Search Results (26)

Wilderness medicine is a rapidly evolving field and has benefited from expanded research efforts. Moreover, with an escalating occurrence of severe and cataclysmic global climatologic events, human illness arising from interaction with wilderness and recreational environments warrants increasing consideration. Within the last decade, the Wilderness Medical Society (WMS) has aggregated research findings and created guidelines on prevention measures and therapeutic options for acute altitude illness, frostbite injuries, and avalanche and non-avalanche snow burials. As new research emerges, some guidelines have been updated to reflect the most current and sound scientific conclusions. In this review, we have synthesized the evidence-based guidelines and have reviewed the quality of the guidelines according to the Appraisal of Guidelines for Research and Evaluation (AGREE) II framework. Further research efforts can expand the scope of evidence-based practice in travel medicine and ideally standardize the implementation of recommendations within both pre-travel and post-travel medical practices. Full article

Fibromyalgia is a chronic illness usually accompanied by long-lasting, general pain throughout the body, often accompanied by anxiety, depression, fatigue, and sleep disruption. Meanwhile, doctors and scientists have not entirely discovered detailed mechanisms; patients always have an exaggerated sensation to pervasive pain without satisfied medical service. Given the lack of knowledge on its underlying mechanism, current treatments aim to provide pain and/or symptom relief. The present study aimed to clarify the role of cannabinoid receptor 1 (CB1) signaling in a mouse fibromyalgia pain model. To develop the mouse fibromyalgia model, mice were subjected to intermittent cold stress (ICS). Our results indicated that mechanical (2.09 ± 0.09 g) and thermal hyperalgesia (4.77 ± 0.29 s), which were evaluated by von Frey and Hargraves’ tests, were induced by ICS, suggesting successful modeling. The hurting replies were then provoked by electroacupuncture (EA) but not for sham EA mice. Further, in a Western blot analysis, we found significantly decreased CB1 protein levels in the thalamus, somatosensory cortex, and anterior cingulate cortex. In addition, the levels of pain-related protein kinases and transcription factor were increased. Treatment with EA reliably increased CB1 expression in various brain regions sequentially alleviated by nociceptive mediators. Furthermore, the administration of a CB1 agonist significantly attenuated fibromyalgia pain, reversed EA analgesia by the CB1 antagonist, and further reversed the chemogenetic inhibition of SSC. Our innovative findings evidence the role of CB1 signaling in the interaction of EA and fibromyalgia, suggesting its potential for clinical trials and as a treatment target. Full article

Characterized in biomedical terms, stretching exercises have been defined as movements applied by external and/or internal forces to increase muscle and joint flexibility, decrease muscle stiffness, elevate the joint range of motion (ROM), increase the length of the “muscle–tendon” morpho-functional unit, and improve joint, muscle, and tendon movements, contraction, and relaxation. The present review examines and summarizes the initial and recent literature data related to the biomechanical, physiological, and therapeutic effects of static stretching (SS) on flexibility and other physiological characteristics of the main structure and the “joint–ligament–tendon–muscle” functional unit. The healing and therapeutic effects of SS, combined with other rehabilitation techniques (massage, foam rolling with and without vibrations, hot/cold therapy, etc.), are discussed in relation to the creation of individual (patient-specific) or group programs for the treatment and prevention of joint injuries, as well as for the improvement of performance in sports. From a theoretical point of view, the role of SS in positively affecting the composition of the connective tissue matrix is pointed out: types I–III collagen syntheses, hyaluronic acid, and glycosaminoglycan (GAG) turnover under the influence of the transforming growth factor beta-1 (TGF-β-1). Different variables, such as collagen type, biochemistry, elongation, and elasticity, are used as molecular biomarkers. Recent studies have indicated that static progressive stretching therapy can prevent/reduce the development of arthrogenic contractures, joint capsule fibrosis, and muscle stiffness and requires new clinical applications. Combined stretching techniques have been proposed and applied in medicine and sports, depending on their long- and short-term effects on variables, such as the ROM, EMG activity, and muscle stiffness. The results obtained are of theoretical and practical interest for the development of new experimental, mathematical, and computational models and the creation of efficient therapeutic programs. The healing effects of SS on the main structural and functional unit—“joint–ligament–tendon–muscle”—need further investigation, which can clarify and evaluate the benefits of SS in prophylaxis and the treatment of joint injuries in healthy and ill individuals and in older adults, compared to young, active, and well-trained persons, as well as compared to professional athletes. Full article

The management of heat-related illness (HRI) in dogs has received limited attention in the veterinary literature, especially regarding effective cooling methods. Guidelines published in 2016 for prehospital management of dogs with HRI advised “cool first, transport second”, and recommended using cold-water immersion and evaporative cooling (water application with air movement) as the optimal approaches to reduce the patient’s temperature. The current retrospective cross-sectional observation study analysed electronic patient records from the VetCompass programme to describe the cooling methods used in dogs with HRI presented to primary care veterinary practices during 2016–2018. Of 623 HRI events identified, 341 (54.74%, 95% CI 50.81–58.60%) included information on cooling in their clinical record. Of these, 74/341 (21.70%, 95% CI 17.65–26.38%) were cooled prior to transport for veterinary care. Overall, 23.97% (95% CI 19.24–29.44%) were cooled using one of the two recommended cooling methods, whilst the most common cooling method recorded was the application of wet towels (51.31%, 95% CI 45.34–57.24%). Canine cooling guidance and messaging in both the public and veterinary sectors requires urgent review to ensure that the most effective cooling methods are promoted because delays to canine temperature reduction worsen patient outcomes. Full article

Extreme weather can cause ill health in older persons due to a direct thermal effect on the body’s thermoregulation and difficulties in maintaining a healthy lifestyle and accessing the health services they need. To understand experiences in relation to their exposures to extreme weather and how they responded to such weather conditions, including cold snaps, heat and air pollution in northern Thai communities, a descriptive qualitative study was conducted to uncover details and the essence of perspectives and experiences of older persons and family members. Three focus group discussions with 15 older persons and 15 family members occurred in three communities in Chiang Rai, a northern province of Thailand. Thematic analysis was performed. Experiences of older persons and families in relation to extreme weather conditions were described in five themes: local actions against weather changes, the double challenges, awareness and reactions to weather changes, protective and comfortable living environments, and mitigation of the impacts of weather conditions. Seasonal adaptability was key for older persons to stay safe and healthy during extreme weather changes. Heat, cold snaps, and air pollution made health and daily living routine maintenance among older persons challenging, especially among those with declining health. Older persons and families employed predictive and adaptive strategies to avoid and minimise extreme weather impacts and maximise their comfort and optimal living. Full article

Low quality in a museum’s internal microclimate can induce both the deterioration of the exhibit collections, as well as affecting the health of visitors, employees and restorers. Starting from this premise, the present study aims to study the perception of visitors and employees of Darvas-La Roche Museum House (Romania) in relation to the air quality in the exhibition spaces. Their opinions were analyzed based on a questionnaire comprising 11 items aimed at understanding the influence of the indoor environment on the health of individuals, the degree of disturbance induced by the indoor air, if they experienced symptoms of illness after visiting the museum, etc. The obtained data were analyzed statistically in the SPSS 28 program, using tests such as coefficient, analysis of variance (ANOVA) and model summary, in order to obtain correlations between the sets of variables. The results obtained indicate that the majority of respondents perceived the indoor air quality as good, but there were also exceptions (approximately 20% of the respondents), which indicated different symptoms induced by the indoor air. Most of those (%) affected stated that they had pre-existing conditions, wear contact lenses or are smokers. In their case, the statistical-mathematical analyses indicated strong correlations between the ailments they suffer from and the appearance of certain discomforts (caused by too low or too high temperature, dust or dry air, etc.) and disease symptoms (nasal congestion, eye and skin irritations, coughs, migraines, frequent colds, etc.). Full article

Background: The utilization of herbal medicine (HM) as a component of complementary and alternative medicine (CAM) is increasing worldwide. Little is known about justifications for its use and the factors associated with it. This study gains insights into the use of herbal medicines in Northern Cyprus, concentrating on targets for its use, the role played by disease type, reasons for its use, and sources of information. Methods: A questionnaire was utilized to achieve the aim of the study. The questionnaire was distributed to a random sample comprised of people in two different regions in Northern Cyprus over a 12-week period from August to November 2020. A self-administered questionnaire was used for data collection. Moreover, qualitative research explored individuals’ decision making regarding CAM, which aimed to examine 20 patients as a context for beliefs, decision making, and dialogue about CAM. After audio-taping and verbatim transcription, the data were analyzed with qualitative content analysis. Results: The findings show that the majority of respondents learned about herbal products (HPs) and CAM from other patients, the Internet, friends, and family. The results indicate that almost half of the respondents were aware of how CAMs, especially herbal preparations, are used to treat common illnesses. Fennel, ginger, and echinacea were the most commonly used HMs, mainly for the treatment of the common cold. Furthermore, nearly 50% of the participants expressed the belief that HMs are safe, have fewer side effects than conventional medicines, and are also effective for treating minor health conditions. The prevalence was strongly associated with education level based on a Pearson Chi-square analysis. Conclusions: Although herbal medicines were mostly used to treat mild to moderate ailments and the participants were aware of their limitations, the combination of self-medication, inexperienced counseling, and lack of awareness of the risks of herbal medicines is potentially harmful. This is particularly important for elderly users, because although they seemed to be more aware of health-related issues, they generally used more medication than younger people. Given our finding that dissatisfaction with modern medicine is the most important reason for the preferred use of herbal medicines, government agencies, physicians, and pharmaceutical companies should be aware of this issue and should aim to create some level of awareness among users. Full article

A decade-long neglect of rhinovirus as an important agent of disease in humans was primarily due to the fact that they were seen as less virulent and capable of causing only mild respiratory infections such as common cold. However, with an advent of molecular diagnostic methods, an increasing number of reports placed them among the pathogens found in the lower respiratory tract and recognized them as important risk factors for asthma-related pathology in childhood. As the spread of rhinovirus was not severely affected by the implementation of social distancing and other measures during the coronavirus disease 2019 (COVID-19) pandemic, its putative pathogenic role has become even more evident in recent years. By concentrating on children as the most vulnerable group, in this narrative review we first present classification and main traits of rhinovirus, followed by epidemiology and clinical presentation, risk factors for severe forms of the disease, long-term complications and the pathogenesis of asthma, as well as a snapshot of treatment trials and studies. Recent evidence suggests that the rhinovirus is a significant contributor to respiratory illness in both high-risk and low-risk populations of children. Full article

Despite being perceived as a warm country, winters in the Central Mexican Plateau frequently reach temperatures below zero Celsius. Prolonged exposures to low temperatures resulting in heart and respiratory morbidities are estimated to be responsible for 50% of the reported illness in the plateau, attributable primarily to the design of homes ill-suited to extreme temperatures. Consequently, there is a growing need to ensure that dwellings provide adequate indoor thermal conditions in the region. Hence, on-site sensors were used to collect temperature and relative humidity data every five minutes in 26 living rooms in the Plateau for 11 months. From these data, a subsample was determined, resulting in dwelling-level thermal comfort and health surveys on 15 homes. Computer simulations were used to investigate whether the building itself could provide thermal comfort under different retrofitting scenarios. Multiple linear regression relating the Predicted Percentage Dissatisfaction (PPD) index to self-perceived health was undertaken. Both monitored and simulated results were matched against our underheating model, finding that 92% of the homes had cold indoor environments, some even during summer. High PPD and intense levels of underheating were positive predictors of higher self-reported health problems. More self-reported health problems were correlated with both lower life satisfaction and self-worth, and with subjects’ use of more adaptive strategies against environmental dissatisfaction. Dynamic computer simulations suggested that indoor thermal environments could be improved by enforcing the non-utilised standard NOM-ENER-020, which recommends the addition of insulation on walls and roofs. These findings suggest that the cold environments within homes of the plateau influence the self-perceived physical and mental health of its population. Hence, the application of adequate measures, such as retrofitting homes with stronger standards than the existing NOM-ENER-020 are needed in place. Full article

Climate extreme events have been observed more frequently since the 1970s throughout Ethiopia, which adversely affects the socio-economic development of the country, as its economy depends on agriculture, which, in turn, relies heavily on annual and seasonal rainfall. Climate extremes studies conducted in Ethiopia are mainly limited to a specific location or watershed, making it difficult to have insights at the national level. The present study thus aims to examine the observed climate extreme events in Ethiopia at both station and agro-ecological zone (AEZ) levels. Daily rainfall and temperature data for 47 and 37 stations, respectively (1986 up to 2020), were obtained from the National Meteorology Agency (NMA). The Modified Mann–Kendall (MMK) trend test and the Theil–Sen slope estimator were employed to estimate the trends in rainfall and temperature extremes. This study examines trends of 13 temperature and 10 rainfall extreme indices using RClimDex in R software. The results revealed that most of the extreme rainfall indices showed a positive trend in the majority of the climate stations. For example, an increase in consecutive dry days (CDD), very heavy rainfall days (R20), number of heavy rainfall days (R10) and consecutive wet days (CWD) were exhibited in most climate stations. In relation to AEZs, the greater number of extreme rainfall indices illustrated an upward trend in cool and sub-humid, cool and humid, and cool and moist AEZs, a declining trend in hot arid AEZ, and equal proportions of increasing and decreasing trends in warm semi-arid AEZs. Concerning extreme temperature indices, the result indicated an increasing trend of warm temperature extreme indices and a downward trend of cold temperature extreme indices in most of the climate stations, indicating the overall warming and dryness trends in the country. With reference to AEZs, an overall warming was exhibited in all AEZs, except in the hot arid AEZ. The observed trends in the rainfall and temperature extremes will have tremendous direct and indirect impacts on agriculture, water resources, health, and other sectors in the country. Therefore, the findings suggest the need for identifying and developing climate change adaptation strategies to minimize the ill effects of these extreme climate events on the social, economic, and developmental sectors. Full article

There is increasing academic and clinical interest in understanding the nature of the relation between diet and response to stress exposure as a risk factor for mental illness. Cross-species evidence shows that conditions of chronic and acute stress increase the intake of, and preference for, caloric-dense palatable foods, a phenomenon thought to be explained by the mitigating effects of comfort foods on the activity of the stress-response network. It is largely unknown whether and how real-world dietary intake of saturated fat and sugars impacts stress responsivity in humans. Therefore, here we examined whether real-world dietary intake of saturated fat and sugars predicted salivary cortisol reactivity following an acute physiological stressor. Multilevel modelling of four salivary cortisol measures collected up to 65 min after the stressor on 54 participants (18–49 years old) were analyzed using a quadratic growth curve model. Sugar intake significantly predicted a weaker cortisol response following the Cold Pressor Test (CPT) controlling for BMI and gender, revealing an inhibitory effect of caloric-dense diets on cortisol reactivity to stress. As the consumption of sugar rose individuals had lower post-stressor cortisol levels, a smaller rate of increase in cortisol 20 and 35 min after the CPT, a lower cortisol peak, and an overall weaker quadratic effect. These observations add to a growing body of evidence reporting suppressive effects of high-energy foods on stress-associated glucocorticoids reactivity and are consistent with the comfort food hypothesis, where people are seen as motivated to eat palatable foods to alleviate the detrimental repercussions of stressor exposure. Full article

Extreme temperature events are linked to increased emergency department visits, hospitalizations, and mortality for individuals with behavioral health disorders (BHD). This study aims to characterize risk factors for concurrent temperature-related illness among BHD hospitalizations in New York State. Using data from the NYS Statewide and Planning Research and Cooperative System between 2005–2019, multivariate log binomial regression models were used in a population of BHD hospitalizations to estimate risk ratios (RR) for a concurrent heat-related (HRI) or cold-related illness (CRI). Dementia (RR 1.65; 95% CI:1.49, 1.83) and schizophrenia (RR 1.38; 95% CI:1.19, 1.60) were associated with an increased risk for HRI among BHD hospitalizations, while alcohol dependence (RR 2.10; 95% CI:1.99, 2.22), dementia (RR 1.52; 95% CI:1.44, 1.60), schizophrenia (RR 1.41; 95% CI:1.31, 1.52), and non-dependent drug/alcohol use (RR 1.20; 95% CI:1.15, 1.26) were associated with an increased risk of CRI among BHD hospitalizations. Risk factors for concurrent HRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, and medium hospital size. Risk factors for concurrent CRI among BHD hospitalizations include increasing age, male gender, non-Hispanic Black race, insurance payor, the presence of respiratory disease, and rural hospital location. This study adds to the literature by identifying dementia, schizophrenia, substance-use disorders, including alcohol dependence and non-dependent substance-use, and other sociodemographic factors as risk factors for a concurrent CRI in BHD hospitalizations. Full article

The aim of this study was to develop a database of historical cold-related mortality in Bangladesh using information obtained from online national newspapers and to analyze such data to understand the spatiotemporal distribution, demographic dynamics, and causes of deaths related to cold temperatures in winter. We prepared a comprehensive database containing information relating to the winter months (December to February) of 2009–2021 for the eight administrative divisions of Bangladesh and systematically removed redundant records. We found that 1249 people died in Bangladesh during this period due to cold and cold-related illnesses, with an average of 104.1 deaths per year. The maximum number of cold-related deaths (36.51%) occurred in the Rangpur Division. The numbers were much higher here than in the other divisions because Rangpur has the lowest average monthly air temperature during the winter months and the poorest socioeconomic conditions. The primary peak of cold-related mortality occurred during 21–31 December, when cold fronts from the Himalayas entered Bangladesh through the Rangpur Division in the north. A secondary peak occurred on 11–20 January each year. Our results also showed that most of the cold-related mortality cases occurred when the daily maximum temperature was lower than 21 °C. Demographically, the highest number of deaths was observed in children aged six years and under (50.68%), followed by senior citizens 65 years and above (20.42%). Fewer females died than males, but campfire burns were the primary cause of female deaths. Most mortality in Bangladesh was due to the cold (75.5%), cold-triggered illness (10.65%), and campfire burns (5.8%). The results of this research will assist policymakers in understanding the importance of taking necessary actions that protect vulnerable public health from cold-related hazards in Bangladesh. Full article

Pharmaceutical wastes are expected to increase given the increasing population growth rates and rapidly rising economic burden of human diseases. This challenge calls for appropriate measures for the management of such hazardous wastes. The purpose of this survey was to document and investigate existing practices for the handling, storage, and disposal of household pharmaceutical wastes (HPWs) in the Johannesburg area. Primary data were collected via online surveys with self-administered questionnaires completed by respondents. The research found that 77% (n = 286) of respondents claimed some knowledge about HPWs. Types of medicines that contributed to HPWs included painkillers or analgesics (73%, n = 270) and drugs for treating colds and flu-related illnesses (52%; n = 193). Although there were a few exceptions, the respondents generally exhibited strong disagreements with environmentally unfriendly and health-threatening disposal practices. Moreover, most participants were willing to return expired medicines to pharmacies (40.7%, n = 151), whereas only 8.6% (n = 32) opposed this solution. Awareness levels tended to vary with employment status, educational qualifications, and place of residence. However, place of residence and household size did not correlate with types of pharmaceutical waste. Additionally, the study found that education attainments significantly influenced the willingness of respondents to return pharmaceutical wastes. Finally, there were no significant differences amongst respondents in terms of waste disposal practices. Altogether, the findings suggest the need for targeted efforts to bring about sustainable waste management at a household level. Full article

The COVID-19 pandemic and its profound global effects may be changing the way we think about illness. In summer 2020, 120 American adults were asked to diagnose symptoms of COVID-19, a cold, and cancer, and to answer questions related to the diagnosis, treatment, prevention, time-course, and transmission of each disease. Results showed that participants were more likely to correctly diagnose COVID-19 (91% accuracy) compared to a cold (58% accuracy) or cancer (52% accuracy). We also found that 7% of participants misdiagnosed cold symptoms as COVID-19, and, interestingly, over twice as many participants (16%) misdiagnosed symptoms of cancer as COVID-19. Our findings suggest a distinct mental model for COVID-19 compared to other illnesses. Further, the prevalence of COVID-19 in everyday discourse—especially early in the pandemic—may lead to biased responding, similar to errors in medical diagnosis that result from physicians’ expertise. We also discuss how the focus of public-health messaging on prevention of COVID-19 might contribute to participants’ mental models. Full article