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A Preclinical Model of Exertional Heat Stroke in Mice
Published on: July 1, 2021
Exertional Heat Illness Complications and Prognosis Among Service Members
Josh B Kazman1, D Alan Nelson, Anwar Ahmed
1From the Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland (J.B.K., D.A.N., F.G.O., P.A.D.); School of Health Professions, University of Texas Health Science Center at San Antonio, San Antonio (D.A.N.); Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland (J.B.K.); Department of Clinical Investigation, Womack Army Medical Center, Fort Bragg, North Carolina (J.B.K.); and Department of Preventive Medicine and Biostatistics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland (J.B.K., A.A., J.M., S.L.).
Objective:
The aim of this study was to examine exertional heat illness (EHI) complications and their associations with post-EHI outcomes.
Methods:
In a retrospective cohort of 24,121 service members (SM) with first-time EHI in 2012 to 2022, we analyzed six EHI complications: rhabdomyolysis, acute kidney injury (AKI), neurological symptoms, acidosis, respiratory/cardiovascular distress, and other organ damage. Post-EHI outcomes included medical military separation and chronic diseases.
Results:
Using clustering, SMs were placed into six clusters based on patterns of complications: mild (81%; no complications), AKI/no rhabdomyolysis (5%), rhabdomyolysis/no AKI (6%), rhabdomyolysis/AKI (5%), and neurological symptoms (2%). AKI and/or rhabdomyolysis clusters were associated with being male, being obese, no chronic conditions, reduced medical separation risk, and increased AKI risk; the smaller neurological cluster had more females, chronic conditions, and separation risk.
Conclusion:
EHI clusters have differential associations with both pre-EHI demographics/history and post-EHI outcomes.
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An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
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Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
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