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[This corrects the article DOI: 10.7759/cureus.918.].
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We report a case of recrudescent Streptococcus suis meningitis requiring a prolonged treatment course. A few similar cases can be found in the burgeoning literature on what remains a relatively uncommon disease in humans, and these patients should be monitored carefully upon completion of therapy.
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Meningites Bacterianas/diagnóstico , Infecções Estreptocócicas/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Proteína C-Reativa/metabolismo , Ceftriaxona/uso terapêutico , Feminino , Seguimentos , Humanos , Meningites Bacterianas/tratamento farmacológico , Recidiva , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus suis/efeitos dos fármacos , Estados UnidosRESUMO
[This corrects the article DOI: 10.7759/cureus.918.].
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BACKGROUND: Hydration status is a controversial determinant of athletic performance. This relationship has not been examined with mountaineering performance. METHODS: This was a prospective observational study of mountaineers who attempted to climb Denali in Alaska. Participants' urine specific gravity (SG), and ultrasound measurements of the inferior vena cava size and collapsibility index (IVC-CI) were measured at rest prior to ascent. Upon descent, climbers reported maximum elevation gained for determination of summit success. RESULTS: One hundred twenty-one participants enrolled in the study. Data were collected on 111 participants (92% response rate); of those, 105 (87%) had complete hydration data. Fifty-seven percent of study participants were found to be dehydrated by IVC-CI on ultrasound, and 55% by urine SG. No significant association was found with summit success and quantitative measurements of hydration: IVC-CI (50.4% +/- 15.6 vs. 52.9% +/- 15.4, p = 0.91), IVC size (0.96 cm +/- 0.3 vs. 0.99 cm +/- 0.3, p = 0.81), and average SG (1.02 +/- 0.008 vs. 1.02 +/- 0.008, p = 0.87). Categorical measurements of urine SG found 24% more successful summiters were hydrated at 14 Camp, but this was not found to be statistically significant (p = 0.56). Summit success was associated with greater water-carrying capacity on univariate analysis only: 2.3 L, 95% confidence interval (2.1 - 2.5) vs. 2.1 L, 95% confidence interval (2 - 2.2); p < 0.01. CONCLUSIONS: Intravascular dehydration was found in approximately half of technical high-altitude mountaineers. Hydration status was not significantly associated with summit success, but increased water-carrying capacity may be an easy and inexpensive educational intervention to improve performance.
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OBJECTIVE: To test whether the 6-minute walk test (6MWT), including postexercise vital sign measurements and distance walked, predicts summit success on Denali, AK. METHODS: This was a prospective observational study of healthy volunteers between the ages of 18 and 65 years who had been at 4267 m for less than 24 hours on Denali. Physiologic measurements were made after the 6MWT. Subjects then attempted to summit at their own pace and, at the time of descent, completed a Lake Louise Acute Mountain Sickness Questionnaire and reported maximum elevation reached. RESULTS: One hundred twenty-one participants enrolled in the study. Data were collected on 111 subjects (92% response rate), of whom 60% summited. On univariate analysis, there was no association between any postexercise vital sign and summit success. Specifically, there was no significant difference in the mean postexercise peripheral oxygen saturation (Spo2) between summiters (75%) and nonsummiters (74%; 95% CI, -3 to 1; P = .37). The distance a subject walked in 6 minutes (6MWTD) was longer in summiters (617 m) compared with nonsummiters (560 m; 95% CI, 7.6 to 106; P = .02). However, this significance was not maintained on a multivariate analysis performed to control for age, sex, and guide status (P = .08), leading to the conclusion that 6MWTD was not a robust predictor of summit success. CONCLUSIONS: This study did not show a correlation between postexercise oxygen saturation or 6MWTD and summit success on Denali.