Non-steroidal anti-inflammatory drugs on core body temperature during exercise: A systematic review

Management of Heat-Related Illness and Injury in the ICU: A Concise Definitive Review

OBJECTIVES

The increasing frequency of extreme heat events has led to a growing number of heat-related injuries and illnesses in ICUs. The objective of this review was to summarize and critically appraise evidence for the management of heat-related illnesses and injuries for critical care multiprofessionals.

DATA SOURCES

Ovid Medline, Embase, Cochrane Clinical Trials Register, Cumulative Index to Nursing and Allied Health Literature, and ClinicalTrials.gov databases were searched from inception through August 2023 for studies reporting on heat-related injury and illness in the setting of the ICU.

STUDY SELECTION

English-language systematic reviews, narrative reviews, meta-analyses, randomized clinical trials, and observational studies were prioritized for review. Bibliographies from retrieved articles were scanned for articles that may have been missed.

DATA EXTRACTION

Data regarding study methodology, patient population, management strategy, and clinical outcomes were qualitatively assessed.

DATA SYNTHESIS

Several risk factors and prognostic indicators for patients diagnosed with heat-related illness and injury have been identified and reported in the literature. Effective management of these patients has included various cooling methods and fluid replenishment. Drug therapy is not effective. Multiple organ dysfunction, neurologic injury, and disseminated intravascular coagulation are common complications of heat stroke and must be managed accordingly. Burn injury from contact with hot surfaces or pavement can occur, requiring careful evaluation and possible excision and grafting in severe cases.

CONCLUSIONS

The prevalence of heat-related illness and injury is increasing, and rapid initiation of appropriate therapies is necessary to optimize outcomes. Additional research is needed to identify effective methods and strategies to achieve rapid cooling, the role of immunomodulators and anticoagulant medications, the use of biomarkers to identify organ failure, and the role of artificial intelligence and precision medicine.

The Synergistic Effect of Quince Fruit and Probiotics (Lactobacillus and Bifidobacterium) on Reducing Oxidative Stress and Inflammation at the Intestinal Level and Improving Athletic Performance during Endurance Exercise

Endurance exercise promotes damage at the intestinal level and generates a variety of symptoms related to oxidative stress processes, inflammatory processes, microbiota dysbiosis, and intestinal barrier damage. This study evaluated the effects of quince (Cydonia oblonga Mill.) and probiotics of the genera Lactobacillus and Bifidobacterium on intestinal protection and exercise endurance in an animal swimming model. Phytochemical characterization of the quince fruit demonstrated a total dietary fiber concentration of 0.820 ± 0.70 g/100 g and a fiber-bound phenolic content of 30,218 ± 104 µg/g in the freeze-dried fruit. UPLC-PDA-ESI-QqQ analyses identified a high content of polyphenol, mainly flavanols, hydroxycinnamic acids, hydroxybenzoic acids, flavonols, and, to a lesser extent, dihydrochalcones. The animal model of swimming was performed using C57BL/6 mice. The histological results determined that the consumption of the synbiotic generated intestinal protection and increased antioxidant (catalase and glutathione peroxidase enzymes) and anti-inflammatory (TNF-α and IL-6 and increasing IL-10) activities. An immunohistochemical analysis indicated mitochondrial biogenesis (Tom2) at the muscular level related to the increased swimming performance. These effects correlated mainly with the polyphenol content of the fruit and the effect of the probiotics. Therefore, this combination of quince and probiotics could be an alternative for the generation of a synbiotic product that improves exercise endurance and reduces the effects generated by the practice of high performance sports.

A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 1: Foundational principles and theories of regulation

This contribution is the first of a four-part, historical series encompassing foundational principles, mechanistic hypotheses and supported facts concerning human thermoregulation during athletic and occupational pursuits, as understood 100 years ago and now. Herein, the emphasis is upon the physical and physiological principles underlying thermoregulation, the goal of which is thermal homeostasis (homeothermy). As one of many homeostatic processes affected by exercise, thermoregulation shares, and competes for, physiological resources. The impact of that sharing is revealed through the physiological measurements that we take (Part 2), in the physiological responses to the thermal stresses to which we are exposed (Part 3) and in the adaptations that increase our tolerance to those stresses (Part 4). Exercising muscles impose our most-powerful heat stress, and the physiological avenues for redistributing heat, and for balancing heat exchange with the environment, must adhere to the laws of physics. The first principles of internal and external heat exchange were established before 1900, yet their full significance is not always recognised. Those physiological processes are governed by a thermoregulatory centre, which employs feedback and feedforward control, and which functions as far more than a thermostat with a set-point, as once was thought. The hypothalamus, today established firmly as the neural seat of thermoregulation, does not regulate deep-body temperature alone, but an integrated temperature to which thermoreceptors from all over the body contribute, including the skin and probably the muscles. No work factor needs to be invoked to explain how body temperature is stabilised during exercise.

An acute naproxen dose does not affect core temperature or Interleukin-6 during cycling in a hot environment

Non-steroidal anti-inflammatory drugs' anti-pyretic and anti-inflammatory effects has led some individuals to theorize these medications may blunt core body temperature (Tc) increases during exercise. We utilized a double-blind, randomized, and counterbalanced cross-over design to examine the effects of a 24-h naproxen dose (3-220 ​mg naproxen pills) and placebo (0 ​mg naproxen) on Tc and plasma interleukin-6 (IL-6) concentrations during cycling in a hot or ambient environment. Participants (n ​= ​11; 6 male, 5 female; age ​= ​27.8 ​± ​6.5 years, weight ​= ​79.1 ​± ​17.9 ​kg, height ​= ​177 ​± ​9.5 ​cm) completed 4 conditions: 1) placebo and ambient (Control); 2) placebo and heat (Heat); 3) naproxen and ambient (Npx); and 4) naproxen and heat (NpxHeat). Dependent measures were taken before, during, and immediately after 90 ​min of cycling and then 3 ​h after cycling. Overall, Tc significantly increased pre- (37.1 ​± ​0.4 ​°C) to post-cycling (38.2 ​± ​0.3 ​°C, F 1.7,67.3 ​= ​150.5, p ​< ​0.001) and decreased during rest (37.0 ​± ​0.3 ​°C, F 2.0,81.5 ​= ​201.6, p ​< ​0.001). Rate of change or maximum Tc were not significantly different between conditions. IL-6 increased pre- (0.54 ​± ​0.06 ​pg/ml) to post-exercise (2.46 ​± ​0.28 ​pg/ml, p ​< ​0.001) and remained significantly higher than pre-at 3 ​h post- (1.17 ​± ​0.14 ​pg/ml, 95% CI ​= ​-1.01 to -0.23, p ​= ​0.001). No significant IL-6 differences occurred between conditions. A 24-h, over-the-counter naproxen dose did not significantly affect Tc or IL-6 among males and females cycling in hot or ambient environments.

A Smart Helmet-Based PLS-BPNN Error Compensation Model for Infrared Body Temperature Measurement of Construction Workers during COVID-19

In the context of the long-term coexistence between COVID-19 and human society, the implementation of personnel health monitoring in construction sites has become one of the urgent needs of current construction management. The installation of infrared temperature sensors on the helmets required to be worn by construction personnel to track and monitor their body temperature has become a relatively inexpensive and reliable means of epidemic prevention and control, but the accuracy of measuring body temperature has always been a problem. This study developed a smart helmet equipped with an infrared temperature sensor and conducted a simulated construction experiment to collect data of temperature and its influencing factors in indoor and outdoor construction operation environments. Then, a Partial Least Square–Back Propagation Neural Network (PLS-BPNN) temperature error compensation model was established to correct the temperature measurement results of the smart helmet. The temperature compensation effects of different models were also compared, including PLS-BPNN with Least Square Regression (LSR), Partial Least Square Regression (PLSR), and single Back Propagation Neural Network (BPNN) models. The results showed that the PLS-BPNN model had higher accuracy and reliability, and the determination coefficient of the model was 0.99377. After using PLS-BPNN model for compensation, the relative average error of infrared body temperature was reduced by 2.745 °C and RMSE was reduced by 0.9849. The relative error range of infrared body temperature detection was only 0.005~0.143 °C.