Escherichia coli Sepsis and Prolonged Hypophosphatemia Following Exertional Heat Stroke

PEDIATRICS ◽  
1990 ◽  
Vol 86 (2) ◽  
pp. 307-309
Author(s):  
MARK A. KAY ◽  
EDWARD D. B. MCCABE
Keyword(s):  
Early Identification ◽  
Sports Medicine ◽  
Clinical Course ◽  
Heat Stroke ◽  
Altered Mental Status ◽  
Exertional Heat Stroke ◽  
Gram Negative ◽  
American Academy Of Pediatrics ◽  
Life Threatening ◽  
Etiologic Relationship

Because of the increasing emphasis on physical activity, sports medicine represents a growing proportion of medical care. Climatic heat stress, including heat stroke, is of sufficient concern that its preventability has been addressed by the American Academy of Pediatrics.1 Although heat stroke is defined by the triad of hyperpyrexia, anhydrosis, and altered mental status, the clinical course of these patients may include multiple complications.2-8 In this article we describe a previously unrecognized etiologic relationship between two of these complications, which may permit early identification and prevention of life-threatening consequences to heat stroke. Two cases of Gram-negative sepsis have been described in previously healthy young adults suffering from fatal exertional heat stroke.7,8

scholarly journals A Case of Exertional Heat Stroke Complicated by Hypoxic Hepatitis

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bertram K. Woitok ◽  
Shawki Bahmad ◽  
Gregor Lindner
Keyword(s):  
Supportive Care ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Multiorgan Failure ◽  
Heat Stroke ◽  
Exertional Heat Stroke ◽  
Hypoxic Hepatitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Delayed Referral

Background.Exertional heat stroke is a life-threatening condition often complicated by multiorgan failure. We hereby present a case of a 25-year-old male presenting with syncope after a 10  km run in 28°C outside temperature who developed acute liver failure. Case Presentation. Initial temperature was found to be 41.1°C, and cooling measures were rapidly applied. He suffered from acute renal failure and rhabdomyolysis and proceeded to acute liver failure (ASAT 6100 U/l and ALAT 6561 U/l) due to hypoxic hepatitis on day 3. He did not meet criteria for emergency liver transplantation and recovered on supportive care. Conclusions. Acute liver failure due to heat stroke is a life-threatening condition with often delayed onset, which nevertheless resolves on supportive care in the majority of cases; thus, a delayed referral to transplant seems to be reasonable.

American College of Sports Medicine Roundtable on Exertional Heat Stroke - Return to Duty/Return to Play

2010 ◽  
Vol 9 (5) ◽  
pp. 314-321 ◽  
Author(s):  
Francis G. O'Connor ◽  
Douglas J. Casa ◽  
Michael F. Bergeron ◽  
Robert Carter ◽  
Patricia Deuster ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Heat Stroke ◽  
Return To Play ◽  
Exertional Heat Stroke ◽  
Return To Duty

Epidemiology and clinics of mushroom poisoning in Northern Italy: A 21-year retrospective analysis

2017 ◽  
Vol 37 (7) ◽  
pp. 697-703 ◽  
Author(s):  
G Cervellin ◽  
I Comelli ◽  
G Rastelli ◽  
F Sanchis-Gomar ◽  
F Negri ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Early Identification ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Clinical Information ◽  
Northern Italy ◽  
Gastrointestinal Toxicity ◽  
Mushroom Poisoning ◽  
Limited Information ◽  
Life Threatening

Background: Limited information exists about epidemiology and management of mushroom poisoning. We analyzed and described epidemiology, clinical presentation, and clinical course of mushroom-poisoned patients admitted to emergency departments (EDs) of the Province of Parma, Italy. Methods: Data from the database of mycological service were matched with clinical information retrieved from hospitals’ database, from January 1, 1996 to December 31, 2016. Results: Mycologist consultation was obtained in 379/443 identified mushroom poisonings. A remarkable seasonality was found, with significant peak in autumn. Thanks to the collaboration, the implicated species could be identified in 397 cases (89.6%); 108 cases (24.4%) were due to edible mushrooms, Boletus edulis being the most represented (63 cases). Overall, 408 (92%) cases presented with gastrointestinal toxicity. Twenty cases of amatoxin poisoning were recorded (11 Amanita phalloides and 9 Lepiota brunneoincarnata). One liver transplantation was needed. We observed 13 cases of cholinergic toxicity and 2 cases of hallucinogenic toxicity. Finally, 46 cases were due to “mixed” toxicities, and a total of 69 needed hospitalization. Conclusions: Early identification and management of potentially life-threatening cases is challenging in the ED, so that a mycologist service on call is highly advisable, especially during periods characterized by the highest incidence of poisoning.

Life-threatening and major cardiac events during long-distance races: updates from the prospective RACE PARIS registry with a systematic review and meta-analysis

2020 ◽  
pp. 204748732094300
Author(s):  
Benoît Gerardin ◽  
Paul Guedeney ◽  
Anne Bellemain-Appaix ◽  
Thomas Levasseur ◽  
Hazrije Mustafic ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Heat Stroke ◽  
Sudden Cardiac Arrest ◽  
Cardiac Events ◽  
Long Distance ◽  
Exertional Heat Stroke ◽  
Life Threatening ◽  
Long Distance Race

Aims Limited data exist regarding the incidence and aetiology of life-threatening events such as major cardiac events or exertional heat stroke during long-distance races. We aimed to provide an updated incidence, etiology and prognosis of life-threatening events during long-distance races. Methods The prospective RACE PARIS registry recorded all life-threatening events/fatal events occurring during 46 marathons, half-marathons and other long-distance races in the Paris area between 2006 and 2016, comprising 1,073,722 runners. Event characteristics were determined by review of medical records and interviews with survivors. Results The incidence of life-threatening events, exertional heat stroke and major cardiac events was 3.35 per 100,000, 1.02 per 100,000 and 2.33 per 100,000, respectively, including 18 sudden cardiac arrests (1.67 per 100,000). The main aetiology of sudden cardiac arrest was myocardial ischaemia (11/18), due to acute coronary thrombosis (6/11), stable atherosclerotic coronary artery disease (2/11), coronary dissection (1/11), anomalous connection (1/11) or myocardial bridging (1/11). A third of participants with ischaemia-related major cardiac events presented with pre-race clinical symptoms. Major cardiac events were more frequent in the case of a high pollution index (6.78 per 100,000 vs. 2.07 per 100,000, odds ratio 3.27, 95% confidence interval 1.12–9.54). Case fatality was low (0.19 per 100,000). Similarly, we report in a meta-analysis of eight long-distance race registries comprising 16,223,866 runners a low incidence of long-distance race-related sudden cardiac arrest (0.82 per 100,000) and fatality (0.39 per 100,000). Death following sudden cardiac arrest was strongly associated with initial asystole or pulseless rhythm. Conclusion Long-distance race-related life-threatening events remain rare although serious events. Better information for runners on the risk of pre-race clinical symptoms, outside air pollution and temperature may reduce their incidence.

scholarly journals Promoting Best Practices Regarding Exertional Heat Stroke: A Perspective from the Team Physician

2012 ◽  
Vol 7 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Stephanie M. Mazerolle ◽  
Kelly D. Pagnotta ◽  
Lindsey McDowell ◽  
Douglas J Casa ◽  
Lawrence Armstrong
Keyword(s):  
Professional Development ◽  
Best Practices ◽  
Sports Medicine ◽  
Water Immersion ◽  
Skill Training ◽  
Heat Stroke ◽  
Real Life ◽  
Assessment Tools ◽  
Team Physician ◽  
Exertional Heat Stroke

Context: Knowing the team physician's perspective regarding the use of evidence-based practice (EBP) for treatment of exertional heat stroke (EHS) may help increase the number of athletic trainers (ATs) implementing best practices and avoiding the use of improper assessment tools and treatment methods. Objective: To ascertain team physicians' perspectives regarding the AT's use of rectal temperature (Tre) and cold-water immersion (CWI) for recognition and treatment of EHS. Design: Exploratory study using semi-structured focus groups and follow-up telephone interviews. Setting: American College of Sports Medicine Annual meeting. Patients or Other Participants: Thirteen family or internal medicine specialists who were currently serving as the team physician for a college/university or secondary school participated. The mean age was 44 ± 4 with 10 ± 8 years of sports medicine specific experience. Of these, 7 participated in a focus group and 5 completed a telephone interview. Data Collection and Analysis: Data analysis included open coding procedures by a 3-member research team. Credibility was established by member checks and multiple analyst triangulations. Results: Two major themes emerged regarding how ATs could be encouraged to use Tre assessment and CWI in clinical practice: 1) pre-certification and 2) post-certification. Pre-certification included two lower level themes: a) real-life experience and b) skill set mandate. The post-certification theme included one lower theme: professional development. Conclusion: Physicians, in recognition of the dichotomy between best and actual practices, believe that ATs must receive both formal skill training in a structured learning environment and field experience using these methods, and remain current through annual professional development seminars and courses.

scholarly journals Acute liver injury developed during the clinical course of non-exertional heat stroke following a hot spring bath

2013 ◽  
Vol 20 (3) ◽  
pp. 415-416
Author(s):  
Kohki Nishikawa ◽  
Tomoya Ito ◽  
Shigeo Tsuchiya ◽  
Yuki Shimodate ◽  
Michiaki Yamakage
Keyword(s):  
Liver Injury ◽  
Acute Liver Injury ◽  
Clinical Course ◽  
Hot Spring ◽  
Heat Stroke ◽  
Exertional Heat Stroke

scholarly journals Sumag (sulphacetamide) induced allergic reaction, aggravating superficial thrombophlebitis

2020 ◽  
Vol 7 (10) ◽  
pp. 1579
Author(s):  
Dharmendra Jain ◽  
Abhishek Kaushley ◽  
Vaibhav Mishra
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Allergic Reaction ◽  
Early Identification ◽  
Clinical Course ◽  
Superficial Thrombophlebitis ◽  
Management Of Complications ◽  
Life Threatening

Adverse drug reaction (ADR) is not only require early identification of the offending drugs but also requires proper care and management of complications. Also adverse drug reaction need to be differentiated from the problem unrelated to the drug so that needed medications are not unnecessarily stopped. Adverse drug reaction may be unpredictable and represent a life-threatening risk. ADR can also complicate the management of any infection. This case report provide the precise clinical course of a rare ADR.

Fact file 1: Critical care and emergency medicine

2017 ◽  
Author(s):  
Daisy Fancourt
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Sports Medicine ◽  
Orthopaedic Surgery ◽  
Extreme Environment ◽  
Disaster Medicine ◽  
Medical Attention ◽  
Life Threatening ◽  
Medical Disciplines ◽  
The Brain

Emergency medicine involves the care of patients who require immediate medical attention. The specialty encompasses a broad range of medical disciplines, including anaesthesia, cardiology (a field related to the heart), neurology (a field related to the brain), plastic surgery, orthopaedic surgery (surgery relating to the bones or muscles), and cardiothoracic surgery (surgery relating to the heart, chest, or lungs). There are also a number of subspecialties including extreme environment medicine, disaster medicine and sports medicine. Related to emergency medicine is the specialty of critical care medicine, which is concerned with the care of patients with life-threatening conditions often treated in intensive care settings....

scholarly journals A novel chemical biology and computational approach to expedite the discovery of new-generation polymyxins against life-threatening Acinetobacter baumannii

2021 ◽  
Author(s):  
Xukai Jiang ◽  
Nitin A. Patil ◽  
Mohammad A. K. Azad ◽  
Hasini Wickremasinghe ◽  
Heidi Yu ◽  
...  
Keyword(s):  
Public Health ◽  
Chemical Biology ◽  
Multidrug Resistant ◽  
Computational Approach ◽  
Gram Negative Bacteria ◽  
Global Public Health ◽  
Gram Negative ◽  
Life Threatening ◽  
New Generation ◽  
Novel Antibiotics

Multidrug-resistant Gram-negative bacteria have been an urgent threat to global public health. Novel antibiotics are desperately needed to combat these 'superbugs'.

scholarly journals Exertional Heat Stroke Knowledge and Management among Emergency Medical Service Providers

2021 ◽  
Vol 18 (9) ◽  
pp. 5016
Author(s):  
Rebecca Hirschhorn ◽  
Oluwagbemiga DadeMatthews ◽  
JoEllen Sefton
Keyword(s):  
Service Providers ◽  
Heat Stroke ◽  
The United States ◽  
Knowledge Assessment ◽  
Years Of Experience ◽  
Exertional Heat Stroke ◽  
Emergency Medical ◽  
Previously Treated ◽  
Stroke Knowledge ◽  
Cooling Methods

This study evaluated emergency medical services (EMS) providers’ knowledge of exertional heat stroke (EHS) and assessed current EMS capabilities for recognizing and managing EHS. EMS providers currently practicing in the United States were recruited to complete a 25-item questionnaire. There were 216 questionnaire responses (183 complete) representing 28 states. On average, respondents were 42.0 ± 13.0 years old, male (n = 163, 75.5%), and white (n = 176, 81.5%). Most respondents were Paramedics (n = 110, 50.9%) and had ≥16 years of experience (n = 109/214, 50.9%) working in EMS. Fifty-five percent (n = 99/180) of respondents had previously treated a patient with EHS. The average number of correct answers on the knowledge assessment was 2.6 ± 1.2 out of 7 (~37% correct). Temporal (n = 79), tympanic (n = 76), and oral (n = 68) thermometers were the most prevalent methods of temperature assessment available. Chemical cold packs (n = 164) and air conditioning (n = 134) were the most prevalent cooling methods available. Respondents demonstrated poor knowledge regarding EHS despite years of experience, and over half stating they had previously treated EHS in the field. Few EMS providers reported having access to an appropriate method of assessing or cooling a patient with EHS. Updated, evidence-based training needs to be provided and stakeholders should ensure their EMS providers have access to appropriate equipment.

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