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Exertional heat stroke

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https://www.readbyqxmd.com/read/28465322/strenuous-exercise-triggers-a-life-threatening-response-in-mice-susceptible-to-malignant-hyperthermia
#1
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 knockout of calsequestrin-1 (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)...
May 2, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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])...
January 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28156130/evaluation-of-various-cooling-systems-after-exercise-induced-hyperthermia
#9
Pearl M S Tan, Eunice Y N Teo, Noreffendy B Ali, Bryan C H Ang, Iswady Iskandar, Lydia Y L Law, Jason K W Lee
CONTEXT: Rapid diagnosis and expeditious cooling of individuals with exertional heat stroke is paramount for survival. OBJECTIVE: To evaluate the efficacy of various cooling systems after exercise-induced hyperthermia. DESIGN: Crossover study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-two men (age = 24 ± 2 years, height = 1.76 ± 0.07 m, mass = 70.7 ± 9.5 kg) participated. INTERVENTION(S): Each participant completed a treadmill walk until body core temperature reached 39...
February 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28140625/ncaa-football-off-season-training-unanswered-prayers%C3%A2-a-prayer-answered
#10
Scott Anderson
Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 33 National Collegiate Athletic Association (NCAA) football players have died in sport: 27 nontraumatic deaths and 6 traumatic deaths, a ratio of 4.5 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season. Best practices, consensus guidelines, and precautions are ignored, elevating the risk...
February 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28128878/heat-stroke-leading-to-acute-liver-injury-failure-a-case-series-from-the-acute-liver-failure-study-group
#11
Brian C Davis, Holly Tillman, Raymond T Chung, Richard T Stravitz, Rajender Reddy, Robert J Fontana, Brendan McGuire, Timothy Davern, William M Lee
BACKGROUND & AIMS: In the United States, nearly 1000 annual cases of heat stroke are reported but the frequency and outcome of severe liver injury in such patients is not well described. The aim of this study was to describe cases of acute liver injury (ALI) or failure (ALF) caused by heat stroke in a large ALF registry. METHODS: Amongst 2675 consecutive subjects enrolled in a prospective observational cohort of patients with ALI or ALF between January 1998 and April 2015, there were eight subjects with heat stroke...
April 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27909226/unique-cytokine-and-chemokine-responses-to-exertional-heat-stroke-in-mice
#12
Michelle A King, Lisa R Leon, Deborah A Morse, Thomas L Clanton
In heat stroke, cytokines are believed to play important roles in multi-organ dysfunction and recovery of damaged tissue. The time course of the cytokine response is well defined in passive heat stroke (PHS), but little is known about exertional heat stroke (EHS). In this study we used a recently developed mouse EHS model to measure the responses of circulating cytokines/chemokines and cytokine gene expression in muscle. A very rapid increase in circulating IL-6 was observed at max core temperature (Tc,max) that peaked at 0...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27874299/cooling-effectiveness-of-a-modified-cold-water-immersion-method-after-exercise-induced-hyperthermia
#13
RANDOMIZED CONTROLLED TRIAL
Katherine E Luhring, Cory L Butts, Cody R Smith, Jeffrey A Bonacci, Ramon C Ylanan, Matthew S Ganio, Brendon P McDermott
CONTEXT:  Recommended treatment for exertional heat stroke includes whole-body cold-water immersion (CWI). However, remote locations or monetary or spatial restrictions can challenge the feasibility of CWI. Thus, the development of a modified, portable CWI method would allow for optimal treatment of exertional heat stroke in the presence of these challenges. OBJECTIVE:  To determine the cooling rate of modified CWI (tarp-assisted cooling with oscillation [TACO]) after exertional hyperthermia...
November 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/27785365/a-bibliometric-analysis-of-exertional-heat-stroke-research-in-web-of-science
#14
Zhi Mao, Chao Liu, Shuo Chen, Zheng-Guo Zhu, Hong-Jun Kang, Fei-Hu Zhou
BACKGROUND: 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. 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...
2016: Military Medical Research
https://www.readbyqxmd.com/read/27781140/mesenchymal-stem-cell-based-treatments-for-stroke-neural-trauma-and-heat-stroke
#15
REVIEW
Yogi Chang-Yo Hsuan, Cheng-Hsien Lin, Ching-Ping Chang, Mao-Tsun Lin
BACKGROUND: Mesenchymal stem cell (MSC) transplantation has been reported to improve neurological function following neural injury. Many physiological and molecular mechanisms involving MSC therapy-related neuroprotection have been identified. METHODS: A review is presented of articles that pertain to MSC therapy and diverse brain injuries including stroke, neural trauma, and heat stroke, which were identified using an electronic search (e.g., PubMed), emphasize mechanisms of MSC therapy-related neuroprotection...
October 2016: Brain and Behavior
https://www.readbyqxmd.com/read/27740656/shape-memory-polymer-nanocomposites-with-a-3d-conductive-network-for-bidirectional-actuation-and-locomotion-application
#16
Qingyu Peng, Hongqiu Wei, Yuyang Qin, Zaishan Lin, Xu Zhao, Fan Xu, Jinsong Leng, Xiaodong He, Anyuan Cao, Yibin Li
Electrical stimulation of shape-memory polymers (SMPs) has many advantages over thermal methods; creating an efficient conductive path through the bulk polymers is essential for developing high performance electroactive systems. Here, we show that a three-dimensional (3D) porous carbon nanotube sponge can serve as a built-in integral conductive network to provide internal, homogeneous, in situ Joule heating for shape-memory polymers, thus significantly improving the mechanical and thermal behavior of SMPs. As a result, the 3D nanocomposites show a fast response and produce large exerting forces (with a maximum flexural stress of 14...
October 14, 2016: Nanoscale
https://www.readbyqxmd.com/read/27737279/exertional-heat-stroke-and-american-football-what-the-team-physician-needs-to-know
#17
REVIEW
Jillian E Sylvester, Luke N Belval, Douglas J Casa, Francis G O'Connor
Football is recognized as a leading contributor to sports injury secondary to the contact collision nature of the endeavor. While direct deaths from head and spine injury remain a significant contributor to the number of catastrophic injuries, indirect deaths (systemic failure) predominate. Exertional heat stroke has emerged as one of the leading indirect causes of death in high school and collegiate football. This review details for the team physician the unique challenge of exercising in the heat to the football player, and the prevention, diagnosis, management, and return-to-play issues pertinent to exertional heat illnesses...
September 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27704519/exertional-heat-stroke-about-4-cases
#18
Mohamed Taha Khoufi, Ali Mrabet, Abderraouf Ben Mansour, Khaled Lamine, Mustapha Ferjani, Mondher Yedeas
Exertional heat stroke is defined as hyperthermia associated with neurological signs related to intense physical activity performed in a hot environment. This is a medical emergency and life-threatening. In this study, we investigated four cases of exertional heat stroke hospitalized at the military hospital in Tunis (Tunisia) to describe the clinical, therapeutic and preventive characteristics and factors favoring this disease. Four young soldiers, 23 to 44 years older, have developed Exertional heat stroke after Intense and prolonged exercise...
April 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/27681888/a-single-dose-escalation-study-to-evaluate-the-safety-and-pharmacokinetics-of-orally-administered-des-aspartate-angiotensin-i-in-healthy-subjects
#19
Ko-Onn Lee, Chin-Meng Khoo, Balram Chowbay, Yiong-Huak Chan, Meng-Kwoon Sim
Des-aspartate-angiotensin I (DAA-I) is an endogenous angiotensin peptide and a prototype angiotensin receptor agonist (ARA). It acts on the angiotensin AT1 receptor and antagonises the deleterious actions of angiotensin II. DAA-I attenuates animal models of human disease in which angiotensin II has been implicated, such as cardiac hypertrophy, neointima formation, arteriosclerosis, renal failure, post-infarction injuries, diabetes, viral infection, chemical-induced inflammation, heat stroke, cancer, and gamma radiation lethality...
December 2016: Drugs in R&D
https://www.readbyqxmd.com/read/27632869/can-temperate-water-immersion-effectively-reduce-rectal-temperature-in-exertional-heat-stroke-situations-a-critically-appraised-topic
#20
Tyler T Truxton, Kevin C Miller
Clinical Scenario Exertional heat stroke (EHS) is a medical emergency which, if left untreated, can result in death. The standard of care for EHS patients includes confirmation of hyperthermia via rectal temperature (Trec) and then immediate cold-water immersion (CWI). While CWI is the fastest way to reduce Trec,(1,2) it may be difficult to lower and maintain water bath temperature in the recommended ranges (1.7°C-15°C [35°F-59°F])(1) because of limited access to ice and/or the bath being exposed to high ambient temperatures for long periods of time...
August 24, 2016: Journal of Sport Rehabilitation
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