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Heat exhaustion.
Kenny, GP, Wilson, TE, Flouris, AD, Fujii, N
Handbook of clinical neurology. 2018;:505-529
Abstract
Heat exhaustion is part of a spectrum of heat-related illnesses that can affect all individuals, although children, older adults, and those with chronic disease are particularly vulnerable due to their impaired ability to dissipate heat. If left uninterrupted, there can be progression of symptoms to heatstroke, a life-threatening emergency. Signs and symptoms of heat exhaustion may develop suddenly or over time. Exposure to a hot environment for a prolonged period and performing exercise or work in the heat can overwhelm the body's ability to cool itself, causing heat exhaustion. Heat exhaustion can be worsened by dehydration due to inadequate access to water or insufficient fluid replacement. Heat exhaustion can be managed by the immediate reduction of heat gain by discontinuing exercise and reducing radiative heat source exposure. The individual should be encouraged to drink cool fluids and remove or loosen clothing to facilitate heat loss. In more extreme situations, more aggressive cooling strategies (e.g., cold shower, application of wet towels) to lower core temperature should be employed. Heat-related illnesses such as heat exhaustion can be prevented by increasing public awareness of the risks associated with exposure to high temperatures and prolonged exercise.
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2.
Conjunctival Tear Layer Temperature, Evaporation, Hyperosmolarity, Inflammation, Hyperemia, Tissue Damage, and Symptoms: A Review of an Amplifying Cascade.
McMonnies, CW
Current eye research. 2017;(12):1574-1584
Abstract
PURPOSE This review examines the evidence for and significance of pre-conjunctival tear temperature being higher than central pre-corneal temperature with associated more rapid evaporation of warmer pre-conjunctival tears in normal eyes but especially in hyperemic dry eye disease. METHODS PubMed searches using the terms "evaporative dry eye," "conjunctival tear evaporation," "tear evaporation," and "dry eye conjunctival hyperemia" indicated 157, 49, 309, and 96 potentially relevant papers, respectively. Selections from these lists were the basis for examining the significance of the evidence relevant to pre-conjunctival tear layer temperature and evaporation. RESULTS There is evidence supporting an amplifying inflammatory and para-inflammatory hyperemia dry eye cascade, which increases pre-conjunctival tear temperature and the risk of accelerated pre-conjunctival tear evaporation with exacerbated osmolarity elevation and inflammation. Dry eye cascade amplification is consistent with increases in symptoms and inflammatory as well as para-inflammatory hyperemia toward the end of the waking day. Apart from age-related conjunctivochalasis, dry eye-related conjunctival epithelial cell pathology including reduced goblet cell numbers and associated mucin deficiency, squamous metaplasia, and increased separation of cell layers could help to destabilize tears and facilitate evaporation as part of an amplifying cascade. CONCLUSIONS Greater difficulty in assessing conjunctival tear break up may contribute to an underestimation of a role for faster evaporation of pre-conjunctival tears in dry eye disease and help explain any non-correspondence between symptoms and corneal signs of dry eye disease. Success with anti-inflammatory therapies for dry eye disease may be at least partly due to reductions in conjunctival hyperemia and deamplification of evaporative cascades. Conjunctival inflammatory hyperemia in other diseases may contribute to accelerated pre-conjunctival tear evaporation and the risk of tear-deficiency- associated exacerbation of those diseases including impaired responses to therapeutic approaches to them. Similarly, postsurgical conjunctival inflammation and associated acceleration of tear evaporation could contribute to delayed wound healing.
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3.
Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis.
Massignan, C, Cardoso, M, Porporatti, AL, Aydinoz, S, Canto, Gde L, Mezzomo, LA, Bolan, M
Pediatrics. 2016;(3):e20153501
Abstract
CONTEXT Symptoms associated with the primary tooth eruption have been extensively studied but it is still controversial. OBJECTIVE To assess the occurrence of local and systemic signs and symptoms during primary tooth eruption. DATA SOURCES Latin American and Caribbean Health Sciences, PubMed, ProQuest, Scopus, and Web of Science were searched. A partial gray literature search was taken by using Google Scholar and the reference lists of the included studies were scanned. STUDY SELECTION Observational studies assessing the association of eruption of primary teeth with local and systemic signs and symptoms in children aged 0 to 36 months were included. DATA EXTRACTION Two authors independently collected the information from the selected articles. Information was crosschecked and confirmed for its accuracy. RESULTS A total of 1179 articles were identified, and after a 2-phase selection, 16 studies were included. Overall prevalence of signs and symptoms occurring during primary tooth eruption in children between 0 and 36 months was 70.5% (total sample = 3506). Gingival irritation (86.81%), irritability (68.19%), and drooling (55.72%) were the most frequent ones. LIMITATIONS Different general symptoms were considered among studies. Some studies presented lack of confounding factors, no clear definition of the diagnostics methods, use of subjective measures and long intervals between examinations. CONCLUSIONS There is evidence of the occurrence of signs and symptoms during primary tooth eruption. For body temperature analyses, eruption could lead to a rise in temperature, but it was not characterized as fever.
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4.
Body-Cooling Paradigm in Sport: Maximizing Safety and Performance During Competition.
Adams, WM, Hosokawa, Y, Casa, DJ
Journal of sport rehabilitation. 2016;(4):382-394
Abstract
CONTEXT Although body cooling has both performance and safety benefits, knowledge on optimizing cooling during specific sport competition is limited. OBJECTIVES To identify when, during sport competition, it is optimal for body cooling and to identify optimal body-cooling modalities to enhance safety and maximize sport performance. EVIDENCE ACQUISITION A comprehensive literature search was conducted to identify articles with specific context regarding body cooling, sport performance, and cooling modalities used during sport competition. A search of scientific peer-reviewed literature examining the effects of body cooling on exercise performance was done to examine the influence of body cooling on exercise performance. Subsequently, a literature search was done to identify effective cooling modalities that have been shown to improve exercise performance. EVIDENCE SYNTHESIS The cooling modalities that are most effective in cooling the body during sport competition depend on the sport, timing of cooling, and feasibility based on the constraints of the sports rules and regulations. Factoring in the length of breaks (halftime substitutions, etc), the equipment worn during competition, and the cooling modalities that offer the greatest potential to cool must be considered in each individual sport. CONCLUSIONS Scientific evidence supports using body cooling as a method of improving performance during sport competition. Developing a strategy to use cooling modalities that are scientifically evidence-based to improve performance while maximizing athlete's safety warrants further investigation.
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A hot topic: temperature sensitive sodium channelopathies.
Egri, C, Ruben, PC
Channels (Austin, Tex.). 2012;(2):75-85
Abstract
Perturbations to body temperature affect almost all cellular processes and, within certain limits, results in minimal effects on overall physiology. Genetic mutations to ion channels, or channelopathies, can shift the fine homeostatic balance resulting in a decreased threshold to temperature induced disturbances. This review summarizes the functional consequences of currently identified voltage-gated sodium (NaV) channelopathies that lead to disorders with a temperature sensitive phenotype. A comprehensive knowledge of the relationships between genotype and environment is not only important for understanding the etiology of disease, but also for developing safe and effective treatment paradigms.
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Membrane-initiated actions of estradiol that regulate reproduction, energy balance and body temperature.
Kelly, MJ, Rønnekleiv, OK
Frontiers in neuroendocrinology. 2012;(4):376-87
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Abstract
It is well known that many of the actions of estrogens in the central nervous system are mediated via intracellular receptor/transcription factors that interact with steroid response elements on target genes. However, there now exists compelling evidence for membrane estrogen receptors in hypothalamic and other brain neurons. But, it is not well understood how estrogens signal via membrane receptors, and how these signals impact not only membrane excitability but also gene transcription in neurons. Indeed, it has been known for sometime that estrogens can rapidly alter neuronal activity within seconds, indicating that some cellular effects can occur via membrane delimited events. In addition, estrogens can affect second messenger systems including calcium mobilization and a plethora of kinases to alter cell signaling. Therefore, this review will consider our current knowledge of rapid membrane-initiated and intracellular signaling by estrogens in the hypothalamus, the nature of receptors involved and how they contribute to homeostatic functions.
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Body temperature variability (Part 1): a review of the history of body temperature and its variability due to site selection, biological rhythms, fitness, and aging.
Kelly, G
Alternative medicine review : a journal of clinical therapeutic. 2006;(4):278-93
Abstract
Body temperature is a complex, non-linear data point, subject to many sources of internal and external variation. While these sources of variation significantly complicate interpretation of temperature data, disregarding knowledge in favor of oversimplifying complex issues would represent a significant departure from practicing evidence-based medicine. Part 1 of this review outlines the historical work of Wunderlich on temperature and the origins of the concept that a healthy normal temperature is 98.6 degrees F (37.0 degrees C). Wunderlich's findings and methodology are reviewed and his results are contrasted with findings from modern clinical thermometry. Endogenous sources of temperature variability, including variations caused by site of measurement, circadian, menstrual, and annual biological rhythms, fitness, and aging are discussed. Part 2 will review the effects of exogenous masking agents - external factors in the environment, diet, or lifestyle that can influence body temperature, as well as temperature findings in disease states.