Papers by Serina McEntire
Exercise
Handbook of Burns Volume 2, 2020
Medicine & Science in Sports & Exercise, 2017
To assess the association between leanness and running performance and training volume among high... more To assess the association between leanness and running performance and training volume among highly trained Japanese long distance runners. METHODS: Body composition was measured by dual energy X-ray absorptiometry in 54 Japanese male long distance runners who belonged to a university track and field team (19.8±1.3 yrs). The training volume was assessed by the average running mileage (km/month) during 5 months prior to the measurement. The runners were routinely divided into 4 categories by the coach of the team according to their performance level and the category of the period was used as the performance level of the runners; team A (n=15), B (n=17), C (n=11), and D (n=11) in the order of the level. Team D included runners who had injuries and restricted their training. Questionnaire survey was performed regarding weight control practices and complaints of fatigue. Written informed consent was obtained from each runner. The mean running mileage of the 54 runners was 606 km/month. Height, body mass, BMI, percent body fat, bone mineral density (BMD), z-score of BMD, and lean soft tissue mass were 172.0±5.2 cm, 57.3±4.4 kg, 19.4±1.0 kg/m 2 , 6.1±1.3%, 1.175±0.057 g/cm 2 , -0.524±0.677, and 51.1±4.0 kg, respectively. The mean running mileage was not significantly correlated with any of those variables (p>0.05). The mean running mileage of each category (A, B, C, & D) were 709, 600, 606, and 475 km/month, respectively (p<0.01). Percent body fat were lowest in A (5.7%) and highest in D (6.4%) whereas z-score of BMD were -0.447 and -0.664, respectively. However, ANOVA showed no significant differences in those variables among the categories. Fisher's exact tests of questionnaire survey revealed significant between-categories differences in percentages of runners attempting weight reduction practices (8.3, 13.3, 53.8, and 38.5%, respectively, p<0.05) and those complained of frequent fatigue (25.0, 53.3, 53.8, and 69.2%, respectively, p<0.05). The runners had exclusively lean bodies regardless of their performance level and running mileage. The runners with the lowest performance level and the least training volume likely attempted weight reduction practice and complained of fatigue. It was concerned that they might pursue the lower level of percent body fat by restricting energy intake.
Journal of burn care & research : official publication of the American Burn Association, Jan 28, 2017
The objective of this study was to test the hypothesis that propranolol, a commonly prescribed β-... more The objective of this study was to test the hypothesis that propranolol, a commonly prescribed β-blocker to burned children, in combination with exercise-heat stress, increases the risk of heat illness and exercise intolerance. In a randomized double-blind study, propranolol was given to 10 burned children, and placebo was given to 10 additional burned children (matched for TBSA burned; mean ± SD, 62 ± 13%), while nonburned children served as healthy controls. All groups were matched for age and body morphology (11.2 ± 3.0 years; 146 ± 19 cm; 45 ± 18 kg; 1.3 ± 0.4 m). All children exercised in hot conditions (34.3 ± 1.0°C; 26 ± 2% relative humidity) at 75% of their peak aerobic capacity. At the end of exercise, none of the groups differed for final or change from baseline intestinal temperature (38.0 ± 0.5°C; 0.021 ± 0.01Δ°C·min), unburned (37.0 ± 0.6°C) and burned skin temperatures (36.9 ± 0.7°C; nonburn group excluded), heat loss (20.5 ± 18 W m), whole-body thermal conductance (11...
Microcirculation (New York, N.Y. : 1994), Jan 10, 2017
Tested the hypothesis that propranolol, a drug given to burn patients to reduce hypermetabolism/c... more Tested the hypothesis that propranolol, a drug given to burn patients to reduce hypermetabolism/cardiac stress, may inhibit heat dissipation by changing the sensitivity of skin blood flow (SkBF) to local heating under neutral and hot conditions. In a randomized double-blind study, a placebo was given to 8 burned children while propranolol was given to 13 burned children with similar characteristics (mean ±SD: 11.9±3y, 147±20cm, 45±23kg, 56±12% TBSA). Non-burned children (n=13, 11.4±3y, 152±15cm, 52±13kg) served as healthy controls. A progressive local heating protocol characterized SkBF responses in burned and unburned skin and non-burned control skin under the two environmental conditions (23°C and 34°C) via laser-Doppler flowmetry. Resting SkBF was greater in burned and unburned skin compared to the non-burned control (main effect: skin, P<0.0001; 57±32 burned; 38±36 unburned vs 9±8 control %SkBFmax ). No difference was found for maximal SkBF capacity to local heating between g...
Lung Diffusing Capacity During Exercise in Burned Children
Medicine & Science in Sports & Exercise, 2006
Effects of Training for a 439 Mile Endurance Run on Performance and Energy Balance
Medicine & Science in Sports & Exercise, 2016
Emergency Incident Rehabilitation: Resource Document to the Position Statement of the National Association of EMS Physicians
Prehospital Emergency Care, 2016
Position Statement: Emergency Incident Rehabilitation The National Association of EMS Physicians®... more Position Statement: Emergency Incident Rehabilitation The National Association of EMS Physicians® believes that: Emergency operations and training conducted while wearing protective clothing and respirators is physiologically and cognitively demanding. The heat stress and fatigue created by working in protective clothing and respirators creates additional risk of illness/injury for the public safety provider. Emergency incident rehabilitation provides a structured rest period for rehydration and correction of abnormal body core temperature following work in protective clothing and respirators. Emergency incident rehab should be conducted at incidents (e.g. fireground, hazardous materials, and heavy rescue emergencies) and trainings involving activities that may lead to exceeding safe levels of physical and mental exertion. Emergency incident rehabilitation is incident care, not fitness for duty, and meant to reduce physiologic strain and prepare the responder to return to duty at the current incident and for the remainder of the shift. EMS should play a role in emergency incident rehabilitation with providers trained to understand the physiologic response of healthy individuals to environmental, exertional, and cognitive stress and implement appropriate mitigation strategies. An appropriately qualified physician should have oversight over the creation and implementation of emergency incident rehabilitation protocols and may be separate from the roles and responsibilities of the occupational medicine physician. There are no peer-reviewed data related to cold weather rehabilitation. Future studies should address this limitation to the literature.
Pilot Study Examining the Effects of Atropine on Performance during Uncompensable Heat Stress
Prehospital Emergency Care, 2015
In many operational scenarios, hypohydration can be corrected with oral rehydration following the... more In many operational scenarios, hypohydration can be corrected with oral rehydration following the work interval. Although rare, there are potential situations that require extended intervals of uncompensable heat stress exposure while working in personal protective equipment (PPE). Under these conditions, retention of body water may be valuable to preserve work capacity and reduce cardiovascular strain. We conducted a pilot study comparing intramuscular atropine sulfate versus saline placebo to establish the safety profile of the protocol and to provide pilot data for future investigations. Five, healthy, heat-acclimated subjects completed this crossover design laboratory study. Each subject performed up to one hour of exertion in a hot environment while wearing a chemical resistant coverall. Atropine sulfate (0.02 mg/kg) or an equivalent volume of sterile saline was administered by intramuscular injection. Core temperature, heart rate, perceptual measures, and changes in body mass were measured. All five subjects completed the acclimation period and both protocols. No adverse events occurred, and no pharmacologically induced delirium was identified. Change in body mass was less following exercise influenced by atropine sulfate (p = 0.002). Exertion time tended to be longer in the atropine sulfate arm (p = 0.08). Other measures appeared similar between groups. Intramuscular atropine sulfate reduced sweating and tended to increase the work interval under uncompensable heat stress when compared to saline placebo. Heart rate and temperature changes during exertion were similar in both conditions suggesting that the influence of an anticholinergic agent on thermoregulation may be minimal during uncompensable heat stress. Key words: thermoregulation; cholinolytic; anticholinergic; reaction time.
Safety and Health at Work, 2015
Background: Heart attack is the most common cause of line-of-duty death in the fire service. Dail... more Background: Heart attack is the most common cause of line-of-duty death in the fire service. Daily aspirin therapy is a preventative measure used to reduce the morbidity of heart attacks but may decrease the ability to dissipate heat by reducing skin blood flow. Methods: In this double-blind, placebo-controlled, crossover study, firefighters were randomized to receive 14 days of therapy (81-mg aspirin or placebo) before performing treadmill exercise in thermalprotective clothing in a hot room [38.8 AE 2.1 C, 24.9 AE 9.1% relative humidity (RH)]. Three weeks without therapy was provided before crossing to the other arm. Firefighters completed a baseline skin blood-flow assessment via laser Doppler flowmetry; skin was heated to 44 C to achieve maximal cutaneous vasodilation. Skin blood flow was measured before and after exercise in a hot room, and at 0 minutes, 10 minutes, 20 minutes, and 30 minutes of recovery under temperature conditions (25.3 AE 1.2 C, 40.3 AE 13.7% RH). Platelet clotting time was assessed before drug administration, and before and after exercise. Results: Fifteen firefighters completed the study. Aspirin increased clotting time before and after exercise compared with placebo (p ¼ 0.003). There were no differences in absolute skin blood flow between groups (p ¼ 0.35). Following exercise, cutaneous vascular conductance (CVC) was 85 AE 42% of maximum in the aspirin and 76 AE 37% in the placebo groups. The percentage of maximal CVC did not differ by treatment before or after recovery. Neither maximal core body temperature nor heart rate responses to exercise differed between trials. Conclusion: There were no differences in skin blood flow during uncompensable heat stress following exercise after aspirin or placebo therapy.
Comprehensive rehabilitation of the burn patient
Total Burn Care, 2012
Exercise
Handbook of Burns, 2012
European Journal of Applied Physiology, 2014
Risk Factors for Hypothermia in EMS-treated Burn Patients
Prehospital Emergency Care, 2014
Hypothermia has been associated with increased mortality in burn patients. We sought to character... more Hypothermia has been associated with increased mortality in burn patients. We sought to characterize the body temperature of burn patients transported directly to a burn center by emergency medical services (EMS) personnel and identify the factors independently associated with hypothermia. We utilized prospective data collected by a statewide trauma registry to carry out a nested case-control study of burn patients transported by EMS directly to an accredited burn center between 2000 and 2011. Temperature at hospital admission ≤36.5°C was defined as hypothermia. We utilized registry data abstracted from prehospital care reports and hospital records in building a multivariable regression model to identify the factors associated with hypothermia. Forty-two percent of the sample was hypothermic. Burns of 20-39% total body surface area (TBSA) (OR 1.44; 1.17-1.79) and ≥40% TBSA (OR 2.39; 1.57-3.64) were associated with hypothermia. Hypothermia was also associated with age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 60 (OR 1.50; 1.30-1.74), polytrauma (OR 1.58; 1.19-2.09), prehospital Glasgow Coma Scale &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;8 (OR 2.01; 1.46-2.78), and extrication (OR 1.49; 1.30-1.71). Hypothermia was also more common in the winter months (OR 1.54; 1.33-1.79) and less prevalent in patients weighing over 90 kg (OR 0.63; 0.46-0.88). A substantial proportion of burn patients demonstrate hypothermia at hospital arrival. Risk factors for hypothermia are readily identifiable by prehospital providers. Maintenance of normothermia should be stressed during prehospital care.
A Randomized Controlled Trial of Aspirin and Exertional Heat Stress Activation of Platelets in Firefighters during Exertion in Thermal Protective Clothing
Prehospital Emergency Care, 2014
Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protect... more Platelet aggregation is enhanced in firefighters following short bouts of work in thermal protective clothing (TPC). We sought to determine if aspirin therapy before and/or following exertion in TPC prevents platelet activation. In a double-blind, placebo-controlled study, 102 firefighters were randomized to receive daily therapy (81 mg aspirin or placebo) for 14 days before and a single dose (325 mg aspirin or placebo) following exercise in TPC resulting in four potential assignments: aspirin before and after exercise (AA), placebo before and after exercise (PP), aspirin before and placebo after exercise (AP), and placebo before and aspirin after exercise (PA). Platelet closure time (PCT) was measured with a platelet function analyzer before the 2-week treatment, after the 2 week treatment period, immediately after exercise, and 30, 60, and 90 minutes later. Baseline PCT did not differ between groups. PCT changed over time in all four groups (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) rising to a median of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 seconds [IQR 99, 300] in AA and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 [92, 300] in AP prior to exercise. Following exercise, median PCT decreased to in all groups. Median PCT returned to &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;300 seconds 30 minutes later in AA and AP and rose to 300 seconds in PA 60 minutes after exercise. Daily aspirin therapy blunts platelet activation during exertional heat stress and single-dose aspirin therapy following exertional heat stress reduces platelet activation within 60 minutes.
Mitigation and Prevention of Exertional Heat Stress in Firefighters: A Review of Cooling Strategies for Structural Firefighting and Hazardous Materials Responders
Prehospital Emergency Care, 2013
Most duties performed by firefighters require the use of personal protective equipment, which inh... more Most duties performed by firefighters require the use of personal protective equipment, which inhibits normal thermoregulation during exertion, creating an uncompensable heat stress. Structured rest periods are required to correct the effects of uncompensable heat stress and ensure that firefighter safety is maintained and that operations can be continued until their conclusion. While considerable work has been done to optimize firefighter cooling during fireground operations, there is little consensus on when or how cooling should be deployed. A systematic review of cooling techniques and practices among firefighters and hazardous materials operators was conducted to describe the state of the science and provide recommendations for deploying resources for fireground rehab (i.e., structured rest periods during an incident). Five electronic databases were searched using a selected combination of key words. One hundred forty publications were found in the initial search, with 27 meeting all the inclusion criteria. Two independent reviewers performed a qualitative assessment of each article based on nine specific questions. From the selected literature, the efficacy of multiple cooling strategies was compared during exertion and immediately following exertion under varying environmental conditions. When considering the literature available for cooling firefighters and hazardous materials technicians during emergency incident rehabilitation, widespread use of cooling devices does not appear to be warranted if ambient temperature and humidity approximate room temperature and protective garments can be removed. When emergency incident rehabilitation must be conducted in hot or humid conditions, active cooling devices are needed. Hand/forearm immersion is likely the best modality for cooling during rehab under hot, humid conditions; however, this therapy has a number of limitations. Cooling during work thus far has been limited primarily to cooling vests and liquid- or air-cooled suits. In general, liquid-perfused suits appear to be superior to air-cooled garments, but both add weight to the firefighter, making current iterations less desirable. There is still considerable work to be done to determine the optimal cooling strategies for firefighters and hazardous materials operators during work.
Dietary Antioxidant Effects on Pulmonary Function at Rest and Following Maximal Exercise in Healthy Subjects
Medicine & Science in Sports & Exercise, 2003
Thermoregulatory Responses During Exercise in Burned Children
Medicine & Science in Sports & Exercise, 2003
Medicine & Science in Sports & Exercise, 2011
Comparison Of Exercise Programs Of Different Frequency In Severely Burned Children
Medicine & Science in Sports & Exercise, 2005
Thermoregulation during Submaximal Exercise in the Heat
Medicine & Science in Sports & Exercise, 2008
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Papers by Serina McEntire