Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392674 (exhaustion)
 13,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hazards experienced by fun runners in Sydney's The Sun City-to-Surf run are principally physical, environmental and medical. The organizers of the event, advised by a representative of the Australian Sports Medicine Federation (N.S.W.), have progressively increased the implementation of the recommendations which were made after the inaugural run in 1971 in the areas of improved organization, competitor education, medical support, recording of competitor data, and conducting the event in cool weather. To ensure the maximum safety of the runners, the number of whom has increased from approximately 1650 in 1971 to 16200 in 1979, additional measurees have been taken. These were (i) the introduction of "spotters" with experience in sports medicine to identify and advise exhausted runners before they collapse; (ii) staffing the run's medical centre with medical and nursing specialists in intensive care; (iii) improved management of heat exhaustion; and (iv) conducting education seminars after the run to make recommendations for improving subsequent events. Since 1971, there has been a progressive reduction in the number of casualties. The incidence of casualties treated in the medical centre fell from 1.76% in 1971 to 0.1% in 1979; and the incidence of those requiring further treatment in hospital fell from 0.42% in 1971 to 0.01% in 1979. None of the participants had suffered severe complications of heat exhaustion. Improvements in the management of heat exhaustion (the most common cause of collapse) which made the use of iced water (hiterto traditional method of cooling casualties with hyperthermia) unnecessary have reduced the risk of using electrical equipment in wet surroundings. The over-all reduction in the incidence and morbidity of collapse casualties is due to a combination of factors. These factors and possibilities of further reduction of hazards are discussed.
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PMID:Reducing the hazards in Sydney's the Sun City-to-Surf runs, 1971 to 1979. 52 71

Heat exhaustion (collapse with rectal temperature of, or higher than 38 degrees C) is the most common major medical complication of fun runs and is caused by dehydration and impaired heat loss with, or without, hypoglycaemia. All patients with heat exhaustion after the City-to-Surf runs from 1977 to 1979 were managed in a medical centre established at the finish of the course. Several methods of management of heat exhaustion are evaluated. Patients were allocated retrospectively to four primary treatment groups: (i) treated with ice-wet towels only; (ii) treated with ice-wet towels and intravenously administered fluids; (iii) treated with intravenously administered fluids and ice-cold packs applied to the neck, axillae, and groins; and (iv) treated with intravenously administered fluids only. There was no death or prolonged morbidity in any treatment group. In Group 1 (n=11), the mean initial rectal temperature was 40.2 +/- 1.5 degrees C. There were insufficient data to assess the mean time taken for the temperature to fall to 38 degrees C. In Group 2(n=16), the mean initial rectal temperature was higher than 40.9 +/- 1.1 degrees C. In three patients, the temperature failed to fall to 38 degrees C within 90 minutes. For the remainder, the mean time taken for the temperature to fall to 38 degrees C was 30 minutes. In Group 3 (n=16), the mean initial rectum temperature was higher than 41.2 +/- 1.0 degrees C. One patient, who had been febrile immediately before the run, was discharged with a temperature of 38.8 degrees C. For the remainder, the mean time taken for the temperature to fall to 38 degrees C was 36 +/- 10 minutes. In Group 4 (n=13), the mean initial rectal temperature was 39.6 +/- 1.1 degrees C and the mean time taken for the temperature to fall to 38 degrees C was 21 +/- 16 minutes. Heat exhaustion in fun-run casualties may be safely and effectively treated by rapid intravenous infusion of fluids with, or without, application of cold packs to the neck, axillae, and groins. The application of ice-wet towels is contraindicated.
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PMID:Management of heat exhaustion in Sydney's the Sun City-to-Surf run runners. 52 72

Hamsters exposed to short days undergo gonadal collapse followed by recrudescence and insensitivity to the regressive effects of such photoperiods. This refractoriness may be due to exhaustion of the pineal gland or desensitization of its target. Hamsters whose gonads had spontaneously recrudesced were injected with melatonin (25 micrograms per injection) once daily (known to induce regression in intact hamsters) or twice daily (reported to arrest reproduction in pinealectomized hamsters) for 7 weeks. In neither case did refractory hamsters respond to melatonin treatment. The gonads of intact hamsters treated with melatonin for 21 weeks regressed and spontaneously recrudesced along a normal time course. These results indicate that gonadal refractoriness is due to insensitivity of the target tissues of the pineal gland and imply that melantonin participates in photoperiodic regulation of reproduction in the golden hamster.
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PMID:Hamster refractoriness: the role of insensitivity of pineal target tissues. 56 11

One of the most important nutritional goals amongst athletes is to maintain adequate energy and fluid balance, since these are subject to relatively rapid changes and are directly related to performance and health. This may especially be the case when exercise intensity is high. Furthermore, when due to exercise and environmental stress food and fluid intake become depressed. In such conditions there may be a dramatic increase in the utilization of carbohydrate (CHO), fluid, and in some instances protein. These increased requirements may then not be covered. Insufficient replacement of CHO may lead to hypoglycemia, altered protein metabolism, central fatigue and exhaustion. Large sweat losses may pose a risk to health by inducing severe dehydration, impaired blood circulation and heat transfer, leading to heat exhaustion and collapse. Inadequate CHO and protein intake leads to a negative nitrogen balance, which over the long term will lead to a loss of muscle mass. In the scope of this presentation we will refer to the most important nutritional factors which are known to affect performance over a short term, at sea level and altitude.
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PMID:Nutritional aspects of health and performance at lowland and altitude. 148 43

Metabolic fatigue is a characteristic muscle response to intense exercise that has outstripped the rate of ATP replacement. The accumulation of metabolic by-products, namely hydrogen ions and diprotonated phosphate, interferes with actin-myosin interaction, effectively preserving muscle ATP levels by preventing further ATP hydrolysis. Muscle force and metabolite concentrations return to normal in about 5 minutes. Less intense exercise causes a more subtle, non-metabolic fatigue due to a still-undefined disturbance of excitation-contraction coupling, which can last for several hours. In this type of fatigue, greater effort is required to generate submaximal forces. Endurance exercise is mainly limited by the size of muscle glycogen stores and how efficiently they are used. Endurance training permits an athlete to work aerobically at high rates, consuming a mixture of lipid and carbohydrate fuels. When muscle glycogen is used up, exercise can only continue at the relatively low rate supportable by lipid metabolism. Anaerobic exercise is also limited by subjective factors such as dyspnoea and muscle pain, which have objective determinants. Extremely prolonged exercise can lead to general collapse because of dehydration, hyperthermia, or hypoglycaemia. None of these factors explains the phenomenon of asthenia, a subjective sense of exhaustion that produces no objective impairment of physical performance. The metabolic myopathies are experiments of nature that promise to shed new light on the biochemical basis of muscle fatigue. This will require quantitative studies of the kind provided by topical magnetic resonance spectroscopy, correlating physiology and metabolism in vivo.
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PMID:Muscle metabolism during fatigue and work. 226 24

Exertional heatstroke (EH) occurs when heat production, generated by muscular exercise, exceeds the body's heat dissipation capacities. This illness has been reported among young, active individuals, laborers, and religious pilgrims. Although EH includes a rectal temperature above 39.5 degrees C (depending on the timing of the measurement) and elevation of serum enzymes, altered mental status is the universally accepted sign which distinguishes EH from heat exhaustion. Once EH is suspected, cooling therapy should be initiated immediately and investigation of multiple-system involvement should be undertaken. Delay in diagnosis occurs more commonly in moderate environments, when suspicion of EH is low. Complications of EH include the central nervous, cardiovascular, pulmonary, and gastrointestinal systems, often with renal and hematologic involvement. Treatment at the point of collapse should focus on clearing the airway, measurement of rectal temperature, whole body cooling, intravenous therapy, and prompt evacuation. Hospital treatment should emphasize whole body cooling, control of convulsions, monitoring of acid-base status, cardiac function, and renal function. The incidence of EH has been reduced markedly in Israel, by using the following simple guidelines: rest periods during exercise in heat, medical monitoring of strenuous activities, use of meteorological indices, and evaluation of medical history.
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PMID:Field and clinical observations of exertional heat stroke patients. 240 46

A time course study was conducted to investigate the possibility of a relationship between fiber degeneration and glycogen depletion in chronically nerve-stimulated extensor digitorum longus muscle of the rabbit. Muscles were stimulated 12 h daily at 10 Hz using alternating one-hour periods of stimulation and rest. When measured for the first time after 3 h (1 h stimulation, 1 h rest, 1 h stimulation), microphotometry revealed complete glycogen depletion of all fiber types (fast glycolytic, FG; fast oxidative glycolytic, FOG; slow oxidative, SO). Different responses were noted beginning at day 4. At this time point, all FOG and SO fibers recovered their glycogen stores with some of the FOG population attaining levels higher than the FOG fibers in the unstimulated, contralateral muscle. Approximately 28% of the FG fibers recovered to normal glycogen values, whereas 58% remained depleted and 14% displayed "overshooting glycogen" levels. Fifteen percent of all fibers were glycogen-depleted after 12 days of stimulation. At this time, classic fiber types could no longer be distinguished. Fiber degeneration, which was recognized by the invasion of nonmuscle cells, began after 6 days and was restricted to the glycogen-depleted fibers. By this time, there was also a significant increase in DNA content. Exhaustion of glycogen, the main fuel of the FG fibers, is believed to cause a collapse of energy-supply and ATP-driven ionic pumps. The latter could be the initial step of fiber deterioration.
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PMID:The time course of glycogen depletion in single fibers of chronically stimulated rabbit fast-twitch muscle. 358 52

This article is an attempt to review and to discuss critically the pros and cons of physical stress to which a pregnant woman is subjected by sports activities or by travel. The review is based on theoretical considerations as communicated in the article as well as on facts derived from casual observations or systematic studies. Besides the subjective feeling of well-being of the pregnant woman associated with sports activities, objective data favour the preservation or enhancement of fitness by training during pregnancy; other factors in favour of physical load, and the capacity to sustain such load, are the positive reports on the course of pregnancy, on birth, and on the influence exercised on the child by the sports activities of the pregnant mother, the often-quoted experiences collected during sports activities of competitive sportswomen who are pregnant, and the behaviour of pregnant animals. Risks consist in an increased danger of traumatization of mother and foetus resulting from certain types of sports requiring maintenance of balance or sudden changes of movement. Hyperthermia should be avoided, for example, excessively long-lasting sauna baths, or physical activity associated with high stress, such as marathon running, because thermoregulation is hampered during pregnancy in such a way that blood flow of the uterus is affected; besides, there is also the risk of teratogenic effects during the early stages of pregnancy. Excess physical stress leading to exhaustion of the pregnant woman (in animal experiments, in circulatory collapse) definitely exercises an adverse effect on the foetus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Travel, sports and pregnancy]. 384 92

The modes of presentation and the management of acute respiratory failure in 11 infants with severe lower respiratory tract infections (due to respiratory syncytial virus in eight) are described. Progressive respiratory difficulties leading to exhaustion, peripheral circulatory collapse, recurrent apnoeic attacks, or generalized convulsions were the main clinical presentations resulting in severe ventilatory failure. In nine infants preventilation carbon dioxide tensions exceeded 65 mm Hg. It seems likely that the use of intermittent positive-pressure ventilation in these patients contributed to the low mortality rate, less than 0.5%, from such illnesses during the 15-month study period.
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PMID:Acute respiratory failure in bronchiolitis and pneumonia in infancy. Modes of presentation and treatment. 436 23

The surface monolayer theory of Clements was tested on open surface films of calf lung surfactant extract in a leak-free vertical film surface balance in which alveolar area (A) changes in each lung zone were simulated in accordance with the theory. We found that: 1) physiologically necessary low surface tension (gamma), < 4 dyn/cm, was sustained only by continuous film compression ("expiration"); 2) compression from A equivalent to total lung capacity to functional residual capacity produced fleeting gamma reduction in all zones and quick reversal to high gamma with A changes that simulated tidal volume (VT) breathing at both 14 (adult) and 40 (neonatal) cpm; 3) phase differences between gamma and A axes of VT loops that indicate mixed surface film composition may be attributable to film inertia and viscoelasticity; 4) estimated alveolar retraction pressure due to gamma (P gamma) exceeds "net" transpulmonary pressure, i.e., favors alveolar collapse, under virtually all conditions of the theory in all zones; 5) return to transient, fleeting low gamma in successive VT cycles was determined by the inherent difference in compression and decompression rates, which results in exhaustion of available A in very few cycles; 6) the "sigh", which restores stable low gamma according to the theory, actually produced unstable high gamma during virtually all phases of the maneuver. In contrast, closed bubble films of the surfactant were structurally stable and produce stable near 0 gamma and P gamma.
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PMID:Surface biophysics of the surface monolayer theory is incompatible with regional lung function. 778 49


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