PubMed · 7121946
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
D Christenberry, J W Jabara. 1982. Working in hot environments.. https://pubmed.ncbi.nlm.nih.gov/7121946/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: This section is under preparation and will be included in the next issue. OBJECTIVES: To assess the effects of radiant warmers versus incubators (in the neonatal period) on fluid and electrolyte balance, neonatal morbidity and mortality. SEARCH STRATEGY: The standard strategy of the Cochrane Neonatal Review Group was used. This includes searches of the Oxford Database of Perinatal Trials, Medline, previous reviews including cross references, abstracts, conference and symposia proceedings, expert informants, journal handsearching mainly in the English language. SELECTION CRITERIA: All randomised or quasi-randomised trials in which radiant warmers are compared to incubators in a neonatal population. DATA COLLECTION AND ANALYSIS: Methods used to collect data from the included studies: Each author extracted data separately, then compared and resolved differences. A referee was sought for unresolved differences. Methods used to synthesise the data : Standard method of Neonatal Review Group with the use of weighted mean difference for outcome data measured on a continuous scale. MAIN RESULTS: A statistically significant increase in insensible water loss (IWL) was shown in neonates nursed under radiant warmers (WMD 0.94g/Kg/day, 95% CI 0.48, 1.41). A trend towards increased oxygen consumption which was not statistically significant was shown for the radiant warmer group (WMD 0. 27mL/kg/min, 95% CI -0.10, 0.63). A comparison of the radiant warmers with heat shields vs incubator without heat shields showed a similar trend for increased IWL in the radiant warmer group which was not statistically significant (WMD 1.00g/kg/day, 95% CI -0.10, 2. 10). No difference was shown in the rate of oxygen consumption when radiant warmers with heat shields were compared to incubators (WMD -0.05, 95% CI -0.84, 0.74). REVIEWER'S CONCLUSIONS: Radiant warmers result in increased IWL compared to incubators which needs to be taken into account when calculating daily fluid requirements.The results of this review do not provide sufficient evidence on important outcomes with the use of radiant warmers vs incubators to guide clinical practice. Further randomised controlled trials are required to assess the role of radiant warmers in neonatal care with particular attention to the extremely low birthweight population.
BACKGROUND: Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. OBJECTIVES: In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. SEARCH STRATEGY: Standard search strategy of the Cochrane Neonatal Collaborative Review Group. SELECTION CRITERIA: Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. DATA COLLECTION AND ANALYSIS: Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. MAIN RESULTS: Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. REVIEWER'S CONCLUSIONS: During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual adjustment of incubator air temperature.
Although understanding of the unique physiology of the female athlete has increased, there are still many questions to be answered. Endogenous and exogenous female sex steroids have been shown to influence various cardiovascular, respiratory, and metabolic parameters, but these changes probably have minimal impact on the ability of most recreational athletes to participate in and enjoy their sport. Statistically significant data may or may not have clinical or performance relevance. By the same token, a statistically nonsignificant change may mean the difference between first and second place to an elite athlete. For an athlete concerned about maximizing performance, individual variability in menstrual cycle changes to various performance parameters must be considered. It is difficult to predict how accurately controlled laboratory findings from a study population apply to an individual competitor on the playing field. Athletes taking OCs for contraception or for menstrual cycle control may be able to minimize any potential side effects and performance influences by taking the lower dose triphasic pills and the newer progestins. For women with menstrual dysfunction, OCs may provide a predictable hormonal milieu for training and competition. Further scientific study is needed using large-scale, prospective, randomized clinical trials on trained athletes and accurate hormonal measurements to determine the phase of the menstrual cycle to determine short- and long-term effects of cycle phase and OCs in exercising women. As more questions continue to be answered, physicians and sport scientists will be better able to guide women not only to maximize their performance but to ensure lifelong good health.