Effects of hot bath therapy on cholinergic urticaria with hypohidrosis or anhidrosis.

Cholinergic urticaria with hypohidrosis or anhidrosis (CUHA) can impair quality of life due to itching, tingling, and reduced sweating. Current treatment options for CUHA include antihistamines, pulsed steroids, and sweat-promoting therapies such as exercise or hot baths. However, the efficacy of these therapies, particularly hot bath therapy, has yet to be established. We evaluated the efficacy of hot bath therapy in patients with CUHA. We enrolled eight patients who underwent hot bath therapy between January 2010 and August 2022. Patients had a half-body bath in a bathtub filled with hot water (40-43°C) for 30-60 minutes daily for 3-7 days. After treatment, pain improved in three (42.9%) patients, urticaria improved in four (50%) patients, and anhidrosis improved in five (62.5%) patients without any severe adverse events. Because hot bath therapy is easily performed, it should be considered a treatment option for patients with CUHA.

A comparison of medium-term heat acclimation by post-exercise hot water immersion or exercise in the heat: adaptations, overreaching, and thyroid hormones.

This research compared thermal and perceptual adaptations, endurance capacity, and overreaching markers in men after 3, 6, and 12 days of post-exercise hot water immersion (HWI) or exercise heat acclimation (EHA) with a temperate exercise control (CON), and examined thyroid hormones as a mechanism for the reduction in resting and exercising core temperature (Tre) after HWI. HWI involved a treadmill run at 65% V̇o2peak at 19°C followed by a 40°C bath. EHA and CON involved a work-matched treadmill run at 65% V̇o2peak at 33°C or 19°C, respectively. Compared with CON, resting mean body temperature (Tb), resting and end-exercise Tre, Tre at sweating onset, thermal sensation, and perceived exertion were lower and whole-body sweat rate (WBSR) was higher after 12 days of HWI (all P ≤ 0.049, resting Tb: CON -0.11 ± 0.15°C, HWI -0.41 ± 0.15°C). Moreover, resting Tb and Tre at sweating onset were lower after HWI than EHA (P ≤ 0.015, resting Tb: EHA -0.14 ± 0.14°C). No differences were identified between EHA and CON (P ≥ 0.157) except WBSR that was greater after EHA (P = 0.013). No differences were observed between interventions for endurance capacity or overreaching markers (mood, sleep, Stroop, P ≥ 0.190). Thermal adaptations observed after HWI were not related to changes in thyroid hormone concentrations (P ≥ 0.086). In conclusion, 12 days of post-exercise hot water immersion conferred more complete heat acclimation than exercise heat acclimation without increasing overreaching risk, and changes in thyroid hormones are not related to thermal adaptations after post-exercise hot water immersion.

Effects of 12 sessions of steam bath intervention on spirometry parameters among healthy adult volunteers.

OBJECTIVES: Steam bath is extensively used around the world. However, its physiological influence is not understood in detail. Objective of the current study is to examine the effects of 12 sessions of steam bath on spirometric parameters among healthy participants. METHODS: Forty healthy adult volunteers of both sex (14 male and 26 female) aged 26.38 ± 8 years participated in the study. A steam bath session (10-15 min) was given once a week for 12 weeks. The spirometric parameters [forced expiratory volume in the 1st second (FEV1, L), forced vital capacity (FVC, L), FEV1/FVC ratio (absolute value), maximal mid-expiratory flow (MMEF, L/s) and peak expiratory flow (PEF, L/s)] were measured by Helios 401 spirometer. RESULTS: Compared to baseline, post-intervention spirometric parameters showed significant (p<0.05) improvement in the FVC (82.40 ± 11.24 to 96.91 ± 18.76), FEV1 (86.13 ± 14.39 to 91.17 ± 12.48), FEV1/FVC ratio (86.96 ± 3.64 to 93.75 ± 4.80), MMEF 25-75% (86.96 ± 3.64 to 94.16 ± 11.57), peak expiratory flow rate (79.82 ± 14.90 to 92.18 ± 18.96). CONCLUSIONS: Taking steam bath improves the spirometric parameters of healthy adult participants. However, future randomized controlled trials with on a large scale have to done to validate our findings.

A comparison of heat acclimation by post-exercise hot water immersion and exercise in the heat.

OBJECTIVES: To compare heat acclimation adaptations after three and six days of either post-exercise hot water immersion (HWI) or exercise-heat-acclimation (EHA) in recreationally active individuals. DESIGN: Randomised, mixed model, repeated measures. METHODS: Post-exercise HWI involved a daily 40-min treadmill-run at 65% V̇O2peak in temperate conditions (19 °C, 45% RH) followed by HWI (≤40 min, 40 °C water; n = 9). Daily EHA involved a ≤60-min treadmill-run in the heat (65% V̇O2peak; 33 °C, 40% RH; n = 9), chosen to elicit a similar endogenous thermal stimulus to HWI. A thermoneutral exercise intervention (TNE, 19 °C, 45% RH; n = 9), work-matched to EHA, was also included to determine thermoregulatory adaptations to daily exercise in temperate conditions. An exercise-heat-stress-test was performed before and after three and six intervention days and involved a 40-min treadmill-run and time-to-exhaustion (TTE) at 65% V̇O2peak in the heat (33 °C, 40% RH). RESULTS: ANCOVA, using baseline values as the covariate, revealed no interaction effects but significant group effects demonstrated that compared to EHA, HWI elicited larger reductions in resting rectal temperature (Tre; p = 0.021), Tre at sweating onset (p = 0.011), and end-exercise Tre during exercise-heat-stress (-0.47 °C; p = 0.042). Despite a similar endogenous thermal stimulus to HWI, EHA elicited a modest reduction in end-exercise Tre (-0.26 °C), which was not different from TNE (-0.25 °C, p = 1.000). There were no main effects or interaction effects for end-exercise Tsk, heart rate, physiological strain index, RPE, thermal sensation, plasma volume, or TTE (all p ≥ 0.154). CONCLUSIONS: Compared with conventional short-term exercise heat acclimation, short-term post-exercise hot water immersion elicited larger thermal adaptations.

Constructing Machine Tool Foundations Using an LMP Alloy.

Currently, the construction of machine tool foundations is a complicated and lengthy procedure with a limited flexibility. In this paper, we present a novel system for constructing machine tool foundations that replaces the need for concrete or concrete-polymer hybrids with a low melting point (LMP) alloy. The system uses a hot bath method to maintain the LMP alloy grouting in liquid form. A fixing device is used to control the embedded depth and positional accuracy of the foundation bolt assembly. The grouting material is injected into the foundation pit by a filling device. This can be extracted from the foundation pit in a later stage with the aid of a recycling device, enabling new machine tool foundations to be manufactured by reusing the LMP alloy grouting material. A prototype was built to test the proposed design. The results show that the system can construct machine tool foundations in a single application, without the delays associated with concrete-based construction, lowering both the economic and environmental cost.

How Does a Delay Between Temperate Running Exercise and Hot-Water Immersion Alter the Acute Thermoregulatory Response and Heat-Load?

Hot-water immersion following exercise in a temperate environment can elicit heat acclimation in endurance-trained individuals. However, a delay between exercise cessation and immersion is likely a common occurrence in practice. Precisely how such a delay potentially alters hot-water immersion mediated acute physiological responses (e.g., total heat-load) remains unexplored. Such data would aid in optimizing prescription of post-exercise hot-water immersion in cool environments, relative to heat acclimation goals. Twelve male recreational runners (mean ± SD; age: 38 ± 13 years, height: 180 ± 7 cm, body mass: 81 ± 13.7 kg, body fat: 13.9 ± 3.5%) completed three separate 40-min treadmill runs (18°C), followed by either a 10 min (10M), 1 h (1H), or 8 h (8H) delay, prior to a 30-min hot-water immersion (39°C), with a randomized crossover design. Core and skin temperatures, heart rate, sweat, and perceptual responses were measured across the trials. Mean core temperature during immersion was significantly lower in 1H (37.39 ± 0.30°C) compared to 10M (37.83 ± 0.24°C; p = 0.0032) and 8H (37.74 ± 0.19°C; p = 0.0140). Mean skin temperature was significantly higher in 8H (32.70 ± 0.41°C) compared to 10M (31.93 ± 0.60°C; p = 0.0042) at the end of the hot-water immersion. Mean and maximal heart rates were also higher during immersion in 10M compared to 1H and 8H (p < 0.05), despite no significant differences in the sweat or perceptual responses. The shortest delay between exercise and immersion (10M) provoked the greatest heat-load during immersion. However, performing the hot-water immersion in the afternoon (8H), which coincided with peak circadian body temperature, provided a larger heat-load stimulus than the 1 h delay (1H).

Prevalence, Magnitude and Methods of Rapid Weight Loss Reported by Male Mixed Martial Arts Athletes in Ireland.

Rapid weight loss (RWL) is frequently practiced in weight category sports, including Mixed Martial Arts (MMA). The aim of the present study was to describe self-reported methods of RWL in a sample of competitive MMA athletes comprising of both amateur and professional fighters. The previously-validated Rapid Weight Loss Questionnaire, with the addition of questions on water loading and hot salt baths, was completed anonymously online by athletes (n = 30; all male, n = 15/15 professional/amateur) from MMA clubs around Dublin, Ireland. All but one (97%) of the athletes surveyed lost weight in order to compete, with the average weight loss being 7.9% ± 3.1% of habitual body mass. The RWL score (mean ± SD) for this sample was 37.9 ± 9.6, and a tendency for higher [6.0 (95%CI; -1.1, 13.1) (p = 0.093; d = 0.64)] RWL scores for professional (40.8 ± 8.9) compared to amateur (34.8 ± 9.6) athletes was observed. Frequencies of "always" or "sometimes" were reported as 90% for water loading, 76% for hot salt baths and 55% for 24 h of fasting. Fellow fighters (41%) and coaches/mentors (38%) were "very influential" on RWL practices of these athletes, with doctors (67%), dietitians (41%), and physical trainers (37%) said to be "not influential". RWL is highly prevalent in MMA across both amateur and professional athletes, and RWL scores are higher than other combat sports. Water loading and hot salt baths are amongst the most commonly used methods of RWL despite little research on these methods for body mass reduction or effects on performance in weight category sports.

Cannabinoid Hyperemesis Syndrome: Reports of Fatal Cases.

Cannabinoid hyperemesis syndrome (CHS) is one of the more clinically challenging effects of cannabis consumption. It is characterized by cyclic attacks of nausea and vomiting in chronic cannabinoid users and learned behavior of compulsive hot bathing. The deaths of a 27-year-old female, a 27-year-old male, and a 31-year-old male with a history of CHS are reported. The decedents had a history of cyclical nausea and vomiting, chronic cannabinoid use and negative laboratory, radiological and endoscopic findings. All presented to the emergency department with nausea and vomiting in the days preceding death and were treated symptomatically. Toxicological analysis revealed tetrahydrocannabinol in postmortem blood. The cause of death of two of the three cases was attributed to CHS. CHS was appreciated in the third case but was not the cause of death. These three cases demonstrate the importance of recognizing CHS as a potential cause or contributing factor to death in cannabinoid user.

Heat Acclimation by Postexercise Hot-Water Immersion: Reduction of Thermal Strain During Morning and Afternoon Exercise-Heat Stress After Morning Hot-Water Immersion.

PURPOSE: Recommendations state that to acquire the greatest benefit from heat-acclimation, the clock time of heat-acclimation sessions should match that of expected exercise-heat stress. It remains unknown if adaptations by postexercise hot-water immersion (HWI) demonstrate time-of-day-dependent adaptations. Thus, the authors examined whether adaptations following postexercise HWI completed in the morning were present during morning and afternoon exercise-heat stress. METHODS: Ten males completed an exercise-heat stress test commencing in the morning (9:45 AM) and afternoon (2:45 PM; 40 min; 65% of maximal oxygen uptake treadmill run) before and after heat-acclimation. The 6-d heat-acclimation intervention involved a daily 40-min treadmill run (65% of maximal oxygen uptake) in temperate conditions followed by ≤40-min HWI (40°C; 6:30-11:00 AM). RESULTS: Adaptations by 6-d postexercise HWI in the morning were similar in the morning and afternoon. Reductions in resting rectal temperature (Tre) (AM -0.34°C [0.24°C], PM -0.27°C [0.23°C]; P = .002), Tre at sweating onset (AM -0.34°C [0.24°C], PM -0.31°C [0.25°C]; P = .001), and end-exercise Tre (AM -0.47°C [0.33°C], PM -0.43°C [0.29°C]; P = .001), heart rate (AM -14 [7] beats·min-1, PM -13 [6] beats·min-1; P < .01), rating of perceived exertion (P = .01), and thermal sensation (P = .005) were not different in the morning compared with the afternoon. CONCLUSION: Morning heat acclimation by postexercise HWI induced adaptations at rest and during exercise-heat stress in the morning and midafternoon.

Passive Heating: Reviewing Practical Heat Acclimation Strategies for Endurance Athletes.

Heat acclimation protocols-both active and passive-have been employed by athletes in an effort to attenuate the detrimental effects of heat stress on physical capacities and sports performance. Active strategies have been extensively reviewed, but have various practical and economic limitations. The purpose of this review was therefore to provide an overview of the passive strategies that have received less attention, yet may be more practical or economically viable; recommendations for athletes are also provided. With a systematic search of the relevant databases ending in June 2018, 16 articles on passive heat acclimation that met the inclusion criteria were included in the review. The review highlighted that passive heat acclimation strategies can successfully induce heat adaptations, evident by reports of improved exercise performance, thermoregulatory, cardiovascular, and perceptual responses accompanying such interventions. Based on the review it is apparent that the use of sauna, hot-water immersion and environmental chambers may be used to provide heat stress under passive conditions, for the purpose of acclimation. To maximize the thermoregulatory-adaptive responses, exercise bouts should be employed prior to passive heat stress, rather than passive heating alone, with a minimal delay between exercise and the application of heat stress. Heating bouts should have a minimum duration of 30 min per session and be employed on consecutive days, when possible, with a minimum of 6-7 exposures to induce adaptation. This review identified that information regarding the magnitude of performance changes that can occur, as well as the perceptual responses to passive heating protocols is limited. Future research should investigate the use of passive heat exposures before and/or after repeated heat training sessions, to assess if a further boost to heat adaptation can be achieved with this strategy.

An Autopsy Case of Sudden Unexpected Death of a Young Adult in a Hot Bath: Molecular Analysis Using Next-Generation DNA Sequencing.

We report a case of sudden unexpected death of a young woman who was found in a bathtub of hot water. The autopsy concluded that all possible causes of sudden loss of consciousness, except cardiac origin, could be excluded. However, the heart did not show any obvious pathological changes. We used next-generation DNA sequencing (NGS) to examine 73 genes and detected 3 rare, potentially pathogenic variants with minor allele frequencies ⩽1.0%. The pathogenicity of these variants was evaluated using 8 in silico predictive algorithms, and SCN5A_p.Gly289Ser, CACNB2_p.Ser502Leu, and MYH11_p.Lys1573Glu were detected as possible pathogenic variants. Inherited heart disease is a likely cause of sudden unexpected deaths of young people in hot baths, even before the clinical manifestation of the disease. In the future, molecular analysis by NGS may help to predict young to early middle-aged people who could be at risk of sudden arrhythmogenic fatality in hot baths.

Post-exercise hot water immersion induces heat acclimation and improves endurance exercise performance in the heat.

We examined whether daily hot water immersion (HWI) after exercise in temperate conditions induces heat acclimation and improves endurance performance in temperate and hot conditions. Seventeen non-heat-acclimatized males performed a 6-day intervention involving a daily treadmill run for 40 min at 65% V̇O2max in temperate conditions (18 °C) followed immediately by either HWI (N = 10; 40 °C) or thermoneutral (CON, N = 7; 34 °C) immersion for 40 min. Before and after the 6-day intervention, participants performed a treadmill run for 40 min at 65% V̇O2max followed by a 5-km treadmill time trial (TT) in temperate (18 °C, 40% humidity) and hot (33 °C, 40% humidity) conditions. HWI induced heat acclimation demonstrated by lower resting rectal temperature (Tre , mean, -0.27 °C, P < 0.01), and final Tre during submaximal exercise in 18 °C (-0.28 °C, P < 0.01) and 33 °C (-0.36 °C, P < 0.01). Skin temperature, Tre at sweating onset and RPE were lower during submaximal exercise in 18 °C and 33 °C after 6 days in HWI (P < 0.05). Physiological strain and thermal sensation were also lower during submaximal exercise in 33 °C after 6 days in HWI (P < 0.05). HWI improved TT performance in 33 °C (4.9%, P < 0.01) but not in 18 °C. Thermoregulatory measures and performance did not change in CON. Hot water immersion after exercise on 6 days presents a simple, practical, and effective heat acclimation strategy to improve endurance performance in the heat.

Bathtub drowning: An 11-year retrospective study in the state of Maryland.

A bathtub drowning is one of the leading causes of death in a bathtub. The purpose of this study was to evaluate how reliable the drowning-related signs could be for identifying a bathtub drowning in the cases of death in the bathtub. Performing a retrospective review of 92 deaths in the bathtub in Maryland, 71.7 percent were the presence of bathtub drowning and 28.3 percent were the absence of bathtub drowning. Three leading contributory causes of death were cardiovascular disease, drug/alcohol-related death, and seizure disorder in both groups. There was a statistically significant difference between the groups in relation to a history of recovery from the water (95.5% and 38.4%, p<0.001), foam in the air way (33.3% and 15.4%, p<0.05), watery fluid in the sphenoid sinuses (81.8% and 11.5%, p<0.05), hyperinflated lungs (36.4% and 3.8%, p<0.01), and watery fluid in the stomach contents (40.9% and 3.8%, p<0.01). More than triple overlapped drowning-related signs could be beneficial for the diagnosis of a bathtub drowning. A comprehensive investigation incorporating a thorough scene investigation, gathering of the victim's medical and psychosocial history, and a meticulous full autopsy is necessary to elucidate both the cause and manner of death in these cases of death in the bathtub.

Effects of a comprehensive intervention program, including hot bathing, on overweight adults: a randomized controlled trial.

AIM: The objective of this study was to evaluate the effects of a comprehensive overweight intervention program, which utilizes hot bathing, on overweight, community-dwelling middle-aged and older adults in a randomized controlled trial. METHODS: The program was carried out in a hot bath facility and included 66 community-dwelling middle-aged and older Japanese adults (mean age 61.6 years, SD 7.5, 77.3% were women). The participants were randomly assigned to an exercise, diet and hot bathing intervention group (group A), exercise and diet intervention group (group B), a hot-bathing intervention group (group C) and a control group (group D). The participants in groups A and B participated in a comprehensive intervention program (including exercise and diet classes) twice a week for 3 months, and groups A and C had hot bathing. RESULTS: After 3 months, the participants in group A showed a reduction in weight, abdominal circumference, body mass index and body fat percentage compared with the other intervention groups. And the lower extremity function (i.e. walking speed) had greater improvement in the participants in groups A and B compared with groups C and D. In group C, in which only hot bathing was the intervention, there were no significant improvements in measurement items. CONCLUSIONS: Our study provides preliminary evidence that a comprehensive intervention program, including hot bathing, is useful for community residents with a tendency toward overweight.