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Exertional heat stroke

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https://www.readbyqxmd.com/read/29095276/outcome-and-risk-factors-associated-with-extent-of-central-nervous-system-injury-due-to-exertional-heat-stroke
#1
Mengmeng Yang, Zhi Li, Yan Zhao, Feihu Zhou, Yu Zhang, Jingli Gao, Ting Yin, Xin Hu, Zhi Mao, Jianguo Xiao, Li Wang, Chao Liu, Liqiong Ma, Zhihao Yuan, Jianfei Lv, Haoliang Shen, Peter C Hou, Hongjun Kang
To explore the relationship between the extent of central nervous system (CNS) injury and patient outcomes meanwhile research the potential risk factors associated with neurologic sequelae. In this retrospective cohort study, we analyzed data from 117 consecutive patients (86 survivors, 31 nonsurvivors) with exertional heat stroke (EHS) who had been admitted to intensive care unit (ICU) at 48 Chinese hospitals between April 2003 and July 2015. Extent of CNS injury was dichotomized according to Glasgow coma scale (GCS) score (severe 3-8, not severe 9-15)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29066054/the-validity-of-the-heat-tolerance-test-in-prediction-of-recurrent-exertional-heat-illness-events
#2
Haggai Schermann, Yuval Heled, Chen Fleischmann, Itay Ketko, Nathan Schiffmann, Yoram Epstein, Ran Yanovich
OBJECTIVES: Heat-tolerance-testing (HTT) protocol is used as a screening test for secondary prevention of exertional heat illness (EHI) in the military. Subjects whose test results are positive (heat-intolerant, HI) are presumed to be at higher risk of repeated EHI events than heat-tolerant subjects (HT) and are therefore prevented from return to combat duty, but may return to unsupervised recreational activity. Our aim was to determine, whether HTT results predict the risk of repeated episodes of exertional heat illness (EHI)...
October 12, 2017: Journal of Science and Medicine in Sport
https://www.readbyqxmd.com/read/29020197/sickle-cell-trait-and-heat-injury-among-u-s-army-soldiers
#3
D Alan Nelson, Patricia A Deuster, Francis G O'Connor, Lianne M Kurina
There is concern that sickle cell trait increases risk of exertional collapse, a primary cause of which is heat injury. However, no population-based studies among active individuals have addressed this, representing a critical evidence gap. We conducted a retrospective cohort study of sickle cell trait-tested African American soldiers on active-duty in the U.S. Army anytime between January 2011 and December 2014. Using Cox proportional hazards models and adjusting for demographic and medical factors, we observed no significant associations between sickle cell trait and either mild heat injury (hazard ratio (HR), 1...
August 17, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28978590/liver-transplantation-for-non-exertional-heat-stroke-related-acute-liver-failure
#4
Sandra Coenen, Khe Tran, Jubi de Haan, Rob de Man
Heat stroke is a life-threatening condition characterised by hyperthermia leading to multiple organ dysfunction. Acute liver failure is a rare and potentially fatal consequence of heat stroke. Management of heat stroke is mainly supportive but liver transplantation can be considered as the treatment of acute liver failure in heat stroke. However, literature on liver transplantation as a treatment for acute liver failure in heat stroke is scarce. Until now, no cases of liver transplantation for acute liver failure in non-exertional heat stroke have been reported...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28964966/ambient-temperature-and-added-heat-wave-effects-on-hospitalizations-in-california-from-1999-to-2009
#5
Toki Sherbakov, Brian Malig, Kristen Guirguis, Alexander Gershunov, Rupa Basu
Investigators have examined how heat waves or incremental changes in temperature affect health outcomes, but few have examined both simultaneously. We utilized distributed lag nonlinear models (DLNM) to explore temperature associations and evaluate possible added heat wave effects on hospitalizations in 16 climate zones throughout California from May through October 1999-2009. We define heat waves as a period when daily mean temperatures were above the zone- and month-specific 95th percentile for at least two consecutive days...
September 28, 2017: Environmental Research
https://www.readbyqxmd.com/read/28951881/state-level-implementation-of-health-and-safety-policies-to-prevent-sudden-death-and-catastrophic-injuries-within-secondary-school-athletics
#6
William M Adams, Samantha E Scarneo, Douglas J Casa
BACKGROUND: Sudden death and catastrophic injuries during sport can be attenuated with the implementation of evidence-based health and safety policies. However, the extent of the implementation of these policies within secondary school athletics is unknown. PURPOSE: To provide an assessment of the implementation of health and safety policies pertaining to the leading causes of sudden death and catastrophic injuries in sport within secondary school athletics in the United States...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28902747/exertional-heat-stroke
#7
Chelsea S Navarro, Douglas J Casa, Luke N Belval, Nathaniel S Nye
No abstract text is available yet for this article.
September 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28885960/international-classification-of-disease-coding-of-exertional-heat-illness-in-u-s-army-soldiers
#8
David W DeGroot, Gordon Mok, Nathanael E Hathaway
INTRODUCTION: The severity of exertional heat illnesses (EHI) ranges from relatively minor heat exhaustion to potentially life-threatening heat stroke. Epidemiological surveillance of the types of and trends in EHI incidence depends on application of the appropriate International Classification of Disease, 9th Revision (ICD-9) diagnostic code. However, data examining whether the appropriate EHI ICD-9 code is selected are lacking. The purpose of this study was to determine whether the appropriate ICD-9 code is selected in a cohort of EHI casualties...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28810981/thermoregulatory-response-to-exercise-after-exertional-heat-stroke
#9
Emmanuel Sagui, Sophie Beighau, Arnaud Jouvion, Julie Trichereau, Delphine Cornet, René Charles Berthelot, Frédéric Canini, Laurent Grélot
BACKGROUND: After one episode of exertional heat stroke (EHS), risk factors must be identified to determine the potential for subsequent episodes. One of these risk factors, core body temperature (Tco) kinetics during strenuous exercise, may be a surrogate marker suggestive of impaired thermoregulation. This study aimed to determine the kinetics of increases in Tco among military subjects who had a history of EHS. METHODS: Forty subjects (38 males, mean age 28.4 ± 4...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810980/risk-factors-for-rhabdomyolysis-in-the-u-s-army
#10
Owen T Hill, Dennis E Scofield, Jenna Usedom, Lakmini Bulathsinhala, Craig McKinnon, Paul Kwon, Timothy Haley, Robert Carter
The standardized mortality rate of rhabdomyolysis (RM) in Active Duty U.S. Army Soldiers is considerably higher than in the civilian population. RM occurs when large amounts of intracellular contents from damaged skeletal muscle escape into circulation, leading to serious sequelae (e.g., acute renal failure, hyperkalemia, compartment syndrome). Extended physical exertion, especially in hot environments, and trauma can precipitate RM. The aim of this study was to identify RM risk factors among U.S. Active Duty Army (ADA) Soldiers...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28680920/exertional-heat-stroke-and-the-evolution-of-field-care-a-physician-s-perspective
#11
EDITORIAL
William O Roberts
No abstract text is available yet for this article.
2017: Temperature: Multidisciplinary Biomedical Journal
https://www.readbyqxmd.com/read/28651196/dancing-to-death-a-case-of-heat-stroke
#12
K Nadesan, Chandra Kumari, Mohd Afiq
Heat stroke is a medical emergency which may lead to mortality unless diagnosed early and treated effectively. Heat stroke may manifest rapidly, hence making it difficult to differentiate it from other clinical causes in a collapsed victim.(1) We are presenting a case report of twelve patients who were admitted to our emergency department from a music festival held on 13-15th of March 2014. They developed complications arising from a combination of severe adverse weather condition, prolonged outdoor physical exertion due to long hours of dancing and drug-use, resulting in heat stroke...
August 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28465322/strenuous-exercise-triggers-a-life-threatening-response-in-mice-susceptible-to-malignant-hyperthermia
#13
Antonio Michelucci, Cecilia Paolini, Simona Boncompagni, Marta Canato, Carlo Reggiani, Feliciano Protasi
In humans, hyperthermic episodes can be triggered by halogenated anesthetics [malignant hyperthermia (MH) susceptibility] and by high temperature [environmental heat stroke (HS)]. Correlation between MH susceptibility and HS is supported by extensive work in mouse models that carry a mutation in ryanodine receptor type-1 (RYR1(Y522S/WT)) and calsequestrin-1 knockout (CASQ1-null), 2 proteins that control Ca(2+) release in skeletal muscle. As overheating episodes in humans have also been described during exertion, here we subjected RYR1(Y522S/WT) and CASQ1-null mice to an exertional-stress protocol (incremental running on a treadmill at 34°C and 40% humidity)...
August 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28457033/clinical-and-biochemical-characteristics-of-exertional-heat-stroke-among-paratroopers-in-agra-india
#14
Rajesh Deshwal, Dhirendra Tiwari, Raj Singh
OBJECTIVE: The purpose of this study was to assess the clinical profile, biochemical parameters and outcome in a series of 78 patients of heat stroke admitted and treated in a military hospital in India. METHODS: This was a prospective study in a military hospital. A total of 78 patients of exertional heat stroke admitted and treated over more than 2 years are reported. Cooling measures started immediately on site of occurrence, carried on during evacuation and in hospital, IV normal saline initiated, clinical symptoms and signs were noted...
February 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28430550/round-table-on-malignant-hyperthermia-in-physically-active-populations-meeting-proceedings
#15
Yuri Hosokawa, Douglas J Casa, Henry Rosenberg, John F Capacchione, Emmanuel Sagui, Sheila Riazi, Luke N Belval, Patricia A Deuster, John F Jardine, Stavros A Kavouras, Elaine C Lee, Kevin C Miller, Sheila M Muldoon, Francis G O'Connor, Scott R Sailor, Nyamkhishig Sambuughin, Rebecca L Stearns, William M Adams, Robert A Huggins, Lesley W Vandermark
CONTEXT:   Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. OBJECTIVE:   To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28395350/variability-in-heat-strain-in-fully-encapsulated-impermeable-suits-in-different-climates-and-at-different-work-loads
#16
Emiel A DenHartog, Candace D Rubenstein, A Shawn Deaton, Cornelis Peter Bogerd
A major concern for responders to hazardous materials (HazMat) incidents is the heat strain that is caused by fully encapsulated impermeable (NFPA 1991) suits. In a research project, funded by the US Department of Defense, the thermal strain experienced when wearing these suits was studied. Forty human subjects between the ages of 25 and 50 participated in a protocol approved by the local ethical committee. Six different fully encapsulated impermeable HazMat suits were evaluated in three climates: moderate (24°C, 50% RH, 20°C WBGT), warm-wet (32°C, 60% RH, 30°C WBGT), and hot-dry (45°C, 20% RH, 37°C WBGT, 200 W m-2 radiant load) and at three walking speeds: 2...
March 1, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/28314926/american-football-and-fatal-exertional-heat-stroke-a-case-study-of-korey-stringer
#17
Andrew Grundstein, John A Knox, Jennifer Vanos, Earl R Cooper, Douglas J Casa
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...
March 17, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28224104/exertional-rhabdomyolysis-and-heat-stroke-beware-of-volatile-anesthetic-sedation
#18
REVIEW
Karel Heytens, Jan De Bleecker, Walter Verbrugghe, Jonathan Baets, Luc Heytens
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...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28207294/validity-of-core-temperature-measurements-at-3-rectal-depths-during-rest-exercise-cold-water-immersion-and-recovery
#19
Kevin C Miller, Lexie E Hughes, Blaine C Long, William M Adams, Douglas J Casa
CONTEXT:   No evidence-based recommendation exists regarding how far clinicians should insert a rectal thermistor to obtain the most valid estimate of core temperature. Knowing the validity of temperatures at different rectal depths has implications for exertional heat-stroke (EHS) management. OBJECTIVE:   To determine whether rectal temperature (Trec) taken at 4 cm, 10 cm, or 15 cm from the anal sphincter provides the most valid estimate of core temperature (as determined by esophageal temperature [Teso]) during similar stressors an athlete with EHS may experience...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28162872/simple-and-effective-method-to-lower-body-core-temperatures-of-hyperthermic-patients
#20
John P O'Connor
Hyperthermia is a potentially life threatening scenario that may occur in patients due to accompanying morbidities, exertion, or exposure to dry and arid environmental conditions. In particular, heat stroke may result from environmental exposure combined with a lack of thermoregulation. Key clinical findings in the diagnosis of heatstroke are (1) a history of heat stress or exposure, (2) a rectal temperature greater than 40 °C, and (3) central nervous system dysfunction (altered mental state, disorientation, stupor, seizures, or coma) (Prendergast and Erickson, 2014 [1])...
June 2017: American Journal of Emergency Medicine
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