1
|
Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
Collapse
Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
| |
Collapse
|
2
|
Huang Y, Xiong K, Wang A, Wang Z, Cui Q, Xie H, Yang T, Fan X, Jiang W, Tan X, Huang Q. Cold stress causes liver damage by inducing ferroptosis through the p38 MAPK/Drp1 pathway. Cryobiology 2023; 113:104563. [PMID: 37532122 DOI: 10.1016/j.cryobiol.2023.104563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/29/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
Acute extreme cold exposure impairs human health and even causes hypothermia which threatens human life. Liver, as a hub in metabolism and thermogenesis, is vital for cold acclimatization. Although accumulating evidence has suggested that cold exposure can cause liver damage, the underlying mechanisms remain poorly understood. This study investigated the role and underlying mechanisms of ferroptosis in cold stress-induced liver damage. To evaluate the role of ferroptosis in cold stress-induced liver damage, rats were pretreated with ferroptosis inhibitor liproxstatin-1 (Lip-1) before exposed to -10 °C for 8 h. Core body temperature was recorded. The levels of ferroptosis-related indicators were examined with the corresponding assay kits or by western blotting. Hepatic pathological changes were analyzed by hematoxylin-eosin staining and ultrastructural observation. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured to assess liver function. Rats were also pretreated with p38 mitogen-activated protein kinase (MAPK) inhibitor SB203580 or Dynamin-related protein 1 (Drp1) inhibitor Mdivi-1 to determine the underlying mechanisms. We found that Lip-1 inhibited ferroptosis, attenuated hepatic pathological damages and blocked the increased ALT and AST levels in cold-exposed rats. Moreover, Mdivi-1 inhibited mitochondrial fission and suppressed ferroptosis. Furthermore, SB203580 and Mdivi-1 administration alleviated cold stress-induced liver injury. Our results suggested that cold stress caused liver damage partially by inducing ferroptosis through the p38 MAPK/Drp1 pathway. These findings might provide an effective preventive and therapeutic target for cold stress-induced liver injury.
Collapse
Affiliation(s)
- Yujie Huang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China.
| | - Kun Xiong
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Aiping Wang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Zejun Wang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Qi Cui
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Hongchen Xie
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Tian Yang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Xu Fan
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Wenjun Jiang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China
| | - Xiaoling Tan
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China.
| | - Qingyuan Huang
- Department of Cold Environmental Medicine, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Shapingba District, Chongqing, 400038, PR China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, PR China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, PR China.
| |
Collapse
|
3
|
Dahmann S, Sanders A, Saarbeck C, Batsilas I, Meyer-Marcotty M. Active Heating following Cryolipolysis Reduces Efficacy and Side Effects: A Randomized Split-Body Trial. Plast Reconstr Surg 2023; 152:965-975. [PMID: 36877615 DOI: 10.1097/prs.0000000000010366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Cryolipolysis-a popular noninvasive technique for body contouring-has fewer side effects compared with liposuction; however, its effectiveness in terms of reducing local adipose tissue is also lower. This study is, to the authors' knowledge, the first prospective, controlled, investigator-blinded split-body trial to evaluate whether postcryolipolytic heating can increase the efficacy. METHODS Twenty-five subjects were treated with one session of cryolipolysis on the lower abdomen and a subsequent heating with a mud pack of a randomized side of the treated region (left or right). Epidemiologic, temperature, edema, erythema, hypesthesia, and pain level data were obtained. Photographs, fat layer thickness (on ultrasound, caliper, and abdominal girth), satisfaction, and side effects were documented over a follow-up period of 12 weeks. RESULTS The side effects-edema, erythema, and hypesthesia-faded almost completely with heating, whereas they remained on the nonheated site. However, the mean sonographic reduction of local adipose tissue after 12 weeks was significantly lower on the heated sites than on the control sites (9.6% versus 14.1%; P = 0.0003). The overall satisfaction was high (9.2 of 10 points), even though only 44% of participants had a subjective recognition of fat loss without difference between the sites. CONCLUSIONS Active heating following cryolipolysis increases bodily well-being by reducing common side effects, but it reduces the effectiveness of cryolipolysis significantly and should therefore be avoided. Further improvements are necessary to enhance the efficacy of cryolipolysis. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, I.
Collapse
Affiliation(s)
- Sonja Dahmann
- From the Clinic for Plastic, Hand, and Reconstructive Surgery, Klinikum Stadt Soest
| | - Agnes Sanders
- From the Clinic for Plastic, Hand, and Reconstructive Surgery, Klinikum Stadt Soest
- Clinic for Plastic, Reconstructive, and Aesthetic Surgery, Klinikum Westfalen
| | - Christina Saarbeck
- From the Clinic for Plastic, Hand, and Reconstructive Surgery, Klinikum Stadt Soest
| | - Ioannis Batsilas
- From the Clinic for Plastic, Hand, and Reconstructive Surgery, Klinikum Stadt Soest
- Clinic for Plastic, Reconstructive, and Aesthetic Surgery, Klinikum Westfalen
| | - Max Meyer-Marcotty
- From the Clinic for Plastic, Hand, and Reconstructive Surgery, Klinikum Stadt Soest
- Clinic for Plastic, Reconstructive, and Aesthetic Surgery/Hand Surgery, Klinikum Lüdenscheid
| |
Collapse
|
4
|
Sidhar K, Elliott K, Ibrahem M. Heat, Cold, and Environmental Emergencies in Athletes. Clin Sports Med 2023; 42:441-461. [PMID: 37208058 DOI: 10.1016/j.csm.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
With the increase in outdoor events, there is an inevitable rise in climate-related environmental emergencies. Heat exposure can place athletes at risk for life-threatening heatstroke which requires emergent diagnosis and rapid in-field management. Cold exposure can lead to hypothermia, frostbite, and other nonfreezing injuries that require prompt evaluation and management to minimize morbidity and mortality. Altitude exposure can lead to acute mountain sickness or other serious neurologic or pulmonary emergencies. Finally, harsh climate exposure can be life-threatening and require appropriate prevention and event planning.
Collapse
Affiliation(s)
- Kartik Sidhar
- Department of Family Medicine, University of Michigan Medical School, 300 North Ingalls Street, NI4C06, Ann Arbor, MI 48109-5435, USA.
| | - Katlyn Elliott
- University of Pittsburgh Medical Center, McKeesport Family Medicine Residency, 2347 5th Avenue, McKeesport, PA 15132, USA
| | - Michael Ibrahem
- University of Pittsburgh Medical Center, Shadyside Family Medicine Residency, 5215 Center Avenue, Pittsburgh, PA 15232, USA
| |
Collapse
|
5
|
Chen F, Fu M, Li Y, Shen S, Yang J, Weng W. A numerical tool for assessing human thermal safety and thermal comfort in cold-weather activities. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:377-388. [PMID: 36515728 DOI: 10.1007/s00484-022-02416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
This paper describes a newly developed software tool to evaluate human thermal safety and thermal comfort in cold-weather activities aimed at guiding users to arrange activity plans and select appropriate clothing ensembles. The software inputs include conditions of activity, environment, human body, and clothing ensemble. It outputs physiological temperatures, cold injury risks, thermal sensations, and thermal comforts in intuitive ways like cloud maps and curves. The software tool is characterized by (1) integration of a thermoregulatory model that predicts human thermophysiological responses under exercise conditions in cold environments, (2) the functions of clothing ensemble database and individual parameter database, (3) the human centric outputs that directly reflect human physiological and mental status, and (4) the user-friendly operation interface and output interface, as well as a wide applicability. The software is validated with human test studies covering ambient temperatures from - 30.6 to 5 °C, clothing ensembles from 1.34 to 3.20 clo, and activity intensities from 2 to 9 Mets. The average prediction RMSEs of core temperature, mean skin temperature, thermal sensation, and thermal comfort are 0.16 °C, 0.45 °C, 0.58, and 1.41, respectively. The software is an advanced expansion to current standards and guidance of cold exposure assessment and a meaningful tool for the fields of occupational health care, cold protection, and environmental ergonomics.
Collapse
Affiliation(s)
- Feiyu Chen
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - Ming Fu
- Hefei Institute for Public Safety Research, Tsinghua University, Hefei, 230601, Anhui Province, China.
- Anhui Province Key Laboratory of Human Safety, Hefei, 230601, Anhui Province, China.
| | - Yayun Li
- Hefei Institute for Public Safety Research, Tsinghua University, Hefei, 230601, Anhui Province, China
- Anhui Province Key Laboratory of Human Safety, Hefei, 230601, Anhui Province, China
| | - Shifei Shen
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, 100084, China.
| | - Jie Yang
- College of Safety Science and Engineering, Xi'an University of Science and Technology, Xi'an, 710054, China
| | - Wenguo Weng
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| |
Collapse
|
6
|
Sun Y, Jin M, Wang G, Xie H. Early warm compress treatment can promote recanalization of vascular embolisms and reduce tissue necrosis after polymethyl methacrylate injection. Sci Rep 2023; 13:1872. [PMID: 36725881 PMCID: PMC9892021 DOI: 10.1038/s41598-023-29043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/30/2023] [Indexed: 02/03/2023] Open
Abstract
Injection of fillers for soft tissue augmentation can lead to a variety of complications, among which vascular occlusion caused by intravascular injection of filler will induce severe or permanent damage. The treatment strategies for intravascular embolization caused by injection include warm compress application, but the exact beneficial effects of this therapy have not been confirmed. The purpose of this study is to construct an intravascular injection embolism model and observe the effectiveness of warm and cold compress through a randomized, controlled trial. Thirty rabbit's sixty ears were randomly divided into warm compress group, cold compress group, and control group. Polymethyl methacrylate (PMMA) was slowly injected into the central ear artery (CEA) to cause vascular embolism. Warm compress and cold compress treatment were performed respectively. The vascular recanalization and other related indexes were observed at 30 min, 1 day, and 7 days after injection, and the tissue necrosis was analyzed at 7 days. In the early stage of vascular embolization, warm compress can immediately promote vascular dilatation, blood circulation and partial blood flow recovery. One day after intravascular injection, warm compress can reduce intravascular embolization and reduce the incidence of tissue necrosis. At 7 days after intravascular injection, the vessels in the cold compress and control groups were still embolized while the percentage of recanalization in the warm compress group was 47.4% (P < 0.000). Early-stage warm compress after intravascular PMMA injection is conducive to recanalization of vascular embolization and reducing tissue necrosis.
Collapse
Affiliation(s)
- Yimou Sun
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Mengying Jin
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China
| | - Hongbin Xie
- Department of Plastic Surgery, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, 100191, China.
| |
Collapse
|
7
|
D King G, Pan E, Millin MG. Wilderness First Responder Medical Clearance - A Scoping Review with Recommendations. PREHOSP EMERG CARE 2023; 28:50-75. [PMID: 36595615 DOI: 10.1080/10903127.2022.2162650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Due to environmental extremes, as well as the nature of the work itself, wilderness first responders are at risk of incurring medical events in the line of duty. There currently do not exist standardized and scientifically supported methods to screen for a wilderness first responder's risk of incurring a medical event. METHODS We performed multiple scoping reviews using PubMed and CINAHL. The reviews covered six medical screening criteria based on previous recommendations from the National Fire Protection Association (NFPA) and the US Forest Service, and we grouped our reviews into two categories: articles that addressed objective screening criteria, and articles that addressed subjective findings with the first responder. RESULTS Of the objective criteria, our reviews identified 21 articles addressing the ability to screen for risk of incurring a medical event by evaluation of a first responder's heart rate, 12 by blood pressure assessment, and 56 by assessment of body temperature. Of the subjective criteria we identified 19 articles focused on self-assessment, 34 articles on the use of standardized tools to assess for fatigue and sleepiness, and two articles on assessment of a first responder's urine to determine level of dehydration. We also identified seven additional articles through a hand search. Overall, there were 151 articles identified in our scoping reviews. These articles were largely of low quality, consisting mostly of case series without comparison groups. CONCLUSION There is a dearth of high-quality research into the medical assessment of first responders. We recommend that this paper, and measures discussed within it, be used as a starting point in the development of an evidence-based assessment protocol for wilderness first responders. We also recommend the development of a national database of medical events incurred by wilderness first responders to facilitate higher-quality research of screening protocols in this community.
Collapse
Affiliation(s)
- Gregory D King
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Erik Pan
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Michael G Millin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| |
Collapse
|
8
|
Grigg MJ, Thake CD, Allgrove JE, King JA, Thackray AE, Stensel DJ, Owen A, Broom DR. Influence of water-based exercise on energy intake, appetite, and appetite-related hormones in adults: A systematic review and meta-analysis. Appetite 2023; 180:106375. [PMID: 36375602 DOI: 10.1016/j.appet.2022.106375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/13/2022]
Abstract
Single bouts of land-based exercise suppress appetite and do not typically alter energy intake in the short-term, whereas it has been suggested that water-based exercise may evoke orexigenic effects. The primary aim was to systematically review the available literature investigating the influence of water-based exercise on energy intake in adults (PROSPERO ID number CRD42022314349). PubMed, Medline, Sport-Discus, Academic Search Complete, CINAHL and Public Health Database were searched for peer-reviewed articles published in English from 1900 to May 2022. Included studies implemented a water-based exercise intervention versus a control or comparator. Risk of bias was assessed using the revised Cochrane 'Risk of bias tool for randomised trials' (RoB 2.0). We identified eight acute (same day) exercise studies which met the inclusion criteria. Meta-analysis was performed using a fixed effects generic inverse variance method on energy intake (8 studies (water versus control), 5 studies (water versus land) and 2 studies (water at two different temperatures)). Appetite and appetite-related hormones are also examined but high heterogeneity did not allow a meta-analysis of these outcome measures. We identified one chronic exercise training study which met the inclusion criteria with findings discussed narratively. Meta-analysis revealed that a single bout of exercise in water increased ad-libitum energy intake compared to a non-exercise control (mean difference [95% CI]: 330 [118, 542] kJ, P = 0.002). No difference in ad libitum energy intake was identified between water and land-based exercise (78 [-176, 334] kJ, P = 0.55). Exercising in cold water (18-20 °C) increased energy intake to a greater extent than neutral water (27-33 °C) temperature (719 [222, 1215] kJ; P < 0.005). The one eligible 12-week study did not assess whether water-based exercise influenced energy intake but did find that cycling and swimming did not alter fasting plasma concentrations of total ghrelin, insulin, leptin or total PYY but contributed to body mass loss 87.3 (5.2) to 85.9 (5.0) kg and 88.9 (4.9) to 86.4 (4.5) kg (P < 0.05) respectively. To conclude, if body mass management is a person's primary focus, they should be mindful of the tendency to eat more in the hours after a water-based exercise session, particularly when the water temperature is cold (18-20 °C).
Collapse
Affiliation(s)
- Marie J Grigg
- Centre for Sport, Exercise and Life Sciences, Coventry University, CV1 2DS, United Kingdom.
| | - C Douglas Thake
- Centre for Sport, Exercise and Life Sciences, Coventry University, CV1 2DS, United Kingdom.
| | - Judith E Allgrove
- Applied and Human Science Department, Kingston University, London, KT1 2EE, United Kingdom.
| | - James A King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom.
| | - Alice E Thackray
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom.
| | - David J Stensel
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, United Kingdom; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester, National Health Service (NHS) Trust and the University of Leicester, Leicester, United Kingdom; Waseda University, Faculty of Sport Sciences, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
| | - Alun Owen
- Centre for Sport, Exercise and Life Sciences, Coventry University, CV1 2DS, United Kingdom.
| | - David R Broom
- Centre for Sport, Exercise and Life Sciences, Coventry University, CV1 2DS, United Kingdom.
| |
Collapse
|
9
|
Modelling and experimental study of thermo-physiological responses of human exercising in cold environments. J Therm Biol 2022; 109:103316. [DOI: 10.1016/j.jtherbio.2022.103316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/18/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022]
|
10
|
Cardiovascular Stress and Characteristics of Cold-Induced Vasodilation in Women and Men during Cold-Water Immersion: A Randomized Control Study. BIOLOGY 2022; 11:biology11071054. [PMID: 36101432 PMCID: PMC9312820 DOI: 10.3390/biology11071054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Cold-induced vasodilation is a phenomenon that refers to a paradoxical increase in finger temperature that sometimes occurs during cold exposure. Differences between sexes in cold-induced vasodilation have been explored in only a handful of studies. These studies investigated finger skin temperature but did not evaluate toe skin temperature, blood flow in the fingers or toes, clothing, as well as potential underlying mechanisms of cutaneous vasomotion. On the whole, our knowledge on the potential impacts of sex differences on CIVD is limited and this may have important implications for workers and how they cope with exposure to cold environments. The aim of the study was to investigate and compare cold-induced vasodilation and other cardiovascular responses between genders, during exposure to different environmental conditions. The present study demonstrated that women experienced elevated cardiovascular strain and higher frequency of CIVD reactions, particularly in the toes, compared to their male counterparts during cold-water immersion. Abstract Background: Cold-induced vasodilation (CIVD) is a phenomenon that refers to a paradoxical increase in finger temperature that sometimes occurs during cold exposure. The aim of this study was to compare CIVD responses between women and men, during exposure to different environmental conditions. Methods: Seven men and seven women participated in a matched controlled study consisting of a familiarization protocol followed by three experimental sessions (cool (10.8 °C WBGT), thermoneutral (17.2 °C WBGT), and hot (27.2 °C WBGT)). In each session, participants were asked to immerse their left hand and foot in warm water (35 ± 1 °C) for five minutes. Thereafter, the left hand and foot were immersed in cold water (8 ± 1 °C) for 40 min. After that, the left hand and foot were removed from the water and participants remained seated for five minutes. Results: For a matched thermal stress, women experienced an elevated cardiovascular strain (heart rate and in some cases mean arterial pressure) and higher frequency of CIVD reactions (men: 31 vs. women: 60) in comparison to their male counterparts. Conclusions: The present study demonstrated that women experienced elevated cardiovascular strain and higher frequency of CIVD reactions, particularly in the toes, compared to their male counterparts during cold-water immersion.
Collapse
|
11
|
Liu A, Whiteis A. Wilderness Medicine: Impacts from the Weather, Water, and World. Pediatr Ann 2022; 51:e212-e217. [PMID: 35667101 DOI: 10.3928/19382359-20220407-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pediatricians play an important role in the prevention of injuries and provide families with anticipatory guidance regularly. As more families are traveling and spending time outdoors, we must be adept at providing them with knowledge and resources to set them up for success on their adventures. Prevention and preparation frequently can help limit injuries sustained in the wilderness. This article will focus specifically on injuries related to the environment (eg, cold weather injuries, heat-related illnesses) and travel location (eg, high-altitude illness, marine-related injuries, diving medicine). [Pediatr Ann. 2022;51(6):e212-217.].
Collapse
|
12
|
Cabral MD, Patel DR, Greydanus DE, Deleon J, Hudson E, Darweesh S. Medical perspectives on pediatric sports medicine–Selective topics. Dis Mon 2022; 68:101327. [DOI: 10.1016/j.disamonth.2022.101327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
13
|
Das P, Chopra A, Kukreja Y, Mohanty Z, Sharma A. Onychomadesis following frostbite: Hitherto unknown. JOURNAL OF MARINE MEDICAL SOCIETY 2022. [DOI: 10.4103/jmms.jmms_155_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
McDermott ER, Tennent DJ, Patzkowski JC. On-field Emergencies and Emergency Action Plans. Sports Med Arthrosc Rev 2021; 29:e51-e56. [PMID: 34730115 DOI: 10.1097/jsa.0000000000000319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sideline coverage can be an enjoyable experience and provide the opportunity to witness and evaluate an athlete's pathology at the time of injury. While the majority of on-field injury will likely be of low acuity, it is essential to develop an Emergency Action Plan (EAP) to deliver excellent medical care efficiently. The EAP should provide a written, standardized multidisciplinary approach involving key personnel. The EAP should be rehearsed on at least an annual basis and should highlight the initial assessment of the patient while also accounting for the various types of trauma that may occur on the field and appropriate field extrication procedures. As most players who have a true on-field emergency will not return to same-day play, a thorough understanding of how to deliver emergency care and transfer the player to a higher level of care is essential.
Collapse
Affiliation(s)
- Emily R McDermott
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX
| | - David J Tennent
- Orthopaedic Surgery Service, Evans Army Community Hospital, Fort Carson, CO
| | - Jeanne C Patzkowski
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX
| |
Collapse
|
15
|
Castellani JW, Eglin CM, Ikäheimo TM, Montgomery H, Paal P, Tipton MJ. ACSM Expert Consensus Statement: Injury Prevention and Exercise Performance during Cold-Weather Exercise. Curr Sports Med Rep 2021; 20:594-607. [PMID: 34752434 DOI: 10.1249/jsr.0000000000000907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT Cold injury can result from exercising at low temperatures and can impair exercise performance or cause lifelong debility or death. This consensus statement provides up-to-date information on the pathogenesis, nature, impacts, prevention, and treatment of the most common cold injuries.
Collapse
Affiliation(s)
- John W Castellani
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, MA
| | - Clare M Eglin
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| | | | - Hugh Montgomery
- University College London, Centre for Human Health and Performance, London, United Kingdom
| | - Peter Paal
- Hospitallers Brothers Hospital, Anaesthesiology and Intensive Care Medicine, Salzburg, Austria
| | - Michael J Tipton
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| |
Collapse
|
16
|
Shakeel CS, Hassan U, Ilyas F, Zariwala MM, Ilyas SM, Khan SJ. A prelude to wearable technology for the measurement and restoration of core body temperature and heart rate in athletes suffering from hypothermia. Proc Inst Mech Eng H 2021; 236:56-64. [PMID: 34632881 DOI: 10.1177/09544119211051176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An individual who is in good physical health tends to exhibit an internal core temperature of 37°C and a heart rate of 60-100 beats per minute. Increase in the temperature of the surrounding environment can serve as the basis for the onset of the condition of Hypothermia. Hypothermia acts as one of the most significant barriers being faced by winter athletes and starts initially with an increase in the heart and breathing rate. However, if the condition persists it can lead to reduction in the heart and breathing rate and ultimately results in cardiac failure. Although, jackets are commercially available, they tend to operate manually and furthermore, do not serve the primary purpose of counteracting the condition of hypothermia, particularly experienced by athletes taking part in winter sports. The objective of this study is to design a heating jacket that enables effective counteraction of the condition of Hypothermia. It enables precise measurement of the of core body temperature with the aid of a pyroelectric sensor. Along with this, a pulse rate sensor for detecting the accurate heart rate has been incorporated on the index finger. Five heating pads would get activated to attain optimal temperature, in case the core body temperature of <37°C is detected. If the condition of hypothermia advances to the moderate stage, two additional heating pads will get activated and provide extra warmth to attain normal heart rate along with core body temperature. Overall, this wearable technology serves as a definitive solution to counteract the condition of hypothermia only when the internal parameters exhibit that you actually have it. The results of the study exhibited that this prototype can be utilized for detecting and treating the condition of Hypothermia.
Collapse
Affiliation(s)
- Choudhary Sobhan Shakeel
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| | - Umer Hassan
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| | - Fatema Ilyas
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| | - Munira Muhammadi Zariwala
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| | - Salman Muhammad Ilyas
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| | - Saad Jawaid Khan
- Department of Biomedical Engineering, Faculty of Engineering, Science, Technology and Management (ZUFESTM), Ziauddin University, Karachi, Pakistan
| |
Collapse
|
17
|
Min JY, Choi YS, Lee HS, Lee S, Min KB. Increased cold injuries and the effect of body mass index in patients with peripheral vascular disease. BMC Public Health 2021; 21:294. [PMID: 33579232 PMCID: PMC7881551 DOI: 10.1186/s12889-020-09789-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023] Open
Abstract
Background Exposure to extremely or moderate low temperatures is associated with increased morbidity and mortality risk. Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. Given that cold temperature causes constriction of the small arteries and veins in the skin, patients who suffer from peripheral circulation problems, like PVD, may be vulnerable to cold injuries. This study aimed to investigate the association between PVD and cold-induced injuries in the winter among Korean adults. We further analyzed the association stratified by body mass index (BMI) classification. Methods We used the 2002–2015 National Health Insurance Service-National Sample Cohort data and included a total of 535,186 adults as the study population. Patients with underlying PVD were identified by ICD-10 code I73. Cold-related illnesses were defined by ICD-10 codes (T690, T691, T698, T699, T330 ~ T339, T340 ~ T349, and T350 ~ T357). Body mass index (BMI) was categorized into underweight, normal weight, overweight, and obese. Results A total of 23.21% (n = 124,224) were PVD patients, and 0.59% (n = 3154) had cold-induced injuries. PVD patients were more likely to be diagnosed with cold injuries, but it was valid only in the underweight or normal weight groups. After adjusting for age, sex, income, cigarette smoking, alcohol consumption, regular exercise, high blood pressure, and hyperglycemia, PVD patients had a significantly increased odds ratio (OR) for cold injuries [adjusted OR = 1.11; 95% confidence intervals (95% CI): 1.01–1.21]. Increased OR for cold injuries in PVD patients was also observed in adults (adjusted OR = 1.14; 95% CI: 1.03–1.25 in Model 2), but not in the elderly. When we classified study subjects into the four BMI groups, the adjusted OR of cold injuries in PVD patients was significant in the underweight group (OR = 1.83; 95% CI, 1.26–2.66) and normal weight group (OR = 1.15; 95% CI, 1.03–1.27), not in those with overweight and obese. In adults, a consistent result was found in adults in the underweight group (OR = 1.63; 95% CI, 1.08–2.47 in Model 2) and normal weight group (OR = 1.19; 95% CI, 1.07–1.33 in Model 2). In the elderly, the adjusted OR for cold injuries was only significant in the underweight group (OR = 3.37; 95% CI, 1.08–10.53 in Model 2). Conclusions We found a significant association between PVD and cold-induced injuries in the general population. BMI modified the association. Thus, the association observed appears to be clinically applicable to PVD patients being low to normal BMI.
Collapse
Affiliation(s)
- Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Yeon-Soo Choi
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Hyeong-Seong Lee
- Department of Statistics and Data Science, College of Commerce and Economics, Yonsei University, Seoul, Republic of Korea
| | - Sohyae Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Seoul, 110-799, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, Seoul, 110-799, Republic of Korea.
| |
Collapse
|
18
|
Cuscuta reflexa Roxb. Expedites the Healing Process in Contact Frostbite. BIOMED RESEARCH INTERNATIONAL 2020; 2020:4327651. [PMID: 33083466 PMCID: PMC7556107 DOI: 10.1155/2020/4327651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/19/2020] [Accepted: 07/07/2020] [Indexed: 11/17/2022]
Abstract
Frostbite is caused due to extreme vulnerability to cold, resulting in damage of deeper and superficial tissues alike. In this study, we report the anti-inflammatory and wound-healing properties of aqueous methanolic extract of Cuscuta reflexa (Cs.Cr) against contact frostbite. Thirty rats were divided into five groups including three treatment groups with increasing doses of Cs.Cr, a standard drug group receiving acetylsalicylic acid (ASA), and a metal bar-induced frostbite group. Frostbite injury was induced by a 3 × 3.5 cm metal bar frozen up to -79°C on shaved skin for continuous 3 minutes. Wounded area percentages were recorded to measure the healing rate in response to Cs.Cr administration. Haematological parameters and malondialdehyde content were also noted. On treatment with Cs.Cr, the healing rate is drastically increased and lipid peroxidation product malondialdehyde was decreased in a dose-dependent manner. Results were compared with frostbite and ASA (standard drug group). These results indicate that Cs.Cr possesses excellent wound-healing properties against frostbite injury and can prove to be a prospective compound in such conditions.
Collapse
|
19
|
Martínez-Sanz JM, Fernández Nuñez A, Sospedra I, Martínez-Rodríguez A, Domínguez R, González-Jurado JA, Sánchez-Oliver AJ. Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114082. [PMID: 32521666 PMCID: PMC7312487 DOI: 10.3390/ijerph17114082] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 01/16/2023]
Abstract
During the last few years, the numbers of competitors in endurance and ultra-endurance sports modalities have increased significantly. This type of competition is an extreme challenge for athletes. Therefore, they have an increased the risk of developing medical and nutritional problems. The aim of the work is to estimate the incidence of nutrition-related adverse outcomes in endurance and ultra-endurance sports, considering the variables that influence them. A critical review was carried out based on the PubMed database, by means of a search strategy based on keywords separated by Boolean connectors. For all the results obtained in a period from 2008 to 2019, a series of inclusion/exclusion criteria was applied to select only the studies that fitted the objective of the present study. Results and discussion: Of the 871 publications identified, 33 met the inclusion criteria. The adverse outcomes found included exercise-associated hyponatremia (EAH), heat stroke by exertion (EHS), gastrointestinal (GI) problems, dehydration, and hypothermia; the provision of misinformation to athletes about nutrient intake and hydration during competition was identified as the main cause. Conclusions: The main adverse outcomes in endurance and ultra-endurance sports modalities are EAH, GI inconveniences, and EHS. These problems can affect the performance and health status of the athlete during and post-competition. Several nutritional guidelines have been suggested that can prevent these adverse outcomes, and it is essential to individualize and adjust the nutritional intake and hydration status according to the characteristics of each competition.
Collapse
Affiliation(s)
- José Miguel Martínez-Sanz
- Departamento de Enfermería, Grupo de Investigación en Alimentación y Nutrición (ALINUT), Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain; (J.M.M.-S.); (I.S.)
| | - Ana Fernández Nuñez
- Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain;
| | - Isabel Sospedra
- Departamento de Enfermería, Grupo de Investigación en Alimentación y Nutrición (ALINUT), Facultad de Ciencias de la Salud, Universidad de Alicante, 03690 Alicante, Spain; (J.M.M.-S.); (I.S.)
| | - Alejandro Martínez-Rodríguez
- Analytical Chemistry, Nutrition and Food Sciences Department, Sciences Faculty, University of Alicante, 03690 Alicante, Spain;
| | - Raúl Domínguez
- Facultad de Ciencias de la Salud de la Universidad Isabel I, 09003 Burgos, Spain;
| | - José Antonio González-Jurado
- Facultad del Deporte, Universidad Pablo Olavide de Sevilla, 41013 Sevilla, Spain
- Correspondence: ; Tel.: +34-651-517-571
| | - Antonio J. Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, 41004 Sevilla, Spain;
| |
Collapse
|
20
|
Deep frostbite: Clinical characteristics and outcomes in northeastern China. J Tissue Viability 2020; 29:110-115. [DOI: 10.1016/j.jtv.2020.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/08/2019] [Accepted: 01/27/2020] [Indexed: 11/18/2022]
|
21
|
Empirical Model of Thermal Comfort for Medium-Sized Cities in Subtropical Climate. ATMOSPHERE 2019. [DOI: 10.3390/atmos10100576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study sought to elaborate an empirical model of thermal comfort for medium-sized cities in subtropical climate, based on a cross-sectional survey in the city of Santa Maria, state of Rio Grande do Sul, Brazil. The research was based on the collection of meteorological, subjective and individual data collected simultaneously in August 2015, January and July 2016, which were submitted to multiple linear regression for the elaboration of the Bioclimatic Model for Subtropical Medium-Sized Cities (MBCMS). The proposed model was validated through a normality test, obtained by the measure of obliquity and kurtosis of the distribution, heteroscedasticity and covariance, as well as by the comparison between already traditional models in the literature, such as PET, SET and PMV, which were calibrated to the study area, and the results observed for MBCMS. The results presented high multiple R-squared and adjusted R-squared, 0.928 and 0.925, respectively, for the proposed model, as well as an F-statistic of 447.6. In the validation, the MBCMS presented R equal to 0.83 and an accuracy score 60% more efficient than the PET, SET and PMV indexes.
Collapse
|
22
|
Boles R, Gawaziuk JP, Cristall N, Logsetty S. Pediatric frostbite: A 10-year single-center retrospective study. Burns 2018; 44:1844-1850. [PMID: 30072195 DOI: 10.1016/j.burns.2018.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe frostbite (freezing cold injured tissue) in children and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to the injury. METHODS Retrospective chart review of children <18 years old referred to a regional pediatric hospital for frostbite, to determine the demographics, environment, and risk factors related to injuries. RESULTS 47 patients met the inclusion criteria. Median age was 15 years (IQR 12-16). All injuries occurred between November and March. 49% were admitted to the hospital and frostbite was associated with use of alcohol (53%), cigarettes (34%), marijuana (23%), and symptoms of depression (with and without suicidal ideation) (32%). Frostbite injury treated with conservative wound management presented at <-6°C and injury that underwent surgical procedures occurred at temperatures ≤-23°C (p=0.001). Longer exposure duration also significantly increased the likelihood of a surgical procedure (p<0.001). Intoxication and lack of supervision were two common factors, with lack of supervision at time of injury most common among patients 0-12 years (64%), and intoxication most common among patients ages 13-17 (61%). CONCLUSION Frostbite injuries in children begins at temperatures <-6°C; with risk of tissue loss increasing at temperatures below -23°C. Lack of supervision and intoxication are major risk factors for frostbite in children. Two-thirds of younger children were unsupervised, whereas intoxication was frequently related to frostbite in adolescents. Both of these factors can be addressed through an education-based prevention program.
Collapse
Affiliation(s)
- Ramy Boles
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Justin P Gawaziuk
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - Nora Cristall
- Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sarvesh Logsetty
- Manitoba Firefighters' Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Departments of Surgery and Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| |
Collapse
|
23
|
Affiliation(s)
- Linda Laskowski-Jones
- Linda Laskowski-Jones is editor-in-chief of Nursing2018 and Vice President of Emergency and Trauma Services at Christiana Care Health System in Newark, Del. She and Lawrence J. Jones are directors of the Appalachian Center for Wilderness Medicine in Morganton, N.C., and members of the Blue Mountain Ski Patrol in Palmerton, Pa
| | | |
Collapse
|
24
|
Wojtys EM. Pushing the Envelope. Sports Health 2016; 8:115-6. [PMID: 26896215 PMCID: PMC4789938 DOI: 10.1177/1941738116631491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|