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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Symptoms of heat exhaustion include nausea, dizziness, irritability, headache, thirst, weakness, high body temperature, excessive sweating, and decreased urine output.
Common causes of heat exhaustion include:
- Hot, sunny, humid weather
- Physical exertion, especially in hot, humid weather
- Due to impaired thermoregulation, elderly people and infants can get serious heat illness even at rest, if the weather outside is hot and humid, and they are not getting enough cool air.
- Some drugs, such as diuretics, antihistamines, beta-blockers, alcohol, ecstasy, and amphetamines can cause an increase in the risk of heat exhaustion.
Especially during physical exertion, risk factors for heat exhaustion include:
- Wearing dark, padded, or insulated clothing; hats; and/or helmets (for example, football pads or turnout gear)
- Having a higher percentage of body fat
- Dehydration
- Fever
- Some medications, like beta blockers and antipsychotic medicines
A number of heat illnesses exist including:
- Heat stroke - Defined by a body temperature of greater than due to environmental heat exposure with lack of thermoregulation. Symptoms include dry skin, rapid, strong pulse and dizziness.
- Heat exhaustion - Can be a precursor of heatstroke; the symptoms include heavy sweating, rapid breathing and a fast, weak pulse.
- Heat syncope - Fainting or dizziness as a result of overheating.
- Heat edema
- Heat cramps - Muscle pains that happen during heavy exercise in hot weather.
- Heat rash - Skin irritation from excessive sweating.
- Heat tetany - Usually results from short periods of stress in intense heat. Symptoms may include hyperventilation, respiratory problems, numbness or tingling, or muscle spasms.
In humans, hyperthermia is defined as a temperature greater than , depending on the reference used, that occurs without a change in the body's temperature set point.
The normal human body temperature can be as high as in the late afternoon. Hyperthermia requires an elevation from the temperature that would otherwise be expected. Such elevations range from mild to extreme; body temperatures above can be life-threatening.
An early stage of hyperthermia can be "heat exhaustion" (or "heat prostration" or "heat stress"), whose symptoms include heavy sweating, rapid breathing and a fast, weak pulse. If the condition progresses to heat stroke, then hot, dry skin is typical as blood vessels dilate in an attempt to increase heat loss. An inability to cool the body through perspiration may cause the skin to feel dry.
Other signs and symptoms vary. Accompanying dehydration can produce nausea, vomiting, headaches, and low blood pressure and the latter can lead to fainting or dizziness, especially if the standing position is assumed quickly.
In severe heat stroke, there may be confused, hostile, or seemingly intoxicated behavior. Heart rate and respiration rate will increase (tachycardia and tachypnea) as blood pressure drops and the heart attempts to maintain adequate circulation. The decrease in blood pressure can then cause blood vessels to contract reflexively, resulting in a pale or bluish skin color in advanced cases. Young children, in particular, may have seizures. Eventually, organ failure, unconsciousness and death will result.
Signs and symptoms vary depending on the degree of hypothermia, and may be divided by the three stages of severity. Infants with hypothermia may feel cold when touched, with bright red skin and an unusual lack of energy.
Hypothermia is often defined as any body temperature below . With this method it is divided into degrees of severity based on the core temperature.
Another classification system, the Swiss staging system, divides hypothermia based on the presenting symptoms which is preferred when it is not possible to determine an accurate core temperature.
Other cold-related injuries that can be present either alone or in combination with hypothermia include:
- Chilblains: superficial ulcers of the skin that occur when a predisposed individual is repeatedly exposed to cold
- Frostbite: the freezing and destruction of tissue
- Frostnip: a superficial cooling of tissues without cellular destruction
- Trench foot or immersion foot: a condition caused by repetitive exposure to water at non-freezing temperatures
The normal human body temperature is often stated as . Hyperthermia and fever, are defined as a temperature of greater than .
Faintness, dizziness, headache, increased pulse, restlessness, nausea, vomiting, and brief loss of consciousness.
Prevention includes avoiding medications that can increase the risk of heat illness (e.g. antihypertensives, diuretics, and anticholinergics), gradual adjustment to heat, and sufficient fluids and electrolytes.
Occupational heat stress is the net load to which a worker is exposed from the combined contributions of metabolic heat, environmental factors, and clothing worn which results in an increase in heat storage in the body. Heat stress can result in heat-related illnesses, such as heat stroke, hyperthermia, heat exhaustion, heat cramps or heat rashes. Although heat exhaustion is less severe, hyperthermia is a medical emergency and requires emergency treatment, which if not provided can even lead to death.
Heat stress causes illness but also may account for an increase in workplace accidents, and a decrease in worker productivity. Worker injuries attributable to heat include those caused by: sweaty palms, fogged-up safety glasses, and dizziness. Burns may also occur as a result of accidental contact with hot surfaces or steam. In United States, occupational heat stress in becoming more significant as the average temperatures increase but remains overlooked. There are few studies and regulations regarding heat exposure of workers.
The diagnosis of heat syncope is done during a physical examination. During the physical exam the practitioner will test the blood pressure of the patient, and the pulse. If the patient is experiencing heat syncope the blood pressure will be low, and the pulse will be elevated. Observation of excess sweating will also be a key sign. Finally, the practitioner will ask questions figuring out the history of the patient's symptoms. If the patient developed symptoms while engaging in physical activity and high temperatures it will then be a true case of heat syncope.
Heat cramps, a type of heat illness, are muscle spasms that result from loss of large amount of salt and water through exercise. Heat cramps are associated with cramping in the abdomen, arms and calves. This can be caused by inadequate consumption of fluids or electrolytes. Frequently, they don't occur until sometime later, especially at night or when relaxing. Heavy sweating causes heat cramps, especially when the water is replaced without also replacing salt or potassium.
Although heat cramps can be quite painful, they usually don't result in permanent damage, though they can be a symptom of heat stroke or heat exhaustion. Heat cramps can indicate a more severe problem in someone with heart disease or if they last for longer than an hour.
In order to prevent them, one may drink electrolyte solutions such as sports drinks during exercise or strenuous work or eat potassium-rich foods like bananas and apples. When heat cramps occur, the affected person should avoid strenuous work and exercise for several hours to allow for recovery.
The main symptoms of heat stress are perspiration, increased heart rate, and dehydration. Other general symptoms include painful muscle cramps, extreme weakness, nausea, dizziness, headache, breathing fast and clammy, pale, cool, and/or moist skin or red, dry skin.
The most common stress reactions include:
- The slowing of reaction time
- Slowness of thought
- Difficulty prioritizing tasks
- Difficulty initiating routine tasks
- Preoccupation with minor issues and familiar tasks
- Indecision and lack of concentration
- Loss of initiative with fatigue
- Exhaustion
Combat stress reaction symptoms align with the symptoms also found in psychological trauma, which is closely related to post-traumatic stress disorder (PTSD). CSR differs from PTSD (among other things) in that a PTSD diagnosis requires a duration of symptoms over one month, which CSR does not.
Heat urticaria presents within five minutes after the skin has been exposed to heat above 43 degrees Celsius (109.4 degrees Fahrenheit), with the exposed area becoming burned, stinging, and turning red, swollen, and indurated.
The symptoms and signs, as described by physician John Caius and others, were as follows: the disease began very suddenly with a sense of apprehension, followed by cold shivers (sometimes very violent), giddiness, headache, and severe pains in the neck, shoulders and limbs, with great exhaustion. After the cold stage, which might last from half an hour to three hours, the hot and sweating stage followed. The characteristic sweat broke out suddenly without any obvious cause. Accompanying the sweat, or after, was a sense of heat, headache, delirium, rapid pulse, and intense thirst. Palpitation and pain in the heart were frequent symptoms. No skin eruptions were noted by observers including Caius. In the final stages, there was either general exhaustion and collapse, or an irresistible urge to sleep, which Caius thought to be fatal if the patient was permitted to give way to it. One attack did not offer immunity, and some people suffered several bouts before dying. The disease tended to occur in summer and early autumn.
Drug-induced fever is a symptom of an adverse drug reaction wherein the administration of drugs intended to help a patient causes a hypermetabolic state resulting in fever. The drug may interfere with heat dissipation peripherally, increase the rate of metabolism, evoke a cellular or humoral immune response, mimic endogenous pyrogen, or damage tissues.
There are several terms which were in general use, but are no longer recommended.
Drowning is most often quick and unspectacular. Its media depictions as a loud, violent struggle have much more in common with distressed non-swimmers, who may well drown but have not yet begun to do so. In particular, an asphyxiating person is seldom able to call for help. The instinctive drowning response covers many signs or behaviors associated with drowning or near-drowning:
- Head low in the water, mouth at water level
- Head tilted back with mouth open
- Eyes glassy and empty, unable to focus
- Eyes open, with fear evident on the face
- Hyperventilating or gasping
- Trying to swim in a particular direction but not making headway
- Trying to roll over on the back to float
- Uncontrollable movement of arms and legs, rarely out of the water.
Frank Pia, a lifeguard and researcher of rescue techniques and drowning, notes that drowning begins at the point a person is unable to keep their mouth above water; inhalation of water takes place at a later stage. Most people demonstrating the instinctive drowning response do not show obvious prior evidence of distress.
The Dancing Plague (or Dance Epidemic) of 1518 was a case of dancing mania that occurred in Strasbourg, Alsace, (then part of the Holy Roman Empire) in July 1518. Around 400 people took to dancing for days without rest and, over the period of about one month, some of those affected collapsed or even died of heart attack, stroke, or exhaustion.
Grade 1: if there is no initial lesion on the area, no amputation or lasting effects are expected
Grade 2: if there is a lesion on the distal body part, tissue and fingernails can be destroyed
Grade 3: if there is a lesion on the intermediate or near body part, autoamputation and loss of function can occur
Grade 4: if there is a lesion very near the body (such as the carpals of the hand), the limb can be lost. Sepsis and/or other systemic problems are expected.
A number of long term sequelae can occur after frostbite. These include transient or permanent changes in sensation, paresthesia, increased sweating, cancers, and bone destruction/arthritis in the area affected.
Frostbite is when exposure to low temperatures causes freezing of the skin or other tissues. The initial symptom is typically numbness. This may be followed by clumsiness with a white or bluish color to the skin. Swelling or blistering may occur following treatment. The hands, feet, and face are most commonly affected. Complications may include hypothermia or compartment syndrome.
People who are exposed to low temperatures for prolonged periods, such as winter sports enthusiasts, military personnel, and homeless individuals, are at greatest risk. Other risk factors include drinking alcohol, smoking, mental health problems, certain medications, and prior injuries due to cold. The underlying mechanism involves injury from ice crystals and blood clots in small blood vessels following thawing. Diagnosis is based on symptoms. Severity may be divided into superficial (1st and 2nd degree) or deep (3rd and 4th degree). A bone scan or MRI may help in determining the extent of injury.
Prevention is by avoiding low temperatures, proper clothing, maintaining hydration and nutrition, and staying active without becoming exhausted. Treatment is by rewarming. This should only be done when refreezing is not a concern. Rubbing or applying snow to the affected part is not recommended. The use of ibuprofen and tetanus toxoid is typically recommended. For severe injuries iloprost or thrombolytics may be used. Surgery is sometimes necessary. Amputation, however, should generally be delayed for a few months to allow determination of the extent of injury.
The number of cases of frostbite is unknown. Rates may be as high as 40% a year among those who mountaineer. The most common age group affected is those 30 to 50 years old. Evidence of frostbite occurring in people dates back 5,000 years. Frostbite has also played an important role in a number of military conflicts. The first formal description of the condition was in 1814 by Dominique Jean Larrey, a physician in Napoleon's army.
Dancing mania (also known as dancing plague, choreomania, St John's Dance and, historically, St. Vitus's Dance) was a social phenomenon that occurred primarily in mainland Europe between the 14th and 17th centuries. It involved groups of people dancing erratically, sometimes thousands at a time. The mania affected men, women, and children who danced until they collapsed from exhaustion. One of the first major outbreaks was in Aachen, in the Holy Roman Empire, in 1374, and it quickly spread throughout Europe; one particularly notable outbreak occurred in Strasbourg in 1518, also in the Holy Roman Empire.
Affecting thousands of people across several centuries, dancing mania was not an isolated event, and was well documented in contemporary reports. It was nevertheless poorly understood, and remedies were based on guesswork. Generally, musicians accompanied dancers, to help ward off the mania, but this tactic sometimes backfired by encouraging more to join in. There is no consensus among modern-day scholars as to the cause of dancing mania.
The several theories proposed range from religious cults being behind the processions to people dancing to relieve themselves of stress and put the poverty of the period out of their minds. It is, however, thought to have been a mass psychogenic illness in which the occurrence of similar physical symptoms, with no known physical cause, affect a large or small group of people as a form of social influence.
Central nervous system fatigue, or central fatigue, is a form of fatigue that is associated with changes in the synaptic concentration of neurotransmitters within the central nervous system (CNS; including the brain and spinal cord) which affects exercise performance and muscle function and cannot be explained by peripheral factors that affect muscle function. In healthy individuals, central fatigue can occur from prolonged exercise and is associated with neurochemical changes in the brain, primarily involving serotonin (5-HT), noradrenaline, and dopamine. Central fatigue plays an important role in endurance sports and also highlights the importance of proper nutrition in endurance athletes.