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This study examined the thermoregulatory and circulatory responses, and exercise performance of trained distance runners during exercise in the heat (31°C) at varying relative humidity (RH). In a randomized order, 11 trained male distance runners performed 5 60 min steady-state runs at a speed eliciting 70% of VO2max in RH of 23, 43, 52, 61 and 71%. This was followed immediately with an incremental exercise test to volitional exhaustion. Core (Tre) and mean skin temperature (T¯sk), cardiac output (Q), heart rate (HR), and stroke volume (SV) were recorded at regular intervals. A significant (P = 0.003) main effect was detected for RH on mean body temperature (Tb), with a significantly higher Tb detected during steady-state exercise in the 61 and 71% RH compared to that in the 23% RH. During the steady-state exercise, no differences were detected in whole body sweat loss (P = 0.183). However, a significant main effect of RH was observed for HR and SV (P = 0.001 and 0.006, respectively) but not Q (P = 0.156). The time to exhaustion of the incremental exercise test was significantly reduced at 61 and 71% RH compared with 23% RH (P = 0.045 and 0.005, respectively). Despite an increase in dry heat loss, a greater thermoregulatory and circulatory stress was evident during steady-state exercise at 61 and 71% RH. This ultimately limits the capacity to perform the subsequent incremental exercise to exhaustion. This study highlighted that in a warm environment, the range of the prescriptive zone progressively narrows as RH increases.

Acute hemorrhagic presentation in pilocytic astrocytomas (PAs) has become increasingly recognized. This type of presentation poses a clinically emergent situation in those hemorrhages arising in PAs of the cerebellum, the most frequent site, because of the limited capacity of the posterior fossa to compensate for mass effect, predisposing to rapid neurological deterioration. As examples, we describe two cases of fatal hemorrhagic cerebellar PAs: one of a child with a slowly growing stereotypical WHO Grade I PA with a 1-year period of symptomatology that preceded a rapid clinical deterioration, and another of an asymptomatic child having a PA variant, presenting with progressive obtundation following a presumed Valsalva event. These two scenarios parallel previous reports in the literature of either a setting of progressive expression of cerebellar dysfunction and transient episodes of raised intracranial pressure (ICP), or abrupt onset of features of increased ICP in a previously well child. The literature is further reviewed for a current understanding of the factors that predispose, initiate and propagate bleeding, with specific reference to the role of vascular endothelial growth factor and other angiogenic agents in the genesis and stability of the vasculature in PAs. In this context, we propose that obliterative vascular mural hyalinization with associated altered flow dynamics and microaneurysm formation was the pathogenesis of the hemorrhage in our first case. In the second case, large tumor size, increased growth rate, looseness of the background myxoid matrix, and thinness of the tumor blood vessels with calcospherite deposition predisposed to vascular leakage and bleeding concurrent with sudden increases in intravascular hydrostatic pressure. In that cerebellar PAs are common, this report underscores the importance of considering in the differential diagnosis the possibility of a spontaneous hemorrhage in a posterior fossa PA in a child presenting with a sudden neurological ictus and raised ICP.

The purpose of this investigation was to measure expired air temperature under cool- and hot-humid environmental conditions at rest and during prolonged exercise to: (1) establish if significant increases in body core temperature affected expired air temperature, and (2) to determine if the temperature setting for heating the pneumotachometer in an open-circuit system requires adjustment during prolonged exercise tests to account for changes in expired air temperature. Six male distance runners completed two tests in cool-humid [dry bulb temperature (Tdb) 15.5 (SD 1.3) degrees C, wet bulb temperature (TWb) 12.1 (SD 1.4) degrees C] and hot-humid [Tdb 31.6 (SD 0.6) degrees C, TWb 24.9 (SD 0.6) degrees C, black globe temperature (Tg) 34.3 (SD 0.3) degrees C] environments, running at a velocity corresponding to 65% [67.1 (SD 2.82)%] of their maximal oxygen uptake. Rectal temperature and expired air temperatures were compared at rest, and after 30 min and 60 min of exercise for each environment. The main finding of this investigation was a significant (P < 0.05) but small increase in expired air temperature between the 30-min and 60-min measures in the hot-humid environment. No significant differences in expired air temperature were found between the 30-min and 60-min measures in the cool-humid environment. These findings suggest that: (1) expired air temperature is influenced by elevations in body core temperature during prolonged exercise in hot-humid conditions, and (2) that the temperature setting for heating the head of the pneumotachometer (after determining the appropriate temperature through measuring expired air temperature for the set environmental condition) may require adjustment during prolonged exercise trials in hot-humid environmental conditions.

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