Heat disorders are not uncommon in the military society due to supposedly hard training to overcome the environmental conditions. Twenty-two soldiers with heat disorders were admitted to Chin Hae Naval Hospital June 1969 through July 1970. Hoping that our clinical studies on them contribute to a renewed understanding, the results are reported in summary as follows: 1) Heat disorders occurred with an overall incidence of 3.1 per cent during running in early summer. 2) Of the twenty-two patients, eight (37 per cent) had heat cramps, six (27 per cent) heat exhaustion, five(23 per cent) heat stroke, and three(13 per cent) had undetermined disorder. 3) Ten patients(45 per cent) were comatous, and this occurred most frequently(80 per cent) among those with heat stroke. 4) All patients were grouped into four according to their physical status on admission. Those with heat exhaustion mostly belonged to group I (good) or group II (fair). Those with heat stroke and heat cramps eomprised most of group III (poor) and group IV (grave). 5) Group I and II patients recovered within 12 hours; group III, within 12~24 hours; and group IV, required more than 24 hours of care. 6) One patient with heat stroke, graded V, expired with sudden hypothermia 15 hours following admission. Overall mortality of heat disorders was 4.5 per cent, and that of heat stroke 20 per cent. 7) The rest recovered uneventfully within 19 hours of average.
Chin ; Emergencies* ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hope ; Hot Temperature* ; Humans ; Hypothermia ; Incidence ; Military Personnel ; Mortality ; Running

PURPOSE: The aim of this study was to examine characteristics of health-related victims identified through the Surveillance System of Heat-related Illness (SSHI) based on emergency department (ED) visits. METHODS: Between July 1 and September 3 of 2011, 443 heat-related patients were reported by 396 of the 461 EDs participating in the SSHI. Heat-related illness included heat (sun) stroke, heat cramp, heat syncope, and heat exhaustion. A hot day was defined as a day above 30degrees C of daily maximum temperature in locations of provincial and metropolitan government offices. We used chi square test for identification of risk factors associated with Heat-related illness in the workplace and heat-related illness heat (sun) stroke. RESULTS: Heatwave, defined as lasting three or more hot days, occurred three times during this period. The daily average number of heat-related patients reported during the heatwave period was 15.7 per day, more than four times the usual rate. The daily maximum temperature showed positive correlation with occurrence of heat-related illness. Heat exhaustion was the most frequent cause (46.0%), with approximately 70% of all cases occurring between noon and 6 p.m. The number of people suffering from heat-related illness while outdoors was three times greater than that of those who experienced it indoors. Work-related occurrence comprised 56.7% of all cases. All six deaths occurred during the heatwave period and were work-related. CONCLUSION: Working conditions, outdoor activities, and old age may be associated with health-related illnesses. A surveillance system that monitors emergency room visits may be useful in assessment of adverse health effects of summer heatwaves.
Climate Change ; Emergencies ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hot Temperature ; Humans ; Infrared Rays ; Korea ; Local Government ; Risk Factors ; Stress, Psychological ; Syncope

PURPOSE: To evaluate the effect of heat wave on emergency department (ED) visits due to heat related illness, we developed an ED based active surveillance system. We want to identify epidemiology of ED visits due to heat related illness and determine the effect of heat index on daily ED visits due to heat related illness. METHODS: We developed an ED based active surveillance system for adults who visited the ED due to heat stroke, heat exhaustion, heat syncope, heat edema, and heat cramp. We collected demographic and clinical variables, risk factors, and heat index by standardized registry on the webpage. We operated the surveillance into 16 emergency departments in Daegu City from June to September 2011. We analyzed epidemiologic variables descriptively and assessed the effect of heat index on the number of daily ED visits by multivariate Poisson regression analysis. RESULTS: During the study period, 34 cases were registered and nine cases were heat stroke. Heat stroke patients were older, and had more unemployment status than those with other heat related illness (p<0.05). More ED visits due to heat related illness were observed during the danger period than during the cool period, classified by heat index severity (Adjusted odds ratio: 1.72, 95% CI: 1.33-2.23). Increasing heat index by one degree caused more ED visits due to heat related illness (Adjusted incident rate ratio: 1.13, 95% CI: 1.07-1.19). CONCLUSION: We developed an ED based active surveillance system and observed more elderly persons and lower educational level in patients with heat stroke. In addition, increase in heat index significantly affected more daily ED visits due to heat related illness.
Adult ; Aged ; Daegu ; Edema ; Emergency Service, Hospital* ; Epidemiology ; Extreme Heat ; Heat Exhaustion ; Heat Stress Disorders ; Heat Stroke ; Hot Temperature* ; Humans ; Infrared Rays ; Odds Ratio ; Public Health Surveillance ; Risk Factors ; Syncope ; Unemployment

Within the global warming context, heat stroke heavily threatens human health as the most severe type of heat-related illnesses. Despite the urgent onset, severe condition and poor prognosis, heat stroke is entirely preventable and treatable. Most of the recipient countries of Chinese foreign medical aid work are concentrated in the tropical and subtropical regions. It is necessary to popularize the knowledge of heat stroke and improve the ability of diagnose and treatment among foreign medical aid members, which is critical to enhance the quality of medical service and provide better medical care for recipient countries and workers in Chinese-funded institutions. This article reviews the latest research progress in the epidemiology, pathophysiology, diagnosis, and treatment of heat stroke to provide scientific reference for actively implementing interventions and reducing morbidity and mortality.
China ; Global Warming ; Heat Stress Disorders/therapy* ; Heat Stroke/prevention & control* ; Humans ; Morbidity

Heat stroke is defined as a core body temperature that rises above 40 degrees C accompanied by central nervous system abnormalities such delirium, convulsions or coma. Despite treatment with optimal cooling, heat stroke causes deaths by complications including rhabdomyolysis, renal failure, hepatic dysfunction, disseminated intravascular coagulation syndrome, acute respiratory distress syndrome, bowel ischemia, myocardial injury, and multiple organ failure. In some cases of survival, heat stroke it can cause irreversible CNS damage. Therefore, if exertional heat stroke is properly diagnosed in the emergency room, we must initiate early and aggressive treatment in order to prevent the multiorgan failure and high mortality associated with this condition. To our knowledge, case reports in the literature are rare describing that patients with multiple organ dysfunction and fulminant pneumonia following exertional heat stroke. This study reports on a relevant case, as well as findingsfrom the literature. The case history is presented of a 20- year-old man who presented with exertional heat stroke with sustained hyperpyrexia ongoing after the first day of admission despite optimal treatment including intensive fluid resuscitation. On the 3rd day of admission, chest infiltrated lesions were discovered. From the high-resolution computed tomography results, multifocal consolidations were discovered in both lungs. Blood cultures revealed Staphylococcus hominis. Treatment with proper antibiotics was begun after identifying the blood culture. The patient fully recovered and was discharged on the 10th day after admission.
Anti-Bacterial Agents ; Body Temperature ; Central Nervous System ; Coma ; Delirium ; Disseminated Intravascular Coagulation ; Emergencies ; Heat Stress Disorders ; Heat Stroke ; Hot Temperature ; Humans ; Lung ; Multiple Organ Failure ; Myocardial Ischemia ; Pneumonia ; Renal Insufficiency ; Respiratory Distress Syndrome, Adult ; Resuscitation ; Rhabdomyolysis ; Seizures ; Staphylococcus hominis ; Thorax

Heat Stress Disorders ; etiology ; Humans ; Mining ; Occupational Diseases

To determine heat-shock protein (Hsp)90 expression is connected with cellular apoptotic response to heat stress and its mechanism, chicken (Gallus gallus) primary myocardial cells were treated with the Hsp90 promoter, aspirin, and its inhibitor, geldanamycin (GA), before heat stress. Cellular viability, heat-stressed apoptosis and reactive oxygen species level under different treatments were measured, and the expression of key proteins of the signaling pathway related to Hsp90 and their colocalization with Hsp90 were detected. The results showed that aspirin treatment increased the expression of protein kinase B (Akt), the signal transducer and activator of transcription (STAT)-3 and p-IKKα/β and the colocalization of Akt and STAT-3 with Hsp90 during heat stress, which was accompanied by improved viability and low apoptosis. GA significantly inhibited Akt expression and p-IKKα/β level, but not STAT-3 quantity, while the colocalization of Akt and STAT-3 with Hsp90 was weakened, followed by lower cell viability and higher apoptosis. Aspirin after GA treatment partially improved the stress response and apoptosis rate of tested cells caused by the recovery of Akt expression and colocalization, rather than the level of STAT-3 (including its co-localization with Hsp90) and p-IKKα/β. Therefore, Hsp90 expression has a positive effect on cellular capacity to resist heat-stressed injury and apoptosis. Moreover, inhibition of Hsp90 before stress partially attenuated its positive effects.
Apoptosis* ; Aspirin ; Cell Survival ; Chickens* ; Heat Stress Disorders ; Heat-Shock Proteins* ; Hot Temperature* ; HSP90 Heat-Shock Proteins ; In Vitro Techniques* ; Proto-Oncogene Proteins c-akt ; Reactive Oxygen Species ; Transducers

OBJECTIVETo demonstrate changes in different frequencies of cerebral electrical activity or electroencephalogram (EEG) following exposure to high environmental heat in three different age groups of freely moving' rats.

METHODSRats were divided into three groups (i) acute heat stress--subjected to a single exposure for four hours at 38 degrees C; (ii) chronic heat stress--exposed for 21 days daily for one hour at 38 degrees C, and (iii) handling control groups. The digital polygraphic sleep-EEG recordings were performed just after the heat exposure from acute stressed rats and on 22nd day from chronic stressed rats by simultaneous recording of cortical EEG, EOG (electrooculogram), and EMG (electromyogram). Further, power spectrum analyses were performed to analyze the effects of heat stress.

RESULTSThe frequency analysis of EEG signals following exposure to high environmental heat revealed that in all three age groups of rats, changes in higher frequency components (beta 2) were significant in all sleep-wake states following both acute and chronic heat stress conditions. After exposure to acute heat, significant changes in EEG frequencies with respect to their control groups were observed, which were reversed partly or fully in four hours of EEG recording. On the other hand, due to repetitive chronic exposure to hot environment, adaptive and long-term changes in EEG frequency patterns were observed.

CONCLUSIONThe present study has exhibited that the cortical EEG is sensitive to environmental heat and alterations in EEG frequencies in different sleep-wake states due to heat stress can be differentiated efficiently by EEG power spectrum analysis.

China ; Environmental Exposure ; Heat Stress Disorders ; prevention & control ; Industry ; Occupational Health ; Temperature ; Workplace

BACKGROUND: Although age and regional climate are considered to have effects on the incidence ratio of heat-related illness, quantitative estimation of age or region on the effect of occurring temperature for heat stroke is limited. METHODS: By utilizing data on the number of daily heat-related ambulance transport (HAT) in each of three age groups (7-17, 18-64, 65 years old, or older) and 47 prefectures in Japan, and daily maximum temperature (DMT) or Wet Bulb Globe Temperature (DMW) of each prefecture for the summer season, the effects of age and region on heat-related illness were studied. Two-way ANOVA was used to analyze the significance of the effect of age and 10 regions in Japan on HAT. The population-weighted average of DMT or DMW measured at weather stations in each prefecture was used as DMT or DMW for each prefecture. DMT or DMW when HAT is one in 100,000 people (T RESULTS: HAT of each age category and prefecture was plotted nearly on the exponential function of corresponding DMT or DMW. Average R CONCLUSIONS Age and regional differences affected the incidence of HAT. Thus, it is recommended that public prevention measures for heat-related disorders take into consideration age and regional variability.
Adult ; Aged ; Ambulances ; Child ; Heat Stress Disorders/epidemiology* ; Hot Temperature ; Humans ; Incidence ; Temperature