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Looney DP, Long ET, Potter AW, Xu X, Friedl KE, Hoyt RW, Chalmers CR, Buller MJ, Florian JP. Divers risk accelerated fatigue and core temperature rise during fully-immersed exercise in warmer water temperature extremes. Temperature (Austin) 2019; 6:150-157. [PMID: 31312674 PMCID: PMC6620004 DOI: 10.1080/23328940.2019.1599182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/14/2019] [Accepted: 03/20/2019] [Indexed: 02/03/2023] Open
Abstract
Physiological responses to work in cold water have been well studied but little is known about the effects of exercise in warm water; an overlooked but critical issue for certain military, scientific, recreational, and professional diving operations. This investigation examined core temperature responses to fatiguing, fully-immersed exercise in extremely warm waters. Twenty-one male U.S. Navy divers (body mass, 87.3 ± 12.3 kg) were monitored during rest and fatiguing exercise while fully-immersed in four different water temperatures (Tw): 34.4, 35.8, 37.2, and 38.6°C (Tw34.4, Tw35.8, Tw37.2, and Tw38.6 respectively). Participants exercised on an underwater cycle ergometer until volitional fatigue or core temperature limits were reached. Core body temperature and heart rate were monitored continuously. Trial performance time decreased significantly as water temperature increased (Tw34.4, 174 ± 12 min; Tw35.8, 115 ± 13 min; Tw37.2, 50 ± 13 min; Tw38.6, 34 ± 14 min). Peak core body temperature during work was significantly lower in Tw34.4 water (38.31 ± 0.49°C) than in warmer temperatures (Tw35.8, 38.60 ± 0.55°C; Tw37.2, 38.82 ± 0.76°C; Tw38.6, 38.97 ± 0.65°C). Core body temperature rate of change increased significantly with warmer water temperature (Tw34.4, 0.39 ± 0.28°C·h−1; Tw35.8, 0.80 ± 0.19°C·h−1; Tw37.2, 2.02 ± 0.31°C·h−1; Tw38.6, 3.54 ± 0.41°C·h−1). Physically active divers risk severe hyperthermia in warmer waters. Increases in water temperature drastically increase the rate of core body temperature rise during work in warm water. New predictive models for core temperature based on workload and duration of warm water exposure are needed to ensure warm water diving safety.
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Affiliation(s)
- David P Looney
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - Edwin T Long
- Navy Experimental Diving Unit (NEDU), Panama City, Florida, USA
| | - Adam W Potter
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA.,Rutgers University, School of Biomedical and Health Sciences, Newark, New Jersey, USA
| | - Xiaojiang Xu
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - Karl E Friedl
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - Reed W Hoyt
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - Christopher R Chalmers
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA.,Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN, USA
| | - Mark J Buller
- Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine (USARIEM), Natick, Massachusetts, USA
| | - John P Florian
- Navy Experimental Diving Unit (NEDU), Panama City, Florida, USA
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Lolley DM, Enerson DM, Rams JJ, Long ET, Rycyna JL, Bauersfeld SR. Should coronary artery bypass be delayed following successful direct coronary artery streptokinase thrombolysis during evolving myocardial infarction? J Vasc Surg 1986; 3:330-7. [PMID: 3484791 DOI: 10.1067/mva.1986.avs0030330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The effect of deferring immediate coronary artery bypass was evaluated in two groups of similar patients having successful direct coronary artery thrombolysis with streptokinase in the treatment of evolving myocardial infarction. Within 6 hours of onset of myocardial infarction, 140 patients underwent immediate cardiac catheterization and infusion of intracoronary streptokinase up to 500,000 units. Of those patients having restoration of orthograde coronary blood flow coupled with immediate evidence of myocardial salvage, 31 patients (group I) had immediate coronary artery bypass and 34 patients (group II) had coronary artery bypass deferred. Group I had no hemorrhagic, hemodynamic, or new cardiac complications. There were no deaths, reinfarction, recurrence of angina, or loss of salvaged myocardium at restudy. In group II, 11 of 34 patients had early reinfarction (p less than 0.01 vs. group I), 16 of 34 patients had recurrent angina (p less than 0.01 vs. group I) and two deaths occurred from cardiac causes. Subsequent coronary bypass was needed in 16 patients. All restudied reinfarction patients lost restored myocardium. We concluded that immediate coronary artery bypass is safe after acute myocardial infarction and coronary artery thrombolysis with streptokinase, delay of coronary artery bypass leads to an unacceptable incidence of reinfarction and recurrent severe angina, and early coronary artery bypass is needed to ensure success of thrombolysis.
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Abstract
Hemodynamic insufficiency resulting from extracranial vertebral artery stenosis or occlusion is believed to be the major cause of vertebrobasilar transient ischemic attacks. The major difficulties in treating this disorder have been exposure of the vertebral artery distal to the stenosis and the risk of vertebral artery cross-clamping for vein grafting or carotid artery transposition. The authors describe a new technique for vertebral artery reconstruction at any level by the use of an intraluminal shunt, thus avoiding the necessity to cross-clamp the artery. This procedure was successfully performed at all three levels of the extracranial vertebral artery: C7-4, C3-1, and C-1 to the foramen magnum. The technique of exposure of the vertebral artery at these three levels and the method of vein grafting without cross-clamping are described. The initial results of the procedure are presented.
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Abstract
A variation of a superficial temporal-middle cerebral artery bypass is presented that can serve as a surgical alternative to long vein subclavian-middle cerebral artery grafting in patients with common carotid artery occlusion and symptoms of ipsilateral ischemia. A vein graft from the subclavian to the external carotid artery at the carotid bifurcation is performed simultaneously with a standard superficial temporal-middle cerebral artery bypass. Advantages of this procedure over a long subclavian-middle cerebral artery vein graft are the technical simplicity associated with a standard superficial temporal-middle cerebral artery bypass, higher patency rates, and lower risk of graft leakage or torsion. Three patients have undergone this procedure, and all had patent bypasses one year after operation.
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Long ET, Adams WE, Benfield JR, Mikouchi T, Reimann AF, Nigro S. ALTERED HEMODYNAMICS IN THE PULMONARY CIRCULATION FOLLOWING REAERATION OF AN ATELECTATIC LUNG. J Thorac Cardiovasc Surg 1960. [DOI: 10.1016/s0022-5223(19)32587-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Harrison RW, Reimann AF, Long ET, Lester W, Adams WE. ADVERSE SURGICAL EXPERIENCE IN THE TREATMENT OF PULMONARY DISEASE CAUSED BY ATYPICAL ACID-FAST, BACILLI. J Thorac Cardiovasc Surg 1959. [DOI: 10.1016/s0022-5223(19)32440-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Harrison RW, Adams WE, Long ET, Burrows B, Reimann A. THE CLINICAL SIGNIFICANCE OF COR PULMONALE IN THE REDUCTION OF CARDIOPULMONARY RESERVE FOLLOWING EXTENSIVE PULMONARY RESECTION. ACTA ACUST UNITED AC 1958. [DOI: 10.1016/s0096-5588(20)30144-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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