    ERIC Educational Resources Information Center

    Perez, Lissette M.

    Children who live with chronic illness are confronted with challenges that frequently force them to cope in myriad ways. The ways in which children face chronic illness are summarized in this literature review. Also covered, are how the effects of family can influence coping strategies and how family members, especially parents, cope with their…

  16. Heat Islands

    EPA Pesticide Factsheets

    EPA's Heat Island Effect Site provides information on heat islands, their impacts, mitigation strategies, related research, a directory of heat island reduction initiatives in U.S. communities, and EPA's Heat Island Reduction Program.

  17. Failing phrenics: an obscure cause of exertional dyspnea

    PubMed Central

    Rafiq, Arsalan; Ijaz, Mohsin; Tariq, Hassan; Vakde, Trupti; Duncalf, Richard

    2016-01-01

    Abstract Introduction: Idiopathic phrenic nerve palsy is a rare cause of exertional dyspnea. We present a case of a patient presenting with worsening dyspnea of an unknown etiology found to be related to bilateral phrenic nerve palsy. Discussion: Forty-two-year-old man presented to our emergency department with exertional dyspnea, orthopnea, and a left lower lobe consolidation treated initially as bronchitis by his primary physician as an outpatient, then subsequently as pneumonia at another institution, with no improvement in symptomatology. After admission to our hospital, CT chest demonstrated only supradiaphragmatic atelectatic changes. Echocardiography was normal. Bronchoscopy was contemplated however the patient could not lie flat. A fluoroscopic sniff test demonstrated diaphragmatic dysfunction and pulmonary function tests revealed restrictive pulmonary disease with evidence of neuromuscular etiology. Nerve conduction studies confirmed bilateral phrenic neuropathy. He was referred to a specialized neuromuscular disease center where subsequent workup did not demonstrate any specific etiology. A sleep study confirmed sleep disordered breathing suggestive of diaphragmatic paralysis and he was discharged on bi-level positive pressure ventilation. Conclusion: This is a unique case of exertional dyspnea and orthopnea from diaphragmatic paresis caused by bilateral phrenic nerve palsy where the initial workup for pulmonary and cardiovascular etiologies was essentially unremarkable. Shortness of breath and orthopnea caused by phrenic neuropathy is a rare condition, yet has a variety of etiologies. Our case suggests a template to the diagnostic approach, management, and follow up of bilateral phrenic nerve palsy. PMID:27442657

  18. Exercise, physical activity, and exertion over the business cycle.

    PubMed

    Colman, Gregory; Dave, Dhaval

    2013-09-01

    Shifts in time and income constraints over economic expansions and contractions would be expected to affect individuals' behaviors. We explore the impact of the business cycle on individuals' exercise, time use, and total physical exertion, utilizing information on 112,000 individual records from the 2003-2010 American Time Use Surveys. In doing so, we test a key causal link that has been hypothesized in the relation between unemployment and health, but not heretofore assessed. Using more precise measures of exercise (and other activities) than previous studies, we find that as work-time decreases during a recession, recreational exercise, TV-watching, sleeping, childcare, and housework increase. This, however, does not compensate for the decrease in work-related exertion due to job-loss, and total physical exertion declines. These effects are strongest among low-educated men, which is validating given that employment in the Great Recession has declined most within manufacturing, mining, and construction. We also find evidence of intra-household spillover effects, wherein individuals respond to shifts in spousal employment conditional on their own labor supply. The decrease in total physical activity during recessions is especially problematic for vulnerable populations concentrated in boom-and-bust industries, and may have longer-term effects on obesity and related health outcomes.

  19. Does Creatine Supplementation Hinder Exercise Heat Tolerance or Hydration Status? A Systematic Review With Meta-Analyses

    PubMed Central

    Lopez, Rebecca M; Casa, Douglas J; McDermott, Brendon P; Ganio, Matthew S; Armstrong, Lawrence E; Maresh, Carl M

    2009-01-01

    Objective: To critically assess original research addressing the effect of creatine supplementation on exercise heat tolerance and hydration status. Data Sources: We searched the electronic databases PubMed, Scopus, Web of Science, SPORTDiscus, and Rehabilitation & Physical Medicine, without date limitations, for the following key words: creatine, exercise, thermoregulation, dehydration, hyperthermia, heat tolerance, exertional heat illnesses, and renal function. Our goal was to identify randomized clinical trials investigating the effect of creatine supplementation on hydration status and thermoregulation. Citations from related articles also were identified and retrieved. Data Synthesis: Original research was reviewed using the Physiotherapy Evidence Database (PEDro) Scale. One author initially screened all articles. Fifteen of 95 articles examined the effects of creatine on thermoregulation or hydration status (or both). Two independent reviewers then reviewed these articles. Ten studies were selected on the basis of inclusion and exclusion criteria. The PEDro scores for the 10 studies ranged from 7 to 10 points (maximum possible score  =  10 points). Conclusions: No evidence supports the concept that creatine supplementation either hinders the body's ability to dissipate heat or negatively affects the athlete's body fluid balance. Controlled experimental trials of athletes exercising in the heat resulted in no adverse effects from creatine supplementation at recommended dosages. PMID:19295968

  20. Does creatine supplementation hinder exercise heat tolerance or hydration status? A systematic review with meta-analyses.

    PubMed

    Lopez, Rebecca M; Casa, Douglas J; McDermott, Brendon P; Ganio, Matthew S; Armstrong, Lawrence E; Maresh, Carl M

    2009-01-01

    To critically assess original research addressing the effect of creatine supplementation on exercise heat tolerance and hydration status. We searched the electronic databases PubMed, Scopus, Web of Science, SPORTDiscus, and Rehabilitation & Physical Medicine, without date limitations, for the following key words: creatine, exercise, thermoregulation, dehydration, hyperthermia, heat tolerance, exertional heat illnesses, and renal function. Our goal was to identify randomized clinical trials investigating the effect of creatine supplementation on hydration status and thermoregulation. Citations from related articles also were identified and retrieved. Original research was reviewed using the Physiotherapy Evidence Database (PEDro) Scale. One author initially screened all articles. Fifteen of 95 articles examined the effects of creatine on thermoregulation or hydration status (or both). Two independent reviewers then reviewed these articles. Ten studies were selected on the basis of inclusion and exclusion criteria. The PEDro scores for the 10 studies ranged from 7 to 10 points (maximum possible score = 10 points). No evidence supports the concept that creatine supplementation either hinders the body's ability to dissipate heat or negatively affects the athlete's body fluid balance. Controlled experimental trials of athletes exercising in the heat resulted in no adverse effects from creatine supplementation at recommended dosages.

  1. Raw and thermally treated cement asbestos exerts different cytotoxicity effects on A549 cells in vitro.

    PubMed

    Pugnaloni, Armanda; Lucarini, Guendalina; Rubini, Corrado; Smorlesi, Arianna; Tomasetti, Marco; Strafella, Elisabetta; Armeni, Tatiana; Gualtieri, Alessandro F

    2015-01-01

    Raw cement asbestos (RCA) undergoes a complete solid state transformation when heated at high temperatures. The secondary raw material produced, high temperatures-cement asbestos (HT-CA) is composed of newly-formed crystals in place of the asbestos fibers present in RCA. Our previous study showed that HT-CA exerts lower cytotoxic cell damage compared to RCA. Nevertheless further investigations are needed to deepen our understanding of pathogenic pathways involving oxidative and nitrative damage. Our aim is to deepen the understanding of the biological effects on A549 cells of these materials regarding DNA damage related proteins (p53, its isoform p73 and TRAIL) and nitric oxide (NO) production during inducible nitric oxide synthase (iNOS)-mediated inflammation. Increments of p53/p73 expression, iNOS positive cells and NO concentrations were found with RCA, compared to HT-CA and controls mainly at 48 h. Interestingly, ferrous iron causing reactive oxygen species (ROS)-mediated DNA damage was found in RCA as a contaminant. HT-CA thermal treatment induces a global recrystallization with iron in a crystal form poorly released in media. HT-CA slightly interferes with genome expression and exerts lower inflammatory potential compared to RCA on biological systems. It could represent a safe approach for storing or recycling asbestos and an environmentally friendly alternative to asbestos waste. Copyright © 2014 Elsevier GmbH. All rights reserved.

  2. A Case-Crossover Study of Heat Exposure and Injury Risk in Outdoor Agricultural Workers

    PubMed Central

    Bonauto, David K.; Sheppard, Lianne; Busch-Isaksen, Tania; Calkins, Miriam; Adams, Darrin; Lieblich, Max; Fenske, Richard A.

    2016-01-01

    Background Recent research suggests that heat exposure may increase the risk of traumatic injuries. Published heat-related epidemiological studies have relied upon exposure data from individual weather stations. Objective To evaluate the association between heat exposure and traumatic injuries in outdoor agricultural workers exposed to ambient heat and internal heat generated by physical activity using modeled ambient exposure data. Methods A case-crossover study using time-stratified referent selection among 12,213 outdoor agricultural workers with new Washington State Fund workers’ compensation traumatic injury claims between 2000 and 2012 was conducted. Maximum daily Humidex exposures, derived from modeled meteorological data, were assigned to latitudes and longitudes of injury locations on injury and referent dates. Conditional logistic regression was used to estimate odds ratios of injury for a priori daily maximum Humidex categories. Results The mean of within-stratum (injury day and corresponding referent days) standard deviations of daily maximum Humidex was 4.8. The traumatic injury odds ratio was 1.14 (95% confidence interval 1.06, 1.22), 1.15 (95% confidence interval 1.06, 1.25), and 1.10 (95% confidence interval 1.01, 1.20) for daily maximum Humidex of 25–29, 30–33, and ≥34, respectively, compared to < 25, adjusted for self-reported duration of employment. Stronger associations were observed during cherry harvest duties in the June and July time period, compared to all duties over the entire study period. Conclusions Agricultural workers laboring in warm conditions are at risk for heat-related traumatic injuries. Combined heat-related illness and injury prevention efforts should be considered in high-risk populations exposed to warm ambient conditions in the setting of physical exertion. PMID:27716794

  3. Human heat adaptation.

    PubMed

    Taylor, Nigel A S

    2014-01-01

    In this overview, human morphological and functional adaptations during naturally and artificially induced heat adaptation are explored. Through discussions of adaptation theory and practice, a theoretical basis is constructed for evaluating heat adaptation. It will be argued that some adaptations are specific to the treatment used, while others are generalized. Regarding ethnic differences in heat tolerance, the case is put that reported differences in heat tolerance are not due to natural selection, but can be explained on the basis of variations in adaptation opportunity. These concepts are expanded to illustrate how traditional heat adaptation and acclimatization represent forms of habituation, and thermal clamping (controlled hyperthermia) is proposed as a superior model for mechanistic research. Indeed, this technique has led to questioning the perceived wisdom of body-fluid changes, such as the expansion and subsequent decay of plasma volume, and sudomotor function, including sweat habituation and redistribution. Throughout, this contribution was aimed at taking another step toward understanding the phenomenon of heat adaptation and stimulating future research. In this regard, research questions are posed concerning the influence that variations in morphological configuration may exert upon adaptation, the determinants of postexercise plasma volume recovery, and the physiological mechanisms that modify the cholinergic sensitivity of sweat glands, and changes in basal metabolic rate and body core temperature following adaptation. © 2014 American Physiological Society.

  4. Heat accumulator

    SciTech Connect

    Bracht, A.

    1981-09-29

    A heat accumulator comprises a thermally-insulated reservoir full of paraffin wax mixture or other flowable or meltable heat storage mass, heat-exchangers immersed in the mass, a heat-trap connected to one of the heat-exchangers, and a heat user connected to the other heat-exchanger. Pumps circulate fluids through the heat-trap and the heat-using means and the respective heat-exchangers, and a stirrer agitates and circulates the mass, and the pumps and the stirrer and electric motors driving these devices are all immersed in the mass.

  5. Youth blogging and serious illness.

    PubMed

    Nesby, Linda; Salamonsen, Anita

    2016-03-01

    In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed.

  6. [Religious beliefs, illness and death: family's perspectives in illness experience].

    PubMed

    Bousso, Regina Szylit; Poles, Kátia; Serafim, Taís de Souza; de Miranda, Mariana Gonçalves

    2011-04-01

    The objectives of this study were to identify predominant themes in religion, illness and death in the life histories of families and examine the relationship between religion creeds, illness and death in the discourse of families that have an ill person. The theoretical framework used in this study was Symbolic Interactionism and the method was Oral History. Participants were seventeen families with nine different religions, who had experienced the death of a relative. Data analysis showed that following a religion is a relevant part of the lives of many families and cannot be neglected in the illness context. Results point to the importance of understanding the meaning that religion has to the families in the health-disease process, so nurses can work on the promotion of health.

  7. [Non thyroidal illnesses (NTIS)].

    PubMed

    Luca, F; Goichot, B; Brue, T

    2010-09-01

    Abnormalities in the circulating levels of thyroid hormones, without evidence of coexisting thyroid or pituitary gland disease can be observed in all general diseases. These nonthyroidal illnesses (NTIS) are the result of complex mechanisms that combine the effect of some drugs, cytokines, nutritional and endocrine factors at all levels of the thyrotropic axis, from the hypothalamus to the cellular transporters and nuclear receptors of thyroid hormones. The patterns of NTIS depend on the underlying disease and its severity. Thirtyfive years after the initial description, the pathophysiological significance of these anomalies remains controversial. One of the dilemma of NTIS is whether the hormone responses represent an adaptive and normal, physiologic response to conserve energy and protect against hypercatabolism in case of aggression, or whether it is a maladaptive response contributing to a worsening of the disease. This debate is not just a theoretical question, because in the first case the process must be respected, in the other case a vigorous treatment to restore circulating thyroid hormone levels is justified. There have been very few clinical studies designed to address whether the substitution with thyroid hormone is advantageous, and there is at current time no permissive evidence for the use of thyroid hormone replacement in patients with NTIS. But the clinical context, the choice of the molecule or of the dose and the way of administration were not necessarily the most relevant. Theoretically, stimulation of thyreotrope axis used a continuous infusion of TRH seems to provide clinical benefit. With the expectation that randomized clinical trials will provide demonstration of NTIS treatment efficiency, the question might remain unanswered for several more years. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  8. Ionizing radiation injuries and illnesses.

    PubMed

    Christensen, Doran M; Iddins, Carol J; Sugarman, Stephen L

    2014-02-01

    Although the spectrum of information related to diagnosis and management of radiation injuries and illnesses is vast and as radiation contamination incidents are rare, most emergency practitioners have had little to no practical experience with such cases. Exposures to ionizing radiation and internal contamination with radioactive materials can cause significant tissue damage and conditions. Emergency practitioners unaware of ionizing radiation as the cause of a condition may miss the diagnosis of radiation-induced injury or illness. This article reviews the pertinent terms, physics, radiobiology, and medical management of radiation injuries and illnesses that may confront the emergency practitioner. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Mental illness and criminal violence.

    PubMed

    Tehrani, J A; Brennan, P A; Hodgins, S; Mednick, S A

    1998-12-01

    This article examines the relationship between criminal violence and mental illness. Our data suggest that mentally ill persons tend to have an increased risk for committing violent offenses, and that the violent offending by these individuals tends to be recidivistic. Our findings suggest that parents who have both committed violent offenses and experienced a psychiatric hospitalization increase the risk of violent offending among their offspring. We propose the hypothesis that mentally ill parents transmit a biological characteristic which may genetically predispose their child towards criminal violence. Prenatal disturbances during critical periods of fetal development may provide clues regarding the etiology of criminal violence.

  10. Personality and illness: genetic connections?

    PubMed

    Hobgood, Donna K

    2011-01-01

    Illness is strongly influenced by genetics. Personality traits are influenced by genetics and have linkages with, at least, affective illness. Because genetics influences both personality and illness, we studied by literature review the genes that illness and personality traits share and, by office assessment, our patient population's illnesses and personality traits. This led to the following hypothesis: illness is related to more Submissive than Dominant personality trait and thus to lower norepinephrine activity. Patient affect and personality are often noted to be subdued in chronic illness, but whether from cause or effect is difficult to determine. After reviewing the literature on wellness, personality and genes, we endeavored to explore and better delineate our impressions of illness and personality relationships and to set the stage for a genetic hypothesis by using an online personality test in an ob-gyn practice to determine which traits could be used as proxies for personality trait genes. We thus confirmed our clinical impression that women with psychiatric and/or medical illness have more Submissive personality. The medical literature on gene markers shared by Submissive personality and illness in our population suggests the hypothesis that this relationship could be mediated by genetically lower neurotransmitter activity. Both norepinephrine activity and monoamine oxidase A, the enzyme controlling its catabolism, are in concert to blunt neuronal activity in such diverse states as depression, asthma, obesity, autoimmune illness, and in smokers. Conversely, norepinephrine activity is enhanced in breastfeeders and in other settings known to be related to good health. A point for possible divergence from the hypothesis is that African-Americans have enhanced norepinephrine activity yet poorer health outcomes although the effect of environmental risk factors in African-Americans is considered prominent by researchers. The possible importance of this

  11. Freud, his illness, and ourselves.

    PubMed

    Haynal, André

    2008-06-01

    The history of Freud's illness shows that he tried to avoid confrontation with it, and to treat it as unimportant. In his personal letters, the ill body remains outside-as another person, "Konrad," not he himself-and it is not taken into account. Particularly in Freud's correspondence with Ferenczi, we realize to what extent certain phenomena, especially depressive ones, he considered somatic, with a tendency to dismiss them, and this despite important occasional insights, such as about the role played by hate in psychosomatic illnesses. In the post-Freudian development, these topics have been more and more integrated in the dialogue, in the discourse between the analyst and the analysand.

  12. Hospitalized dogs recovery from naturally occurring heatstroke; does serum heat shock protein 72 can provide prognostic biomarker?

    PubMed

    Bruchim, Yaron; Segev, Gilad; Kelmer, Efrat; Codner, Carolina; Marisat, Ahmad; Horowitz, Michal

    2016-01-01

    Heatstroke is a serious illness in dogs characterized by core temperatures above 41°C with central nervous system dysfunction. Experimental heatstroke models have tried to correlate biomarker levels with the severity of the syndrome. Serum heat shock protein (eHSP70) levels were recently evaluated as a biomarker of heat tolerance and acclimation, their role as a marker of heatstroke is inconclusive. Here, we monitored eHSP70 levels in correlation with systemic biomarkers in 30 naturally occurring canine heatstroke cases. Thirty dogs diagnosed with environmental (33%) or exertional (66%) heatstroke admitted to hospital (0-14 h post-injury) were tested for biomarkers of organ damage and coagulation parameters. eHSP70 levels were measured upon admission and 4, 12, and 24 h later (T1, T2, and T3, respectively). No differences were found between exertional and environmental heatstroke cases. The eHSP profile demonstrated an inverted bell shape, with the lowest levels at the 12 h time point. A positive correlation between eHSP70, lactate, and aPPT was also noted at T2 in all the dogs in the study. Twenty-four h after presentation, eHSP70 levels returned to those measured upon admission, this change was only significant in the survivors. The obtained results suggest that eHSP72 level profile may be predictive of survival.

  13. Wheelchair users' perceived exertion during typical mobility activities.

    PubMed

    Qi, L; Ferguson-Pell, M; Salimi, Z; Haennel, R; Ramadi, A

    2015-09-01

    Each participant performed a series of wheelchair exercises equivalent in intensity to minimal functional speed (1 m s(-1)), functional walking speed (1.3 m s(-1)), a relatively challenging speed (1.6 m s(-1)) and a self-selected speed. Each participant also completed a graded exercise test (GXT) to volitional exhaustion (VO2peak). The purpose of this study was (1) to assess the physical capacity of wheelchair users as they undertake typical mobility activities and (2) to investigate how closely the components of a differentiated model of perceived exertion mirror wheelchair users' own perception of exertion. Eleven (eight males and three females) spinal cord-injured or congenitally impaired wheelchair-dependent participants volunteered for the study. Differentiated ratings of perceived exertion (RPE_arm and RPE_respiration) and oxygen uptake (VO2) and heart rate were recorded during each exercise. The mean comfortable speed at which the participants propelled their own wheelchairs on the wheelchair ergometer was 1.1±0.2 m s(-1). Speeds of 1 m s(-1) and 1.3 m s(-1) are typical of everyday functional propulsion. The corresponding RPE_respiration and RPE_arm ranged from 7 to 13 on the Borg scale; the %VO2peak measured in these trials ranged from 37 to 80% VO2peak. For propulsion intensities used in the present study-low, moderate, high and graded exercise intensity-no difference could be observed between RPE_respiration and RPE_arm. There were no significant differences between RPE_arm and RPE_respiration at the termination of the GXT. The current study showed potential for the use of RPE to assess and monitor daily wheelchair propulsion intensity in individuals with paraplegia.

  14. Pressure garment design tool to monitor exerted pressures.

    PubMed

    Macintyre, Lisa; Ferguson, Rhona

    2013-09-01

    Pressure garments are used in the treatment of hypertrophic scarring following serious burns. The use of pressure garments is believed to hasten the maturation process, reduce pruritus associated with immature hypertrophic scars and prevent the formation of contractures over flexor joints. Pressure garments are normally made to measure for individual patients from elastic fabrics and are worn continuously for up to 2 years or until scar maturation. There are 2 methods of constructing pressure garments. The most common method, called the Reduction Factor method, involves reducing the patient's circumferential measurements by a certain percentage. The second method uses the Laplace Law to calculate the dimensions of pressure garments based on the circumferential measurements of the patient and the tension profile of the fabric. The Laplace Law method is complicated to utilise manually and no design tool is currently available to aid this process. This paper presents the development and suggested use of 2 new pressure garment design tools that will aid pressure garment design using the Reduction Factor and Laplace Law methods. Both tools calculate the pressure garment dimensions and the mean pressure that will be exerted around the body at each measurement point. Monitoring the pressures exerted by pressure garments and noting the clinical outcome would enable clinicians to build an understanding of the implications of particular pressures on scar outcome, maturation times and patient compliance rates. Once the optimum pressure for particular treatments is known, the Laplace Law method described in this paper can be used to deliver those average pressures to all patients. This paper also presents the results of a small scale audit of measurements taken for the fabrication of pressure garments in two UK hospitals. This audit highlights the wide range of pressures that are exerted using the Reduction Factor method and that manual pattern 'smoothing' can dramatically

  15. [Exertion syncope disclosing supravalvular mitral stenosis in an infant].

    PubMed

    Buyse, G; Kuchler, H; Crittin, J; Sekarski, N; Hurni, M; Cotting, J; Payot, M

    1993-05-01

    An infant with frequent upper airways infections presented syncopes during meals and weeping since the age of eleven months. Cardiac examination was always normal. At 14 months of age, an echocardiogram with colour Doppler demonstrated a severely stenotic isolated supramitral membrane with severe pulmonary hypertension. The membrane was immediately excised curing the malformation and suppressing definitively the syncopes, probably due to decreased cerebral blood flow during exertion. An echocardiogram should always be performed when syncopes remain unexplained in small children. It allows early diagnosis and treatment of congenital heart defects which do not have auscultatory findings especially those resulting in severe pulmonary venous obstruction.

  16. Short-term hyperoxia does not exert immunologic effects during experimental murine and human endotoxemia

    PubMed Central

    Kiers, Dorien; Gerretsen, Jelle; Janssen, Emmy; John, Aaron; Groeneveld, R.; van der Hoeven, Johannes G.; Scheffer, Gert-Jan; Pickkers, Peter; Kox, Matthijs

    2015-01-01

    Oxygen therapy to maintain tissue oxygenation is one of the cornerstones of critical care. Therefore, hyperoxia is often encountered in critically ill patients. Epidemiologic studies have demonstrated that hyperoxia may affect outcome, although mechanisms are unclear. Immunologic effects might be involved, as hyperoxia was shown to attenuate inflammation and organ damage in preclinical models. However, it remains unclear whether these observations can be ascribed to direct immunosuppressive effects of hyperoxia or to preserved tissue oxygenation. In contrast to these putative anti-inflammatory effects, hyperoxia may elicit an inflammatory response and organ damage in itself, known as oxygen toxicity. Here, we demonstrate that, in the absence of systemic inflammation, short-term hyperoxia (100% O2 for 2.5 hours in mice and 3.5 hours in humans) does not result in increased levels of inflammatory cytokines in both mice and healthy volunteers. Furthermore, we show that, compared with room air, hyperoxia does not affect the systemic inflammatory response elicited by administration of bacterial endotoxin in mice and man. Finally, neutrophil phagocytosis and ROS generation are unaffected by short-term hyperoxia. Our results indicate that hyperoxia does not exert direct anti-inflammatory effects and temper expectations of using it as an immunomodulatory treatment strategy. PMID:26616217

  17. Improving Communication About Serious Illness

    ClinicalTrials.gov

    2017-01-07

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  18. Student Attitudes Toward Mental Illness

    ERIC Educational Resources Information Center

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  19. Student Attitudes Toward Mental Illness

    ERIC Educational Resources Information Center

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  20. Heat pumps

    NASA Astrophysics Data System (ADS)

    Gilli, P. V.

    1982-11-01

    Heat pumps for residential/commercial space heating and hot tap water make use of free energy of direct or indirect solar heat and save from about 40 to about 70 percent of energy if compared to a conventional heating system with the same energy basis. In addition, the electrically driven compressor heat pump is able to substitute between 40% (bivalent alternative operation) to 100% (monovalent operation) of the fuel oil of an oilfired heating furnace. For average Central European conditions, solar space heating systems with high solar coverage factor show the following sequence of increasing cost effectiveness: pure solar systems (without heat pumps); heat pump assisted solar systems; solar assisted heat pump systems; subsoil/water heat pumps; air/water heat pumps; air/air heat pumps.

  1. The Ubiquity of Chronic Illness.

    PubMed

    Fonseca, Claudia; Fleischer, Soraya; Rui, Taniele

    2016-01-01

    This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

  2. Heat Without Heat

    NASA Astrophysics Data System (ADS)

    Lubkin, Elihu

    1997-04-01

    Logic of the Second Law of Thermodynamics demands acquisition of naked entropy. Accordingly, the leanest liaison between systems is not a diathermic membrane, it is a purely informational tickler, leaking no appreciable energy. The subsystem here is a thermodynamic universe, which gets `heated' entropically, yet without gaining calories. Quantum Mechanics graciously supports that(Lubkin, E. and Lubkin, T., International Journal of Theoretical Physics,32), 933-943 (1993) (at a cost of about 1 bit) through entanglement---across this least permeable of membranes---with what is beyond that universe. Heat without heat(Also v. forthcoming Proceedings of the 4th Drexel University Conference of September 1994) is the aspirin for Boltzmann's headache, conserving entropy in mechanical isolation, even while increasing entropy in thermodynamic isolation.

  3. Heat strain during explosive ordnance disposal.

    PubMed

    Stewart, Ian B; Rojek, Amanda M; Hunt, Andrew P

    2011-08-01

    Bomb technicians perform their work while encapsulated in explosive ordnance disposal suits. Designed primarily for safety, these suits have an unintended consequence of impairing the body's natural mechanisms for heat dissipation. Consequently, bomb technicians are known to experience symptoms of heat illness while performing their work. This research provides the first field based analysis of heat strain in bomb technicians. Six participants undertook simulated operational tasks across 2 days of variable climate. All subjects demonstrated high levels of heat strain as evidenced by elevated heart rate, core body temperature, and physiological strain index. Participants also reported signs and symptoms associated with heat illness. These results were exacerbated by more intense physical activity despite being undertaken in a cooler environment. The universal experience of heat strain in this sample has significant implications for the health of bomb technicians and additional research examining methods to improve temperature regulation and performance is warranted.

  4. Delayed puberty in chronic illness.

    PubMed

    Pozo, Jesús; Argente, Jesús

    2002-03-01

    Delayed puberty can be defined as the lack of pubertal development at an age of 2 SD above the mean, which corresponds to an age of approximately 14 years for males and 13 years for females, taking both sex and ethnic origin into consideration. Its incidence associated with chronic illnesses is unknown; however, its clinical importance is relevant due to the larger percentage of patients with chronic disorders surviving until the age of puberty. Virtually every child with any chronic disease could present with delayed puberty (due to recurrent infections, immunodeficiency, gastrointestinal disease, renal disturbances, respiratory illnesses, chronic anaemia, endocrine disease, eating disorders, exercise and a number of miscellaneous abnormalities). Pubertal delay associated with chronic illness is accompanied by a delay in growth and the pubertal growth spurt. The degree to which growth and pubertal development are affected in chronic illness depends upon the type of disease and individual factors, as well as on the age at illness onset, its duration and severity. The earlier its onset and the longer and more severe the illness, the greater the repercussions on growth and pubertal development. The mechanism that trigger the start of physiological puberty remain unknown. Although malnutrition is probably the most important mechanism responsible for delayed puberty, emotional deprivation, toxic substances, stress and the side effects of chronic therapy, among others, have been implicated in the pathophysiology of delayed puberty. Therefore, early diagnosis is essential and appropriate and specific therapy fundamental.

  5. Chromosomal abnormalities and mental illness.

    PubMed

    MacIntyre, D J; Blackwood, D H R; Porteous, D J; Pickard, B S; Muir, W J

    2003-03-01

    Linkage studies of mental illness have provided suggestive evidence of susceptibility loci over many broad chromosomal regions. Pinpointing causative gene mutations by conventional linkage strategies alone is problematic. The breakpoints of chromosomal abnormalities occurring in patients with mental illness may be more direct pointers to the relevant gene locus. Publications that describe patients where chromosomal abnormalities co-exist with mental illness are reviewed along with supporting evidence that this may amount to an association. Chromosomal abnormalities are considered to be of possible significance if (a) the abnormality is rare and there are independent reports of its coexistence with psychiatric illness, or (b) there is colocalisation of the abnormality with a region of suggestive linkage findings, or (c) there is an apparent cosegregation of the abnormality with psychiatric illness within the individual's family. Breakpoints have been described within many of the loci suggested by linkage studies and these findings support the hypothesis that shared susceptibility factors for schizophrenia and bipolar disorder may exist. If these abnormalities directly disrupt coding regions, then combining molecular genetic breakpoint cloning with bioinformatic sequence analysis may be a method of rapidly identifying candidate genes. Full karyotyping of individuals with psychotic illness especially where this coexists with mild learning disability, dysmorphism or a strong family history of mental disorder is encouraged.

  6. Mental illness and Egyptian families.

    PubMed

    Endrawes, Gihane; O'Brien, Louise; Wilkes, Lesley

    2007-06-01

    People from Egypt have cultural belief systems about mental illness and its causes that are at variance from Anglo-Saxon-derived understandings that predominate in Australian psychiatry. These differences in understanding can affect how mental health services are experienced and accepted by this cultural group. This paper is a review of the literature on Egyptians' beliefs about mental illness and how families in Egypt cope with a relative with mental illness. Because of limited literature on Egyptians' experience with mental illness in Australia, this paper will be used to shed some light on the way in which people experience mental illness and communicate this suffering in the Australian context, based on what has been known to occur in Egypt. The Zar cult and related practices focusing on belief in the evil eye, magic, and evil possession will be explored. Historical and contemporary mental health care systems in Egypt, and the influence of education and religion are discussed. In order to provide culturally sensitive care, nurses need to be aware of possible influences on belief systems about mental illness. This paper has the potential of helping nurses to gain a deeper understanding of cultures that differ from theirs and to provide care to clients and their families based on respect for the others' beliefs, values, and practices.

  7. Weight loss reduces dyspnea on exertion in obese women.

    PubMed

    Bernhardt, Vipa; Babb, Tony G

    2014-12-01

    During submaximal exercise, some otherwise healthy obese women experience breathlessness, or dyspnea on exertion (+DOE), while others have mild or no DOE (-DOE). We investigated whether weight loss could reduce DOE. Twenty nine obese women were grouped based on their Ratings of Perceived Breathlessness (RPB) during constant load 60 W cycling: +DOE (n = 14, RPB ≥ 4, 34 ± 8 years, and 36 ± 3 kg/m(2)) and -DOE ( n= 15, RPB ≤ 2, 32 ± 8 years, and 36 ± 4 kg/m(2)) and then completed a 12-week weight loss program. Both groups lost a moderate amount of weight (+DOE: 6.6 ± 2.4 kg, -DOE: 8.4 ± 3.5 kg, and p < 0.001). RPB decreased significantly in the +DOE group (from 4.7 ± 1.1 to 3.1 ± 1.6) and remained low in the -DOE (from 1.5 ± 0.7 to 1.6 ± 1.1) (interaction p < 0.002). Most physiological variables measured (i.e. body composition, fat distribution, pulmonary function, oxygen cost of breathing, and cardiorespiratory measures) improved with weight loss; however, the decrease in RPB was not correlated with any of these variables (p > 0.05). In conclusion, moderate weight loss was effective in reducing breathlessness on exertion in obese women who experienced DOE at baseline. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Calibrating Borg scale ratings of hand force exertion.

    PubMed

    Spielholz, Peregrin

    2006-09-01

    A study was conducted to assess the efficacy of calibrating subjective worker ratings of hand exertions to reduce error in estimates of applied force. Twenty volunteer subjects applied pinch and power grip forces corresponding to their perceptions of different Borg CR-10 scale levels using both "grip-to-scale" and "guided-grip" procedures. These data were used separately to define relationships between scale ratings and actual force application. Two gripping tasks were performed and corresponding subjective hand force ratings were calibrated using the grip-to-scale calibration data. Results showed that the mean estimation error for a 44.5 N (10 lb) power grip task was significantly reduced from 142.8 (+/-69.0) to 62.3 (+/-58.3) N. The guided-grip calibration method also significantly reduced rating error for the power grip task, however the estimates were biased toward zero. Neither calibration procedure improved rating accuracy of an 8.9 N (2 lb) pinch grip task. The study results indicate that calibration of hand force ratings using the grip-to-scale procedure may improve the accuracy of hand exertion measurements using the Borg CR-10 scale.

  9. Caffeine ingestion, affect and perceived exertion during prolonged cycling.

    PubMed

    Backhouse, Susan H; Biddle, Stuart J H; Bishop, Nicolette C; Williams, Clyde

    2011-08-01

    Caffeine's metabolic and performance effects have been widely reported. However, caffeine's effects on affective states during prolonged exercise are unknown. Therefore, this was examined in the present study. Following an overnight fast and in a randomised, double-blind, counterbalanced design, twelve endurance trained male cyclists performed 90 min of exercise at 70% VO(₂ max) 1h after ingesting 6 mg kg⁻¹ BM of caffeine (CAF) or placebo (PLA). Dimensions of affect and perceived exertion were assessed at regular intervals. During exercise, pleasure ratings were better maintained (F(₃,₃₈)=4.99, P < 0.05) in the CAF trial compared to the PLA trial with significantly higher ratings at 15, 30 and 75 min (all P < 0.05). Perceived exertion increased (F(₃,₃₈) = 19.86, P < 0.01) throughout exercise and values, overall, were significantly lower (F(₁,₁₁) = 9.26, P < 0.05) in the CAF trial compared to the PLA trial. Perceived arousal was elevated during exercise but did not differ between trials. Overall, the results suggest that a moderate dose of CAF ingested 1h prior to exercise maintains a more positive subjective experience during prolonged cycling. This observation may partially explain caffeine's ergogenic effects. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Pirfenidone exerts antifibrotic effects through inhibition of GLI transcription factors.

    PubMed

    Didiasova, Miroslava; Singh, Rajeev; Wilhelm, Jochen; Kwapiszewska, Grazyna; Wujak, Lukasz; Zakrzewicz, Dariusz; Schaefer, Liliana; Markart, Philipp; Seeger, Werner; Lauth, Matthias; Wygrecka, Malgorzata

    2017-02-01

    Pirfenidone is an antifibrotic drug, recently approved for the treatment of patients suffering from idiopathic pulmonary fibrosis (IPF). Although pirfenidone exhibits anti-inflammatory, antioxidant, and antifibrotic properties, the molecular mechanism underlying its protective effects remains unknown. Here, we link pirfenidone action with the regulation of the profibrotic hedgehog (Hh) signaling pathway. We demonstrate that pirfenidone selectively destabilizes the glioma-associated oncogene homolog (GLI)2 protein, the primary activator of Hh-mediated gene transcription. Consequently, pirfenidone decreases overall Hh pathway activity in patients with IPF and in patient-derived primary lung fibroblasts and leads to diminished levels of Hh target genes such as GLI1, Hh receptor Patched-1, α-smooth muscle actin, and fibronectin and to reduced cell migration and proliferation. Interestingly, Hh-triggered TGF-β1 expression potentiated Hh responsiveness of primary lung fibroblasts by elevating the available pool of glioma-associated oncogene homolog (GLI)1/GLI2, thus creating a vicious cycle of amplifying fibrotic processes. Because GLI transcription factors are not only crucial for Hh-mediated changes but are also required as mediators of TGF-β signaling, our findings suggest that pirfenidone exerts its clinically beneficial effects through dual Hh/TGF-β inhibition by targeting the GLI2 protein.-Didiasova, M., Singh, R., Wilhelm, J., Kwapiszewska, G., Wujak, L., Zakrzewicz, D., Schaefer, L., Markart, P., Seeger, W., Lauth, M., Wygrecka, M. Pirfenidone exerts antifibrotic effects through inhibition of GLI transcription factors.

  11. Ratings of perceived exertion in adults with chronically physical challenges.

    PubMed

    Satonaka, A; Suzuki, N; Kawamura, M

    2012-10-01

    The purposes of this study were to investigate: the relationship between ratings perceived exertion (RPE) and percentage of maximal oxygen uptake (%VO2max) during submaximal exercise; the influence of daily physical activities on RPE; and the influence of aerobic fitness on RPE. The participants were thirty-eight adults with chronically physical challenges. Submaximal exercise testing was conducted to estimate VO2max. The participants themselves declared their perceived exertion just before the end of the exercise testing by indicating the Borg's 6-20 RPE scale. Measurement of continuous heart rates was employed for measurement of the intensity of daily physical activities. The relationship between %VO2max and RPE was analyzed. There was a significant correlation between %VO2max and RPE only in the active men who did daily aerobic physical activities with intensity of 30%HRR and more (N.=9, r=0.74, P=0.02). In the good fitness groups of both women and men, the actual %VO2max in 11 out of 12 participants was lower than the reference value of %VO2max of the RPE while the opposite trend was found in poor aerobic fitness group. Our results recommend that RPE should be used together with objective physiological variables such as HR for assessment of exercise intensity in people with chronically physical challenges, especially who are low in aerobic fitness or who are inactive.

  12. Weight Loss Reduces Dyspnea on Exertion in Obese Women

    PubMed Central

    Bernhardt, Vipa; Babb, Tony G.

    2014-01-01

    During submaximal exercise, some otherwise healthy obese women experience breathlessness, or dyspnea on exertion (+DOE), while others have mild or no DOE (−DOE). We investigated whether weight loss could reduce DOE. 29 obese women were grouped based on their Ratings of Perceived Breathlessness (RPB) during constant load 60W cycling: +DOE (n=14, RPB≥4, 34±8yr, 36±3kg/m2) and −DOE (n=15, RPB≤2, 32±8yr, 36±4kg/m2) and then completed a 12-week weight loss program. Both groups lost a moderate amount of weight (+DOE: 6.6±2.4kg, −DOE: 8.4±3.5kg, p<0.001). RPB decreased significantly in the +DOE group (from 4.7±1.1 to 3.1±1.6) and remained low in the −DOE (from 1.5±0.7 to 1.6±1.1) (interaction p<0.002). Most physiological variables measured (i.e. body composition, fat distribution, pulmonary function, oxygen cost of breathing, cardiorespiratory measures) improved with weight loss; however, the decrease in RPB was not correlated with any of these variables (p>0.05). In conclusion, moderate weight loss was effective in reducing breathlessness on exertion in obese women who experienced DOE at baseline. PMID:25220695

  13. Chronic Exertional Compartment Syndrome in a Healthy Young Man.

    PubMed

    Joubert, Sonia V; Duarte, Manuel A

    2016-06-01

    The purpose of this case report is to describe a patient who presented with symptoms of exercise-induced compartment syndrome and was later referred for bilateral fasciotomy surgery. A 21-year-old patient presented for chiropractic care with the inability to run due to foot paresthesia and weakness. An exertion test and compartment pressure test diagnosed exercise-induced compartment syndrome. Exertion test and compartment pressure test were used to identify and diagnose exercise-induced compartment syndrome. The patient was diagnosed with exercise-induced compartment syndrome. He was treated conservatively and referred for additional testing. The orthopedic surgeon requested that 12 weeks of conservative care be provided prior to testing; treatment consisted of chiropractic care and rehabilitation exercises. Following the 12 weeks of treatment, the patient did not significantly respond to conservative care. A compartment pressure test confirmed the initial diagnosis of exercise-induced compartment syndrome. The patient underwent a unilateral fasciotomy surgery and recovered fully. Following the surgery, the patient returned to the chiropractic clinic with the same presentation in the contralateral leg. The same protocol of management resulted in the same outcome. Two years after surgical intervention, the patient continues to maintain an active lifestyle, able to run 2 to 3 miles per day without any exacerbations or symptomatology. Clinical awareness, a detailed history, and thorough examination with reproduction of symptomatology are necessary to form a proper diagnosis and treatment plan for these patients. Therefore, multidisciplinary medical communication would prove to be the most beneficial approach for the patient.

  14. Development of the color scale of perceived exertion: preliminary validation.

    PubMed

    Serafim, Thais H S; Tognato, Andrea C; Nakamura, Priscila M; Queiroga, Marcos R; Nakamura, Fábio Y; Pereira, Gleber; Kokubun, Eduardo

    2014-12-01

    This study developed a Color Scale of Perceived Exertion (RPE-color scale) and assessed its concurrent and construct validity in adult women. One hundred participants (18-77 years), who were habitual exercisers, associated colors with verbal anchors of the Borg RPE scale (RPE-Borg scale) for RPE-color scale development. For RPE-color scale validation, 12 Young (M = 21.7 yr., SD = 1.5) and 10 Older (M = 60.3 yr., SD = 3.5) adult women performed a maximal graded exercise test on a treadmill and reported perceived exertion in both RPE-color and RPE-Borg scales. In the Young group, the RPE-color scale was significantly associated with heart rate and oxygen consumption, having strong correlations with the RPE-Borg scale. In the Older group, the RPE-color scale was significantly associated with heart rate, having moderate to high correlations with the RPE-Borg scale. The RPE-color scale demonstrated concurrent and construct validity in the Young women, as well as construct validity in Older adults.

  15. Designing pressure garments capable of exerting specific pressures on limbs.

    PubMed

    Macintyre, Lisa

    2007-08-01

    Pressure garments have been used prophylactically and to treat hypertrophic scars, resulting from serious burns, since the early 1970s. They are custom-made from elastic fabrics by commercial producers and hospital staff. However, no clear scientifically established method has ever been published for their design and manufacture. Previous work [2] identified the most commonly used fabrics and construction methods for the production of pressure garments by hospital staff in UK burn units. These methods were evaluated by measuring pressures delivered to both cylinder models and to human limbs using I-scan pressure sensors. A new calibration method was developed for the I-scan system to enable measurement of low interface pressures to an accuracy of +/-2.5 mmHg. The effects of cylinder/limb circumference and pressure garment design on the pressures exerted were established. These measurements confirm the limitations of current pressure garment construction methods used in UK hospitals. A new method for designing pressure garments that will exert specific known pressures is proposed and evaluated for human thighs. Evaluation of the proposed design method is ongoing for other body parts.

  16. Heat Pipes

    ERIC Educational Resources Information Center

    Lewis, J.

    1975-01-01

    Describes the construction, function, and applications of heat pipes. Suggests using the heat pipe to teach principles related to heat transfer and gives sources for obtaining instructional kits for this purpose. (GS)

  17. Heat Stress

    MedlinePlus

    ... Work in the Heat: Why Acclimatization Matters The natural adaptation to the heat takes time, and from a management perspective, it may require careful planning. NIOSH Science Blog: Extreme Heat – Are you prepared for summer ...

  18. 46 CFR 153.434 - Heat transfer coils within a tank.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Cargo Temperature Control Systems § 153.434 Heat transfer coils within a tank. When a cargo tank contains any quantity of cargo, a cargo cooling or heating system having coils within the tank must keep the heat transfer fluid at a pressure greater than the pressure exerted on the heating or cooling...

  19. 46 CFR 153.434 - Heat transfer coils within a tank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 5 2011-10-01 2011-10-01 false Heat transfer coils within a tank. 153.434 Section 153... Cargo Temperature Control Systems § 153.434 Heat transfer coils within a tank. When a cargo tank... the heat transfer fluid at a pressure greater than the pressure exerted on the heating or...

  20. 46 CFR 153.434 - Heat transfer coils within a tank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Heat transfer coils within a tank. 153.434 Section 153... Cargo Temperature Control Systems § 153.434 Heat transfer coils within a tank. When a cargo tank... the heat transfer fluid at a pressure greater than the pressure exerted on the heating or...

  1. 46 CFR 153.434 - Heat transfer coils within a tank.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 5 2014-10-01 2014-10-01 false Heat transfer coils within a tank. 153.434 Section 153... Cargo Temperature Control Systems § 153.434 Heat transfer coils within a tank. When a cargo tank... the heat transfer fluid at a pressure greater than the pressure exerted on the heating or cooling...

  2. 46 CFR 153.434 - Heat transfer coils within a tank.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 5 2013-10-01 2013-10-01 false Heat transfer coils within a tank. 153.434 Section 153... Cargo Temperature Control Systems § 153.434 Heat transfer coils within a tank. When a cargo tank... the heat transfer fluid at a pressure greater than the pressure exerted on the heating or cooling...

  3. [Vulnerability to environmental heat among persons with mental health problems].

    PubMed

    Vida, Stephen

    2011-01-01

    This review is intended to alert health professionals to the particular vulnerability of persons with mental health problems or taking certain medications to heat-related illness, a threat that is increasing due to climate change. It reviews epidemiology, physiology and clinical features of heat-related illness. For acute medical management, it refers readers to existing guidelines and recommendations. It reviews risk and protective factors. Finally, it presents preventive strategies that may help reduce the impact of heat-related illness in this population.

  4. [Gustave Flaubert's illness].

    PubMed

    Gastaut, H; Gastaut, Y

    1982-01-01

    All those interested in Gustave Flaubert's illness, during his lifetime as well as after his death, have agreed that he had epilepsy. The one important exception is Jean-Paul Sartre, who, in the 2800 pages of his "Idiot de la famille" claimed that Flaubert was a hysteric with very moderate intelligence who somatized his neurosis in the form of seizures. These, in Sartre's views, were moreover probably hysterical, but possibly epileptic resulting from the existence of a psychogenic epilepsy bred from the neurosis. The basis for this neurosis could have originated at the time of Gustave's birth, as this occurred between those of two brothers who both died young, and as his mother had wished for a daughter. Further development of the neurosis might have taken place during a temporary phase of learning difficulties, exaggerated and exploited by his father to make his youngest son the idiot of a family in which the eldest son was the dauphin. Destroyed in this way, Gustave would have sought refuge in passivity and could have developed a hatred for his father and for his elder brother, who he would have liked to kill before killing himself. But, unable to carry out his wishes and desiring both to die and to survive, Gustave, adolescent, might have chosen the pathway of "false deaths", as exemplified by the seizures. Modern epileptology data enables not only to confirm the epileptic etiology and to discount the hysterical nature of the fits, but also: 1. to establish precise details of the site and nature of the cerebral lesions responsible for the attacks: neonatal atrophy or vascular malformation of the occipitotemporal cortex of the left hemisphere, the only lesion capable of provoking: a) the phosphenes marking the onset of the seizures; b) the intellectual manifestations (forced thoughts or flight of ideas), affective features (panic terror), and psychosensory (ecmnesic hallucinations) or psychomotor (confusional automatism) symptoms accompanying some attacks; c) the

  5. Physiological tolerance to uncompensated heat stress in soldiers: effects of various types of body cooling systems.

    PubMed

    Jovanović, Dalibor; Karkalić, Radovan; Zeba, Snjezana; Pavlović, Miroslav; Radaković, Sonja S

    2014-03-01

    In military services, emergency situations when soldiers are exposed to a combination of nuclear, biological and chemical (NBC) contamination combined with heat stress, are frequent and complex. In these specific conditions, usage of personal body cooling systems may be effective in reducing heat stress. The present study was conducted in order to evaluate the efficiency of four various types of contemporary personal body cooling systems based on the "Phase Change Material" (PCM), and its effects on soldiers' subjective comfort and physiological performance during exertional heat stress in hot environments. Ten male soldiers were voluntarily subjected to exertional heat stress tests (EHSTs) consisted of walking on a treadmill (5.5 km/h) in hot conditions (40 degreesC) in climatic chamber, wearing NBC isolating impermeable protective suits. One of the tests was performed without any additional cooling solution (NOCOOL), and four tests were performed while using different types of cooling systems: three in a form of vests and one as underwear. Physiological strain was determined by the mean skin temperature (Tsk), tympanic temperature (Tty), and heart rate values (HR), while sweat rates (SwR) indicated changes in hydration status. In all the cases EHST induced physiological response manifested through increasing Tty, HR and SwR. Compared to NOCOOL tests, when using cooling vests, Tty and Tsk were significantly lower (on 35th min, for 0.44 +/- 0.03 and 0.49 +/- 0.05 degrees C, respectively; p < 0.05), as well as the average SwR (0.17 +/- 0.03 L/m2/h). When using underwear, the values of given parameters were not significantly different compared to NOCOOL tests. Using a body cooling system based on PCM in the form of vest under NBC protective clothes during physical activity in hot conditions, reduces sweating and alleviates heat stress manifested by increased core and skin temperatures and heart rate values. These effects directly improve heat tolerance, hydration

  6. Optimum polygenic profile to resist exertional rhabdomyolysis during a marathon

    PubMed Central

    Valero, Marjorie; Salinero, Juan José; Lara, Beatriz; Gallo-Salazar, César; Areces, Francisco

    2017-01-01

    Purpose Exertional rhabdomyolysis can occur in individuals performing various types of exercise but it is unclear why some individuals develop this condition while others do not. Previous investigations have determined the role of several single nucleotide polymorphisms (SNPs) to explain inter-individual variability of serum creatine kinase (CK) concentrations after exertional muscle damage. However, there has been no research about the interrelationship among these SNPs. The purpose of this investigation was to analyze seven SNPs that are candidates for explaining individual variations of CK response after a marathon competition (ACE = 287bp Ins/Del, ACTN3 = p.R577X, CKMM = NcoI, IGF2 = C13790G, IL6 = 174G>C, MLCK = C37885A, TNFα = 308G>A). Methods Using Williams and Folland’s model, we determined the total genotype score from the accumulated combination of these seven SNPs for marathoners with a low CK response (n = 36; serum CK <400 U·L-1) vs. marathoners with a high CK response (n = 31; serum CK ≥400 U·L-1). Results At the end of the race, low CK responders had lower serum CK (290±65 vs. 733±405 U·L-1; P<0.01) and myoglobin concentrations (443±328 vs. 1009±971 ng·mL-1, P<0.01) than high CK responders. Although the groups were similar in age, anthropometric characteristics, running experience and training habits, total genotype score was higher in low CK responders than in high CK responders (5.2±1.4 vs. 4.4±1.7 point, P = 0.02). Conclusion Marathoners with a lower CK response after the race had a more favorable polygenic profile than runners with high serum CK concentrations. This might suggest a significant role of genetic polymorphisms in the levels of exertional muscle damage and rhabdomyolysis. Yet other SNPs, in addition to exercise training, might also play a role in the values of CK after damaging exercise. PMID:28257486

  7. Heat acclimation responses of an ultra-endurance running group preparing for hot desert-based competition.

    PubMed

    Costa, Ricardo J S; Crockford, Michael J; Moore, Jonathan P; Walsh, Neil P

    2014-01-01

    C T amb. Preventing exertional heat illnesses and optimising performance outcomes in ultra-endurance runners may occur with exposure to at least 2 h of exercise-heat stress on at least two occasions in the days leading up to multi-stage ultra-marathon competition in the heat.

  8. Cognitions and Procedures in Response to Illness.

    ERIC Educational Resources Information Center

    Diefenbach, Michael A.; And Others

    Recent research in illness has stressed the importance of constructive processes as determinants for coping and appraisal with illnesses. The goal of this study was to construct a lexicon of cognitive and behavioral responses people employ to cope with illness. Undergraduate college students (N=105) were given two illness scenarios describing the…

  9. Illness in the Returned International Traveler.

    PubMed

    Sanford, Christopher A; Fung, Claire

    2016-03-01

    Familiarity with the distribution, mode of transmission, and risk factors for acquisition of illnesses commonly transmitted to travelers to low-income nations can help guide clinicians in their work-up of an ill returned traveler. The 3 most common categories of illness in returned international travelers are gastrointestinal illness, fever, and dermatoses. Diarrhea is the most common illness reported in returned international travelers. Fever is a marker of a potentially significant illness; work-up of the ill febrile returned traveler should be conducted promptly. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The use of subjective rating of exertion in Ergonomics.

    PubMed

    Capodaglio, P

    2002-01-01

    In Ergonomics, the use of psychophysical methods for subjectively evaluating work tasks and determining acceptable loads has become more common. Daily activities at the work site are studied not only with physiological methods but also with perceptual estimation and production methods. The psychophysical methods are of special interest in field studies of short-term work tasks for which valid physiological measurements are difficult to obtain. The perceived exertion, difficulty and fatigue that a person experiences in a certain work situation is an important sign of a real or objective load. Measurement of the physical load with physiological parameters is not sufficient since it does not take into consideration the particular difficulty of the performance or the capacity of the individual. It is often difficult from technical and biomechanical analyses to understand the seriousness of a difficulty that a person experiences. Physiological determinations give important information, but they may be insufficient due to the technical problems in obtaining relevant but simple measurements for short-term activities or activities involving special movement patterns. Perceptual estimations using Borg's scales give important information because the severity of a task's difficulty depends on the individual doing the work. Observation is the most simple and used means to assess job demands. Other evaluations integrating observation are the followings: indirect estimation of energy expenditure based on prediction equations or direct measurement of oxygen consumption; measurements of forces, angles and biomechanical parameters; measurements of physiological and neurophysiological parameters during tasks. It is recommended that determinations of performances of occupational activities assess rating of perceived exertion and integrate these measurements of intensity levels with those of activity's type, duration and frequency. A better estimate of the degree of physical activity

  11. Spinal cord stimulation exerts neuroprotective effects against experimental Parkinson's disease.

    PubMed

    Shinko, Aiko; Agari, Takashi; Kameda, Masahiro; Yasuhara, Takao; Kondo, Akihiko; Tayra, Judith Thomas; Sato, Kenichiro; Sasaki, Tatsuya; Sasada, Susumu; Takeuchi, Hayato; Wakamori, Takaaki; Borlongan, Cesario V; Date, Isao

    2014-01-01

    In clinical practice, deep brain stimulation (DBS) is effective for treatment of motor symptoms in Parkinson's disease (PD). However, the mechanisms have not been understood completely. There are some reports that electrical stimulation exerts neuroprotective effects on the central nervous system diseases including cerebral ischemia, head trauma, epilepsy and PD, although there are a few reports on neuroprotective effects of spinal cord stimulation (SCS). We investigated the neuroprotective effects of high cervical SCS on PD model of rats. Adult female Sprague-Dawley rats received hour-long SCS (2, 50 or 200 Hz) with an epidural electrode at C1-2 level for 16 consecutive days. At 2 days after initial SCS, 6-hydroxydopamine (6-OHDA) was injected into the right striatum of rats. Behavioral evaluations of PD symptoms were employed, including cylinder test and amphetamine-induced rotation test performed at 1 and 2 weeks after 6-OHDA injection. Animals were subsequently euthanized for immunohistochemical investigations. In order to explore neurotrophic and growth factor upregulation induced by SCS, another cohort of rats that received 50 Hz SCS was euthanized at 1 and 2 weeks after lesion for protein assays. Behavioral tests revealed that the number of amphetamine-induced rotations decreased in SCS groups. Immunohistochemically, tyrosine hydroxylase (TH)-positive fibers in the striatum were significantly preserved in SCS groups. TH-positive neurons in the substantia nigra pars compacta were significantly preserved in 50 Hz SCS group. The level of vascular endothelial growth factor (VEGF) was upregulated by SCS at 1 week after the lesion. These results suggest that high cervical SCS exerts neuroprotection in PD model of rats, at least partially by upregulation of VEGF. SCS is supposed to suppress or delay PD progression and might become a less invasive option for PD patients, although further preclinical and clinical investigations are needed to confirm the effectiveness

  12. Physiological responses and perceived exertion during cycling with superimposed electromyostimulation.

    PubMed

    Wahl, Patrick; Schaerk, Jonas; Achtzehn, Silvia; Kleinöder, Heinz; Bloch, Wilhelm; Mester, Joachim

    2012-09-01

    The goal of the study was to evaluate and to quantify the effects of local electromyostimulation (EMS) during cycling on the cardiorespiratory system, muscle metabolism, and perceived exertion compared with cycling with no EMS. Ten healthy men (age: 24.6 ± 3.2 years, V[Combining Dot Above]O2max: 54.1 ± 6.0 ml·min·kg) performed 3 incremental cycle ergometer step tests, 1 without and 2 with EMS (30 and 85 Hz) until volitional exhaustion. Lactate values and respiratory exchange ratio were significantly higher at intensities ≥75% peak power output (PPO) when EMS was applied. Bicarbonate concentration, base excess (BE), and Pco2 were significantly lower when EMS was applied compared with the control at intensities ≥75% PPO. Saliva cortisol levels increased because of the exercise but were unaffected by EMS. Furthermore, EMS showed greater effects on CK levels 24 hours postexercise than normal cycling did. Rating of perceived exertion was significantly higher at 100% PPO with EMS. No statistical differences were found for heart rate, pH, and Po2 between the tested cycling modes. The main findings of this study are greater metabolic changes (lactate, respiratory exchange ratio, BE, (Equation is included in full-text article.), Pco2) during cycling with EMS compared with normal cycling independent of frequency, mainly visible at higher work rates. Because metabolic alterations are important for the induction of cellular signaling cascades and adaptations, these results lead to the hypothesis that applied EMS stimulations during cycling exercise might be an enhancing stimulus for skeletal muscle metabolism and related adaptations. Thus, superimposed EMS application during cycling could be beneficial to aerobic performance enhancements in athletes and in patients who cannot perform high workloads. However, the higher demand on skeletal muscles involved must be considered.

  13. Physical exertion and working efficiency of reforestation workers.

    PubMed

    Hodges, Alastair Nh; Kennedy, Michael D

    2011-06-28

    The purpose of this study was to quantify the physical exertion during tree planting work and to examine the relationships between exertion, task efficiency, and productivity. Heart rate (HR) was monitored on 34 tree planters while they worked. HR data was collected for a complete working day on 19 subjects and for shorter periods of time on 15 subjects. Video of work tasks was recorded on 22 subjects (video was recorded on 7 of the subjects for whom HR was monitored through a full working day) and analyzed for working pace and proportion of time spent on each task. HR during a full day (9.0 ± 1.2 hours) of tree planting work was 115.2 ± 8.8 beats.min-1, and working HR was 128.2 ± 15.6 beats.min-1 for 82.5 ± 6.8% of the work day. Mean work pace was 452 ± 174 trees.h-1, and the proportion of time spent planting each tree was 53 ± 8% of the working time. Significant (P < 0.05) positive correlations were found between work pace and experience level, and between work pace and working HR, and a significant (P < 0.05) negative correlation was found between experience level and HR for a given work pace. No significant relationships were found between experience level or work pace and the proportion of time spent planting each tree. Tree planters work at approximately 65% of age-predicted HRmax, and maintain HR at approximately 59% of HRmax throughout the entire working day. Productivity in these workers appears to be related to effort rather than to experience or task efficiency per se.

  14. Swallowing Dysfunction After Critical Illness

    PubMed Central

    White, S. David; Moss, Marc

    2014-01-01

    Critical care practitioners must frequently make decisions about their patients’ ability to swallow food, liquids, and pills. These decisions can be particularly difficult given the incompletely defined epidemiology, diagnostic criteria, and prognostic features of swallowing disorders in critically ill patients. Furthermore, the consequences of improper decisions—namely, aspiration, malnutrition, hunger, and thirst—can be devastating to patients and their families. This review outlines the problem of swallowing dysfunction in critically ill patients and then addresses the most clinically relevant questions that critical care practitioners face today. First, we review the epidemiology of swallowing dysfunction in critically ill patients. Next, we describe the different diagnostic tests for swallowing dysfunction and describe a general approach to the initial assessment for swallowing disorders. Finally, we explore the existing treatments for swallowing dysfunction. Given the burden of swallowing dysfunction in patients recovering from critical illness, enabling critical care practitioners to manage these disorders, while stimulating new investigation into their pathophysiology, diagnosis, and management, will enhance our care of critically ill patients. PMID:25451355

  15. Somali Refugees' Perceptions of Mental Illness.

    PubMed

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  16. Concepts of illness in Icelandic children.

    PubMed

    Hansdottir, I; Malcarne, V L

    1998-06-01

    To investigate the development of illness concepts among healthy Icelandic children. Participants were 68 schoolchildren, 6-7, 10-11, and 14-15 years of age, and their parents. Cognitive developmental level and understanding of physical illness were assessed within a Piagetian framework. In addition, illness experience and illness behaviors (Child Illness Behavior Questionnaire) were assessed. Results were consistent with previous studies in that the development of illness concepts among Icelandic children was consistent with Piaget's theory of cognitive development. No relation was found between illness experience and understanding of illness. A more mature understanding of illness was related to willingness to report the onset of illness. The results suggest that findings from previous studies may be generalized to a broader population.

  17. Simultaneous Multiple Control Force Exertion Capabilities of Males and Females versus Helicopter Control Force Design Limits,

    DTIC Science & Technology

    1987-09-01

    percent) than for collective inputs ( typically 20-35 percent). Substantial proportions of the subjects (approximately 50 percent of the males and more ...nearly 86 percent of the females performed one or more exertions below the design limit. The exertions of 28.6 percent of the females were below the pedal...design limit for more than one-half of the 16 exertions they performed; 75 percent of the exertions by 6 of the 63 females were below design-limit

  18. Polyneuropathy in critically ill patients.

    PubMed Central

    Bolton, C F; Gilbert, J J; Hahn, A F; Sibbald, W J

    1984-01-01

    Five patients developed a severe motor and sensory polyneuropathy at the peak of critical illness (sepsis and multiorgan dysfunction complicating a variety of primary illnesses). Difficulties in weaning from the ventilator as the critical illness subsided and the development of flaccid and areflexic limbs were early clinical signs. However, electrophysiological studies, especially needle electrode examination of skeletal muscle, provided the definite evidence of polyneuropathy. The cause is uncertain, but the electrophysiological and morphological features indicate a primary axonal polyneuropathy with sparing of the central nervous system. Nutritional factors may have played a role, since the polyneuropathy improved in all five patients after total parenteral nutrition had been started, including the three patients who later died of unrelated causes. The features allow diagnosis during life, and encourage continued intensive management since recovery from the polyneuropathy may occur. Images PMID:6094735

  19. Circadian Rhythms and Psychiatric Illness

    PubMed Central

    Asarnow, Lauren D.; Soehner, Adriane M.; Harvey, Allison G.

    2014-01-01

    Purpose of review The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. Recent Findings In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. Summary Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions, address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes. PMID:24060916

  20. Carrion's disease: an eradicable illness?

    PubMed

    Gomes, Cláudia; Pons, Maria J; Del Valle Mendoza, Juana; Ruiz, Joaquim

    2016-12-01

    Carrion's disease is a neglected tropical disease caused by Bartonella bacilliformis, a vector-borne pathogen restricted to the Andean valleys of Peru, Ecuador and Colombia. Carrion's disease is a biphasic illness; in the acute phase the case-fatality rate can be as high as 88 %, related to high parasitemia, arriving to almost all erythrocytes, and secondary bacterial infections close related with the development of transient immunosuppression in the earlier illness phases. In addition, there are an undefined number of asymptomatic carriers that are reservoirs of the etiological agent of Carrion's disease in endemic areas, they make take into account due to they are the perpetuators of this disease. The actual scenario of Carrion's disease, in which the illness is arriving to new areas, due to the expansion of the vector's distribution, suggests that now may be a crucial time to design a strategy focusing on its elimination.

  1. Rehabilitation of mentally ill women

    PubMed Central

    Chatterjee, Rajni; Hashim, Uzma

    2015-01-01

    Women, the fair sex, are principal providers of care and support to families. But, they are considered to be the weaker sex and one of the most powerless and marginalized sections of our society. The provision of Rehabilitation for mentally ill women has been, and still is, one of the major challenges for mental health systems reform in the last decades, for various reasons. The present paper discusses the global and Indian scenario of rehabilitation of mentally ill women and goes on to detail the contribution of the state and voluntary agencies in this regard. It explores the need of recovery, multilayered strategy of Rehabilitation services and the availability of present services. The stigma attached and legal defects which interfere in good quality of life for the mentally ill women are reviewed. Strategies for changes in future are recommended. PMID:26330653

  2. [Illness behavior in chronic pain].

    PubMed

    Lavielle, Pilar; Clark, Patricia; Martínez, Homero; Mercado, Francisco; Ryan, Gery

    2008-01-01

    To describe the illness behaviour in patients with chronic pain. We conducted semi-structured interviews to 53 patients during 2000, in a tertiary care center. We explored their initial interpretations, responses and subsequent practices to chronic pain, until they received a diagnosis that satisfied them. Illness behaviour was determined by pain intensity and disability; beliefs regarding pain causes, trust in social networks, and quality and satisfaction with the health care systems. In terms of the decision to seek care, the first option was to go to the popular sector, followed by consulting a general physician, and as last resort, to go to a tertiary care center ("with a specialist"). Illness behaviour should be conceptualized as a process, which combines the use of different health care sectors by the same subjects, as a result of care provided sequentially by each previous sector.

  3. Serious Illness Conversations in ESRD.

    PubMed

    Mandel, Ernest I; Bernacki, Rachelle E; Block, Susan D

    2016-12-28

    Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less. This high intensity of care is often inconsistent with the wishes of patients on dialysis but persists due to failure to explore or discuss patient goals, values, and preferences in the context of their serious illness. Fewer than 10% of patients on dialysis report having had a conversation about goals, values, and preferences with their nephrologist, although nearly 90% report wanting this conversation. Many nephrologists shy away from these conversations, because they do not wish to upset their patients, feel that there is too much uncertainty in their ability to predict prognosis, are insecure in their skills at broaching the topic, or have difficulty incorporating the conversations into their clinical workflow. In multiple studies, timely discussions about serious illness care goals, however, have been associated with enhanced goal-consistent care, improved quality of life, and positive family outcomes without an increase in patient distress or anxiety. In this special feature article, we will (1) identify the barriers to serious illness conversations in the dialysis population, (2) review best practices in and specific approaches to conducting serious illness conversations, and (3) offer solutions to overcome barriers as well as practical advice, including specific language and tools, to implement serious illness conversations in the dialysis population.

  4. Nutrition of critically ill horses.

    PubMed

    Carr, Elizabeth A; Holcombe, Susan J

    2009-04-01

    Nutritional supplementation is becoming the standard of practice in equine medicine, although there are minimal data on nutritional support in critically ill horses and its association or effect on morbidity and mortality or length of hospital stay. Horses can be fed orally and when that is not possible, intravenously or parenterally. Enteral feeding is less expensive, more physiologic, improves immunity, and is easier and safer. This article reviews available information on the development of a nutritional plan for critically ill horses, and describes methods for and complications of enteral and parenteral feeding.

  5. Presumptive nonthyroidal illness syndrome in critically ill foals.

    PubMed

    Himler, M; Hurcombe, S D A; Griffin, A; Barsnick, R J; Rathgeber, R A; MacGillivray, K C; Toribio, R E

    2012-02-01

    Hypothalamic-pituitary-thyroid (HPT) axis dysfunction is associated with morbidity and mortality in critically ill people. To date, investigations of HPT axis in critically ill foals are limited. To document the occurrence of low thyroid hormone concentrations (presumptive nonthyroidal illness syndrome; NTIS) in critically ill newborn foals and investigate whether NTIS is associated with severity of disease and outcome. NTIS occurs frequently in foals with sepsis and is associated with sepsis score and outcome. Reverse T3 (rT3) concentrations will be increased in septic foals and highest in nonsurvivors. Thyroid hormones (total and free thyroxine [TT4 and fT4], total and free tri-iodothyronine [TT3 and fT3], reverse T3 [rT3]) were prospectively measured in healthy, sick nonseptic and septic foals. Clinical and laboratory information was retrieved from the medical records. Hormones were measured by validated radioimmunoassays. Concentrations of all thyroid hormones except rT3 (P = 0.69) were decreased in septic and sick nonseptic foals (P < 0.01). Reductions in hormone concentrations were associated with an increased sepsis score (P < 0.01). Nonsurviving septic foals had lower TT4, fT4, TT3 and fT3 concentrations than surviving septic foals (P < 0.01). rT3 concentrations were higher in nonsurviving septic prematurefoals than surviving septic premature foals (P < 0.05). NTIS (euthyroid sick syndrome) is frequently observed in critically ill and premature foals, and associated with severity of disease and mortality. More research is needed to better understand the mechanism of this finding and determine whether manipulation of the HPT axis or thyroid replacement therapy could be beneficial.

  6. Exertional Hyponatremia and Serum Sodium Change During Ultraendurance Cycling.

    PubMed

    Armstrong, Lawrence E; Lee, Elaine C; Casa, Douglas J; Johnson, Evan C; Ganio, Matthew S; McDermott, Brendon P; Vingren, Jakob L; Oh, Hyun M; Williamson, Keith H

    2017-04-01

    Exertional hyponatremia (EH) during prolonged exercise involves all avenues of fluid-electrolyte gain and loss. Although previous research implicates retention of excess fluid, EH may involve either loss, gain, or no change of body mass. Thus, the etiology, predisposing factors, and recommendations for prevention are vague-except for advice to avoid excessive drinking. This retrospective field study presents case reports of two unacquainted recreational cyclists (LC, 31y and AM, 39 years) who began exercise with normal serum electrolytes but finished a summer 164-km ride (ambient, 34±5°C) with a serum [Na+] of 130 mmol/L. To clarify the etiology of EH, their pre- and post-exercise measurements were compared to a control group (CON) of 31 normonatremic cyclists (mean ± SD; 37±6 years; 141±3 mmol Na+/L). Anthropomorphic characteristics, exercise time, and post-exercise ratings of thermal sensation, perceived exertion and muscle cramp were similar for LC, AM and CON. These two hyponatremic cyclists consumed a large and similar volume of fluid (191 and 189 ml/kg), experienced an 11 mmol/L decrease of serum [Na+], reported low thirst sensations; however, LC gained 3.1 kg (+4.3% of body mass) during 8.9 hr of exercise and AM maintained body mass (+0.1kg, +0.1%, 10.6h). In the entire cohort (n = 33), post-event serum [Na+] was strongly correlated with total fluid intake (R(2) = 0.45, p < .0001), and correlated moderately with dietary sodium intake (R(2)=0.28, p = .004) and body mass change (R(2) = 0.22, p = .02). Linear regression analyses predicted the threshold of EH onset (<135 mmol Na+/L) as 168 ml fluid/kg. The wide range of serum [Na+] changes (+6 to -11 mmol/L) led us to recommend an individualized rehydration plan to athletes because the interactions of factors were complex and idiosyncratic.

  7. Assessing illness- and non-illness-based motivations for violence in persons with major mental illness.

    PubMed

    Penney, Stephanie R; Morgan, Andrew; Simpson, Alexander I F

    2016-02-01

    Research on violence perpetrated by individuals with major mental illness (MMI) typically focuses on the presence of specific psychotic symptoms near the time of the violent act. This approach does not distinguish whether symptoms actually motivate the violence or were merely present at the material time. It also does not consider the possibility that non-illness-related factors (e.g., anger, substance use), or multiple motivations, may have been operative in driving violence. The failure to make these distinctions clouds our ability to understand the origins of violence in people with MMI, to accurately assess risk and criminal responsibility, and to appropriately target interventions to reduce and manage risk. This study describes the development of a new coding instrument designed to assess motivations for violence and offending among individuals with MMI, and reports on the scheme's interrater reliability. Using 72 psychiatric reports which had been submitted to the court to assist in determining criminal responsibility, we found that independent raters were able to assess different motivational influences for violence with a satisfactory degree of consistency. More than three-quarters (79.2%) of the sample were judged to have committed an act of violence as a primary result of illness, whereas 20.8% were deemed to have offended as a result of illness in conjunction with other non-illness-based motivating influences. Current findings have relevance for clarifying the rate of illness-driven violence among psychiatric patients, as well as legal and clinical issues related to violence risk and criminal responsibility more broadly.

  8. Exercise Challenge in Gulf War Illness Reveals Two Subgroups with Altered Brain Structure and Function

    PubMed Central

    Rayhan, Rakib U.; Stevens, Benson W.; Raksit, Megna P.; Ripple, Joshua A.; Timbol, Christian R.; Adewuyi, Oluwatoyin; VanMeter, John W.; Baraniuk, James N.

    2013-01-01

    Nearly 30% of the approximately 700,000 military personnel who served in Operation Desert Storm (1990–1991) have developed Gulf War Illness, a condition that presents with symptoms such as cognitive impairment, autonomic dysfunction, debilitating fatigue and chronic widespread pain that implicate the central nervous system. A hallmark complaint of subjects with Gulf War Illness is post-exertional malaise; defined as an exacerbation of symptoms following physical and/or mental effort. To study the causal relationship between exercise, the brain, and changes in symptoms, 28 Gulf War veterans and 10 controls completed an fMRI scan before and after two exercise stress tests to investigate serial changes in pain, autonomic function, and working memory. Exercise induced two clinical Gulf War Illness subgroups. One subgroup presented with orthostatic tachycardia (n = 10). This phenotype correlated with brainstem atrophy, baseline working memory compensation in the cerebellar vermis, and subsequent loss of compensation after exercise. The other subgroup developed exercise induced hyperalgesia (n = 18) that was associated with cortical atrophy and baseline working memory compensation in the basal ganglia. Alterations in cognition, brain structure, and symptoms were absent in controls. Our novel findings may provide an understanding of the relationship between the brain and post-exertional malaise in Gulf War Illness. PMID:23798990

  9. Exercise challenge in Gulf War Illness reveals two subgroups with altered brain structure and function.

    PubMed

    Rayhan, Rakib U; Stevens, Benson W; Raksit, Megna P; Ripple, Joshua A; Timbol, Christian R; Adewuyi, Oluwatoyin; VanMeter, John W; Baraniuk, James N

    2013-01-01

    Nearly 30% of the approximately 700,000 military personnel who served in Operation Desert Storm (1990-1991) have developed Gulf War Illness, a condition that presents with symptoms such as cognitive impairment, autonomic dysfunction, debilitating fatigue and chronic widespread pain that implicate the central nervous system. A hallmark complaint of subjects with Gulf War Illness is post-exertional malaise; defined as an exacerbation of symptoms following physical and/or mental effort. To study the causal relationship between exercise, the brain, and changes in symptoms, 28 Gulf War veterans and 10 controls completed an fMRI scan before and after two exercise stress tests to investigate serial changes in pain, autonomic function, and working memory. Exercise induced two clinical Gulf War Illness subgroups. One subgroup presented with orthostatic tachycardia (n = 10). This phenotype correlated with brainstem atrophy, baseline working memory compensation in the cerebellar vermis, and subsequent loss of compensation after exercise. The other subgroup developed exercise induced hyperalgesia (n = 18) that was associated with cortical atrophy and baseline working memory compensation in the basal ganglia. Alterations in cognition, brain structure, and symptoms were absent in controls. Our novel findings may provide an understanding of the relationship between the brain and post-exertional malaise in Gulf War Illness.

  10. The critically ill immunosuppressed patient

    SciTech Connect

    Parrillo, J.E.; Masur, H. )

    1987-01-01

    This book discusses the papers on the diagnosis and management of immunosuppressed patient. Some of the topics are: life-threatening organ failure in immunosuppressed patients; diagnosis and therapy of respiratory disease in the immunosuppressed patient; CNS complication of immunosuppression; infections; antineoplastic therapy of immunosuppressed patient; radiation therapy-issues in critically ill patient; AIDS; and management of bone marrow transplant patients.

  11. Nonthyroidal illness syndrome in children.

    PubMed

    Marks, Seth D

    2009-12-01

    Neuroendocrine changes in the hypothalamic-pituitary-thyroid axis during critical illness result in nonthyroidal illness syndrome (NTIS) characterized by abnormal thyrotropin (TSH) and thyroid hormone levels. Studies looking at the natural history of neuroendocrine changes during critical illness have revealed the presence of NTIS. NTIS has been described in a variety of patient settings. Many studies have tried to uncover the pathophysiology behind NTIS and several theories are proposed. Whether NTIS requires treatment or intervention is still controversial and the results of the treatment studies are arguably mixed. Whether implicitly stated or not, the underlying purpose of all the natural history, pathophysiology, or treatment studies is to determine whether NTIS is adaptive or maladaptive. Some studies have illustrated a correlation between illness severity and the degree of NTIS but a cause and effect relationship is still elusive. The human studies can be divided between those with either adult or pediatric subjects, with much less data available in the latter. This review examines the available literature on NTIS with an emphasis on the pediatric literature.

  12. Illness, suffering and voluntary euthanasia.

    PubMed

    Varelius, Jukka

    2007-02-01

    It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

  13. Program for the Chronically Ill.

    ERIC Educational Resources Information Center

    Schoenherr, Arline; Schnarr, Barbara

    The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

  14. Marriage, mental illness and law

    PubMed Central

    Sharma, Indira; Reddy, Karri Rama; Kamath, Rabindra Mukund

    2015-01-01

    The Special Marriage Act (SMA), 1954 and the Hindu Marriage Act (HMA), 1955 have put restrictions on the marriage of persons with mental illness, which are proving to be detrimental to patients and their families. There is an urgent need to address this problem. The deficiencies in the existing legislation have been projected and constructive suggestions have been put forward. PMID:26330652

  15. Family Therapy and Psychosomatic Illness.

    ERIC Educational Resources Information Center

    Waring, Edward M.

    1980-01-01

    Reviews the use of family therapy in dealing with illnesses such as childhood diabetes, asthma, pain, and anorexia nervosa. Marital and family therapy may be effective in treating some psychosomatic problems. Family assessment is helpful in the management of all psychosomatic problems. (Author/JAC)

  16. Teaching the Terminally Ill Child.

    ERIC Educational Resources Information Center

    Ainsa, Trisha

    1981-01-01

    Classroom teachers of terminally ill children face potentially difficult, challenging, rewarding and professionally expanding experiences which require an understanding of the basic needs of the dying. Strategies for teaching such children include literature, writing, role playing, magic circle discussions, play therapy, art therapy, counseling,…

  17. Foodborne illness and microbial agents

    USDA-ARS?s Scientific Manuscript database

    Foodborne illnesses result from the consumption of food containing microbial agents such as bacteria, viruses, parasites or food contaminated by poisonous chemicals or bio-toxins. Pathogen proliferation is due to nutrient composition of foods, which are capable of supporting the growth of microorgan...

  18. Diarrhoea in the critically ill.

    PubMed

    Reintam Blaser, Annika; Deane, Adam M; Fruhwald, Sonja

    2015-04-01

    To summarize existing evidence on definition, epidemiology, mechanisms, risk factors, consequences, outcome and management of diarrhoea in the critically ill. In health, diarrhoea is defined as the passage of three or more loose or liquid stools per day. In the critically ill, the diagnosis is yet to be formalized and reported prevalence of diarrhoea varies according to the definition used. Recent studies estimate the prevalence between 14 and 21% and describe risk factors for diarrhoea in critically ill patients. The precipitant of diarrhoea always needs to be identified, as targeted therapies are important for several causes. Although the majority of patients with diarrhoea require only supportive care, it is always essential to exclude, or confirm and treat infectious diarrhoea. There is little evidence to support delaying or withdrawing provision of enteral nutrition in patients with diarrhoea, and we recommend continuing enteral nutrition whenever possible. However, the consequences of diarrhoea - hypovolaemia, electrolyte disturbances, malnutrition, skin lesions and contamination of wounds - should be avoided or at least recognized promptly. A definition of diarrhoea and a practical approach to identify the precipitant and to manage diarrhoea in critically ill patients are proposed.

  19. Program for the Chronically Ill.

    ERIC Educational Resources Information Center

    Schoenherr, Arline; Schnarr, Barbara

    The program for chronically ill students in the Detroit public schools is described. Forms are presented listing needed information and implications for teachers of the following conditions: diabetes, sickle cell anemia, chronic renal failure, congenital heart disease, hemophilia, rheumatoid arthritis, asthma, leukemia, and cystic fibrosis. The…

  20. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes

    PubMed Central

    Oláh, Attila; Tóth, Balázs I.; Borbíró, István; Sugawara, Koji; Szöllõsi, Attila G.; Czifra, Gabriella; Pál, Balázs; Ambrus, Lídia; Kloepper, Jennifer; Camera, Emanuela; Ludovici, Matteo; Picardo, Mauro; Voets, Thomas; Zouboulis, Christos C.; Paus, Ralf; Bíró, Tamás

    2014-01-01

    The endocannabinoid system (ECS) regulates multiple physiological processes, including cutaneous cell growth and differentiation. Here, we explored the effects of the major nonpsychotropic phytocannabinoid of Cannabis sativa, (-)-cannabidiol (CBD), on human sebaceous gland function and determined that CBD behaves as a highly effective sebostatic agent. Administration of CBD to cultured human sebocytes and human skin organ culture inhibited the lipogenic actions of various compounds, including arachidonic acid and a combination of linoleic acid and testosterone, and suppressed sebocyte proliferation via the activation of transient receptor potential vanilloid-4 (TRPV4) ion channels. Activation of TRPV4 interfered with the prolipogenic ERK1/2 MAPK pathway and resulted in the downregulation of nuclear receptor interacting protein-1 (NRIP1), which influences glucose and lipid metabolism, thereby inhibiting sebocyte lipogenesis. CBD also exerted complex antiinflammatory actions that were coupled to A2a adenosine receptor-dependent upregulation of tribbles homolog 3 (TRIB3) and inhibition of the NF-κB signaling. Collectively, our findings suggest that, due to the combined lipostatic, antiproliferative, and antiinflammatory effects, CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris. PMID:25061872

  1. [Injury and exertion patterns in football on artificial turf].

    PubMed

    Gaulrapp, H; Siebert, C; Rosemeyer, B

    1999-12-01

    This controlled non-selected cross-sectional study supplies a basic survey on the topic analysing 1783 injuries in 433 of 736 athletes out of a closed collective. Aged 11 to 40 years and having played an average of 3.7 years an artificial turf the players had sustained 38% skin injuries (58% in the legs), 28% sprains (64% in the ankle joints, 21% in the knee joints) and 17% muscle injuries. 76% of all injuries were minor, i.e. leading to an interruption of under one week, only 8% were severe with a break of over 3 weeks. The average risk of injury was 6 per 1000 hours of participation, similar to that in football on natural grass. More than half of the players protocol pain in the joints, muscles or column persisting even one day after the game, which only led to medical assistance in 3% of all cases. Playing football on artificial grass displays a specific pattern of injuries and exertion syndromes without a higher rate or grade of injuries and therefore shows no medical need for restriction.

  2. Respiratory and leg muscles perceived exertion during exercise at altitude.

    PubMed

    Aliverti, A; Kayser, B; Lo Mauro, A; Quaranta, M; Pompilio, P; Dellacà, R L; Ora, J; Biasco, L; Cavalleri, L; Pomidori, L; Cogo, A; Pellegrino, R; Miserocchi, G

    2011-07-31

    We compared the rate of perceived exertion for respiratory (RPE,resp) and leg (RPE,legs) muscles, using a 10-point Borg scale, to their specific power outputs in 10 healthy male subjects during incremental cycle exercise at sea level (SL) and high altitude (HA, 4559 m). Respiratory power output was calculated from breath-by-breath esophageal pressure and chest wall volume changes. At HA ventilation was increased at any leg power output by ∼ 54%. However, for any given ventilation, breathing pattern was unchanged in terms of tidal volume, respiratory rate and operational volumes of the different chest wall compartments. RPE,resp scaled uniquely with total respiratory power output, irrespectively of SL or HA, while RPE,legs for any leg power output was exacerbated at HA. With increasing respective power outputs, the rate of change of RPE,resp exponentially decreased, while that of RPE,legs increased. We conclude that RPE,resp uniquely relates to respiratory power output, while RPE,legs varies depending on muscle metabolic conditions. Copyright © 2011 Elsevier B.V. All rights reserved.

  3. Chronic exertional compartment syndrome of the forearm in adolescents.

    PubMed

    García-Mata, Serafín

    2013-12-01

    Chronic exertional compartment syndrome (CECS) is a well-known process, although rare in the forearm. The diagnosis is based on history, clinical examination, and compartment pressure readings. My objective is to present the largest series of CECS of the forearm in adolescents and describe my experience in its management and evolution. I reviewed 5 patients, 4 male (competing in motorcycling or motocross) and 1 female (CECS in both the legs and forearms), aged between 15 and 18 years. Volar and dorsal compartments were affected in 3 patients and isolated volar in 2 cases. The clinical diagnosis was objectively confirmed by measuring ICP with a low-pressure digital transducer (Stryker). Open fasciotomy was carried out in 4 patients. They resumed their athletic activities 6 weeks after surgery without complications, increasing their athletic performance level in line with their preoperative status. All these patients remained asymptomatic, recovering their previous competitive levels. The results were objectively classified as excellent in all 4 cases. After a mean follow-up of 6 years, the condition has not relapsed in any of the patients. Two of the patients agreed to a new ICP measurement 1 year after the surgery, showing normal values. CECS in the forearm in adolescents is a rare condition that occurs after puberty. A high index of suspicion is necessary to diagnose it. It is based on symptoms and ICP measurements. Most patients are competing motorcyclists. Surgical treatment, involving isolated decompression of the superficial volar compartment, is safe and effective (restoring normal ICP).

  4. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes.

    PubMed

    Oláh, Attila; Tóth, Balázs I; Borbíró, István; Sugawara, Koji; Szöllõsi, Attila G; Czifra, Gabriella; Pál, Balázs; Ambrus, Lídia; Kloepper, Jennifer; Camera, Emanuela; Ludovici, Matteo; Picardo, Mauro; Voets, Thomas; Zouboulis, Christos C; Paus, Ralf; Bíró, Tamás

    2014-09-01

    The endocannabinoid system (ECS) regulates multiple physiological processes, including cutaneous cell growth and differentiation. Here, we explored the effects of the major nonpsychotropic phytocannabinoid of Cannabis sativa, (-)-cannabidiol (CBD), on human sebaceous gland function and determined that CBD behaves as a highly effective sebostatic agent. Administration of CBD to cultured human sebocytes and human skin organ culture inhibited the lipogenic actions of various compounds, including arachidonic acid and a combination of linoleic acid and testosterone, and suppressed sebocyte proliferation via the activation of transient receptor potential vanilloid-4 (TRPV4) ion channels. Activation of TRPV4 interfered with the prolipogenic ERK1/2 MAPK pathway and resulted in the downregulation of nuclear receptor interacting protein-1 (NRIP1), which influences glucose and lipid metabolism, thereby inhibiting sebocyte lipogenesis. CBD also exerted complex antiinflammatory actions that were coupled to A2a adenosine receptor-dependent upregulation of tribbles homolog 3 (TRIB3) and inhibition of the NF-κB signaling. Collectively, our findings suggest that, due to the combined lipostatic, antiproliferative, and antiinflammatory effects, CBD has potential as a promising therapeutic agent for the treatment of acne vulgaris.

  5. Chlorogenic Compounds from Coffee Beans Exert Activity against Respiratory Viruses.

    PubMed

    Sinisi, Valentina; Stevaert, Annelies; Berti, Federico; Forzato, Cristina; Benedetti, Fabio; Navarini, Luciano; Camps, Anita; Persoons, Leentje; Vermeire, Kurt

    2017-05-01

    Chlorogenic acids are secondary metabolites in diverse plants. Some chlorogenic acids extracted from traditional medicinal plants are known for their healing properties, e.g., against viral infections. Also, green coffee beans are a rich source of chlorogenic acids, with 5-O-caffeoylquinic acid being the most abundant chlorogenic acid in coffee. We previously reported the synthesis of the regioisomers of lactones, bearing different substituents on the quinidic core. Here, 3,4-O-dicaffeoyl-1,5-γ-quinide and three dimethoxycinnamoyl-γ-quinides were investigated for in vitro antiviral activities against a panel of 14 human viruses. Whereas the dimethoxycinnamoyl-γ-quinides did not show any antiviral potency in cytopathogenic effect reduction assays, 3,4-O-dicaffeoyl-1,5-γ-quinide exerted mild antiviral activity against herpes simplex viruses, adenovirus, and influenza virus. Interestingly, when the compounds were evaluated against respiratory syncytial virus, a potent antiviral effect of 3,4-O-dicaffeoyl-1,5-γ-quinide was observed against both subtypes of respiratory syncytial virus, with EC50 values in the submicromolar range. Time-of-addition experiments revealed that this compound acts on an intracellular post-entry replication step. Our data show that 3,4-O-dicaffeoyl-1,5-γ-quinide is a relevant candidate for lead optimization and further mechanistic studies, and warrants clinical development as a potential anti-respiratory syncytial virus drug. Georg Thieme Verlag KG Stuttgart · New York.

  6. Resveratrol exerts pharmacological preconditioning by activating PGC-1alpha.

    PubMed

    Tan, Lan; Yu, Jin-Tai; Guan, Hua-Shi

    2008-11-01

    Resveratrol (RSV), a polyphenol phytoalexin abundantly found in grape skins and in wines, is currently the focus of intense research as a pharmacological preconditioning agent in kidney, heart, and brain from ischemic injury. However, the exact molecular mechanism of RSV preconditioning remains obscure. The data from current studies indicate that pharmacological preconditioning with RSV were attributed to its role as intracellular antioxidant, anti-inflammatory agent, its ability to induce nitric oxide synthase (NOS) expression, its ability to induce angiogenesis, and its ability to increases sirtuin 1 (SIRT1) activity. Peroxisome proliferators-activated receptor (PPAR) gamma co-activator-1alpha (PGC-1alpha) is a member of a family of transcription coactivators that owns mitochondrial biogenesis, antioxidation, growth factor signaling regulation, and angiogenesis activities. And, almost all the signaling pathways activated by RVS involve in PGC-1alpha activity. Moreover, it has been proofed that RVS could mediate an increase PGC-1alpha activity. These significant conditions support the hypothesis that RSV exerts pharmacological preconditioning by activating PGC-1alpha. Attempts to confirm this hypothesis will provide new directions in the study of pharmaceutical preconditioning and the development of new treatment approaches for reducing the extent of ischemia/reperfusion injury.

  7. Can a String's Tension Exert a Torque on a Pulley?

    NASA Astrophysics Data System (ADS)

    Krause, Dennis E.; Sun, Yifei

    2011-04-01

    A typical textbook problem in rotational dynamics involves calculating the angular acceleration of a massive pulley due to a string, such as in the example shown in Fig. 1. The string is assumed to be massless and to move without slipping over the pulley, which is mounted on a frictionless axle. If TL and TR are the tensions pulling at the left and right edges of the pulley (see Fig. 1), respectively, the net torque on the pulley is then τnet = (TL - TR)R, where R is the radius of the pulley. (It is assumed that positive torque corresponds to the counterclockwise direction.) While this analysis, which is typical of what is found in many introductory physics texts, is correct, it should raise several questions in the mind of a student. First, since most texts argue that the tension everywhere in a massless string is constant,2 why is TL ≠ TR? Second, since tension is an internal force (except at the ends of the string, which are obviously not tied to the pulley),3 how can tension exert a force and torque on a pulley? In this paper, we will address these questions, which are overlooked in most textbook treatments of this problem whose approach appears inconsistent with the concepts presented elsewhere in the text.

  8. Selective Mitochondrial Targeting Exerts Anxiolytic Effects In Vivo

    PubMed Central

    Nussbaumer, Markus; Asara, John M; Teplytska, Larysa; Murphy, Michael P; Logan, Angela; Turck, Christoph W; Filiou, Michaela D

    2016-01-01

    Current treatment strategies for anxiety disorders are predominantly symptom-based. However, a third of anxiety patients remain unresponsive to anxiolytics highlighting the need for more effective, mechanism-based therapeutic approaches. We have previously compared high vs low anxiety mice and identified changes in mitochondrial pathways, including oxidative phosphorylation and oxidative stress. In this work, we show that selective pharmacological targeting of these mitochondrial pathways exerts anxiolytic effects in vivo. We treated high anxiety-related behavior (HAB) mice with MitoQ, an antioxidant that selectively targets mitochondria. MitoQ administration resulted in decreased anxiety-related behavior in HAB mice. This anxiolytic effect was specific for high anxiety as MitoQ treatment did not affect the anxiety phenotype of C57BL/6N and DBA/2J mouse strains. We furthermore investigated the molecular underpinnings of the MitoQ-driven anxiolytic effect and found that MitoQ treatment alters the brain metabolome and that the response to MitoQ treatment is characterized by distinct molecular signatures. These results indicate that a mechanism-driven approach based on selective mitochondrial targeting has the potential to attenuate the high anxiety phenotype in vivo, thus paving the way for translational implementation as long-term MitoQ administration is well-tolerated with no reported side effects in mice and humans. PMID:26567514

  9. Effects of caffeine on the rate of perceived exertion.

    PubMed

    Rodrigues, L O; Russo, A K; Silva, A C; Piçarro, I C; Silva, F R; Zogaib, P S; Soares, D D

    1990-01-01

    The role of caffeine in improving performance in endurance exercises is controversial and its mechanism of action is not well understood. The purpose of the present study was to evaluate the effects of caffeine on the rate of perceived exertion (RPE) by exercising athletes. Six male non-smoking runners, aged 26.8 +/- 4.9 years (mean +/- SD), who had been in training continuously for at least two years before the experiment were studied. Mean maximum oxygen consumption (VO2max) was 61.21 +/- 5.36 ml kg-1 min-1. The subjects were asked to exercise on a bicycle ergometer for 3 min each at 300 and 600 kg m min-1, after which the work load was elevated to 1200 kg m min-1 and they exercised until exhaustion. In order to evaluate the effects of caffeine, the exercise was performed twice following the ingestion of 200 ml decaffeinated coffee with and without caffeine (5 mg/kg body weight). Caffeine had no significant effect on exercise time, pulmonary ventilation, oxygen consumption, carbon dioxide extraction or exchange respiratory ratio, but the RPE was significantly lower (P less than 0.05) at the work load of 1200 kg m min-1 after the ingestion of caffeine for both trials I and II. The present results suggest that metabolic acidosis and glycogen depletion were not the main causes of exhaustion.

  10. Selective Mitochondrial Targeting Exerts Anxiolytic Effects In Vivo.

    PubMed

    Nussbaumer, Markus; Asara, John M; Teplytska, Larysa; Murphy, Michael P; Logan, Angela; Turck, Christoph W; Filiou, Michaela D

    2016-06-01

    Current treatment strategies for anxiety disorders are predominantly symptom-based. However, a third of anxiety patients remain unresponsive to anxiolytics highlighting the need for more effective, mechanism-based therapeutic approaches. We have previously compared high vs low anxiety mice and identified changes in mitochondrial pathways, including oxidative phosphorylation and oxidative stress. In this work, we show that selective pharmacological targeting of these mitochondrial pathways exerts anxiolytic effects in vivo. We treated high anxiety-related behavior (HAB) mice with MitoQ, an antioxidant that selectively targets mitochondria. MitoQ administration resulted in decreased anxiety-related behavior in HAB mice. This anxiolytic effect was specific for high anxiety as MitoQ treatment did not affect the anxiety phenotype of C57BL/6N and DBA/2J mouse strains. We furthermore investigated the molecular underpinnings of the MitoQ-driven anxiolytic effect and found that MitoQ treatment alters the brain metabolome and that the response to MitoQ treatment is characterized by distinct molecular signatures. These results indicate that a mechanism-driven approach based on selective mitochondrial targeting has the potential to attenuate the high anxiety phenotype in vivo, thus paving the way for translational implementation as long-term MitoQ administration is well-tolerated with no reported side effects in mice and humans.

  11. Multiple Mechanisms of Anti-Cancer Effects Exerted by Astaxanthin

    PubMed Central

    Zhang, Li; Wang, Handong

    2015-01-01

    Astaxanthin (ATX) is a xanthophyll carotenoid which has been approved by the United States Food and Drug Administration (USFDA) as food colorant in animal and fish feed. It is widely found in algae and aquatic animals and has powerful anti-oxidative activity. Previous studies have revealed that ATX, with its anti-oxidative property, is beneficial as a therapeutic agent for various diseases without any side effects or toxicity. In addition, ATX also shows preclinical anti-tumor efficacy both in vivo and in vitro in various cancer models. Several researches have deciphered that ATX exerts its anti-proliferative, anti-apoptosis and anti-invasion influence via different molecules and pathways including signal transducer and activator of transcription 3 (STAT3), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and peroxisome proliferator-activated receptor gamma (PPARγ). Hence, ATX shows great promise as chemotherapeutic agents in cancer. Here, we review the rapidly advancing field of ATX in cancer therapy as well as some molecular targets of ATX. PMID:26184238

  12. Matrix Metalloproteinase 9 Exerts Antiviral Activity against Respiratory Syncytial Virus

    PubMed Central

    Dabo, Abdoulaye J.; Cummins, Neville; Eden, Edward; Geraghty, Patrick

    2015-01-01

    Increased lung levels of matrix metalloproteinase 9 (MMP9) are frequently observed during respiratory syncytial virus (RSV) infection and elevated MMP9 concentrations are associated with severe disease. However little is known of the functional role of MMP9 during lung infection with RSV. To determine whether MMP9 exerted direct antiviral potential, active MMP9 was incubated with RSV, which showed that MMP9 directly prevented RSV infectivity to airway epithelial cells. Using knockout mice the effect of the loss of Mmp9 expression was examined during RSV infection to demonstrate MMP9’s role in viral clearance and disease progression. Seven days following RSV infection, Mmp9-/- mice displayed substantial weight loss, increased RSV-induced airway hyperresponsiveness (AHR) and reduced clearance of RSV from the lungs compared to wild type mice. Although total bronchoalveolar lavage fluid (BALF) cell counts were similar in both groups, neutrophil recruitment to the lungs during RSV infection was significantly reduced in Mmp9-/- mice. Reduced neutrophil recruitment coincided with diminished RANTES, IL-1β, SCF, G-CSF expression and p38 phosphorylation. Induction of p38 signaling was required for RANTES and G-CSF expression during RSV infection in airway epithelial cells. Therefore, MMP9 in RSV lung infection significantly enhances neutrophil recruitment, cytokine production and viral clearance while reducing AHR. PMID:26284919

  13. Heat Stroke: Role of the Systemic Inflammatory Response

    DTIC Science & Technology

    2010-06-01

    including delirium, seizures, or coma and severe hyperthermia. Rapid cooling and support of multi-organ function are the most effective clinical...exertional heat stroke while performing strenuous physical activity in temperate or hot climates. Factors that predispose to heat stroke collapse...organ function are the most effective clinical treatments, but many patients experience permanent neurological impairments or death despite these

  14. Integration of Decentralized Thermal Storages Within District Heating (DH) Networks

    NASA Astrophysics Data System (ADS)

    Schuchardt, Georg K.

    2016-12-01

    Thermal Storages and Thermal Accumulators are an important component within District Heating (DH) systems, adding flexibility and offering additional business opportunities for these systems. Furthermore, these components have a major impact on the energy and exergy efficiency as well as the heat losses of the heat distribution system. Especially the integration of Thermal Storages within ill-conditioned parts of the overall DH system enhances the efficiency of the heat distribution. Regarding an illustrative and simplified example for a DH system, the interactions of different heat storage concepts (centralized and decentralized) and the heat losses, energy and exergy efficiencies will be examined by considering the thermal state of the heat distribution network.

  15. Mental Illness Disclosure Decision Making.

    PubMed

    Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

    2017-04-10

    Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record

  16. Communication About Chronic Critical Illness

    PubMed Central

    Nelson, Judith E.; Mercado, Alice F.; Camhi, Sharon L.; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I.; Morrison, R. Sean

    2008-01-01

    Background Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. Methods In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3–7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Results Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Conclusions Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented. PMID

  17. Life Event, Stress and Illness

    PubMed Central

    Salleh, Mohd. Razali

    2008-01-01

    The relationship between stress and illness is complex. The susceptibility to stress varies from person to person. Among the factors that influenced the susceptibility to stress are genetic vulnerability, coping style, type of personality and social support. Not all stress has negative effect. Studies have shown that short-term stress boosted the immune system, but chronic stress has a significant effect on the immune system that ultimately manifest an illness. It raises catecholamine and suppressor T cells levels, which suppress the immune system. This suppression, in turn raises the risk of viral infection. Stress also leads to the release of histamine, which can trigger severe broncho-constriction in asthmatics. Stress increases the risk for diabetes mellitus, especially in overweight individuals, since psychological stress alters insulin needs. Stress also alters the acid concentration in the stomach, which can lead to peptic ulcers, stress ulcers or ulcerative colitis. Chronic stress can also lead to plaque buildup in the arteries (atherosclerosis), especially if combined with a high-fat diet and sedentary living. The correlation between stressful life events and psychiatric illness is stronger than the correlation with medical or physical illness. The relationship of stress with psychiatric illness is strongest in neuroses, which is followed by depression and schizophrenia. There is no scientific evidence of a direct cause-and-effect relationship between the immune system changes and the development of cancer. However, recent studies found a link between stress, tumour development and suppression of natural killer (NK) cells, which is actively involved in preventing metastasis and destroying small metastases. PMID:22589633

  18. Camelid heat stress: 15 cases (2003–2011)

    PubMed Central

    Norton, Piper L.; Gold, Jenifer R.; Russell, Karen E.; Schulz, Kara L.; Porter, Brian F.

    2014-01-01

    This case series describes novel findings associated with heat stress in 15 cases in South American camelids that had no pre-existing illnesses and which had clinical signs of illness after exposure to a warm environment. Novel findings include decreased packed cell volume and albumin concentration and mild spinal axonal degeneration. Heat stress should be considered in weak camelids with a history of hyperthermia. PMID:25320390

  19. Strategies and factors associated with preparing for competing in the heat: a cohort study at the 2015 IAAF World Athletics Championships

    PubMed Central

    Périard, Julien D; Racinais, Sébastien; Dahlström, Örjan; Spreco, Armin; Bargoria, Victor; Halje, Karin; Alonso, Juan-Manuel

    2017-01-01

    Purpose Assess exertional heat illness (EHI) history and preparedness in athletes competing in a World Athletics Championships under hot/humid conditions and identify the factors associated with preparedness strategies. Methods Of the 207 registered national teams invited to participate in the study, 50 (24%) accepted. The 957 athletes (49% of all 1965 registered) in these teams were invited to complete a precompetition questionnaire evaluating EHI history, heat stress prevention (heat acclimatisation, precooling and hydration) and recovery. Responses from 307 (32%) athletes were separated in field events, sprints, middle-distance and long-distance running, and decathlon/heptathlon for analysis. Results 48% of athletes had previously experienced EHI symptoms and 8.5% had been diagnosed with EHI. 15% heat acclimatised (∼20 days) before the championships. 52% had a precooling strategy, ice slurry ingestion (24%) being the most prevalent and women using it more frequently than men (p=0.005). 96% of athletes had a fluid consumption strategy, which differed between event categories (p<0.001). The most common volumes planned on being consumed were 0.5–1 L (27.2%) and ≥2 L (21.8%), water being the most frequent. 89% of athletes planned on using at least one recovery strategy. Female sex (p=0.024) and a previous EHI diagnosis increased the likelihood of using all 3 prevention strategies (p<0.001). Conclusions At a World Championships with expected hot/humid conditions, less than one-fifth of athletes heat acclimatised, half had a precooling strategy and almost all a hydration plan. Women, and especially athletes with an EHI history, were more predisposed to use a complete heat stress prevention strategy. More information regarding heat acclimatisation should be provided to protect athlete health and optimise performance at major athletics competitions in the heat. PMID:27815238

  20. Predictors of quality of life in type 2 diabetes patients with schizophrenia, major mood disorder, and without mental illness.

    PubMed

    Dickerson, Faith; Wohlheiter, Karen; Medoff, Deborah; Fang, Lijuan; Kreyenbuhl, Julie; Goldberg, Richard; Brown, Clayton; Dixon, Lisa

    2011-11-01

    The aim of the current study is to compare the predictors of health-related quality of life in individuals with schizophrenia, major mood disorder, and no mental illness, all with type 2 diabetes. A total of 100 individuals with schizophrenia, 101 with a major mood disorder, and 99 without mental illness, all with type 2 diabetes, rated their health-related quality of life on the Medical Outcomes Survey, Short Form-12; physical and mental composite scores (PCS and MCS) were calculated. We performed a hierarchical multiple regression on PCS and MCS in each sample starting with a basic set of predictors and then adding diabetes-related variables. We compared the regression weights and incremental variance explained within each group. The number of co-occurring medical conditions was significantly associated with lower PCS in all three groups and with lower MCS in the no mental illness group. Diabetes-related variables added significant incremental variance to the prediction of PCS in the no mental illness group but not in either psychiatric group. For persons with diabetes and mental illness, as well as with no mental illness, additional medical conditions exert a strong effect on physical well-being. The impact on quality of life of diabetes-related factors may be lower in persons with diabetes and serious mental illness compared to those with diabetes and no mental illness.

  1. Exertional Heatstroke: An International Perspective. An Introduction: The Role of Exercise in the Etiology of Exertional Heatstroke

    DTIC Science & Technology

    1989-06-12

    responses of heat loss mechanisms ( sweating and vasodilation or skin blood flow). Human eccrine sweat glands behave physiologically and...mean = 41.1 C, n=8) and all were sweating profusely. So subtle are the evolving symptoms of hyperthermia that only three had signs of restlessness...loss. Under these conditions, heatstroke can occur even in the presence of profusc sweating . In such circumstances, the longer that exercise and the

  2. Respiratory illness caused by overheating of polyvinyl chloride.

    PubMed Central

    Froneberg, B; Johnson, P L; Landrigan, P J

    1982-01-01

    On 9 August 1979, 62 (30.8%) of 201 workers and one of 60 management personnel in a polyvinyl chloride (PVC) fabricating plant developed acute upper and lower respiratory irritation, headache, nausea, and fainting. All were taken to hospital; none died. Sixty of the patients were women. Interviews two weeks later with 57 affected and 14 unaffected workers disclosed that illness had followed exposure to fumes from an overheated (362 degrees C) PVC extruding machine. Fumes were emitted from 1100 until 1150; cases occurred from 1100 until late afternoon. All workers who became ill worked west of the overheated extruder, and the affected manager had visited that area. The earliest cases occurred closest to the machine, and incidence decreased (from 53.3% to 15.4%) with distance westward. This pattern was consistent with plant ventilation. Incidence rates in men and women did not differ (p greater than 0.1). At two and 14 weeks, pulmonary function testing of workers with persistent pulmonary symptoms showed abnormalities in 13 of 16 and in 9 of 11 respectively; the group with persistent symptoms contained an excess of non-smokers and of those with previous respiratory illnesses. One kilogram of PVC heated to 300 degrees C releases an estimated 12.9 g of hydrochloric acid (HCl) and 4.9 g of carbon monoxide (CO). We attributed the outbreak to exposure to toxic HCl and CO and rejected the hypothesis of mass psychogenic illness. PMID:7093150

  3. Multi-symptom illnesses, unexplained illness and Gulf War Syndrome

    PubMed Central

    Ismail, Khalida; Lewis, Glyn

    2006-01-01

    Explanatory models for the increased prevalence of ill health in Gulf veterans compared to those not deployed to the Gulf War 1990–1991 remain elusive. This article addresses whether multi-symptom reporting in Gulf veterans are types of medically unexplained symptoms and whether the alleged Gulf War Syndrome is best understood as a medically unexplained syndrome. A review of the epidemiological studies, overwhelmingly cross-sectional, describing ill health was conducted including those that used factor analysis to search for underlying or latent clinical constructs. The overwhelming evidence was that symptoms in Gulf veterans were either in keeping with currently defined psychiatric disorders such as depression and anxiety or were medically unexplained. The application of factor analysis methods had varied widely with a risk of over interpretation in some studies and limiting the validity of their findings. We concluded that ill health in Gulf veterans and the alleged Gulf War Syndrome is best understood within the medically unexplained symptoms and syndromes constructs. The cause of increased reporting in Gulf veterans are still not clear and requires further inquiry into the interaction between sociological factors and symptomatic distress. PMID:16687260

  4. Dimethylsulfoniopropionate Promotes Process Outgrowth in Neural Cells and Exerts Protective Effects against Tropodithietic Acid

    PubMed Central

    Wichmann, Heidi; Brinkhoff, Thorsten; Simon, Meinhard; Richter-Landsberg, Christiane

    2016-01-01

    The marine environment harbors a plethora of bioactive substances, including drug candidates of potential value in the field of neuroscience. The present study was undertaken to investigate the effects of dimethylsulfoniopropionate (DMSP), produced by several algae, corals and higher plants, on cells of the mammalian nervous system, i.e., neuronal N2a and OLN-93 cells as model system for nerve cells and glia, respectively. Additionally, the protective capabilities of DMSP were assessed in cells treated with tropodithietic acid (TDA), a marine metabolite produced by several Roseobacter clade bacteria. Both cell lines, N2a and OLN-93, have previously been shown to be a sensitive target for the action of TDA, and cytotoxic effects of TDA have been connected to the induction of oxidative stress. Our data shows that DMSP promotes process outgrowth and microtubule reorganization and bundling, accompanied by an increase in alpha-tubulin acetylation. Furthermore, DMSP was able to prevent the cytotoxic effects exerted by TDA, including the breakdown of the mitochondrial membrane potential, upregulation of heat shock protein Hsp32 and activation of the extracellular signal-regulated kinases 1/2 (ERK1/2). Our study points to the conclusion that DMSP provides an antioxidant defense, not only in algae but also in mammalian neural cells. PMID:27164116

  5. Effects of caffeine on session ratings of perceived exertion.

    PubMed

    Killen, L G; Green, J M; O'Neal, E K; McIntosh, J R; Hornsby, J; Coates, T E

    2013-03-01

    This study examined effects of caffeine on session ratings of perceived exertion (RPE) following 30 min constant-load cycling. Individuals (n = 15) of varying aerobic fitness completed a [Formula: see text] max trial and two 30 min cycling bouts (double-blind, counterbalanced) following ingestion of 6 mL/kg of caffeine or matched placebo. RPE overall, legs and breathing were estimated every 5 min and session RPE was estimated 30 min post-exercise using the OMNI pictorial scale. Session RPE for caffeine and placebo trails were compared using paired t test. Between-trial comparisons of HR, RPE overall, RPE legs and RPE breathing were analyzed using an independent 2 (trial) × 6 (time point) repeated measures analysis of variance (ANOVA) for each dependent variable. Caffeine resulted in a significantly lower session RPE (p < 0.05) for caffeine (6.1 ± 2.2) versus placebo (6.8 ± 2.1). Acute perceptual responses were significantly lower for caffeine for RPE overall (15, 20, 25, and 30 min), RPE breathing (15, 20, 25, and 30 min) and RPE legs (20 and 30 min). Survey responses post-exercise revealed greater feelings of nervousness, tremors, restlessness and stomach distress following caffeine versus placebo. Blunted acute RPE and survey responses suggest participants responded to caffeine ingestion. Caffeine decreased acute RPE during exercise which could partially account for lower session RPE responses. However, decreased session RPE could also reveal a latent analgesic affect of caffeine extending into recovery. Extending the understanding of session RPE could benefit coaches in avoiding overtraining when adjusting training programs.

  6. Grip forces exerted against stationary held objects during gravity changes.

    PubMed

    Hermsdörfer, J; Marquardt, C; Philipp, J; Zierdt, A; Nowak, D; Glasauer, S; Mai, N

    1999-05-01

    In the present study, grip forces exerted against a stationary held object were recorded during parabolic flights. Such flight maneuvers induce changes of gravity with two periods of hypergravity, associated with a doubling of normal terrestrial gravity, and a 20 s period of microgravity. Accordingly, the object's weight changed from being twice as heavy as normally experienced and weightless. Grip-force recordings demonstrated that force control was seriously disturbed only during the first experience of hyper- and microgravity, with the grip forces being exceedingly high and yielding irregular fluctuations. Thereafter, however, grip force traces were smooth, the force level was scaled to the object's weight under normal and high-G conditions, and the grip force changed in parallel with the weight during the transitions between hyper- and microgravity. In addition, during weightlessness, when virtually no force was necessary to stabilize the object, a low force was established, which obviously represented a reasonable safety margin for preventing possible perturbations. Thus, all relevant aspects of grip-force control observed under normal gravity conditions were preserved during gravity changes induced by parabolic flights. Hence, grip-force control mechanisms were able to cope with hyper- and microgravity, either by incorporating relevant receptor signals, such as those originating from cutaneous mechanoreceptors, or by adequately including perceived gravity signals into control programs. However, the adaptation to the uncommon gravity conditions was not complete following the first experience; finer tuning of the control system to both hyper- and microgravity continued over the measurement interval, presumably with a longer observation period being necessary before a stable performance can be reached.

  7. Resveratrol exerts a biphasic effect on apolipoprotein M.

    PubMed

    Kurano, Makoto; Hara, Masumi; Nojiri, Takahiro; Ikeda, Hitoshi; Tsukamoto, Kazuhisa; Yatomi, Yutaka

    2016-01-01

    Resveratrol exerts a range of beneficial actions in several areas of pathophysiology, including vascular biology. Here, we have investigated the effects of resveratrol on apolipoprotein M (apoM), a carrier and modulator of sphingosine 1-phosphate (S1P), a vasoactive lipid mediator. We used a hepatoma cell line (HepG2), human primary hepatocytes and C57BL/6 mice. We measured apoM, S1P and related enzymes, LDL receptors and sirtuin1 activity, using Western blotting, RT-PCR and enzyme assays. We also used si-RNA to knock-down sirtuin1 in HepG2 cells. In cultures of HepG2 cells, resveratrol (1-10 μM) increased intracellular apoM and S1P. High concentrations of resveratrol (100 μM) decreased extracellular (in the culture medium) apoM, whereas moderate concentrations of resveratrol (1-10 μM) increased extracellular apoM. High concentrations of resveratrol also increased LDL receptor expression, while all concentrations of resveratrol activated the histone deacetylase sirtuin1. In cultures of human primary hepatocytes, resveratrol, at all concentrations, increased both intra- and extracellular apoM. When wild-type mice were fed a resveratrol-containing chow (0.3% w/w) for 2 weeks, both the plasma and hepatic apoM and S1P levels were increased. However, the resveratrol diet did not affect hepatic LDL receptor levels in this in vivo study. Resveratrol increased intra- and extracellular levels of apoM, along with intracellular S1P levels, while a high concentration of resveratrol reduced extracellular apoM. The present findings suggest that resveratrol has novel effects on the metabolic kinetics of S1P, a multi-functional bioactive phospholipid. © 2015 The British Pharmacological Society.

  8. Resveratrol exerts a biphasic effect on apolipoprotein M

    PubMed Central

    Kurano, Makoto; Hara, Masumi; Nojiri, Takahiro; Ikeda, Hitoshi; Tsukamoto, Kazuhisa

    2015-01-01

    Background and Purpose Resveratrol exerts a range of beneficial actions in several areas of pathophysiology, including vascular biology. Here, we have investigated the effects of resveratrol on apolipoprotein M (apoM), a carrier and modulator of sphingosine 1‐phosphate (S1P), a vasoactive lipid mediator. Experimental Approach We used a hepatoma cell line (HepG2), human primary hepatocytes and C57BL/6 mice. We measured apoM, S1P and related enzymes, LDL receptors and sirtuin1 activity, using Western blotting, RT‐PCR and enzyme assays. We also used si‐RNA to knock‐down sirtuin1 in HepG2 cells. Key Results In cultures of HepG2 cells, resveratrol (1‐10 μM) increased intracellular apoM and S1P. High concentrations of resveratrol (100 μM) decreased extracellular (in the culture medium) apoM, whereas moderate concentrations of resveratrol (1–10 μM) increased extracellular apoM. High concentrations of resveratrol also increased LDL receptor expression, while all concentrations of resveratrol activated the histone deacetylase sirtuin1. In cultures of human primary hepatocytes, resveratrol, at all concentrations, increased both intra‐ and extracellular apoM. When wild‐type mice were fed a resveratrol‐containing chow (0.3% w/w) for 2 weeks, both the plasma and hepatic apoM and S1P levels were increased. However, the resveratrol diet did not affect hepatic LDL receptor levels in this in vivo study. Conclusions and Implications Resveratrol increased intra‐ and extracellular levels of apoM, along with intracellular S1P levels, while a high concentration of resveratrol reduced extracellular apoM. The present findings suggest that resveratrol has novel effects on the metabolic kinetics of S1P, a multi‐functional bioactive phospholipid. PMID:26445217

  9. Outcomes of exertional rhabdomyolysis following high-intensity resistance training.

    PubMed

    Huynh, A; Leong, K; Jones, N; Crump, N; Russell, D; Anderson, M; Steinfort, D; Johnson, D F

    2016-05-01

    High-intensity resistance training (HIRT) programmes are increasingly popular amongst personal trainers and those attending gymnasiums. We report the experience of exertional rhabdomyolysis (ER) at two tertiary hospitals in Melbourne, Australia. To compare the clinical outcomes of ER with other causes of rhabdomyolysis. Retrospective cross-sectional study of patients presenting with a serum creatine kinase (CK) of greater than 25 000 units/L from 1 September 2013 to 31 August 2014 at two tertiary referral hospitals in Melbourne, Australia. Records were examined to identify care measures implemented during hospital stay, clinical outcomes during admission and on subsequent follow up. Thirty four cases of rhabdomyolysis with a CK of greater than 25 000 units/L (normal range: 20-180 units/L) were identified during the 12-month study period. Twelve of the 34 cases (35%) had ER with 10 of 12 related to HIRT. No acute kidney injury, intensive care admission or death were seen among those with ER. All cases were managed conservatively, with 11 admitted and 9 receiving intravenous fluids only. In contrast, patients with rhabdomyolysis from other causes experienced significantly higher rates of intensive care admission (64%, P = 0.0002), acute kidney injury (82%, P = 0.0001) and death (27%, P = 0.069). ER resulting from HIRT appears to have a benign course compared with rhabdomyolysis of other aetiologies in patients with a serum CK greater than 25 000 units/L. Conservative management of ER appears to be adequate, although this requires confirmation in future prospective studies. © 2016 Royal Australasian College of Physicians.

  10. Perceived exertion responses to changing resistance training programming variables.

    PubMed

    Hiscock, Daniel J; Dawson, Brian; Peeling, Peter

    2015-06-01

    This study examined the influence of intensity (%1 repetition maximum [1RM]), tonnage (sets × repetitions × load), rate of fatigue (percentage decrement in repetitions from set to set), work rate (total tonnage per unit of time), rest interval (time between sets), time under load, and session duration on session rating of perceived exertion (sRPE: Borg's CR-10 scale). Here, participants performed a standardized lifting session of 5 exercises (bench press, leg press, lat pulldown, leg curl, and triceps pushdown) as either: (a) 3 sets × 8 repetitions × 3-minute recovery at 70% 1RM, (b) 3 sets × 14 repetitions × 3-minute recovery at 40% 1RM, (c) 3 sets × MNR (maximum number of repetitions) × 1-minute recovery at 70% 1RM, (d) 3 sets × MNR × 3-minute recovery at 70% 1RM, (e) 3 sets × MNR × 1-minute recovery at 40% 1RM, or (f) 3 sets × MNR × 3-minute recovery at 40% 1RM. The sRPE for session A (4 ± 1) was significantly higher than session B (2.5 ± 1), despite matched tonnage. Protocols involving MNR showed no significant difference in sRPE. Work rate was the only variable to significantly relate with sRPE (r = 0.45). Additionally, sRPE at 15-minute postexercise (5 ± 2) was not different to 30-minute postexercise (5 ± 2). In resistance training with matched tonnage and rest duration between sets, sRPE increases with intensity. In sets to volitional failure, sRPE is likely to be similar, regardless of intensity or rest duration between sets.

  11. Isolated Chronic Exertional Compartment Syndrome of the Lateral Lower Leg

    PubMed Central

    van Zantvoort, Aniek P.M.; de Bruijn, Johan A.; Winkes, Michiel B.; Dielemans, Jeanne P.; van der Cruijsen-Raaijmakers, Marike; Hoogeveen, Adwin R.; Scheltinga, Marc R.

    2015-01-01

    Background: Exercise-induced lower leg pain may be caused by chronic exertional compartment syndrome (CECS). The anterior (ant-CECS) or deep posterior compartment (dp-CECS) is usually affected. Knowledge regarding CECS of the lateral compartment (lat-CECS) is limited. Purpose: To describe demographic characteristics and symptoms in a consecutive series of patients with isolated CECS of the lateral compartment of the leg. Study Design: Case series; Level of evidence, 4. Methods: Since 2001, patients undergoing dynamic intracompartmental pressure (ICP) measurements for suspected CECS in a single institution were prospectively monitored. Individuals with a history possibly associated with lat-CECS and elevated ICP measurements (Pedowitz criteria) were identified. Exclusion criteria were concomitant ipsilateral ant-CECS/dp-CECS, acute compartment syndrome, recent significant trauma, peroneal nerve entrapment, or vascular claudication. Results: During an 11-year time period, a total of 26 patients with isolated lat-CECS fulfilled study criteria (15 females; median age, 21 years; range, 14-48 years). Frequently identified provocative sports were running (n = 4), walking (n = 4), field hockey (n = 3), soccer (n = 3), and volleyball (n = 2). Exercise-induced lateral lower leg pain (92%) and tightness (42%) were often reported. The syndrome was bilateral in almost two-thirds (62%, n = 16). Delay in diagnosis averaged 24 months (range, 2 months to 10 years). Conclusion: Young patients with exercise-induced pain in the lateral portions of the lower leg may suffer from isolated CECS of the lateral compartment. ICP measurements in the lateral compartment in these patients are recommended. PMID:26740955

  12. Physiological and Perceived Exertion Responses during International Karate Kumite Competition

    PubMed Central

    Tabben, Montassar; Sioud, Rim; Haddad, Monoem; Franchini, Emerson; Chaouachi, Anis; Coquart, Jeremy; Chaabane, Helmi; Chamari, Karim; Tourny-Chollet, Claire

    2013-01-01

    Purpose Investigate the physiological responses and rating of perceived exertion (RPE) in elite karate athletes and examine the relationship between a subjective method (Session-RPE) and two objective heart-rate (HR)-based methods to quantify training-load (TL) during international karate competition. Methods Eleven karatekas took part in this study, but only data from seven athletes who completed three matches in an international tournament were used (four men and three women). The duration of combat was 3 min for men and 2 min for women, with 33.6±7.6 min for the first interval period (match 1–2) and 14.5±3.1 min for the second interval period (match 2–3). HR was continuously recorded during each combat. Blood lactate [La-] and (RPE) were measured just before the first match and immediately after each match. Results Means total fights time, HR, %HRmax, [La-], and session-RPE were 4.7±1.6 min, 182±9 bpm, 91±3%, 9.02±2.12 mmol.L-1 and 4.2±1.2, respectively. No significant differences in %HRmax, [La-], and RPE were noticed across combats. Significant correlations were observed between RPE and both resting HR (r=0.60; P=0.004) and mean HR (r=0.64; P=0.02), session-RPE and Banister training-impulse (TRIMP) (r=0.84; P<0.001) and Edwards TL (r=0.77; P<0.01). Conclusion International karate competition elicited near-maximal cardiovascular responses and high [La-]. Training should therefore include exercise bouts that sufficiently stimulate the zone between 90 and 100% HRmax. Karate coaches could use the RPE-method to follow competitor's competition loads and consider it in their technical and tactical training. PMID:24800001

  13. Differentiated perceived exertion and self-regulated wheelchair exercise.

    PubMed

    Paulson, Thomas A; Bishop, Nicolette C; Eston, Roger G; Goosey-Tolfrey, Victoria L

    2013-11-01

    To investigate the utility of the differentiated rating of perceived exertion (RPE) for the self-regulation of submaximal wheelchair propulsion in novice users. Each participant completed a submaximal incremental test and a graded test to exhaustion to determine peak oxygen consumption (Vo(2)peak) on a wheelchair ergometer. On a separate day, two 12-minute intermittent bouts consisting of three 4-minute stages were completed at individualized imposed power outputs equating to light (40% Vo(2)peak) and moderate (60% Vo(2)peak) intensity exercise. On a third occasion, participants were assigned to either the overall group or the peripheral group and were required to self-regulate 12-minute intermittent exercise according to either overall RPE or peripheral RPE reported during the corresponding imposed intensity trial. Laboratory facilities at a university. Preliminary population of able-bodied participants with no prior experience of wheelchair propulsion (N=18). Not applicable. Differences in oxygen consumption (Vo(2)), heart rate, blood lactate concentration, and power output between the imposed and self-regulated exercise trials. No difference was found in physiological responses between the moderate-intensity imposed and RPE-regulated trials in the peripheral group, whereas a significant (P<.05) underproduction in Vo(2) (1.76±.31 vs 1.59±.25L/min) and blood lactate concentration (2.8±0.90 vs 2.21±.83mmol/L) was seen in the overall group. In contrast, a significant (P<.05) overproduction was seen in the peripheral group at a light exercise intensity, whereas no difference was found between all variables during the light-intensity imposed and RPE-regulated trials in the overall group. Peripheral RPE enabled a more precise self-regulation during moderate-intensity wheelchair exercise in novice users. In contrast, overall RPE provided a more accurate stimulus when performing light-intensity propulsion. Copyright © 2013 American Congress of Rehabilitation

  14. Dual Diagnosis: Substance Abuse and Mental Illness

    MedlinePlus

    ... when someone experiences a mental illness and a substance abuse problem simultaneously. Dual diagnosis is a very broad ... person abuses heroin during periods of mania. Either substance abuse or mental illness can develop first. A person ...

  15. Mental Illness in Children: Know the Signs

    MedlinePlus

    ... how you can help. By Mayo Clinic Staff Mental illness in children can be hard for parents to ... help they need. Understand the warning signs of mental illness in children and how you can help your ...

  16. Heat exchanger

    DOEpatents

    Daman, Ernest L.; McCallister, Robert A.

    1979-01-01

    A heat exchanger is provided having first and second fluid chambers for passing primary and secondary fluids. The chambers are spaced apart and have heat pipes extending from inside one chamber to inside the other chamber. A third chamber is provided for passing a purge fluid, and the heat pipe portion between the first and second chambers lies within the third chamber.

  17. On the heating mechanism of magnetic flux loops in the solar atmosphere

    NASA Technical Reports Server (NTRS)

    Song, M. T.; Wu, S. T.

    1984-01-01

    An investigation is conducted of physical heating mechanisms due to the ponderomotive forces exerted by turbulent waves along the solar atmosphere's curved magnetic flux loops. Results indicate that the temperature difference between the inside and outside of the flux loop can be classified into three parts, two of which represent the cooling or heating effect exerted by the ponderomotive force, while the third is the heating effect due to turbulent energy conversion from the localized plasma. This heating mechanism is used to illustrate solar atmospheric heating by means of an example that leads to the formulation of plages.

  18. 'Chronic' identities in mental illness.

    PubMed

    von Peter, Sebastian

    2013-04-01

    The term 'chronicity' is still widely used in psychiatric discourse and practice. A category employed in political, administrative and therapeutic contexts, it guides practitioners' beliefs and actions. This paper attempts a review of the attitudes and procedures that result as a consequence of identifying 'chronically' disturbed identities in clinical practice. An essentially social, relational and materialist understanding of mental illness is used to highlight the kind of thinking underlying the notion of 'chronic' identities in day-to-day psychiatric routines. Problematising the notions of singularity and expressiveness, as well as mind/body- and self/other-distinctions, it claims the category itself is responsible for creating a 'chronic' kind of being. A spatial metaphor is presented in the conclusion, illustrating a mental strategy by which we can re-shape our thinking about 'chronic' identities. It attempts to describe how the shift from an epistemological to a praxeographic approach could build a more complete understanding of mental illness.

  19. Adult Neurogenesis and Mental Illness

    PubMed Central

    Schoenfeld, Timothy J; Cameron, Heather A

    2015-01-01

    Several lines of evidence suggest that adult neurogenesis, the production of new neurons in adulthood, may play a role in psychiatric disorders, including depression, anxiety, and schizophrenia. Medications and other treatments for mental disorders often promote the proliferation of new neurons; the time course for maturation and integration of new neurons in circuitry parallels the delayed efficacy of psychiatric therapies; adverse and beneficial experiences similarly affect development of mental illness and neurogenesis; and ablation of new neurons in adulthood alters the behavioral impact of drugs in animal models. At present, the links between adult neurogenesis and depression seem stronger than those suggesting a relationship between new neurons and anxiety or schizophrenia. Yet, even in the case of depression there is currently no direct evidence for a causative role. This article reviews the data relating adult neurogenesis to mental illness and discusses where research needs to head in the future. PMID:25178407

  20. Hypernatremia in critically ill patients.

    PubMed

    Lindner, Gregor; Funk, Georg-Christian

    2013-04-01

    Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical assessment and urine electrolyte analysis. Because many critically ill patients have impaired levels of consciousness, their water balance can no longer be regulated by thirst and water uptake but is managed by the physician. Therefore, the intensivists should be very careful to provide the adequate sodium and water balance for them. Hypernatremia is treated by the administration of free water and/or diuretics, which promote renal excretion of sodium. The rate of correction is critical and must be adjusted to the rapidity of the development of hypernatremia. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Bipolar illness, creativity, and treatment.

    PubMed

    Rothenberg, A

    2001-01-01

    There have been in recent years increasing claims in both popular and professional literature for a connection between bipolar illness and creativity. A review of studies supporting this claim reveals serious flaws in sampling, methodology, presentation of results, and conclusions. Although there is therefore no evidence for etiological or genetic linkages, it is still necessary to explain interrelationships in those creative persons suffering from the illness. Examples of the work in progress of artists with bipolar disorder, Jackson Pollock and Edvard Munch, illustrate the use of healthy and adaptive creative cognition--janusian and homospatial processes--in the former's breakthrough conception during an improvement phase in treatment leading to the development of the Abstract Expressionist Movement and in the latter's transformation of an hallucination into his famous artwork "The Scream." Treatment options that do not produce cognitive effects are important for creative persons with bipolar disorder.

  2. Hinduism, marriage and mental illness.

    PubMed

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.

  3. Hinduism, marriage and mental illness

    PubMed Central

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations. PMID:23858262

  4. A systems biology approach to heat stress, heat injury, and heat stroke

    NASA Astrophysics Data System (ADS)

    Stallings, Jonathan D.; Ippolito, Danielle L.

    2015-05-01

    Heat illness is a major source of injury for military populations in both deployed and training settings. Developing tools to help leaders enhance unit performance while reducing the risk of injury is of paramount importance to the military. Here, we review our recent systems biology approaches to heat stress in order to develop a 3-dimensional (3D) realistic thermoregulation model, identify the molecular basis and mediators of injury, and characterize associated biomarkers. We discuss the implications of our work, future directions, and the type of tools necessary to enhance force health protection in the future.

  5. Probiotics in critically ill children

    PubMed Central

    Singhi, Sunit C.; Kumar, Suresh

    2016-01-01

    Gut microflora contribute greatly to immune and nutritive functions and act as a physical barrier against pathogenic organisms across the gut mucosa. Critical illness disrupts the balance between host and gut microflora, facilitating colonization, overgrowth, and translocation of pathogens and microbial products across intestinal mucosal barrier and causing systemic inflammatory response syndrome and sepsis. Commonly used probiotics, which have been developed from organisms that form gut microbiota, singly or in combination, can restore gut microflora and offer the benefits similar to those offered by normal gut flora, namely immune enhancement, improved barrier function of the gastrointestinal tract (GIT), and prevention of bacterial translocation. Enteral supplementation of probiotic strains containing either Lactobacillus alone or in combination with Bifidobacterium reduced the incidence and severity of necrotizing enterocolitis and all-cause mortality in preterm infants. Orally administered Lactobacillus casei subspecies rhamnosus, Lactobacillus reuteri, and Lactobacillus rhamnosus were effective in the prevention of late-onset sepsis and GIT colonization by Candida in preterm very low birth weight infants. In critically ill children, probiotics are effective in the prevention and treatment of antibiotic-associated diarrhea. Oral administration of a mix of probiotics for 1 week to children on broad-spectrum antibiotics in a pediatric intensive care unit decreased GIT colonization by Candida, led to a 50% reduction in candiduria, and showed a trend toward decreased incidence of candidemia. However, routine use of probiotics cannot be supported on the basis of current scientific evidence. Safety of probiotics is also a concern; rarely, probiotics may cause bacteremia, fungemia, and sepsis in immunocompromised critically ill children. More studies are needed to answer questions on the effectiveness of a mix versus single-strain probiotics, optimum dosage regimens

  6. Electroencephalogram monitoring in critically ill children: indications and strategies.

    PubMed

    Gutierrez-Colina, Ana M; Topjian, Alexis A; Dlugos, Dennis J; Abend, Nicholas S

    2012-03-01

    Continuous electroencephalographic monitoring often detects nonconvulsive seizures in critically ill children, but it is resource-intense and has not been demonstrated to improve outcomes. As institutions develop clinical pathways for monitoring, they should consider how seemingly minor variations may exert substantial impacts on resource utilization and cost. In our 1-month prospective observational study, each patient in a 45-bed pediatric intensive care unit was screened for potential monitoring indications. We screened 247 patients. Minor differences in monitoring indications would exert substantial impact on resource utilization. We then calculated the number of monitoring days required each month, based on two strategies that differed in monitoring duration. The prolonged-targeted and brief-targeted strategies would have required 106 and 33 monitoring days, respectively. Based on nonconvulsive seizure occurrence data, these strategies would detect 0.14, and 0.43 patients with seizures per monitoring day performed, respectively. A brief-targeted strategy provides a high yield for nonconvulsive seizure identification, but would fail to diagnose some patients with seizures. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Heat Pipes

    NASA Technical Reports Server (NTRS)

    1996-01-01

    Heat Pipes were originally developed by NASA and the Los Alamos Scientific Laboratory during the 1960s to dissipate excessive heat build- up in critical areas of spacecraft and maintain even temperatures of satellites. Heat pipes are tubular devices where a working fluid alternately evaporates and condenses, transferring heat from one region of the tube to another. KONA Corporation refined and applied the same technology to solve complex heating requirements of hot runner systems in injection molds. KONA Hot Runner Systems are used throughout the plastics industry for products ranging in size from tiny medical devices to large single cavity automobile bumpers and instrument panels.

  8. Heat Pipes

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Phoenix Refrigeration Systems, Inc.'s heat pipe addition to the Phoenix 2000, a supermarket rooftop refrigeration/air conditioning system, resulted from the company's participation in a field test of heat pipes. Originally developed by NASA to control temperatures in space electronic systems, the heat pipe is a simple, effective, heat transfer system. It has been used successfully in candy storage facilities where it has provided significant energy savings. Additional data is expected to fully quantify the impact of the heat pipes on supermarket air conditioning systems.

  9. Depressive illness and Navajo healing.

    PubMed

    Storck, M; Csordas, T J; Strauss, M

    2000-12-01

    What is the experience of Navajo patients in Navajo religious healing who, by the criteria and in the vernacular of contemporary psychiatry, would be diagnosed with the disorder called depression? We ask this question in the context of a double dialogue between psychiatry and anthropology and between these disciplines' academic constructs of illness and those of contemporary Navajos. The dialogue is conducted in the arena of patient narratives, providing a means for observing and explicating processes of therapeutic change in individuals, for illustrating variations in forms of Navajo religious healing sought out by patients demonstrating similar symptoms of distress, and for considering the heuristic utility of psychiatric diagnoses and nomenclature in the conceptualization of illness, recovery, and religious healing. From among the 37 percent of patients participating in the Navajo Healing Project who had a lifetime history of a major depressive illness, three are discussed herein, their selection based on two criteria: (1) all met formal psychiatric diagnostic criteria for a major depressive episode at the time of their healing ceremonies, and (2) together, their experiences illustrate the range of contemporary Navajo religious healing, including Traditional, Native American Church (NAC), and Christian forms. We suggest that, despite the explicit role of the sacred in religious healing interventions available to Navajo patients, differences between biomedical and religious healing systems may be of less significance than their shared existential engagement of problems such as those glossed as depression.

  10. Explanatory Models for Psychiatric Illness

    PubMed Central

    Kendler, Kenneth S.

    2009-01-01

    How can we best develop explanatory models for psychiatric disorders? Because causal factors have an impact on psychiatric illness both at micro levels and macro levels, both within and outside of the individual, and involving processes best understood from biological, psychological, and sociocultural perspectives, traditional models of science that strive for single broadly applicable explanatory laws are ill suited for our field. Such models are based on the incorrect assumption that psychiatric illnesses can be understood from a single perspective. A more appropriate scientific model for psychiatry emphasizes the understanding of mechanisms, an approach that fits naturally with a multicausal framework and provides a realistic paradigm for scientific progress, that is, understanding mechanisms through decomposition and reassembly. Simple subunits of complicated mechanisms can be usefully studied in isolation. Reassembling these constituent parts into a functioning whole, which is straightforward for simple additive mechanisms, will be far more challenging in psychiatry where causal networks contain multiple nonlinear interactions and causal loops. Our field has long struggled with the interrelationship between biological and psychological explanatory perspectives. Building from the seminal work of the neuronal modeler and philosopher David Marr, the author suggests that biology will implement but not replace psychology within our explanatory systems. The iterative process of interactions between biology and psychology needed to achieve this implementation will deepen our understanding of both classes of processes. PMID:18483135

  11. Women living with environmental illness.

    PubMed

    Chircop, Andrea; Keddy, Barbara

    2003-01-01

    We used a case study approach to explore the experiences of 4 women who live with environmental illness (EI). From the unstructured interviews we found a variety of themes that pointed to the complexity of EI and its severe impact on the lives of these women, their families, and their significant others. The methodology was guided by an ecofeminist approach, which enabled a critical analysis of the data to move beyond the personal to the broader sociopolitical forces shaping society. We identified the following themes from the women's stories: indirect exposure to incitants through people with whom these women come in close physical contact; the phenomenon of burden of proof, meaning that these women are forced to explain and legitimize their illness on a continuous basis; taking refuge from a hostile environment in social isolation to a more controlled environment, not as a matter of choice, but because of the severity of the illness; and, finally, a change in value system was integral to the entire process of living with EI.

  12. Delirium in critically ill patients.

    PubMed

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models. Treatment of delirium can be improved with frequent monitoring, as early detection and subsequent treatment of the underlying condition can improve outcome. Cautious use or avoidance of benzodiazepines may reduce the likelihood of developing delirium. Nonpharmacologic strategies with early mobilization, reducing causes for sleep deprivation, and reorientation measures may be effective in the prevention of delirium. Antipsychotics are effective in treating hallucinations and agitation, but do not reduce the duration of delirium. Combined pain, agitation, and delirium protocols seem to improve the outcome of critically ill patients and may reduce delirium incidence. © 2017 Elsevier B.V. All rights reserved.

  13. Epigenetic Basis of Mental Illness.

    PubMed

    Nestler, Eric J; Peña, Catherine J; Kundakovic, Marija; Mitchell, Amanda; Akbarian, Schahram

    2016-10-01

    Psychiatric disorders are complex multifactorial illnesses involving chronic alterations in neural circuit structure and function as well as likely abnormalities in glial cells. While genetic factors are important in the etiology of most mental disorders, the relatively high rates of discordance among identical twins, particularly for depression and other stress-related syndromes, clearly indicate the importance of additional mechanisms. Environmental factors such as stress are known to play a role in the onset of these illnesses. Exposure to such environmental insults induces stable changes in gene expression, neural circuit function, and ultimately behavior, and these maladaptations appear distinct between developmental versus adult exposures. Increasing evidence indicates that these sustained abnormalities are maintained by epigenetic modifications in specific brain regions. Indeed, transcriptional dysregulation and the aberrant epigenetic regulation that underlies this dysregulation is a unifying theme in psychiatric disorders. Here, we provide a progress report of epigenetic studies of the three major psychiatric syndromes, depression, schizophrenia, and bipolar disorder. We review the literature derived from animal models of these disorders as well as from studies of postmortem brain tissue from human patients. While epigenetic studies of mental illness remain at early stages, understanding how environmental factors recruit the epigenetic machinery within specific brain regions to cause lasting changes in disease susceptibility and pathophysiology is revealing new insight into the etiology and treatment of these conditions. © The Author(s) 2015.

  14. Informal care and terminal illness.

    PubMed

    Rhodes, Penny; Shaw, Sandra

    1999-01-01

    This paper is based on a study of the care and services received by people in the year before death in one Yorkshire health authority. In the spring of 1997 in-depth interviews were carried out with bereaved relatives and carers of a weighted sample of 33 people who had died in one Yorkshire health authority in the previous 18 months. Deaths where people were judged to have needed no input from palliative care services were excluded. The sample covers a range of different caring arrangements, experiences of caring for someone who is dying, support from formal services, place and manner of death. All those interviewed were providing some form of informal care or support to those who died, in some cases 24-h care. The interviews provided a valuable insight into ordinary people's experiences of death and of caring for someone who is dying. Most importantly for the purposes of this study, they gave insight into their experiences of services to support both the dying person and themselves in their caring role. The paper discusses the ways in which care of the terminally ill is distinctive. It explores the role of informal care in relation to the wider character and history of the local community, in particular the significance of its declining industrial base, and secondly, the availability of appropriate services to support those caring for the terminally ill. Finally, it makes recommendations about service planning and delivery which challenge the current framework for providing services to the terminally ill.

  15. Meditation's impact on chronic illness.

    PubMed

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.

  16. Asymmetric Heat Conduction in Nonlinear Systems

    NASA Astrophysics Data System (ADS)

    Hu, Bambi

    2008-12-01

    Heat conduction is an old yet important problem. Since Fourier introduced the law bearing his name two hundred years ago, a first-principle derivation of this law from statistical mechanics is still lacking. Worse still, the validity of this law in low dimensions, and the necessary and sufficient conditions for its validity are still far from clear. In this talk I'll give a review of recent works done on this subject. I'll also report our latest work on asymmetric heat conduction in nonlinear systems. The study of heat condution is not only of theoretical interest but also of practical interest. The study of electric conduction has led to the invention of such important electric devices such as electric diodes and transistors. The study of heat conduction may also lead to the invention of thermal diodes and transistors in the future. Note from Publisher: This article contains the abstract only.

  17. Surgical Treatment of Chronic Exertional Compartment Syndrome in Pediatric Patients.

    PubMed

    Beck, Jennifer J; Tepolt, Frances A; Miller, Patricia E; Micheli, Lyle J; Kocher, Mininder S

    2016-10-01

    Chronic exertional compartment syndrome (CECS) is a cause of leg pain in running athletes and is treated with fasciotomy after failure of nonoperative management. CECS is being seen with increased frequency in younger patients. The demographics and outcomes of fasciotomy for CECS in pediatric patients, including risk factors for treatment failure, have not been described. To describe characteristics of pediatric patients with CECS and determine surgical outcomes of the condition in this population. Case series; Level of evidence, 4. A retrospective review was performed for patients 18 years and younger treated surgically for CECS with compartment release at a single institution from 1995 to 2014. Demographic and condition characteristics, operative procedure, postoperative course, and clinical outcomes were recorded for 286 legs of 155 patients. Compartment pressure testing using the Pedowitz criteria confirmed the diagnosis in all patients. A total of 155 patients were included in the study (average patient age at presentation, 16.4 ± 1.38 years); 136 (88%) were female. All 155 patients presented with leg pain; of these patients, 8 (5%) also had neurologic symptoms, and 131 (85%) presented with bilateral symptoms requiring bilateral compartment release. Symptoms were chronic in nature, with duration over 1 year in 63% of patients. The primary sport was most commonly reported as running (25%), soccer (23%), or field hockey (12%); 50% of patients were multisport athletes. Of 286 legs, 138 (48%) had only anterior and/or lateral compartments released, while 84 (29.4%) had all 4 compartments released. Documented return to sport was seen in 79.5% of patients. Outcomes analysis was performed for 250 of 286 legs. Of these 250 legs, 47 (18.8%) had recurrent CECS requiring reoperation at a median of 1.3 years (interquartile range, 0.8-3.5) after initial compartment release. For each additional month between presentation and release, the odds of recurrence decreased by 12

  18. FMRI reveals abnormal central processing of sensory and pain stimuli in ill Gulf War veterans.

    PubMed

    Gopinath, Kaundinya; Gandhi, Parina; Goyal, Aman; Jiang, Lei; Fang, Yan; Ouyang, Luo; Ganji, Sandeepkumar; Buhner, David; Ringe, Wendy; Spence, Jeffrey; Biggs, Melanie; Briggs, Richard; Haley, Robert

    2012-06-01

    Many veterans chronically ill from the 1991 Gulf War exhibit symptoms of altered sensation, including chronic pain. In this study of 55 veterans of a Construction Battalion previously examined in 1995-1996 and 1997-1998, brain activation to innocuous and noxious heat stimuli was assessed in 2008-2009 with a quantitative sensory testing fMRI protocol in control veterans and groups representing three syndrome variants. Testing outside the scanner revealed no significant differences in warm detection or heat pain threshold among the four groups. In the fMRI study, Syndrome 1 and Syndrome 2, but not Syndrome 3, exhibited hypo-activation to innocuous heat and hyper-activation to noxious heat stimuli compared to controls. The results indicate abnormal central processing of sensory and painful stimuli in 2 of 3 variants of Gulf War illness and call for a more comprehensive study with a larger, representative sample of veterans.

  19. Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC)

    DTIC Science & Technology

    2016-10-01

    AWARD NUMBER: W81XWH-13-2-0072 TITLE: Brain Immune Interactions as the Basis of Gulf War Illness : Gulf War Illness Consortium (GWIC...Title and Subtitle Brain Immune Interactions as the Basis of Gulf War Illness : Gulf War Illness Consortium (GWIC) 5. Award Number W81XWH-13-2-0072...distribution unlimited 12b. Distribution Code (Leave Blank) 13. Abstract (Maximum 200 Words) The primary function of the Gulf War Illness (GWIC) consortium

  20. Brain Immune Interactions as the Basis of Gulf War Illness: Gulf War Illness Consortium (GWIC)

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-13-2-0072 TITLE: Brain Immune Interactions as the Basis of Gulf War Illness : Gulf War Illness Consortium (GWIC) PRINCIPAL...4. TITLE AND SUBTITLE Brain Immune Interactions as the Basis of Gulf War Illness : Gulf War Illness Consortium (GWIC) 5a. CONTRACT NUMBER 5b. GRANT...Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The primary function of the Gulf War Illness (GWIC) consortium is to identify the