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Biomedical subjects

Eran Hadad

Publications and source records attributed to Eran Hadad.

10 recordsLinked to original sources
PubMed2005

[Exercise induced rhabdomyolysis--characteristics, mechanisms and treatment].

Rhabdomyolysis is defined as a syndrome resulting from skeletal muscle injury with release of muscle cell contents into the plasma. One of the main causes of rhabdomyolysis is eccentric exercise against high resistance. There are mechanical as well as metabolic causes in exercise induced rhabdomyolysis. The mechanical aspect includes high physical tension on the muscle fiber and the metabolic causes include lack of available ATP and disturbance in intracellular electrolyte balance, especially calcium. The clinical picture of rhabdomyolysis may include muscle soreness, reduction of the range of motion, decreased muscle strength, black urine and, in severe cases, acute renal failure. Laboratory results may include delayed high levels of muscle enzymes in the plasma, myoglobinemia and myoglobinuria, disturbance in blood electrolyte balance, and in severe cases, disturbance in coagulatory function and DIC. Compartment syndrome may also be part of severe rhabdomyolyis. The main treatment for rhabdomyolysis is fluids administration and maintaining urination, in order to preserve renal function. In severe compartment syndrome fasciotomy may be necessary. There is a wide variability in the severity of rhabdomyolysis. This variability is not completely understood but may be related to the level of physical fitness, morphometrical characteristics and gender. In order to prevent exercise induced rhabdomyolysis, a gradual training program should be maintained providing enough recovery time, preserving fluid balance, and avoiding extreme eccentric exercise and exercise in high heat load.

Exercise↗
PubMed2004

Clinical review: Treatment of heat stroke: should dantrolene be considered?

Rapid and efficient cooling is the most important therapeutic objective in patients with heat stroke (HS). This article reviews the mechanism of action and rationale for the use of dantrolene as a potential supportive cooling method in the treatment of HS. Relevant studies were included to support discussion of the role of dantrolene for the treatment of HS. In some studies dantrolene was shown to accelerate cooling rate when administered after the development of exertional HS. Dantrolene was also found to be effective in reducing the extent of HS signs when given as pretreatment in an animal model. Accumulated data do not support the routine use of dantrolene as an adjuvant cooling technique in HS, but administration of this drug in severe cases, or in which no improvement is observed, appears rational. Further trials are needed in order to assess the true effectiveness of dantrolene in HS.

Chemical and Drug Induced Liver Injury↗
PubMed2004

Liver transplantation in exertional heat stroke: a medical dilemma.

BACKGROUND: Exertional heat stroke (EHS) is a life-threatening condition caused by an extreme elevation in core body temperature. Hepatic involvement is one of the hallmarks of heat stroke, affecting nearly all heat stroke patients. It is usually manifested by increased serum levels of liver enzymes, but acute liver failure has also been reported. Liver transplantation has been proposed as a potential treatment in cases of severe liver failure, but there are no unanimous criteria pointing to the right stage in which to conduct the transplantation. CASE PRESENTATION: We report a case of an 18-year old patient who suffered heat-induced liver failure. The patient was referred for orthotopic liver transplantation (OLT) but spontaneously recovered completely with conservative treatment. CONCLUSIONS: This case demonstrates the complexity of the decision for liver transplantation in EHS. The various prognostic criteria of acute hepatic failure and their relevance to EHS are critically reviewed, with an aim to assess their application for such a condition.

Adult↗
PubMed2004

Fatal exertional heat stroke: a case series.

BACKGROUND: Exertional heat stroke (EHS) is one of the most serious conditions that occur when excess heat, generated by muscular exercise, exceeds the body's heat-dissipation rate. The consequent elevated body core temperature causes damage to the body's tissues, resulting in a characteristic multiorgan syndrome, which is occasionally fatal. METHODS: We analyzed the fatal EHS cases that occurred in the Israeli Defence Forces during the last decade according to Minard's paradigm for evaluation of EHS predisposing factors, aiming to characterize the common features and unique circumstances leading to fatality. RESULTS: Accumulation of predisposing factors, particularly those concerning training regulations, coupled with inappropriate treatment at site, were found to be strong predictors of a grave prognosis. Analysis of the pathologic findings of the fatal EHS cases on autopsy revealed a possible association between the duration and length of exercise prior to EHS occurrence and the extent of pathologic findings. CONCLUSIONS: Strict adherence to existing training regulations may prevent further heat stroke fatalities.

Adolescent↗
PubMed2004

Heat stroke : a review of cooling methods.

The prognosis of heat stroke in patients is directly related to the degree of hyperthermia and its duration. Therefore, the most important feature in the treatment of heat stroke is rapid cooling. Several cooling methods have been presented in the literature including immersion in water at different temperatures, evaporative cooling, ice pack application, pharmacological treatment and invasive techniques. This article describes the various cooling techniques in terms of efficacy, availability, adverse effects and mortality rate. Data suggest that cooling should be initiated immediately at time of collapse and should be based on feasible field measures including ice or tepid water (1-16 degrees C), which are readily available. In the emergency department, management should be matched to the patient's age and medical background and include immersion in ice water (1-5 degrees C) or evaporative cooling.

Animals↗
PubMed2004

[Exercise induced hyponatremia].

A normal water-electrolyte balance is essential for normal function of body systems during physical activity. During recent years, awareness of the importance of drinking amongst athletes and Israeli Defense Force (IDF) soldiers, in particular, has been highlighted. A large number of athletes tend to drink prior to, during and after their exercise in order to enhance physical abilities and to prevent heat casualties and dehydration. However, excessive water consumption combined with sweat induced electrolytes loss during physical activity, may cause hyponatremia in extreme cases. Recently, several cases of exercise induced hyponatremia were reported in the IDF, resulting from improper water consumption. In this article, we describe a clinical case of exercise-induced hyponatremia in a soldier and a review of the literature, including the etiology, clinical characterization and recommended treatment. Moreover, water consumption recommendations with regard to physical activity are presented. The application of such recommendations may prevent future events of exercise-induced hyponatremia.

Adult↗
PubMed2003

Drug-induced hyperthermia and muscle rigidity: a practical approach.

Body thermoregulation can be violently offset by drugs capable of altering the balance between heat production and dissipation. Such events may rapidly become fatal. The drugs that are involved in the eruption of such syndromes include inhalation anaesthetics, sympathomimetic agents, serotonin antagonists, antipsychotic agents and compounds that exhibit anticholinergic properties. The resultant hyperthermia is frequently accompanied by an intense skeletal muscle hypermetabolic reaction that leads to rapidly evolving rigidity, extensive rhabdomyolysis and hyperkalemia. The differential diagnosis should, however, rule out non-drug-induced causes, such as lethal catatonia, central nervous system infection or tetanus, strychnine poisoning, thyrotoxic storm and pheochromocytoma. Prompt life-saving procedures include aggressive body temperature reduction. Patients with a suspected drug (or non-drug) hypermetabolic reaction should be admitted into an intensive care area for close monitoring and system-oriented supportive treatment. We present six conditions, in decreasing order of gravity and potential lethality, in which hyperthermia plays an essential role, and suggest a clinical approach in such conditions.

Body Temperature Regulation↗
PubMed2003

Vasopressin in cardiac arrest and vasodilatory shock: a forgotten drug for new indications.

Vasopressin is a potent endogenous vasoconstrictor that increases blood pressure and systemic vascular resistance. The administration of exogenous vasopressin during closed and open cardiopulmonary resuscitation in humans was shown to be more effective than optimal doses of epinephrine in several clinical studies. We summarize here the recent experimental and clinical data on the use of vasopressin in cardiopulmonary resuscitation and septic shock. As the use of vasopressin in human resuscitation is now in its early stages, it is expected that accumulated future experience will shed more light regarding the risk-benefit aspects of its use.

Animals↗
PubMed2002

[Diagnostic and resuscitative aspects of pediatric nerve agent intoxication].

Chemical warfare and the use of nerve agents are still a threat to the civilian population in the 21st century. Modern history of chemical warfare began in 1915 in the battle of Ypres when German troops used chlorine against the French army. Since then, the arsenal of such agents has included asphyxiates, burn-causing and nerve paralytic agents. Nerve gases are considered the most dangerous of all chemical weapons with little known about the treatment of the civilian population especially children. Management of the civilian population injured by these agents may be a tremendous challenge, especially in children, due to lack of previous data regarding pediatric resuscitation. This review emphasizes resuscitation issues of the child who suffers from multiple trauma and nerve agent poisoning, mainly based on data from reports concerning episodic civilian exposure to organophosphates.

Chemical Warfare↗