The impact of exercise-induced core body temperature elevations on coagulation responses

Motor-free telerobotic endomicroscopy for steerable and programmable imaging in complex curved and localized areas

Intraluminal epithelial abnormalities, potential precursors to significant conditions like cancer, necessitate early detection for improved prognosis. We present a motor-free telerobotic optical coherence tomography (OCT) endoscope that offers high-resolution intraluminal imaging and overcomes the limitations of traditional systems in navigating curved lumens. This system incorporates a compact magnetic rotor with a rotatable diametrically magnetized cylinder permanent magnet (RDPM) and a reflector, effectively mitigating thermal and electrical risks by utilizing an external magnetic field to maintain temperature increases below 0.5 °C and generated voltage under 0.02 mV. Additionally, a learning-based method corrects imaging distortions resulting from nonuniform rotational speeds. Demonstrating superior maneuverability, the device achieves steerable angles up to 110° and operates effectively in vivo, providing distortion-free 3D programmable imaging in mouse colons. This advancement represents a significant step towards guidewire-independent endomicroscopy, enhancing both safety and potential patient outcomes.

The prognostic value of routine coagulation tests for patients with heat stroke

OBJECTIVE

To evaluate the prognostic value of routine coagulation tests for patients with heat stroke.

METHODS

This was a multi-center retrospective study. Patients who arrived at the hospital <24 h after the onset of Heat Stroke (HS) were included. The routine coagulation variables were detected within 24 h after the onset, including the lowest platelet count (PLC).

RESULTS

60-day mortality rate was 20.9%. The median Prothrombin Time-International Normalized Ratio (PT-INR) of the non-surviving patients was significantly higher than that of the survivors (P < 0.01). The median Activated Partial Thromboplastin Time (APTT) in non-surviving patients was significantly higher than in the surviving patients (P < 0.01). A Cox regression analysis revealed that 60-day mortality was associated with PT-INR (P = 0.032) and APTT (P = 0.004). The optimal PT-INR point for predicting 60-day mortality rate was 1.7. The optimal APTT point for predicting 60-day mortality was 51.45. Patients with increased PT-INR (≥1.7) levels had, overall, a significantly reduced survival time (P < 0.01). Patients with elevated APTT (≥51.45) also had a decrease in survival time (P < 0.01). The prognostic scoring, with increased PT-INR (≥1.7) and prolonged APTT (≥51.45) at one point each, was also demonstrated to be useful in predicting 60-day mortality. Patients whose temperature fell to 38.9 °C within 30 min had significantly lower levels of PT-INR and APTT within 24 h than those who took longer to cool down.

CONCLUSIONS

A prolonged APTT and elevated PT-INR within 24 h are independent prognostic factors of 60-day mortality in HS.

Influence of a high-temperature programme on serum, urinary and sweat levels of selenium and zinc

INTRODUCTION

The effect of hyperthermia on the antioxidant system in the human organism is well known.

AIM

The objective of this study was to observe the effects of heat on the concentration of Se and Zn, elements related to antioxidant systems.

METHODS

Twenty-nine subjects voluntarily participated in this study. They were divided into a control group (CG; n = 14) and an experimental group (EG; n = 15). All of them underwent two incremental tests until exhaustion in normothermia (22 °C, 20-40%RH) and hyperthermia (42 °C, 20-40%RH). EG experienced nine sessions of repeated heat exposure at high temperatures (100 °C, 20%RH) for three weeks (HEHT). After the intervention, the initial measurements were repeated. Urine and blood samples were collected before and after each test. Additionally, sweat samples were collected after tests in hyperthermia.

RESULTS

There were no significant changes in serum. An increase in the elimination of Zn and Se in EG was observed in urine after HEHT (p < .05). The elimination of Zn by sweating decreased after HEHT in EG (p < .05).

CONCLUSIONS

Exposure to heat at high temperatures increases the urinary excretion of Se and Zn.

Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association

Epidemiological and biological plausibility studies support a cause-and-effect relationship between increased levels of physical activity or cardiorespiratory fitness and reduced coronary heart disease events. These data, plus the well-documented anti-aging effects of exercise, have likely contributed to the escalating numbers of adults who have embraced the notion that "more exercise is better." As a result, worldwide participation in endurance training, competitive long distance endurance events, and high-intensity interval training has increased markedly since the previous American Heart Association statement on exercise risk. On the other hand, vigorous physical activity, particularly when performed by unfit individuals, can acutely increase the risk of sudden cardiac death and acute myocardial infarction in susceptible people. Recent studies have also shown that large exercise volumes and vigorous intensities are both associated with potential cardiac maladaptations, including accelerated coronary artery calcification, exercise-induced cardiac biomarker release, myocardial fibrosis, and atrial fibrillation. The relationship between these maladaptive responses and physical activity often forms a U- or reverse J-shaped dose-response curve. This scientific statement discusses the cardiovascular and health implications for moderate to vigorous physical activity, as well as high-volume, high-intensity exercise regimens, based on current understanding of the associated risks and benefits. The goal is to provide healthcare professionals with updated information to advise patients on appropriate preparticipation screening and the benefits and risks of physical activity or physical exertion in varied environments and during competitive events.

Influence of a physical exercise until exhaustion in normothermic and hyperthermic conditions on serum, erythrocyte and urinary concentrations of magnesium and phosphorus

AIM

The aim of this study was to evaluate the effect of the performance of a maximal exercise test until exhaustion in normothermic and hyperthermic conditions on body concentrations of magnesium (Mg) and phosphorus (P).

METHODS

19 adult males (age: 22.58 ± 1.05 years) performed two maximum incremental exercise tests on a cycloergometer separated by 48 h. The first was performed in normothermia (22 ± 2 °C) and the second in hyperthermic conditions induced with a sauna (42 ± 2 °C). Blood and urine samples were taken before and after each test.

RESULTS

The tests in hyperthermia did not produce ergospirometric alterations or a noticeable cardiovascular drift. Serum Mg concentrations underwent a reduction after the stress test in hyperthermia (p > 0.05) but not in normothermia. Nevertheless, urinary and erythrocyte concentrations of Mg, and urinary, erythrocyte and serum concentrations of P did not undergo alterations in either conditions.

CONCLUSIONS

It seems that exercise in hyperthermic conditions induces a tissue redistribution of Mg in the body, a fact which was not observed in normothermic conditions.

Data Analytics of a Wearable Device for Heat Stroke Detection

When exercising in a high-temperature environment, heat stroke can cause great harm to the human body. However, runners may ignore important physiological warnings and are not usually aware that a heat stroke is occurring. To solve this problem, this study evaluates a runner’s risk of heat stroke injury by using a wearable heat stroke detection device (WHDD), which we developed previously. Furthermore, some filtering algorithms are designed to correct the physiological parameters acquired by the WHDD. To verify the effectiveness of the WHDD and investigate the features of these physiological parameters, several people were chosen to wear the WHDD while conducting the exercise experiment. The experimental results show that the WHDD can identify high-risk trends for heat stroke successfully from runner feedback of the uncomfortable statute and can effectively predict the occurrence of a heat stroke, thus ensuring safety.

Design and Development of a Wearable Device for Heat Stroke Detection

Heat stroke can be potentially damaging for people while exercising in hot environments. To prevent this dangerous situation, we designed a wearable heat-stroke-detection device (WHDD) with early notification ability. First, we used several physical sensors, such as galvanic skin response (GSR), heart beat, and body temperature, to acquire medical data from exercising people. In addition, we designed risk evaluation functional components that were based on fuzzy theory to detect the features of heat stroke for users. If a dangerous situation is detected, then the device will activate the alert function to remind the user to respond adequately to avoid heat stroke.

Pathophysiology of heatstroke in dogs - revisited

Heatstroke results from a failure to dissipate accumulated heat during exposure to hot environments, or during strenuous physical exercise under heat stress. It is characterized by core body temperatures > 41°C, with central nervous system dysfunction. Functional morphology and thermoregulatory effectors differences between dogs and humans may require special heatstroke protective adaptations in dogs, however, the risk factors for developing heatstroke are similar in both. In dogs, these include hot, especially highly humid environments, excessive physical activity, obesity, large (>15 kg) body weight, being of certain breed (e.g., Labrador retrievers and brachycephalic breeds), upper airway obstruction and prolonged seizures. Lack of acclimation to heat and physical fitness decreases the survival of heat stroked dogs. At the systemic level, blood pooling within the large internal organs (e.g., spleen, liver) is a major contributor to the development of shock and consequent intestinal ischemia, hypoxia and endothelial hyperpermeability, commonly occurring in heatstroke patients. Evoked serious complications include rhabdomyolysis, acute kidney injury, acute respiratory distress syndrome and ultimately, sepsis and disseminated intravascular coagulation. The most common clinical signs in dogs include acute collapse, tachypnea, spontaneous bleeding, shock signs and mental abnormalities, including depression, disorientation or delirium, seizures, stupor and coma. In such dogs, presence of peripheral blood nucleated red blood cells uniquely occurs, and is a highly sensitive diagnostic and prognostic biomarker. Despite early, appropriate body cooling, and intensive supportive treatment, with no available specific treatment to ameliorate the severe inflammatory and hemostatic derangements, the mortality rate is around 50%, similar to that of human heatstroke victims. This review discusses the pathophysiology of canine heatstroke from a veterinarian's point of view, integrating new and old studies and knowledge.