11/83. Exertion-induced heat exhaustion. An often overlooked diagnosis.Exertion-induced heat exhaustion is a potentially lethal condition. The earliest signs include unsteady gait and confusion. Recording of rectal temperature is essential. skin colour, blood pressure and heart rate are not reliable diagnostic signs. The mainstays of therapy are rapid rehydration and cooling. Prompt diagnosis and rapid effective therapy will minimise the risk of death.- - - - - - - - - - ranking = 1keywords = heat (Clic here for more details about this article) |
12/83. A complicated case of exertional heat stroke in a military setting with persistent elevation of creatine phosphokinase.A case is presented of exertional heat stroke in a military setting with numerous complications that have been previously described. In addition, the complication of late rhabdomyolysis with profound elevation of creatine phosphokinase (CPK) is here described for the first time. This rare condition responded to systemic steroids on this occasion. Late elevation of CPK is a rare complication of exertional heat stroke that appears to respond to systemic steroids.- - - - - - - - - - ranking = 6.8809591617699keywords = heat stroke, heat (Clic here for more details about this article) |
13/83. Recurrent heat-related illnesses during antipsychotic treatment.OBJECTIVE: To report a case of recurrent heat-related illnesses associated with the use of benzhexol, chlorpromazine, and zuclopenthixol decanoate. CASE SUMMARY: During the summer of 2004, a 48-year-old man with a history of diabetes mellitus and schizophrenia was twice admitted to the hospital because of heat-related illnesses. On both occasions, he had been working under the sun in an open car park. His medications included benzhexol 2 mg twice daily, chlorpromazine 650 mg at bedtime, and zuclopenthixol decanoate intramuscular injection 600 mg every 4 weeks. In the first admission, the clinical diagnosis was heat stroke. He was discharged home on day 14, with precautionary advice against heat stroke. In the second admission, the clinical diagnosis was heat exhaustion. He was discharged home on day 4 and reminded of the precautions against heat stroke. An objective causality assessment revealed that the adverse event was possibly drug related in the first admission and probably drug related in the second admission. DISCUSSION: Several drugs can impair thermoregulation during exercise or under conditions of environmental heat stress. Anticholinergic drugs or drugs with anticholinergic effects can inhibit sweating and reduce heat elimination. Neuroleptics (antipsychotics), such as phenothiazines, have combined anticholinergic and central thermoregulatory effects. The set point of the temperature regulation center can be elevated by the antidopaminergic effect of antipsychotics, such as phenothiazines and thioxanthenes. CONCLUSIONS: Certain drugs may induce or worsen heat-related illnesses. During a heat wave, special attention should be given to those most at risk, and the importance of preventive measures should be emphasized.- - - - - - - - - - ranking = 5.6404795808849keywords = heat stroke, heat (Clic here for more details about this article) |
14/83. Evidence for related myopathies in exertional heat stroke and malignant hyperthermia.malignant hyperthermia may be a human stress syndrome, of which heat stroke is one manifestation. Two men in military service who had episodes of exertional heat stroke, and their immediate family members, were tested for susceptibility to malignant hyperthermia by in-vitro contracture tests on skeletal muscle samples. Muscle from both patients had a normal response to caffeine but an abnormal response to halothane. Muscle from the father of one patient had an abnormal response to halothane, and that from the father of the second patient had an abnormal response to ryanodine. The results indicate that clinical heat stroke may be associated with an underlying inherited abnormality of skeletal muscle that is similar, but not identical, to that of malignant hyperthermia.- - - - - - - - - - ranking = 8.0277856887315keywords = heat stroke, heat (Clic here for more details about this article) |
15/83. Permanent neurologic deficits in heat stroke.heat stroke rarely develops permanent neurologic deficits. We present two patients (patients 1 and 2) who suffered from persistent neurologic deficits 3 years after heat stroke. Both patients have cerebellar dysfunction. In addition to cerebellar dysfunction, the first patient whose CT scan of brain demonstrates cerebellar atrophy, also has signs of transverse myelopathy of thoracic cord. We conclude the cerebellar symptoms are common neurologic complication of heat stroke and the heat stroke may be one of rare causes of the transverse myelopathy.- - - - - - - - - - ranking = 8.0277856887315keywords = heat stroke, heat (Clic here for more details about this article) |
16/83. Rapid onset of severe heat illness: a case report.Aviators flying extended periods in hot environments are known to be at risk for heat-related illness. The risk when wearing chemical individual protective equipment (IPE) is increased even at relatively warm temperatures and light workloads. In this paper, we report the physiological responses of an aviator who had been flying a UH-1H helicopter up to 6 h/d clothed in full IPE on 6 consecutive days prior to the sudden onset of heat illness. His performance during the study was normal, and no clear physiological derangements were noted prior to his symptoms. The rapid evolution of his symptoms after voicing no complaints provides a graphic illustration of the difficult predictability and initial central nervous system effects of this condition.- - - - - - - - - - ranking = 1.2keywords = heat (Clic here for more details about this article) |
17/83. heat stroke following Rugby League football.OBJECTIVE: To present a case of severe heat stroke after Rugby League football. CLINICAL FEATURES: A 29-year-old Rugby League forward with a mild infection of the upper respiratory tract collapsed while playing football in late March, when the ambient temperature was 24.1 degrees C and the relative humidity up to 73%. He was initially thought to have sustained a head injury and was markedly dehydrated. He suffered severe disseminated intravascular coagulation and gross neurological, renal and hepatic disturbances. INTERVENTION AND OUTCOME: He required repeated haemodialysis, assisted ventilation and supportive therapy and remained unconscious for 10 days. He then recovered fully. CONCLUSION: heat stroke is potentially fatal and can be easily mistaken for head injury in contact sports. When players are dehydrated, have febrile illness and play in warm conditions, they may succumb to heat stroke.- - - - - - - - - - ranking = 2.2936530539233keywords = heat stroke, heat (Clic here for more details about this article) |
18/83. Muscle biopsy for diagnosis of malignant hyperthermia susceptibility in two patients with severe exercise-induced myolysis.Muscle biopsy and in vitro contracture tests for diagnosis of susceptibility to malignant hyperthermia (MH) were performed in two patients who had developed fever and severe myolysis during exercise. MH susceptibility was confirmed in one patient, but in the other, exercise-induced heat stroke proved to be the correct diagnosis. Clinical presentation and epidemiology of exercise-induced MH and its relation to the heat stroke syndrome are discussed.- - - - - - - - - - ranking = 2.2936530539233keywords = heat stroke, heat (Clic here for more details about this article) |
19/83. liver failure occurring as a component of exertional heatstroke.An unusual case of an exertional heatstroke in a healthy 25-year-old man is presented. Initially, the patient was deeply comatose and developed severe rhabdomyolysis and massive hepatic necrosis. Subsequently, he received a liver transplant with remarkable improvement in his mental status, although the rhabdomyolysis continued. The patient died 41 days after the transplant due to a complicating infection. Providing that infections can be effectively controlled, liver transplants might be a promising therapeutic alternative for the few patients who survive the initial neurological consequences of this unusual event.- - - - - - - - - - ranking = 1keywords = heat (Clic here for more details about this article) |
20/83. technetium-99m MDP scintigraphy of rhabdomyolysis induced by exertional heat stroke: a case report.A case of rhabdomyolysis induced by exertional heat stroke in a police officer recruit is reported. technetium-99m methylene diphosphonate scintigraphy demonstrated marked uptake of the injured skeletal muscle. This bone-scanning agent provided an excellent means of localizing and evaluating the muscle injury of rhabdomyolysis. nuclear medicine physicians should be aware of the special conditions and causes in which bone scan may demonstrate striking findings.- - - - - - - - - - ranking = 5.7341326348082keywords = heat stroke, heat (Clic here for more details about this article) |
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