When a runner's heart stops during a marathon, it gets a lot of press - even though it's actually a pretty rare event. A more common killer among runners, and a condition that needs more prevention efforts, is heat stroke, according to a study by Israeli researchers.
During a 2011 running race, physicians at a Tel Aviv hospital noticed there were far more heat stroke victims admitted than cardiac patients. They wondered if this was an anomaly, and analyzed local races from March 2007 to November 2013, encompassing 137,580 runners.
Across those races, there were two serious cardiac events, neither of which was fatal or life threatening. But there were 21 serious heat stroke cases, including two fatalities and 12 that were life threatening.
There's a continuum of heat illnesses, ranging from milder heat cramps all the way to heat stroke, which is defined as a fever above 104 degrees and symptoms including dry, hot skin, rapid breathing and unconsciousness. When the body gets that hot, the kidneys, brain and other organs can fail.
One caveat: It gets hot in Tel Aviv. It's possible that not every race site will face the same heat-stroke danger, though "it's reasonable to assume that heat stroke is just as common in other countries with similar climate," Dr. Sami Viskin, senior author of the study and a cardiologist at Tel Aviv Medical Center, told Shots via email. (And heat stroke can occur in mild climates too.)
It's important for racers to be prepared for heat. That means acclimatizing to warmer weather — though that can take up to two weeks, so it's not always practical. The authors say it may be better to schedule races during the summer, when participants are used to the heat, rather than the spring. People also should beware of racing if they've recently had a fever, since that can reduce the body's ability to ward off heat stroke, the authors say.
The National Athletic Trainers' Association also recommends drinking enough fluids before, during and after exercise to help avoid overheating.
And race organizers need to be able to diagnose heat stroke quickly by taking a runner's body temperature rectally on site, so they can provide proper cooling, most effectively by immersing the person in a cold water bath.
Heat stroke is a big problem, says Dr. George Chiampas, a Northwestern Medicine emergency medicine physician. He's also medical director of the Chicago Marathon, which made some changes after the 2007 race was halted amid high temperatures that sickened hundreds. (The single death that year was actually a result of a heart condition, not the heat.)
Now runners see green, yellow, red or black flags along the route to indicate whether the conditions, including weather, are good, less-than-ideal, potentially dangerous or so bad that the race has been stopped, Chiampas tells Shots. Post-race surveys show that runners run more slowly and adjust their strategy if conditions are yellow or red, he says.
And medical personnel near the finish line are trained to talk with runners to see if their mental status has been affected - a sign of heat illness.
The study was published Monday in the Journal of the American College of Cardiology.
The central committee of China's communist party placed a former top-ranking official under investigation on Tuesday.
China's state-run news agency Xinhua reports Zhou Yongkang is accused of "serious disciplinary violation."
Reporting from Beijing, NPR's Anthony Kuhn tells our Newscast unit that while there is no specificity to those charges from the party, this usually implies that criminal corruption charges will follow.
"Before his retirement in 2012, Zhou was a member of the politburo standing committee. He had control over police, security and intelligence services," Anthony reports. "In recent months, many of Zhou's family members and former subordinates have been detained on suspicion of corruption, raising expectations that Zhou would soon fall as well."
As The New York Times points out, Zhou is the "most serious party figure ever to face a formal graft inquiry," and this is an "audacious move" by President Xi Jingping to "impose his authority" over a "potentially dangerous adversary, with ties to more senior retired figures."
The Times explains:
"Until now, the detention and investigation of Mr. Zhou has been secretive and unconfirmed by the government, although known among party insiders and reported abroad.
"Charges against Mr. Zhou could well center on the fortunes made by members of his family, often in sectors once under his sway. An investigation by The New York Times showed that Mr. Zhou's son, a sister-in-law and his son's mother-in-law held assets worth some $1 billion, much of it in the oil and gas sector that was Mr. Zhou's political fiefdom, where he could shape decisions and promotions. That estimate was based on publicly available records and a limited assessment of their companies' value and did not include real estate or overseas assets, which are more difficult to identify and assess."
Xinhua reports that Central Committee of the Communist Party of China's Central Commission for Discipline Inspection will conduct the investigation.
The daily lowdown on books, publishing, and the occasional author behaving badly.
- Louise Shivers, who published her first book, Here to Get My Baby Out of Jail, at the age of 53, has died. She was 84. The 1983 novella followed the wife of a North Carolina tobacco farmer who begins an affair with the "red-headed, jagged faced" hired hand Jack Ruffian. The book was a critical and commercial success: The Washington Post called Shivers "a late-blooming Flannery O'Connor," and USA Today named the book the best first novel of 1983. Shivers submitted the story to a writing contest, hoping to win the $50 prize. The judge happened to be the novelist Mary Gordon, who was so impressed with Shivers' book that, when the manuscript was finished, she passed it on to her agent, who placed it at Random House. "Almost nobody believes me," Shivers told the Post after the novel came out, "but I didn't write the book thinkin' it was gonna get published."
- Kim Kardashian is apparently working on a book of selfies. Now you know.
- "[L]ast year, [Peter] Mendelsund, the associate art director at Alfred A. Knopf, became his own worst nightmare." — Alexandra Alter describes a book jacket designer's struggle to make the cover of his own book.
- Linda Gregerson has a new poem, "Ceres Lamenting," in The New Yorker:
"She hated the plow.
She hated the cattle.
that her sweet acres when the girl
had been taken away should still
contrive to be
the barley, even the grape, as though
her heart had not been torn
- The Associated Press writes about reports of sexual harassment at the country's biggest comic book convention: "Amid the costumes and fantasy of this weekend's Comic-Con convention [in San Diego], a group of young women drew widespread attention to a very real issue — allegations of sexual harassment at the annual pop-culture festival. Geeks for CONsent, founded by three women from Philadelphia, gathered nearly 2,600 signatures on an online petition supporting a formal anti-harassment policy at Comic-Con."
Despite calls from the United Nations for a cease-fire, Israeli Prime Minister Benjamin Netanyahu warned his country to prepare for a "prolonged" war.
Netanyahu made the comments during a televised address on Monday. As NBC News reports, Netanyahu also defended its offensive in Gaza as just.
"We will continue to act aggressively and responsibly until the mission is completed to protect our citizens, soldiers and children," Netanyahu added.
With that, here's what you need to know as the conflict enters its 22nd day:
— The Death Toll:
Israel had its deadliest day on Monday. NPR's Soraya Sarhaddi Nelson reports that at least five soldiers guarding a kibbutz were killed by Hamas militants who used tunnels to burrow into Israel.
According to a New York Times count, that brings total Israeli deaths to 51.
The death toll in Gaza also keeps climbing: It's more than 1,110; 15 people were killed overnight.
— Attacking Gaza's Only Power Plant:
Reporting from Gaza, NPR's Emily Harris said last night saw the "longest, loudest and closest attacks so far."
At least one shell struck Gaza's only power plan, the head of Gaza's electricity company told Emily.
"It started a blaze that destroyed the storage tanks," Emily tells us. "He says the plant is no longer producing. Combined with downed lines from Israel, Gazan homes are getting something around less than four hours of electricity a day. This affects water as water needs pumps."
— A Stunning Time-Lapse:
Buzzfeed's Sheera Frankel describes the video below like this: "Time lapse shows entire neighborhood in Gaza being flattened by air strikes over the course of one hour."