The roles of exercise-induced immune system disturbances in the pathology of heat stroke - The dual pathway model of heat stroke

Heat stroke is a life-threatening condition that can be fatal if not appropriately managed. Although heat stroke has been recognised as a medical condition for centuries, a universally accepted definition of heat stroke is lacking and the pathology of heat stroke is not fully understood. Information derived from autopsy reports and the clinical presentation of patients with heat stroke indicates that hyperthermia, septicaemia, central nervous system impairment and cardiovascular failure play important roles in the pathology of heat stroke. The current models of heat stroke advocate that heat stroke is triggered by hyperthermia but is driven by endotoxaemia. Endotoxaemia triggers the systemic inflammatory response, which can lead to systemic coagulation and haemorrhage, necrosis, cell death and multi-organ failure. However, the current heat stroke models cannot fully explain the discrepancies in high core temperature (Tc) as a trigger of heat stroke within and between individuals. Research on the concept of critical Tc: as a limitation to endurance exercise implies that a high Tc may function as a signal to trigger the protective mechanisms against heat stroke. Athletes undergoing a period of intense training are subjected to a variety of immune and gastrointestinal (GI) disturbances. The immune disturbances include the suppression of immune cells and their functions, suppression of cell-mediated immunity, translocation of lipopolysaccharide (LPS), suppression of anti-LPS antibodies, increased macrophage activity due to muscle tissue damage, and increased concentration of circulating inflammatory and pyrogenic cytokines. Common symptoms of exercise-induced GI disturbances include diarrhoea, vomiting, gastrointestinal bleeding, and cramps, which may increase gut-related LPS translocation. This article discusses the current evidence that supports the argument that these exercise-induced immune and GI disturbances may contribute to the development of endotoxaemia and heat stroke. When endotoxaemia can be tolerated or prevented, continuing exercise and heat exposure will elevate Tc to a higher level (> 42 degrees C), where heat stroke may occur through the direct thermal effects of heat on organ tissues and cells. We also discuss the evidence suggesting that heat stroke may occur through endotoxaemia (heat sepsis), the primary pathway of heat stroke, or hyperthermia, the secondary pathway of heat stroke. The existence of these two pathways of heat stroke and the contribution of exercise-induced immune and GI disturbances in the primary pathway of heat stroke are illustrated in the dual pathway model of heat stroke. This model of heat stroke suggests that prolonged intense exercise suppresses anti-LPS mechanisms, and promotes inflammatory and pyrogenic activities in the pathway of heat stroke.

Drifting blooms of the endemic filamentous brown alga Hincksia sordida at Noosa on the subtropical east Australian coast

Since 2002, the usually uncommon endemic filamentous brown alga Hincksia sordida (Harvey) Silva (Ectocarpales, Phaeophyta) has formed nuisance blooms annually during spring/early summer at Main Beach, Noosa on the subtropical east Australian coast. The Hincksia bloom coincides with the normally intensive recreational use of the popular bathing beach by the local population and tourists. The alga forms dense accumulations in the surf zone at Main Beach, giving the seawater a distinct brown coloration and deterring swimmers from entering the water. Decomposing algae stranded by receding tides emit a nauseating sulphurous stench which hangs over the beach. The stranded algal biomass is removed from the beach by bulldozers. During blooms, the usually crowded Main Beach is deserted, bathers preferring to use the many unaffected beaches on the Sunshine Coast to the south of Main Beach. The bloom worsens with north-easterly winds and is cleared from Noosa by south easterly winds, observations which have prompted the untenable proposal by local authorities that the bloom is forming offshore of Fraser Island in the South Pacific Ocean. The Noosa River estuarine system/Laguna Bay is the more probable source of the bloom and the nutrient inputs into this system must be substantial to generate the high bloom biomass. Current mitigation procedures of removing the blooming alga off the beach with bulldozers treat the symptom, not the cause and are proving ineffective. Environmental management must be based on science and the Noosa bloom would benefit greatly from the accurate ecological data on which to base management options. (c) 2006 Elsevier Ltd. All rights reserved.

The development of a new measure of quality of life for children with congenital cardiac disease

The purpose of the study was to develop a questionnaire measuring health-related R1 quality of life for children and adolescents with congenital heart disease, the ConQol, that would have both clinical and research applications. We describe here the process of construction of a questionnaire, the piloting and the development of a weighted scoring system, and data on the psychometric performance of the measure in a sample of 640 children and young people recruited via 6 regional centres for paediatric cardiology from across the United Kingdom. The ConQol has two versions, one designed for children aged from 8 to 11 years, and the other for young people aged from 12 to 16 years. Initial findings suggest that it is a valid and reliable instrument, is acceptable to respondents, and is simple to administer in both a research and clinical context.

Clay mineralogical and isotopic (K-Ar, delta O-18, delta D) constraints on the evolution of the North Anatolian Fault Zone, Turkey

This study presents the first attempt to constrain the evolution of the North Anatolian Fault Zone (NAFZ) by age dating and isotope tracing of clay minerals formed during near-surface faulting. Extensive illitic clay mineralisation occurred along the NAFZ related to hydrothermal alteration of the fault gouges and pseudotachylytes. Samples representing the pre-fault protoliths outside the fault zone do not contain authigenic illitic clay minerals indicating that hydrothermal processes were confined to the areas within the fault zone. K-Ar age data indicate that the hydrothermal system and the associated illite authigenesis initiated at similar to 57 Ma. This process is interpreted to reflect the onset of significant strike-slip or transtensional faulting immediately after the continental collision related to the closure of the Neotethys Ocean. Following the initiation of the fault movements in the latest Paleocene-Early Eocene, displacements along the NAFZ have continued, with probably intensified fault activities at similar to 26 Ma and later than similar to 8 Ma. Oxygen isotope compositions of the illitic clays from different locations along the NAFZ are similar, with narrow ranges in delta O-18 values indicating clay precipitation from fluids with similar oxygen isotope compositions and crystallisation temperatures. The delta O-18 and delta D values of the calculated fluid isotopic composition (delta O-18=5.9 parts per thousand to 11.2 parts per thousand, delta D=-59 parts per thousand to -73 parts per thousand) are consistent with metamorphic and magmatic origin of fluids mobilised during active tectonism. The interpretation of the fluid flow history of the NAFZ is in agreement with that reported previously for some well-known large-scale high-angle fault zones, which similarly developed along collisional-type orogenic belts and are commonly associated with significant mesothermal ore mineralisation. (c) 2005 Elsevier B.V. All rights reserved.