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Purpose: We examined fluid intake, the relation between body mass (BM) loss and performance, and core temperature in young triathletes during a competition in tropical climate. Methods: Fluid intake and pre and post BM were measured in 35 adolescent athletes, and core temperature was measured in one female and one male. Results: Mean urine specific gravity (1.024 [0.007]) indicated that athletes were in suboptimal state of hydration upon waking. Race time was 73.2 (8.0) minutes. BM decreased by 0.6 (0.3) kg (P <.05). Fluid intake (528.5 [221.6] mL) replaced 47% of the fluid loss (1184.9 [256.4] mL) and was higher during run (11.5 [6.6] mL·min−1) compared to bike (7.3 [3.1] mL·min−1), P <.01. Loss in BM was ≥1.0% in 66% and ≥1.5% in 29% of the athletes. Males showed a moderate association between percentage loss in BM and finishing time (r = −.52), higher sweat rates (1.0 [0.3] L·h−1), and faster times (69.4 [7.5] min; P <.05). Core temperature rose to 40.1 °C in the female and 39.6 °C in the male. Conclusion: Young triathletes competing in a hot/humid climate became mildly to moderately dehydrated and hyperthermic even when water and sports drinks were available but did not show symptoms of heat illness. [ABSTRACT FROM AUTHOR]

Sunscreens may affect thermoregulation and sweating during exercise in warm climates. In this study, we compared the effects of three sunscreens on local sweating rate (LSR) during exercise under controlled conditions (32°C, relative humidity 55%). Fifteen subjects (8 men, 7 women) underwent 20-min cycles in four randomized conditions: control (CON), sunscreen A (SSA), sunscreen B (SSB) and sunscreen C (SSC). LSR was measured by a patch on the scapular region (p < .001). CON showed higher LSR (182.21 μL/min·dm2, CI95% 168 to 195 μL/min·dm2) compared to SSA (142.10 μL/min·dm2, CI95% 128 to 155 μL/min·dm2), SSB (158.06 μL/min·dm2, CI95% 144 to 171 μL/min·dm2), and SSC (159.00 μL/min·dm2, CI95% 145 to 172 μL/min·dm2). In men, SSA showed lower LSR compared to CON, SSB, and SSC (p < .05). On the other hand, no statistically significant differences were found in LSR between SSB, SSC, and CON conditions. In women, CON was superior to all sunscreens in LSR (p < .001), and there was no difference between them (SSA, SSB, SSC, p > .05). Sunscreen reduced LSR during moderate exercise in a hot and moderate humidity environment compared to CON, especially SSA in men and all sunscreens in women. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of taurine supplementation on sweating and core temperature responses, including the transition from compensable to uncompensable heat stress, during prolonged low-intensity exercise of a fixed-heat production (~ 200W/m2) in hot conditions (37.5 °C), at both fixed and incremental vapour-pressure. Methods: Fifteen females (n = 3) and males (n = 12; 27 ± 5 years, 78 ± 9 kg, V ˙ O2max 50.3 ± 7.8 mL/kg/min), completed a treadmill walking protocol (~ 200W/m2 heat production [Ḣprod]) in the heat (37.5 ± 0.1 °C) at fixed-(16-mmHg) and ramped-humidity (∆1.5-mmHg/5-min) following 1 week of oral taurine supplementation (50 mg/kg/bm) or placebo, in a double-blind, randomised, cross-over design. Participants were assessed for whole-body sweat loss (WBSL), local sweat rate (LSR), sweat gland activation (SGA), core temperature (Tcore), breakpoint of compensability (Pcrit) and calorimetric heat transfer components. Plasma volume and plasma taurine concentrations were established through pre- and post-trial blood samples. Results: Taurine supplementation increased WBSL by 26.6% and 5.1% (p = 0.035), LSR by 15.5% and 7.8% (p = 0.013), SGA (1 × 1 cm) by 32.2% and 29.9% (p < 0.001) and SGA (3 × 3 cm) by 22.1% and 17.1% (p = 0.015) during the fixed- and ramped-humidity exercise periods, respectively. Evaporative heat loss was enhanced by 27% (p = 0.010), heat-storage reduced by 72% (p = 0.024) and Pcrit was greater in taurine vs placebo (25.0-mmHg vs 21.7-mmHg; p = 0.002). Conclusion: Taurine supplementation increased sweating responses during fixed Ḣprod in hot conditions, prior to substantial heat strain and before the breakpoint of compensability, demonstrating improved thermoregulatory capacity. The enhanced evaporative cooling and reduced heat-storage delayed the subsequent upward inflection in Tcore—represented by a greater Pcrit—and offers a potential dietary supplementation strategy to support thermoregulation. [ABSTRACT FROM AUTHOR]

This study aimed to investigate seasonal heat acclimatization in active adolescents following summer. Fifteen (5 females) active adolescents (14.6 ± 1.0 y) completed a 45-min heat response test (HRT) walking at 60% $\dot {\rm V}$ V ˙ O2peak in 40°C and 30% relative humidity before and after summer (i.e. November 2022 and March 2023). During the HRT, gastro-intestinal temperature (Tgi), skin temperature (Tsk), heart rate, local sweat rate (LSR) and whole-body sweat loss (WBSL) were recorded. Carbon monoxide rebreathing and dual-energy X-ray absorptiometry scans determined resting hematological measures and body composition. Participants completed physical activity (PA) diaries and wore an accelerometer for two one-week periods (pre- and post-summer). Daytime wet-bulb globe temperature (WBGT) was calculated for each summer day. Data are presented as posterior mean and 90% credible intervals. Participants reported 7 ± 4 h·wk−1 of outdoor PA, and daytime WBGT was 21.2 ± 4.6°C. Following summer, resting Tgi and heart rate were reduced by 0.2°C [−0.3, −0.1; probability of direction = 99%] and 7 beats·min−1 [−10, −3; 100%], respectively. During the HRT, there was an earlier onset of sweating (−0.2°C [−0.3, −0.0; 98%]), an attenuated rise of Tgi (0.2°C [−0.5, 0.0; 92%]) and mean Tsk changed by −0.2°C [−0.5, 0.1; 86%]. There was minimal evidence for heat adaptations in LSR or WBSL, hematological parameters or perceptual measures. This is the first study to demonstrate seasonal heat adaptations in active adolescents. Reductions in resting Tgi and exercising Tsk and a lower Tgi at the onset of sweating were associated with a smaller rise in Tgi during the HRT following summer. [ABSTRACT FROM AUTHOR]

Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans, is a rare dermatological condition characterized by single or multiple annular or semi-annular centrifugally growing lesions surrounded by tiny erythematous papules typically observed on the trunk. EPC is prevalent, particularly in Japan and China, although only a few cases have been reported outside Asia. Herein, we present the case of a 47-year-old female from Thailand who experienced a pruritic annular erythematous rash on her right arm for two months. The diagnosis of EPC was established based on clinical manifestations and confirmed by histopathological examination. The lesions resolved after one month of treatment with 0.1% betamethasone valerate cream and avoiding warm weather. This case report contributes to the understanding of EPC, which may be underrecognized in clinical practice due to its self-limiting nature and frequent misdiagnosis. Furthermore, this article provides a comprehensive review of 17 previously reported cases of EPC, focusing on their detailed descriptions. [ABSTRACT FROM AUTHOR]

Introduction: Identifying subgroups of patients with primary hyperhidrosis (PHH) can improve the understanding of the disease pathophysiology. The study objective was to determine the naturally occurring subgroups of patients with PHH based on clinical characteristics. Methods: In this retrospective cohort study, data were collected from participants included in a clinical trial. The data were collected between January 2020 and June 2021 from outpatients with PHH attending a dermatologic department in Denmark. Overall, 84 patients with PHH were screened for inclusion in the clinical trial. Of these, 41 met the eligibility criteria. Four participants were excluded because of missing data. The main outcome was the identification of subgroups of patients with PHH using an unsupervised hierarchical cluster analysis. Results: Overall, 37 patients were included {28 (76.7%) females; median age at inclusion 28.0 (interquartile range [IQR] 24.0–38.3); median body mass index 24.9 (IQR 20.9–27.4); median age of onset 13.0 (IQR 9.5–18.5); and 26 (70.3%) had a familial disposition toward PHH}. Two clusters of 18 and 17 patients were identified. The first cluster had, when compared to the second, a younger age of onset (median age 11.0 [IQR 0–13.0] vs. 17.0 [IQR 15.0–21.0], p = 0.003) and higher sweat rates on gravimetry (median 175.0 [IQR 121.2–252.5] vs. 40.0 [IQR 20.0–60.0] milligrams of sweat/5 min, p < 0.001) and transepidermal water loss (median 93.7 [IQR 91.2–97.8] vs. 59.0 [IQR 44.4–73.2] g/m2/h, p < 0.001). No differences were observed for the other variables. Conclusions: This study identifies 2 subgroups of patients with PHH. The patients with an onset of PHH during childhood had a substantially higher sweat and evaporation rate in adulthood than those with an onset during adolescence. These findings may imply a changed understanding of the pathophysiology of PHH, by indicating that an early disease onset can lead to a worse disease course. [ABSTRACT FROM AUTHOR]

Understanding human temperature physiology and its management has significant relevance across all clinical specialties. Not only does it influence anaesthetic drug metabolism, it also affects perioperative outcome. Thermal management is equally crucial in a multitude of clinical settings. In the neonatal intensive care unit (ICU), paediatricians must carefully manage preterm babies' temperature. In the accident and emergency department, physicians manage near-drowning patients. Post-operative care for a patient with a traumatic brain injury in an adult ICU requires strict temperature control to prevent secondary brain injury. This article hopes to bring forth some key principles of thermoregulation, however temperature measurements and warming strategies are to be covered in other review articles. The article also highlights some important concepts of thermal-dysregulation such as fever and heat stroke, especially in the context of an ageing population and global warming. [ABSTRACT FROM AUTHOR]

Background: Hyposalivation is treated using oral cholinergic drugs; however, systemic side effects occasionally lead to discontinuation of treatment. We aimed to investigate the effects of transdermal pilocarpine on the salivary gland skin on saliva secretion and safety in rats. Methods: Pilocarpine was administered to rats orally (0.5 mg/kg) or topically on the salivary gland skin (5 mg/body). Saliva volume, the number of sweat dots, and fecal weight were measured along with pilocarpine concentration in plasma and submandibular gland tissues. Results: Saliva volume significantly increased 0.5 h after oral administration and 0.5, 3, and 12 h after topical administration. Fecal weight and sweat dots increased significantly 1 h after oral administration; however, no changes were observed after topical application. The pilocarpine concentration in the submandibular gland tissues of the topical group was higher than that in the oral group at 0.5, 3, and 12 h of administration. Conclusions: Pilocarpine application to salivary gland skin persistently increased salivary volume in rats without inducing sweating or diarrhea. Transdermal pilocarpine applied to the skin over the salivary glands may be an effective and safe treatment option for hyposalivation. [ABSTRACT FROM AUTHOR]

Abstract Background Hyposalivation is treated using oral cholinergic drugs; however, systemic side effects occasionally lead to discontinuation of treatment. We aimed to investigate the effects of transdermal pilocarpine on the salivary gland skin on saliva secretion and safety in rats. Methods Pilocarpine was administered to rats orally (0.5 mg/kg) or topically on the salivary gland skin (5 mg/body). Saliva volume, the number of sweat dots, and fecal weight were measured along with pilocarpine concentration in plasma and submandibular gland tissues. Results Saliva volume significantly increased 0.5 h after oral administration and 0.5, 3, and 12 h after topical administration. Fecal weight and sweat dots increased significantly 1 h after oral administration; however, no changes were observed after topical application. The pilocarpine concentration in the submandibular gland tissues of the topical group was higher than that in the oral group at 0.5, 3, and 12 h of administration. Conclusions Pilocarpine application to salivary gland skin persistently increased salivary volume in rats without inducing sweating or diarrhea. Transdermal pilocarpine applied to the skin over the salivary glands may be an effective and safe treatment option for hyposalivation.

Heart palpitations are the sensations or feelings that accompany an excessively rapid, skip-beat, or fluttering heartbeat. Heart palpitations can be brought on by a variety of factors, such as anxiety, tension, fear, caffeine, nicotine, some medications, dietpills, physical activity, and fever. Herbal remedies have long been utilized widely in the therapeutic management of palpitations because available synthetic medications have substantial negative effects. The purpose of this study is to assess the safety and effectiveness of the Unani medication Jawarish-e-Shahi in patients experiencing palpitations. The information provided here is an open-level, multicentric clinical study that was carried out at the "Regional Research Institute of Unani Medicine in Aligarh", Uttar Pradesh, from 2016 to 2019 on 74 cases of palpitation streated with Jawarish-e-Shahi. A p-value of<0.05 was proved to be significant in the statistical analysis of the presented data, which was conducted using one-way analysis of variance (ANOVA) and Dunnett's test. The study's findings, which were compared to baseline data from various follow-ups of palpitation cases treated with Jawarish-e-Shahi, demonstrated a notable improvement in a number of palpitation symptoms, including anxiety, perspiration, nausea, vomiting, and chest heaviness. A significant decline in diastolic pressure and pulse rate had also been observed. Reduction in number of pallor (pale appearance of patients) in baseline, 1st follow-up and post-treatment had been noted. Based on the investigation, the Unani medicine is safe and non-toxic. More research on a large size of population with palpitations is suggested for further study. [ABSTRACT FROM AUTHOR]

Humans produce different rates of sweating depending on the intensity level of a given activity. The clothing worn during the activity has a significant effect on the latent heat loss that can occur before, during, and after the activity. The water adsorption and spreading properties of a material yield differences in the amount of heat exchange that can occur between the person and the environment. Current test methods evaluate this using a value known as evaporative resistance, which is used to determine the heat exchange potential of a material. However, this value is only taken once the material has reached "steady state" and does not consider the sweating period before steady state is reached, or the drying period after steady state is reached. Therefore, an area under the curve (AUC) value was derived during these periods to compare the heat exchange properties of different materials. A sweating guarded hot plate was used to simulate different sweat rates, and therefore activity levels, to compare materials constructed of cotton, viscose, polyester, and wool. The overall latent heat loss of the hydrophobic wool was much less compared to the other samples with a gentler slope and lower AUC values than the other samples. It was found that the segment of time analyzed has a significant impact on the conclusion drawn about the latent heat loss of a material, p < 0.0001. Sweat rate also has a significant impact on the heat loss value, p < 0.0001, but is perhaps less useful when comparing samples to each other. It was found that comparing the different periods of the test could yield different conclusions when comparing materials for latent heat loss. Several current test methods do not consider phases outside of the steady state period and therefore miss valuable information pertinent to user comfort during these phases, especially in the post-exercise phase. [ABSTRACT FROM AUTHOR]

Sweating is one of the most important processing methods of Chinese medicinal herbs. However, the high temperature and humidity environment required for sweating Chinese medicinal herbs makes it very easy for fungi to breed, especially toxigenic fungi. The mycotoxins produced by these fungi will then contaminate the Chinese medicinal herbs. In this study, we explored the changes in mycobiota, toxigenic fungi, and mycotoxins with and without sweating in Radix Dipsaci (RD), a typical representative of traditional Chinese medicine that requires processing through sweating. We also isolated and identified the toxigenic fungi from RD, whether they were subjected to sweating treatment or not, and examined their toxigenic genes and ability. The results showed that the detection rate of mycotoxins (aflatoxins, ochratoxins, zearalenone, and T-2 toxin) in RD with sweating was 36%, which was 2.25-fold higher than that in RD without sweating. We also detected T-2 toxin in the RD with sweating, whereas it was not found in the RD without sweating. The sweating process altered the fungal composition and increased the abundance of Fusarium and Aspergillus in RD. Aspergillus and Fusarium were the most frequently contaminating fungi in the RD. Morphological and molecular identification confirmed the presence of key toxigenic fungal strains in RD samples, including A. flavus, A. westerdijkiae, F. oxysporum and F. graminearum. These four fungi, respectively, carried AflR, PKS, Tri7, and PKS14, which were key genes for the biosynthesis of aflatoxins, ochratoxins, zearalenone, and T-2 toxin. The toxigenic ability of these four fungal strains was verified in different matrices. We also found that A. flavus, A. westerdijkiae, and F. oxysporum were isolated in RD both with sweating and without sweating, but their isolation frequency was significantly higher in the RD with sweating than in the RD without sweating. F. graminearum was not isolated from RD without sweating, but it was isolated from RD with sweating. These findings suggest that the sweating process promotes the expansion of toxigenic fungi and increases the risk of combined mycotoxin contamination in RD. [ABSTRACT FROM AUTHOR]

• Cassis polyphenol (CaP; 400 mg/d, 4 weeks) did not improve menopausal symptoms. • CaP (400 mg/d, 4 weeks) did not improve anxiety, quality of life, or sleep. • CaP (400 mg/d, 4 weeks) did not improve hot flashes (HF) or sweating. • HF and sweating improved in the CaP group during a 2-week post-intervention period. • CaP had limited effects on menopausal symptoms and may require longer intervention. Hormonal changes during the menopause transition may lead to vasomotor symptoms, including hot flashes (HFs) and neuropsychiatric symptoms such as anxiety and irritability. We hypothesized that the effects of cassis polyphenol (CaP) to improve microcirculation and vasorelaxation may alleviate menopausal symptoms. We performed a randomized, double-blind, parallel-group, placebo-controlled trial involving 59 healthy women (mean [standard deviation] age, 51.3 [4.3] years; body mass index, 20.8 [2.6] kg/m2). Participants experiencing subjective menopausal symptoms consumed CaP tablets (400 mg/d, CaP group) or placebo tablets (placebo group) for 4 weeks. Participants were evaluated using questionnaires at baseline, during the 4-week intervention period, and during a 2-week postinterventional observation period. The primary objective was to evaluate the effects of supplementation with CaP on HFs in healthy Japanese women with menopausal symptoms. Additional assessments included the modified Kupperman menopausal index, World Health Organization-5 Well-Being Index, World Health Organization quality-of-life 26-item index, State-Trait Anxiety Inventory (anxiety and trait components), and Oguri–Shirakawa–Azumi sleep inventory (middle-aged and elderly versions). During the 4-week intervention period, no significant between-group differences were detected in the HF frequency, HF score, sweating frequency, menopausal symptoms, quality of life, anxiety, or sleep. During the 2-week postintervention observational period, the HF score and sweating frequency were significantly decreased in the CaP group compared with the placebo group. These findings suggest that twice daily intake of CaP for 4 weeks does not alleviate menopause symptoms, but the improvement observed in the CaP intake group during the postintervention period warrants confirmation through further large-scale studies. CaP may alleviate menopausal symptoms by microcirculatory and antioxidant effects. A randomized, double-blind, parallel-group trial in 59 healthy women (mean ± standard deviation; age: 51.3 ± 4.3 years, BMI, 20.8 ± 2.6 kg/m2) revealed no significant differences in HF or sweating frequency, HF score, menopausal symptoms, quality of life, anxiety, or sleep between groups. In the 2-week observation after the intervention, HF scores and sweating frequency were significantly reduced in the CaP group. Abbreviations: BMI, body mass index; CaP, cassis polyphenols; HF, hot flash. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Although Huntington's disease (HD) is usually thought of as a triad of motor, cognitive, and psychiatric symptoms, there is growing appreciation of HD as a systemic illness affecting the entire body. Objectives: This review aims to draw attention to these systemic non‐motor symptoms in HD. Methods: We identified relevant studies published in English by searching MEDLINE (from 1966 to September 2023), using the following subject headings: Huntington disease, autonomic, systemic, cardiovascular, respiratory, gastrointestinal, urinary, sexual and cutaneous, and additional specific symptoms. Results: Data from 123 articles were critically reviewed with focus on systemic features associated with HD, such as cardiovascular, respiratory, gastrointestinal, urinary, sexual and sweating. Conclusion: This systematic review draws attention to a variety of systemic and autonomic co‐morbidities in patients with HD. Not all of them correlate with the severity of the primary HD symptoms or CAG repeats. More research is needed to better understand the pathophysiology and treatment of systemic and autonomic dysfunction in HD. [ABSTRACT FROM AUTHOR]

Thermal balance is paramount to human comfort and safety. To better understand the effects of the material and environment, a modified sweating-hot-plate test was used to incorporate environmental parameters such as the ventilation and microclimate thickness. It was found that at wind speeds ≤ 0.5 m/s, the environment has the most significant effect on the insulation. However, at an increased wind speed (1.3 m/s), the construction of the material has a large influence on the insulation of the system. At a low metabolic rate, the heat storage can be compensated for through dry heat loss; but, at a higher metabolic rate, substantial differences in the sweating rates are required based on the material and environment. The various aspects of the environment wind speed, microclimate thickness, and ventilation are crucial, but, in certain combinations, the material can have a significant impact as well. [ABSTRACT FROM AUTHOR]

Cholinergic urticaria (CholU) is a rare condition characterized by itchy hives in the form of 1-4 mm small, raised wheals on skin, which are short-lived for duration of 15 to 20 minutes; they are caused by stimuli associated with sweating such as from physical exercise. CholU is also known as cholinergic angioedema urticaria. Hereby, we present a case report of a 42-year-old male with ChoIU who presented with systemic manifestation in the form of recurrent attacks of syncope. Diagnosis was made after a detailed history taking and all cardiac and neurological evaluations done that were normal, and widespread literature research was done to rule out other causes of syncope as systemic symptoms are rarely seen in ChoIU. His IgE antibodies levels were highly increased. He was managed with nonsedating antihistamines and health education regarding the rare condition.

(1) Background: Trainers and athletes have always sought to reduce the failure of muscle function during long endurance events. However, nowadays, it is a topic that is generating much debate in the scientific field. Currently, deep-sea water (DSW) intake seems to be a suitable hydration alternative for this type of endurance event. Therefore, the aim of this study was to determine whether DSW consumption during a triathlon event could preserve muscle function after exercise. (2) Methods: Nineteen trained male triathletes (age = 39.0 ± 4.25 years; BMI = 23.67 ± 1.81 kg/m2) randomly performed three triathlons, one of them consuming DSW (Totum SPORT 30 AB, Laboratories Quinton International, S.L., Spain), the other consuming isotonic placebo and the last with tap water-hydration. A vertical jump test with countermovement and an isometric muscle strength test were conducted before and after the triathlon test. (3) Results: There was a significant difference between treatment × time during the isometric muscle strength test. Based on the Tukey post hoc analysis, the peak net force decreased statistically in the placebo (p = 0.045) and control conditions (p = 0.026), but not in the experimental condition (p = 0.121). In addition, all of the conditions studied obtained similar results in the countermovement vertical jump after exercise. (4) Conclusions: As a result, consumption of DSW seems to delay the failure of muscle function specifically in isometric exercises but does not improve performance in sports. Thus, DSW does not alter muscle capacity in a negative way; therefore, its consumption may be recommended. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with pruritus, an impaired cutaneous barrier function and a disrupted water holding capacity. Levels of ceramides, which are major components of intercellular lipids and are crucial for their functions, are decreased in the stratum corneum of patients with AD. Treatments to increase ceramide levels are effective for AD care. Synthetic pseudo-ceramide (cetyl PG hydroxyethyl palmitamide (SLE66)), which has a structure developed via molecular designs, and a eucalyptus leaf extract (ELE) enhance ceramide synthesis in the epidermis. The topical application of a skin moisturizer containing SLE66 and ELE improves the barrier functions and water holding capacity of AD skin accompanied by an improvement in skin symptoms. This is a multifaceted review that summarizes the efficacy of the topical application of a skin moisturizer containing SLE66 and ELE on atopic dermatitis. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Thoracoscopic sympathicotomy may be an effective treatment for disabling facial blushing in selected patients. Short- and mid-term results are good but very long-term results are scarce in the medical literature and there is no knowledge which extent of sympathicotomy is better long-term for isolated facial blushing. METHODS We previously randomized 100 patients between a rib-oriented R2 or R2–R3 sympathicotomy for isolated facial blushing, and reported local effects, side effects and quality of life after 12 months. In the present study, we sent identical questionnaires to all patients after a median of 16 years (interquartile range 15–17 years). RESULTS The response rate was 66%. Overall, 82% reported excellent or satisfactory results on facial blushing, with significant better local effect after R2 sympathicotomy compared with R2–R3 sympathicotomy. Patients who underwent R2 sympathicotomy were also significantly more satisfied with the operation. We found no significant difference between R2 and R2–R3 sympathicotomy in quality of life or rates of compensatory sweating (77%) and recurrence of blushing (41%) which was milder than preoperatively in most patients. CONCLUSIONS R2 sympathicotomy should be the preferred approach for isolated facial blushing because of better local effect and higher satisfaction rates. Although this was a very long-term follow-up of the only randomized trial of its kind the response rate was limited leaving a risk of undetected bias. [ABSTRACT FROM AUTHOR]

Background: A programme based on health education has been developed to prevent foot dermatoses (FD) in patients with work‐related skin diseases (WRSD). Objective: To evaluate the effectiveness of the programme in a prospective cohort study (OCCUPES). Methods: Six and 12 months after completing the programme, follow‐up questionnaires were sent to 231 patients with WRSD and FD. Assessments included occupational footwear and foot care, self‐reported disease course, and health‐related quality of life. Results: Response to follow‐ups was >70%. Wearing functional socks and changing footwear and socks during one work shift increased (all p < 0.001). Complaints about occupational footwear decreased, including sweating and exposure to moisture/wetness. More than 60% reported improved FD while quality of life significantly increased. After 12 months, all foot symptoms were less frequent, including itch (p = 0.009), pain when walking (p = 0.005), pain in rest (p = 0.015) and smell (p = 0.001). The programme received very good ratings by the participants. Conclusions: The intervention was effective in improving occupational footwear, foot care and preventive behaviour. It resulted in a reduced burden of FD and should be implemented in the general care of patients with WRSD. [ABSTRACT FROM AUTHOR]

Cholinergic urticaria (CholU) is a rare condition characterized by itchy hives in the form of 1-4 mm small, raised wheals on skin, which are short-lived for duration of 15 to 20 minutes; they are caused by stimuli associated with sweating such as from physical exercise. CholU is also known as cholinergic angioedema urticaria. Hereby, we present a case report of a 42-year-old male with ChoIU who presented with systemic manifestation in the form of recurrent attacks of syncope. Diagnosis was made after a detailed history taking and all cardiac and neurological evaluations done that were normal, and widespread literature research was done to rule out other causes of syncope as systemic symptoms are rarely seen in ChoIU. His IgE antibodies levels were highly increased. He was managed with nonsedating antihistamines and health education regarding the rare condition.

Reports indicate that an interaction between TRPV4 and anoctamin 1 (ANO1) could be widely involved in water efflux of exocrine glands, suggesting that the interaction could play a role in perspiration. In secretory cells of sweat glands present in mouse foot pads, TRPV4 clearly colocalized with cytokeratin 8, ANO1, and aquaporin-5 (AQP5). Mouse sweat glands showed TRPV4-dependent cytosolic Ca2+ increases that were inhibited by menthol. Acetylcholine-stimulated sweating in foot pads was temperature-dependent in wild-type, but not in TRPV4-deficient mice and was inhibited by menthol both in wild-type and TRPM8KO mice. The basal sweating without acetylcholine stimulation was inhibited by an ANO1 inhibitor. Sweating could be important for maintaining friction forces in mouse foot pads, and this possibility is supported by the finding that wild-type mice climbed up a slippery slope more easily than TRPV4-deficient mice. Furthermore, TRPV4 expression was significantly higher in controls and normohidrotic skin from patients with acquired idiopathic generalized anhidrosis (AIGA) compared to anhidrotic skin from patients with AIGA. Collectively, TRPV4 is likely involved in temperature-dependent perspiration via interactions with ANO1, and TRPV4 itself or the TRPV4/ANO 1 complex would be targeted to develop agents that regulate perspiration.

Salvia miltiorrhiza Bge. (S. miltiorrhiza) is a well-known traditional Chinese medicine for the treatment of cardiovascular diseases. The processing of S. miltiorrhiza requires the raw herbs to sweat first and then dry. The aim of this study was to investigate the anti-acute myocardial ischemia (AMI) of S. miltiorrhiza extracts (including tanshinones and phenolic acids) before and after sweating, and to further explore whether the “sweating” primary processing affected the efficacy of S. miltiorrhiza. The AMI animal model was established by subcutaneous injection of isoprenaline hydrochloride (ISO). After treatment, the cardiac function of rats was evaluated by electrocardiogram (ECG), biochemical, and histochemical analysis. Moreover, the regulation of S. miltiorrhiza extracts on the peroxisome proliferator-activated receptor α (PPARα)/retinoid X receptor α (RXRα)/nuclear transcription factor-kappa B (NF-κB) signaling pathway of rats was assessed by the Western blotting. The results showed that sweated and non-sweated S. miltiorrhiza extracts including tanshinones and phenolic acids significantly reduced ST-segment elevation in ECG and the myocardial infarction area in varying degrees. Meanwhile, sweated and non-sweated S. miltiorrhiza reversed the activities of aspartate transaminase (AST), lactic dehydrogenase (LDH), creatine kinase-MB (CK-MB), and superoxide dismutase (SOD), as well as the levels of interleukin-6 (IL-6), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) in AMI rats. Concurrently, the results of Western blotting revealed that S. miltiorrhiza extracts regulated the PPARα/RXRα/NF-κB signaling pathway to exert an anti-inflammatory effect. Most importantly, sweated S. miltiorrhiza tanshinones extracts are more effective than the non-sweated S. miltiorrhiza, and the anti-inflammatory efficacy of tanshinones extract was also better than that of phenolic acid extract. Although phenolic acid extracts before and after sweating were effective in anti-AMI, there was no significant difference between them. In conclusion, both tanshinones and phenolic acids extracts of sweated and non-sweated S. miltiorrhiza promote anti-oxidative stress and anti-inflammatory against AMI via regulating the PPARα/RXRα/NF-κB signaling pathway. Further, the comparations between sweated and non-sweated S. miltiorrhiza extracts indicate that sweated S. miltiorrhiza tanshinones extracts have better therapeutic effects on AMI.

Objectives: Primary Hyperhidrosis (HH) is the excessive sweating condition in one or more parts of the body. The definitive treatment method is surgical. The most commonly applied surgical method is endoscopic thoracic sympathectomy (ETS). We aimed to investigate the effectiveness of patients with hyperhidrosis by making temperature measurements. Methods: We analyzed the findings of 30 patients who were diagnosed with HH between January 1, 2019 and November 1, 2022 in Kahramanmaraş Sütçü İmam University Thoracic Surgery Clinic. Preoperative, intraoperative and postoperative hand temperatures of the patients who underwent bilateral endoscopic thoracic sympathectomy were examined by measuring hand temperatures with a thermal camera. Results: After the evaluation of the examination, it was revealed that there was an increase in the hand temperature measurement values before sympathectomy and after the sympathectomy operation. Conclusions: We believe that endoscopic thoracic sympathectomy performed by measuring temperature with a thermal camera will increase the comfort and safety of the surgery both on the part of the physician and the patient. [ABSTRACT FROM AUTHOR]

In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumor (SFT) is an extremely rare mesenchymal neoplasm usually detected in the pleura, which generally follows a benign course. The localization inside lung parenchyma has more rarely been reported. We present a case of a 51-year-old male with a dry cough, dyspnea, chest pain, and increased perspiration. Radiological images revealed a giant circumscribed mass on the right side of the chest. A transbronchial cryobiopsy of the lung was performed and revealed an SFT. The right upper lobectomy through lateral thoracotomy was performed. The pathological examination confirmed an SFT with a central zone of necrosis that is a sign of malignancy. At a 2-year follow-up, the patient is free of symptoms and with no evidence of recurrence. Although the intrapulmonary localization of an SFT is a rare entity, we should be aware of it as a potential malignant pulmonary neoplasm. [ABSTRACT FROM AUTHOR]

It was reported that metabolic acidosis inhibits the activity of warm-sensitive hypothalamic neurons. The present study was designed to test the hypothesis that metabolic alkalosis may improve heat loss during intensive exercise in men. Fifteen male subjects aged 22-24 years were submitted to incremental exercise on two randomized occasions one week apart. During the bicarbonate trial exercise was preceded by ingestion of NaHCO3 at a dose 250 mg/kg whilst during the placebo trial lactose was administered. Exercise load was increased every 3 min by 30 W until volitional exhaustion. Ambient temperature was kept at 23-24°C and humidity 50-60%. Tympanic and skin temperatures were recorded and the rate of sweating was assayed by humidity measurement of nitrogen flowing through a capsule attached to the mid posterior chest. Total sweat loss was determined by the changes in body mass. Venous blood samples were taken before exercise and at the end of each workload for determination of acid-base parameters. The subjects attained similar maximal workload in the two tests (260 ± 6 W) with heart rate 185 ± 6 beats/min. Blood concentration of hydrogen ions was lower (p < 0.001) in the bicarbonate than in the placebo trial throughout the whole exercise period. There were no significant differences between these tests in tympanic and mean skin temperatures, sweating rate and total sweat loss. The present data showed that in men attenuation of metabolic acidosis by bicarbonate ingestion did not influence thermoregulation during incremental exercise performed until volitional exhaustion, possibly due to too short duration of exertional uncompensated metabolic acidosis. [ABSTRACT FROM AUTHOR]

Affecting the eccrine glands, granulosis rubra nasi (GRN) is an inherited disorder that manifests itself as redness, sweating, and papules distributed mainly in the center of the face. It is diagnosed clinically and the cornerstone of management is reassurance and education about the benign nature of the condition. A wide array of treatment modalities has been proposed, such as Botox and corticosteroids injections; however curative measures are yet to be discovered. In this paper, we present a case of a 26-year-old man complaining of chronic nose sweating. The case was successfully managed with Botox injections, though we suggested our theory of undercutting the glands through aggressive defatting as part of open rhinoplasty to the patient; he declined our suggested modality. It remains an untested option and caution should be exercised in high-risk patients to avoid compromising blood supply to the skin and risking skin necrosis. [ABSTRACT FROM AUTHOR]

Thermal balance is paramount to human comfort and safety. To better understand the effects of the material and environment, a modified sweating-hot-plate test was used to incorporate environmental parameters such as the ventilation and microclimate thickness. It was found that at wind speeds ≤ 0.5 m/s, the environment has the most significant effect on the insulation. However, at an increased wind speed (1.3 m/s), the construction of the material has a large influence on the insulation of the system. At a low metabolic rate, the heat storage can be compensated for through dry heat loss; but, at a higher metabolic rate, substantial differences in the sweating rates are required based on the material and environment. The various aspects of the environment wind speed, microclimate thickness, and ventilation are crucial, but, in certain combinations, the material can have a significant impact as well.

Hyperhidrosis is a disease that is characterized by excessive sweating of the body as a result of excessive activity of the eccrine sweat glands and negatively affects the quality of life of the patients. It is seen at the same rate in men and women. The cause of primary hyperhidrosis is unknown and sweating most commonly occurs in the hands, feet, and axillary region. Secondary hyperhidrosis develops secondary to a disease. Sweating occurs throughout the body rather than regional sweating. Primary hyperhidrosis is the most common. Its treatment is difficult due to the unknown pathophysiology. However, the quality of life of patients can be increased with various surgical and non-surgical treatment methods. Neural therapy is a technique in which local anesthetic injections are used for diagnosis and treatment. In this article, a case of primary hyperhidrosis treated with neural therapy is presented. [ABSTRACT FROM AUTHOR]

Background: A programme based on health education has been developed to prevent foot dermatoses (FD) in patients with work-related skin diseases (WRSD). Objective: To evaluate the effectiveness of the programme in a prospective cohort study (OCCUPES). Methods: Six and 12 months after completing the programme, follow-up questionnaires were sent to 231 patients with WRSD and FD. Assessments included occupational footwear and foot care, self-reported disease course, and health-related quality of life. Results: Response to follow-ups was >70%. Wearing functional socks and changing footwear and socks during one work shift increased (all p < 0.001). Complaints about occupational footwear decreased, including sweating and exposure to moisture/wetness. More than 60% reported improved FD while quality of life significantly increased. After 12 months, all foot symptoms were less frequent, including itch (p = 0.009), pain when walking (p = 0.005), pain in rest (p = 0.015) and smell (p = 0.001). The programme received very good ratings by the participants. Conclusions: The intervention was effective in improving occupational footwear, foot care and preventive behaviour. It resulted in a reduced burden of FD and should be implemented in the general care of patients with WRSD. © 2023 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Poria cocos is a natural source of fungal food raw materials. Processing method is a key effecting the aroma of Poria cocos. In this study, the aroma compounds of Poria cocos products processed using sweating-low-temperature drying (SW-LD), sweating-high-temperature drying (SW-HD), steaming-low-temperature drying (ST-LD), and steaming-high-temperature drying (ST-HD) were compared by headspace solid-phase microextraction (HS-SPME) combined with gas chromatography–mass spectrometry (GC–MS), and the changes in aroma compounds of Poria cocos products during processing were analyzed. GC–MS analysis showed SW-HD product had highest content of aroma compounds. Aroma activity value (OAV) analysis indicated that 9 aroma compounds contributed to the overall aroma of Poria cocos. Among 9 compounds of Poria cocos , 1-octen-3-ol, hexanal, nonanal, octanal, trans -2-octenal, and heptanal contributed to mushroom, refreshing, sweet and fatty characters. In addition, the aroma compound changes during the processing were analyzed, revealing that steaming and sweating were the key processes affecting the aroma of Poria cocos products. The findings of this study provide valuable theoretical guidance for the development of Poria cocos processing technology. [Display omitted] • Steaming and sweating are the key processes affecting the aroma of Poria cocos products. • A total of 55 volatile compounds were identified in Poria cocos. • 1-Octen-3-ol, hexanal, octanal, trans -2-octenal, and heptanal were identified as key aroma compounds in Poria cocos. • The sweating-high-temperature drying (SW-HD) has the highest aroma intensity among the processing methods. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat., Methods: 12 males (age: 27±6 years, V̇O 2peak : 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C wet-bulb globe temperature) with different cooling configurations: regular match without cooling breaks (REG), 3 min breaks without cooling (BRK no-cool ), 3 min breaks with cooling (BRK cool : current FIFA policy; chilled fluid ingestion and ice towel across neck and shoulders), 5 min extended half-time without cooling breaks (ExtHT only ) and 3 min cooling breaks with 5 min ExtHT (ExtHT cool ). Rectal temperature (T re ), heart rate, whole-body sweat rate (WBSR) and rating of perceived exertion (RPE) were recorded. Data are presented as mean (95% CIs)., Results: Final T re was lower in BRK no-cool (0.20°C (0.01, 0.39), p=0.038), BRK cool (0.39°C (0.21, 0.57), p<0.001) and ExtHT cool (0.40°C (0.22, 0.58), p<0.001) than REG (39.1°C (38.8, 39.3)). Mean T re was lower in ExtHT cool (38.2°C (38.0, 38.4)) than BRK cool (38.3°C (38.1, 38.5), p=0.018), BRK no-cool and ExtHT only (38.4°C (38.2, 38.6), p<0.001) and REG (38.5°C (38.3, 38.7), p<0.001). Mean heart rate was lower during BRK cool (6 beats/min (4, 7), p<0.001) and ExtHT cool (7 beats/min (6, 8), p<0.001) compared with REG. WBSR was comparable across trials (p ≥ 0.07) and RPE was attenuated during BRK cool (0.4 (0.1, 0.7), p=0.004) and ExtHT cool (0.5 (0.2, 0.7), p=0.002), compared with REG., Conclusion: BRK cool and ExtHT cool attenuated thermal, cardiovascular and perceptual strain during a simulated football match in the heat. Additional strategies may be required in field settings or under harsher conditions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Hyperhidrosis is associated with social and emotional stress, affecting quality of life. Microwave energy technology treats primary axillary hyperhidrosis by thermolysis of sweat glands. The successful reduction of sweating in patients with primary axillary hyperhidrosis after microwave treatment has been studied, but there is limited evidence on the psychological and long-term effects. This study examined patient- reported outcome measures including depression and anxiety in patients with primary axillary hyperhidrosis and the effect of microwave therapy on these parameters. Patients received 1 or 2 microwave-based treatments, within 3-month intervals. All patients were finally examined at approximately 1 year after the first treatment using the Hyperhidrosis Disease Severity Scale, Hyperhidrosis Quality of Life©, Dermatology Life Quality Index, and Hospital Anxiety and Depression Scale©. A total of 103 individuals with primary axillary hyperhidrosis were included in the study, with a Hyperhidrosis Disease Severity Scale score of 3 or 4. Statistically significant improvement in quality of life, anxiety, and depression scores were observed at 1-year follow-up. The primary endpoint, Hyperhidrosis Disease Severity Scale of 2 or less 1 year after the first treatment, was achieved by 88.2% of patients. No serious adverse side effects were observed.

Background: Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized., Methods: Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment., Results: Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL., Conclusions: Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU., (Copyright © 2024 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.)

Objective: Vasomotor symptoms (VMS) due to menopause cause substantial burden and distress. Some women join online communities to share experiences and treatment outcomes through peer-to-peer interactions. This study describes women's experiences with VMS and symptom management on the PatientsLikeMe online support group., Methods: Mixed-methods research included women aged 40 to 65 years in the PatientsLikeMe community who were recruited using convenience sampling. Text from online posts by members was analyzed retrospectively using natural language processing. Relevant data, including numbers and percentages of women and frequencies of mentions, were summarized descriptively. Qualitative semistructured interviews were conducted; data, notes, and recordings were transcribed and deidentified and thematic analyses were performed., Results: Demographic information was available from 1,614 accounts included in retrospective text analyses. Women had a mean age of 56.7 years; most were White (87.8%) and not Hispanic/Latino (90.2%). Hot flashes and night sweats were most commonly mentioned symptoms (n = 146). Of 16 women who were interviewed, 14 met the inclusion criteria, and their responses were included in the analysis. VMS impacted life quality in terms of physical (43%) and mental well-being (36%), social activities (21%), and productivity (14%). Symptom management included temperature regulation (43%), lifestyle changes (36%), over-the-counter Estroven (29%), hormone therapy (21%), and contraceptives (21%). Half of the women were surprised by symptom intensity and duration; many felt unheard by their healthcare providers., Conclusions: VMS have a substantial negative impact on multiple aspects of women's life. Management strategies for these symptoms vary widely, and many women feel unprepared for navigating the complex challenges of menopause., Competing Interests: Financial disclosure/conflicts of interest: J. Shepherd has no relationships to disclose. A. Shiowaza, A. L. Schild, and S. A. Mancuso are employees of Astellas Pharma, Inc. D. Singh is an employee of PatientsLikeMe, LLC., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The Menopause Society.)

Effective sweat management fabric for sportswear facilitates sweat removal from the skin and elevates the comfort for human. However, when the body is in a strong hot and humid environment or after strenuous exercise, the sweat management fabric will be totally wetted and saturated quickly. As a result, excess sweat cannot be absorbed effectively by the garment, which creates obvious stickiness and heaviness. In this paper, a directional water transport and collection multilayered knitted fabric (DWTCF) is prepared by plasma pretreatment technology and screen coating. The treelike water transport network inspired from nature is designed in order to drive the liquid flow along the channels. By surface modification, branched hydrophilic flow paths are fabricated, and other regions are hydrophobic. As a demonstration, DWTCF has been injected with water to observe the liquid transport behavior. During the experiment, 76.7% liquid is collected by DWTCF, but there is just 0.06% collected by an ordinary knitted fabric. The weight increase of the ordinary fabric is 555.4% larger than that of DWTCF. Specifically, DWTCF utilizes the wetting and pressure-gradient-induced interfacial tension as well as the gravitational effect to facilitate the fluid motion along the hydrophilic channel, in addition to the capillarity present in the fabric structure. This study provides a new idea to develop directional water transport and collection fabric to solve the moisture absorption saturation problem of the fabric, especially for conditions requiring intense sweating.

This study evaluated the impact of coat color (CC) and hair coat characteristics (HC) on productive and physiological traits related to thermotolerance in Angus heifers. The goal was to determine if HC and/or CC were reliable indicators of thermotolerance on a large scale for future breeding programs. Ninety-three 15-month-old Angus heifers (52 black, 41 red) were evaluated in three periods on a beef cattle farm in Brazil. Heifers were classified by CC and HC, and body weight, body condition score (BCS), and reproductive tract score (RTS) were compared between groups. In the summer evaluation, surface temperature (infrared thermography), internal temperature (intravaginal sensors), sweating rate, and behavior were assessed in a subset of heifers. Temperature-humidity index (THI) was calculated using meteorological data. The proportion of heifers with short, fine, and smooth hair (HC1) increased (P < 0.05) over the evaluations. Heifers with thick, long, and woolly hair (HC3) had lower (P < 0.05) body weights than those with finer coats, regardless of CC. Black heifers had greater (P < 0.05) puberty rates than red heifers in the first two evaluations. At a THI of 66, black heifers with HC1 exhibited a lower (P < 0.05) internal temperature compared to black heifers with HC3. At a THI of 75, all heifers with HC1 had lower (P < 0.05) internal temperatures, regardless of CC. Red heifers and those with HC3 experienced hyperthermia for longer (P < 0.05) periods. Neither HC nor CC affected (P > 0.05) surface temperatures or sweating rates. At a THI of 72, more black heifers remained standing, suggesting behavioral adaptation. In conclusion, coat color and characteristics influence thermal stress and performance in Angus heifers, though color impact is limited. Internal temperature monitoring effectively determines thermotolerance. In tropical regions, selecting for short, fine, smooth hair may improve heat tolerance., Competing Interests: Declaration of competing interest The authors declare no conflict of interest, financial or otherwise., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Herpes zoster is an infectious skin disease caused by the reactivation of the varicella zoster virus (VZV), which has been latent in the posterior root ganglia of the spinal cord or cranial ganglia for an extended period. Neurological complications caused by herpes zoster include aseptic meningitis, white matter disease, peripheral motor neuropathy, and Guillain-Barré syndrome. However, reduced unilateral sweating caused by the VZV is very rare., Case Presentation: This article reports the case of a 34-year-old woman who was admitted to our hospital with sore throat, dizziness, and reduced sweating on the left side of her body. Physical examination found herpes lesions on the left upper lip and left external ear canal (scabbed) and reduced sweating on the left side of the body. Head magnetic resonance imaging (MRI) with contrast showed no abnormalities. After a lumbar puncture, the patient was diagnosed with viral meningitis by VZV infection. The electromyographic skin sympathetic reflex indicated damage to the left sympathetic nerve., Conclusions: Secondary unilateral sweating reduction is a rare neurological complication of herpes zoster, caused by damage to the autonomic nervous system. Literature review and comprehensive examination indicated that the reduced unilateral sweating was due to the activation of latent herpes zoster virus in the autonomic ganglia which has damaged the autonomic nervous system. For patients who exhibit acute hemibody sweat reduction, doctors should consider the possibility of secondary autonomic nervous system damage caused by herpes zoster., (© 2024. The Author(s).)

Background: Zinc fever is well described in medical literature, particularly in workers after handling zinc-containing materials at high temperatures e.g., in the welding of hot-dip galvanized steel sheets. It is not known whether zinc fever also occurs at low temperatures., Case Presentation: We present the case of a 33-year-old Caucasian atopic painter and varnisher with work-related dyspnea, sweating, as well as multiple occurrences of fever. He was sent to Institute for Prevention and Occupational medicine of the German Social Accident Insurance, Institute of the Ruhr-Universität Bochum (IPA) for the evaluation of isocyanate asthma, but an inhalative challenge with hexamethylene diisocyanate was negative. Since symptoms were closely related to the use of zinc coatings at room temperature without adequate protective measures, the diagnosis of zinc fever was made. After exposure cessation the worker immediately became symptom-free. The work as painter and varnisher may be associated with various exposures to hazardous substances. Besides solvents, epoxy compounds and isocyanates, which can cause obstructive respiratory diseases; additionally, zinc-containing agents should be considered as health hazards., Conclusions: This case demonstrates that zinc fever may occur also after application of zinc coatings by spray painting at low temperatures., (© 2024. The Author(s).)

Cholinergic urticaria (CholU) is a rare condition characterized by itchy hives in the form of 1-4 mm small, raised wheals on skin, which are short-lived for duration of 15 to 20 minutes; they are caused by stimuli associated with sweating such as from physical exercise. CholU is also known as cholinergic angioedema urticaria. Hereby, we present a case report of a 42-year-old male with ChoIU who presented with systemic manifestation in the form of recurrent attacks of syncope. Diagnosis was made after a detailed history taking and all cardiac and neurological evaluations done that were normal, and widespread literature research was done to rule out other causes of syncope as systemic symptoms are rarely seen in ChoIU. His IgE antibodies levels were highly increased. He was managed with nonsedating antihistamines and health education regarding the rare condition., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Toshniwal S et al.)

Reports indicate that an interaction between TRPV4 and anoctamin 1 (ANO1) could be widely involved in water efflux of exocrine glands, suggesting that the interaction could play a role in perspiration. In secretory cells of sweat glands present in mouse foot pads, TRPV4 clearly colocalized with cytokeratin 8, ANO1, and aquaporin-5 (AQP5). Mouse sweat glands showed TRPV4-dependent cytosolic Ca 2+ increases that were inhibited by menthol. Acetylcholine-stimulated sweating in foot pads was temperature-dependent in wild-type, but not in TRPV4-deficient mice and was inhibited by menthol both in wild-type and TRPM8KO mice. The basal sweating without acetylcholine stimulation was inhibited by an ANO1 inhibitor. Sweating could be important for maintaining friction forces in mouse foot pads, and this possibility is supported by the finding that wild-type mice climbed up a slippery slope more easily than TRPV4-deficient mice. Furthermore, TRPV4 expression was significantly higher in controls and normohidrotic skin from patients with acquired idiopathic generalized anhidrosis (AIGA) compared to anhidrotic skin from patients with AIGA. Collectively, TRPV4 is likely involved in temperature-dependent perspiration via interactions with ANO1, and TRPV4 itself or the TRPV4/ANO 1 complex would be targeted to develop agents that regulate perspiration., Competing Interests: MK, SD, RY, KS, JL, MK, MT No competing interests declared, (© 2024, Kashio, Derouiche et al.)

Sweating is one of the most important processing methods of Chinese medicinal herbs. However, the high temperature and humidity environment required for sweating Chinese medicinal herbs makes it very easy for fungi to breed, especially toxigenic fungi. The mycotoxins produced by these fungi will then contaminate the Chinese medicinal herbs. In this study, we explored the changes in mycobiota, toxigenic fungi, and mycotoxins with and without sweating in Radix Dipsaci (RD), a typical representative of traditional Chinese medicine that requires processing through sweating. We also isolated and identified the toxigenic fungi from RD, whether they were subjected to sweating treatment or not, and examined their toxigenic genes and ability. The results showed that the detection rate of mycotoxins (aflatoxins, ochratoxins, zearalenone, and T-2 toxin) in RD with sweating was 36%, which was 2.25-fold higher than that in RD without sweating. We also detected T-2 toxin in the RD with sweating, whereas it was not found in the RD without sweating. The sweating process altered the fungal composition and increased the abundance of Fusarium and Aspergillus in RD. Aspergillus and Fusarium were the most frequently contaminating fungi in the RD. Morphological and molecular identification confirmed the presence of key toxigenic fungal strains in RD samples, including A. flavus, A. westerdijkiae, F. oxysporum and F. graminearum . These four fungi, respectively, carried AflR , PKS , Tri7 , and PKS14 , which were key genes for the biosynthesis of aflatoxins, ochratoxins, zearalenone, and T-2 toxin. The toxigenic ability of these four fungal strains was verified in different matrices. We also found that A. flavus , A. westerdijkiae , and F. oxysporum were isolated in RD both with sweating and without sweating, but their isolation frequency was significantly higher in the RD with sweating than in the RD without sweating. F. graminearum was not isolated from RD without sweating, but it was isolated from RD with sweating. These findings suggest that the sweating process promotes the expansion of toxigenic fungi and increases the risk of combined mycotoxin contamination in RD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ge, Wang, Su, Yuan, Xiao, Hu, Kang, Guo, Zhou and Zhang.)