scholarly journals A case report: Glycopyrrolate for treatment of exercise-induced hyperhidrosis

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772160
Author(s):  
Matthew Negaard ◽  
Christopher Anthony ◽  
Daniel Bonthius ◽  
Matthew Jepson ◽  
Britt Marcussen ◽  
...  
Keyword(s):  
Case Report ◽  
Core Temperature ◽  
Perceived Exertion ◽  
Sweat Rate ◽  
Case Reports ◽  
Return To Sport ◽  
Exercise Intolerance ◽  
Anticholinergic Medication ◽  
Sweat Production ◽  
Exercise Induced

Objective: Hyperhidrosis can cause dehydration and exercise intolerance. There are several case reports of extremely high sweat rates in athletes. We present as case report of a 17-year-old male with the highest sweat rate recorded in the literature (5.8 L/h). Our goal was to determine if glycopyrrolate, an anticholinergic medication with primarily anti-muscarinic effects that is known to decrease sweat production, would reduce the sweat rate of our subject in a controlled exercise setting. Methods: Our patient and a control subject were subjected to an exercise protocol consisting of running on a treadmill (5.4–6.7 mile/h at 1° of incline) in a warm climate-controlled chamber after receiving 0, 2, or 4 mg of glycopyrrolate. Core temperature, heart rate, rater of perceived exertion, and sweat rate were monitored in both subjects. Results: Glycopyrrolate dose was not significantly correlated with decreased sweat rate and maximal core temperature. However, the clinical effect of reducing the sweat rate was very strong. The improvement of the subject’s sweat rate allowed him to successfully return to sport. Conclusion: Our findings suggest that low-dose glycopyrrolate may be a safe and effective method of controlling exertional hyperhidrosis.

scholarly journals Enhancing sweat rate using a novel device for the treatment of congestion in heart failure

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D Aronson ◽  
Y Nitzan ◽  
S Petcherski ◽  
E Bravo ◽  
M Habib ◽  
...  
Keyword(s):  
Heart Failure ◽  
Weight Loss ◽  
Adverse Events ◽  
Skin Temperature ◽  
Core Temperature ◽  
Sweat Rate ◽  
Interquartile Range ◽  
Private Company ◽  
The Core ◽  
Sweat Production

Abstract Background Current treatment of fluid retention in heart failure (HF) relies primarily on diuretics. However, adequate decongestion is not achieved in many patients. Purpose To study the feasibility and short-term performance of a novel approach to remove fluids and sodium directly from the interstitial compartment by enhancing sweat rate. Methods We used a device designed to enhance fluid and salt loss via the eccrine sweat glands. Skin temperature in the lower body was increased to 35–38°, where the slope of the relationship between temperature and sweat production is linear. With this wearable device, the sweat evaporates instantaneously, thus avoiding the awareness of perspiration. The primary efficacy endpoint was the ability to increase skin temperature to the desired range without elevating the core temperature above normal range. A secondary efficacy endpoint was a clinically meaningful hourly sweat output, defined as ≥150 mL/h. The primary safety endpoint was any procedure-related adverse events. Results We studied 6 normal subjects and 10 HF patients with clinical evidence of congestion and median NT-proBNP of 602 pg/mL [interquartile range 427 to 1719 pg/mL]. Participants underwent 3 treatment sessions of up to 4h. Skin temperature increased to a median of 37.5°C (interquartile range 37.1–37.9°C) with the core temperature remaining unchanged. The median total weight loss during treatment was 219±67 g/h (Figure) with a range of 100–338 g/h. In 77% of cases, the average sweat rate was ≥150 mL/h. Systolic (P=0.25) and diastolic (P=0.48) blood pressure and heart rate (P=0.11) remained unchanged during the procedure. There were no significant changes in renal function and no procedure-related adverse events. Conclusion Enhancing sweat rate was safe and resulted in a clinically meaningful fluid removal and weight loss. Further evaluation of this concept is warranted. FUNDunding Acknowledgement Type of funding sources: Private company. Main funding source(s): AquaPass Inc Weight loss due to sweat

scholarly journals Blunted sweating does not alter the rise in core temperature in people with multiple sclerosis exercising in the heat

2020 ◽  
Author(s):  
Georgia K Chaseling ◽  
Davide Filingeri ◽  
Dustin R. Allen ◽  
Michael Barnett ◽  
Steve Vucic ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Heat Loss ◽  
Core Temperature ◽  
Heat Production ◽  
Sweat Rate ◽  
Onset Time ◽  
Local Sweat Rate ◽  
Temperature Heat ◽  
C 30 ◽  
Exercise Induced

Purpose: To determine whether thermoregulatory capacity is altered by MS during exercise in the heat. Methods: Sixteen MS (EDSS: 2.9±0.9; 47±8 y; 77.6±14.0 kg) and 14 healthy (CON) control participants (43±11 y; 78.6±17.0 kg) cycled at a heat production of 4 W.kg-1 for 60 minutes at 30˚C, 30%RH (WARM). A subset of 8 MS (EDSS: 2.6±0.5; 44±8 y; 82.3±18.2 kg) and 8 CON (44±12 y; 81.2±21.1 kg) also exercised at 35°C, 30%RH (HOT). Rectal (Tre), mean skin (Tsk) temperature, and local sweat rate on the upper-back (LSRback) and forearm (LSRarm), were measured. Results: All CON, yet only 9 of 16, and 7 of 8 MS participants completed 60 min of exercise in WARM and HOT trials, respectively. All MS participants unable to complete exercise stopped with ∆Tre between 0.2-0.5˚C. The time to reach a ∆Tre of 0.2˚C was similar (MS:28±15 min, CON: 32±18 min; P=0.51). For MS participants completing 60-min of exercise in WARM, ∆Tre (P=0.13), ∆Tsk (P=0.45), LSRback (P=0.69) and LSRarm (P=0.54) were similar to CON, but ΔTb (MS:0.16±0.13˚C, CON:0.07±0.06˚C; P=0.02) and onset time (MS:16±10 min, CON:8±5 min; P=0.02) for sweating were greater. Similarly, in HOT, ∆Tre (P=0.52), ∆Tsk (P=0.06), LSRback (P=0.59) and LSRarm (P=0.08) were similar, but ΔTb (MS: 0.19±0.16˚C, CON: 0.06±0.04˚C; P=0.04) and onset time (MS:13±7 min, CON:6±3 min; P=0.02) for sweating were greater with MS. Conclusion: Even at 35˚C, a delayed sweating onset didn't alter heat loss to sufficiently affect exercise-induced rises in core temperature. Heat intolerance with MS does not seem attributable to thermoregulatory impairments.

scholarly journals Mild Dehydration and Cycling Performance During 5-Kilometer Hill Climbing

2013 ◽  
Vol 48 (6) ◽  
pp. 741-747 ◽  
Author(s):  
Costas N. Bardis ◽  
Stavros A. Kavouras ◽  
Giannis Arnaoutis ◽  
Demosthenes B. Panagiotakos ◽  
Labros S. Sidossis
Keyword(s):  
Body Mass ◽  
Core Temperature ◽  
Perceived Exertion ◽  
Performance Test ◽  
Sweat Rate ◽  
Cycling Performance ◽  
Rating Of Perceived Exertion ◽  
Hill Climbing ◽  
Performance Time ◽  
Steady State Cycling

Context: Hydration has been shown to be an important factor in performance; however, the effects of mild dehydration during intense cycling are not clear. Objective: To determine the influence of mild dehydration on cycling performance during an outdoor climbing trial in the heat (ambient temperature = 29.0°C ± 2.2°C). Design: Crossover study. Setting: Outdoor. Patients or Other Participants: Ten well-trained, male endurance cyclists (age = 28 ± 5 years, height = 182 ± 0.4 cm, mass = 73 ± 4 kg, maximal oxygen uptake = 56 ± 9 mL·min−1·kg−1, body fat = 23% ± 2%, maximal power = 354 ± 48 W). Intervention(s): Participants completed 1 hour of steady-state cycling with or without drinking to achieve the desired pre-exercise hydration level before 5-km hill-climbing cycling. Participants started the 5-km ride either euhydrated (EUH) or dehydrated by −1% of body mass (DEH). Main Outcome Measure(s): Performance time, core temperature, sweat rate, sweat sensitivity, and rating of perceived exertion (RPE). Results: Participants completed the 5-km ride 5.8% faster in the EUH (16.6 ± 2.3 minutes) than DEH (17.6 ± 2.9 minutes) trial (t1 = 10.221, P = .001). Postexercise body mass was −1.4% ± 0.3% for the EUH trial and −2.2% ± 0.2% for the DEH trial (t1 = 191.384, P < .001). Core temperature after the climb was greater during the DEH (39.2°C ± 0.3°C) than EUH (38.8°C ± 0.2°C) trial (t1 = 8.04, P = .005). Sweat rate was lower during the DEH (0.44 ± 0.16 mg·m−2·s−1) than EUH (0.51 ± 0.16 mg·m−2·s−1) trial (t8 = 2.703, P = .03). Sweat sensitivity was lower during the DEH (72.6 ± 32 g·°C−1·min−1) than EUH (102.6 ± 54.2 g·°C−1·min−1) trial (t8 = 3.072, P = .02). Lastly, RPE after the exercise performance test was higher for the DEH (19.0 ± 1.0) than EUH (17.0 ± 1.0) participants (t9 = −3.36, P = .008). Conclusions: We found mild dehydration decreased cycling performance during a 5-km outdoor hill course, probably due to greater heat strain and greater perceived intensity.

scholarly journals Impaired Heat Adaptation From Combined Heat Training and “Live High, Train Low” Hypoxia

2019 ◽  
Vol 14 (5) ◽  
pp. 635-643 ◽  
Author(s):  
Erin L. McCleave ◽  
Katie M. Slattery ◽  
Rob Duffield ◽  
Philo U. Saunders ◽  
Avish P. Sharma ◽  
...  
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Core Temperature ◽  
Perceived Exertion ◽  
Sweat Rate ◽  
Cardiovascular Responses ◽  
Sodium Concentration ◽  
Peak Oxygen Uptake ◽  
Submaximal Heart Rate ◽  
Independent Heat

Purpose: To determine whether combining training in heat with “Live High, Train Low” hypoxia (LHTL) further improves thermoregulatory and cardiovascular responses to a heat-tolerance test compared with independent heat training. Methods: A total of 25 trained runners (peak oxygen uptake = 64.1 [8.0] mL·min−1·kg−1) completed 3-wk training in 1 of 3 conditions: (1) heat training combined with “LHTL” hypoxia (H+H; FiO2 = 14.4% [3000 m], 13 h·d−1; train at <600 m, 33°C, 55% relative humidity [RH]), (2) heat training (HOT; live and train <600 m, 33°C, 55% RH), and (3) temperate training (CONT; live and train <600 m, 13°C, 55% RH). Heat adaptations were determined from a 45-min heat-response test (33°C, 55% RH, 65% velocity corresponding to the peak oxygen uptake) at baseline and immediately and 1 and 3 wk postexposure (baseline, post, 1 wkP, and 3 wkP, respectively). Core temperature, heart rate, sweat rate, sodium concentration, plasma volume, and perceptual responses were analyzed using magnitude-based inferences. Results: Submaximal heart rate (effect size [ES] = −0.60 [−0.89; −0.32]) and core temperature (ES = −0.55 [−0.99; −0.10]) were reduced in HOT until 1 wkP. Sweat rate (ES = 0.36 [0.12; 0.59]) and sweat sodium concentration (ES = −0.82 [−1.48; −0.16]) were, respectively, increased and decreased until 3 wkP in HOT. Submaximal heart rate (ES = −0.38 [−0.85; 0.08]) was likely reduced in H+H at 3 wkP, whereas CONT had unclear physiological changes. Perceived exertion and thermal sensation were reduced across all groups. Conclusions: Despite greater physiological stress from combined heat training and “LHTL” hypoxia, thermoregulatory adaptations are limited in comparison with independent heat training. The combined stimuli provide no additional physiological benefit during exercise in hot environments.

Fournier's gangrene as Amyand's hernia complication

2019 ◽  
Vol 98 (7) ◽  
pp. 291-296
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Rare Condition ◽  
Sporadic Case ◽  
Fournier’S Gangrene ◽  
Amyand’S Hernia ◽  
Fournier's Gangrene ◽  
Randomized Controlled Studies ◽  
Based Medicine ◽  
Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

Hemangiomatosis of the greater omentum – a case report

2019 ◽  
Vol 98 (4) ◽  
pp. 178-180
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Histological Examination ◽  
Case Reports ◽  
Greater Omentum ◽  
Surgical Removal ◽  
Consumption Coagulopathy ◽  
Cavernous Hemangiomas ◽  
Mesodermal Origin ◽  
Benign Tumours

Cavernous hemangiomas are benign tumours of mesodermal origin. Even though various localizations of hemangioma have been described in the literature, its occurrence in the greater omentum is very rare. Only symptomatic hemangiomas are indicated for surgical treatment. There are case reports presenting resection or surgical removal of the greater omentum with hemangioma because of mechanical syndrome, consumption coagulopathy, bleeding, infection or suspicion of a malignancy. This article presents a case report of a patient operated on for a suspicion of carcinomatosis of the greater omentum. Histological examination found hemangiomatosis in the resected greater omentum.

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus

Lupus ◽  
2020 ◽  
pp. 096120332096570
Author(s):  
Juliana P Ocanha-Xavier ◽  
Camila O Cola-Senra ◽  
Jose Candido C Xavier-Junior
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Literature Review ◽  
English Language ◽  
Case Reports ◽  
Histopathological Diagnosis ◽  
Skin Disorders ◽  
Histopathological Findings ◽  
Inflammatory Skin

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.

scholarly journals Herb–Drug Interactions: Worlds Intersect with the Patient at the Center

Medicines ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 44
Author(s):  
Mary Beth Babos ◽  
Michelle Heinan ◽  
Linda Redmond ◽  
Fareeha Moiz ◽  
Joao Victor Souza-Peres ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Case Report ◽  
Drug Interactions ◽  
Clinical Studies ◽  
Drug Information ◽  
Case Reports ◽  
Full Information ◽  
Information Need ◽  
Herbal Products ◽  
Reduce Risk

This review examines three bodies of literature related to herb–drug interactions: case reports, clinical studies, evaluations found in six drug interaction checking resources. The aim of the study is to examine the congruity of resources and to assess the degree to which case reports signal for further study. A qualitative review of case reports seeks to determine needs and perspectives of case report authors. Methods: Systematic search of Medline identified clinical studies and case reports of interacting herb–drug combinations. Interacting herb–drug pairs were searched in six drug interaction resources. Case reports were analyzed qualitatively for completeness and to identify underlying themes. Results: Ninety-nine case-report documents detailed 107 cases. Sixty-five clinical studies evaluated 93 mechanisms of interaction relevant to herbs reported in case studies, involving 30 different herbal products; 52.7% of these investigations offered evidence supporting reported reactions. Cohen’s kappa found no agreement between any interaction checker and case report corpus. Case reports often lacked full information. Need for further information, attitudes about herbs and herb use, and strategies to reduce risk from interaction were three primary themes in the case report corpus. Conclusions: Reliable herb–drug information is needed, including open and respectful discussion with patients.

Proteus syndrome in pregnancy: A case report

2020 ◽  
pp. 1753495X2097079
Author(s):  
Niccole Ranaei-Zamani ◽  
Mandeep K Kaler ◽  
Rehan Khan
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Proteus Syndrome ◽  
Cutaneous Lesions ◽  
Genetic Syndrome ◽  
Skeletal Tissue ◽  
First Case ◽  
Large Teaching Hospital ◽  
Clinical Presentations ◽  
In Pregnancy

Proteus syndrome is a rare, multi-system, genetic syndrome characterised by atypical and excessive growth of skeletal tissue. Clinical presentations include abnormal musculoskeletal growth and cutaneous lesions. Due to its rarity, there have been a limited number of published case reports of Proteus syndrome. This is the first case report on the management of Proteus syndrome in pregnancy. We present the case of a pregnant woman with Proteus syndrome in her first pregnancy in a large teaching hospital and discuss the considerations and challenges faced in her antenatal, intrapartum and postnatal care.

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