ABSTRACT
Several troops evacuated from field training sites as heat casualties were determined to be fluid overload casualties. Common features of this paradoxical syndrome were dilute primary electrolytes with physical exhaustion and muscle weakness after rapid free water intake. A pattern of skipping meals, working in a hot and humid environment, and consuming large volumes of water as "protection against becoming a heat casualty" predisposed these troops to the physical impairment that they intended to avoid. The mechanisms leading to both appropriate and inappropriate physiological responses to free water replacement are discussed as a basis for avoiding this specific heat casualty situation.
Subject(s)
Heat Stress Disorders/etiology , Military Personnel , Water Intoxication/etiology , Adult , Causality , Drinking Behavior , Feeding Behavior , Female , Heat Stress Disorders/diagnosis , Heat Stress Disorders/therapy , Humans , Male , Middle Aged , Water Intoxication/diagnosis , Water Intoxication/therapyABSTRACT
OBJECTIVE: To determine whether women delay or avoid necessary health care because they are overweight. DESIGN: Observational study using a self-administered survey. SETTING: A 250-bed community hospital in La Crosse, Wis. PARTICIPANTS: All female nurses, nursing assistants, health unit coordinators, and general psychiatric assistants who were employed full- or part-time at the community hospital in July 1992. We received 310 (76%) responses from 409 potential respondents. MEASUREMENTS/MAIN RESULTS: Overall, 12.7% of respondents reported delaying or canceling a physician appointment because of weight concerns. Another 2.6% kept their appointments but refused to be weighed. Only body mass index was significantly associated with appointment cancellation. The odds ratio of an obese woman (body mass index in excess of 27) delaying medical care was 3.885 (95% confidence interval, 1.509 to 10.274). CONCLUSION: Obese women commonly delay health care because of weight concerns.
