Identification of risk factors for exertional heat illness: a brief commentary on genetic testing.

@article{Muldoon2007IdentificationOR,
  title={Identification of risk factors for exertional heat illness: a brief commentary on genetic testing.},
  author={Sheila M. Muldoon and Rolf Bunger and Patricia A. Deuster and Nyamkhishig Sambuughin},
  journal={Journal of sport rehabilitation},
  year={2007},
  volume={16 3},
  pages={
          222-6
        }
}
OBJECTIVE This commentary discusses known links between Exertional Heat Illness (EHI), Malignant Hyperthermia (MH), and other hereditary diseases of muscle. Genetic and functional testing is also evaluated as measures of fitness to return to duty/play. DATA SOURCES Reviews and research articles from Sports Medicine, Applied Physiology, and Anesthesiology. DATA EXTRACTION Detailed comparisons of existing literature regarding clinical cases of EHI and MH and the potential utility of genetic… 
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References

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TLDR
There is a need to bypass considerations of the etiology of EHI and to identify the vulnerable and handicapped soldier by exposure after an interval of time to one or more exercise tolerance tests.
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TLDR
There is a link between malignant hyperthermia and exertional heat illness and there are, however, sporadic cases that occur in individuals, with no obvious predisposing factors, exercising in unremarkable weather conditions.
A Noninvasive Investigation of Muscle Energetics Supports Similarities Between Exertional Heat Stroke and Malignant Hyperthermia
TLDR
It is demonstrated that muscle energetics are abnormal in subjects who have experienced EHS and a possible link between MH and EH is suggested, although all EHS cannot be considered as MH.
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TLDR
DNA sequence analysis of each kindred revealed the presence of a common novel mutation that results in an arginine401-cysteine substitution in the skeletal muscle ryanodine receptor gene (RYR1), providing confirmation that the MH/central core disease region 1 of RYR1 is a mutation hot spot.
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TLDR
It was concluded that tolerance to heat must be tested during heat stress and the test duration cannot be shorter than 120 min and the comfort tolerance test was found as irrelevant for heat intolerance assessment.
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TLDR
Patients with type II fibre predominance are more susceptible to exertional heatstroke and tend to have a higher blood lactate concentration and a shorter time to reachBlood lactate threshold under a treadmill load test.
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TLDR
The in vitro contracture test is the only method used to determine susceptibility to malignant hyperthermia and should be performed when the diagnosis is suggested on clinical grounds.
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