2019
DOI: 10.1152/japplphysiol.00452.2019
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Abstract: During the past several decades, the incidence of exertional heat stroke (EHS) has increased dramatically. Despite an improved understanding of this syndrome, numerous controversies still exist within the scientific and health professions regarding diagnosis, pathophysiology, risk factors, treatment, and return to physical activity. This review examines the following eight controversies: 1) reliance on core temperature for diagnosing and assessing severity of EHS; 2) hypothalamic damage induces heat stroke and… Show more

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Cited by 62 publications
(70 citation statements)
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“…Perceptual cooling via menthol should not be seen as an alternative to thermal cooling based on the potential to induce reductions in perceived temperature. Menthol does not appear to offer any enhanced heat loss properties, despite acting upon smooth muscle, and thus, in scenarios where reducing the physiological temperature of an individual is required, well-rehearsed recommended strategies for performance enhancement [ 62 , 68 ] and treatment of heat illness [ 15 , 46 ] should be implemented.…”
Section: Discussionmentioning
confidence: 99%
“…Perceptual cooling via menthol should not be seen as an alternative to thermal cooling based on the potential to induce reductions in perceived temperature. Menthol does not appear to offer any enhanced heat loss properties, despite acting upon smooth muscle, and thus, in scenarios where reducing the physiological temperature of an individual is required, well-rehearsed recommended strategies for performance enhancement [ 62 , 68 ] and treatment of heat illness [ 15 , 46 ] should be implemented.…”
Section: Discussionmentioning
confidence: 99%
“…Physically active individuals are known to prophylactically take NSAIDs in an attempt to blunt pain and inflammation during exercise, and controversy exists as to whether individuals may also use NSAIDs to try to mitigate core temperature (Tc) increases during exercise. 6 Theoretically, NSAIDs’ may prevent exertional hyperthermia, including exertional heat stroke (EHS), via their anti-pyretic effect. 6 It is important to briefly mention EHS pathophysiology to understand how NSAIDs may positively or negatively alter Tc and exertional heat illness risk.…”
Section: Introductionmentioning
confidence: 99%
“…Exertional heat stroke (EHS) is a life-threatening medical condition involving total thermoregulatory failure, which is the most severe condition along a continuum of heat-related illnesses [1]. Although anecdotal records have documented mortality from EHS as far back as biblical times [2,3], to the present day, EHS still has no universal medical definition [4]. Instead, the most popular definitions broadly outline characteristic patient symptoms at time of clinical admission [5].…”
Section: Introductionmentioning
confidence: 99%
“…In healthy individuals, the GI tract is largely effective in preventing GI microbial translocation (MT) into the systemic circulation [40], however, growing evidence hypothesises a fundamental role of GI MT within the pathophysiology of EHS [36,37]. The focus of this review is to evaluate: (1) the GI paradigm of EHS; (2) GI barrier integrity assessment techniques; (3) typical GI barrier integrity responses to exertional-heat stress; (4) the aetiology of GI barrier integrity loss; and (5) nutritional countermeasures to support GI barrier integrity during exertional-heat stress.…”
Section: Introductionmentioning
confidence: 99%