Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A nationwide survey of the management of severe head injury was carried out in 1988 by sending the questionnaires to 1,088 main neurosurgical hospitals in Japan. The items of the survey included annual number of patients with closed severe head injury (GCS score of 8 or less), place of patients' care, type of neuromonitorings, medical and surgical treatments, severity and outcome measures. Out of 1,088 questionnaires, 457 (42% response rate) were collected and analyzed. Characteristic features of the management status were the scarcity of patients annually in each institution, limited use of specific neuromonitorings, and variety of the actual managements. Aggressive managements such as hyperventilation, barbiturate and/or hypothermia have been employed in many hospitals to control high ICP. External and internal decompression are also used widely for intradural hematomas. These results clarified not only present status of Japan but also the problems to be solved in the actual managements.
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PMID:Result of nationwide survey of the management of severe head injury in Japan. 1178 52

A 2-year-old female spayed domestic shorthair cat was examined because of lethargy, inappetance, vocalization, and abnormal aggressive behavior of 1 day's duration. The cat had been groomed the previous day with a d-limonene-based insecticidal shampoo. Skin lesions consisted of coalescing erythematous patches. Despite supportive care, the cat's condition deteriorated. Dermatohistopathologic changes included multifocal areas of acute coagulative epidermal necrosis. The dermis was infiltrated by a dense population of bacilli. d-Limonene toxicosis has been rarely described in dogs and cats. Toxic effects such as hypersalivation, ataxia, shivering, hypothermia, scrotal irritation, hypotension, and erythema multiforme major have been reported. Treatment for septicemia and disseminated intravascular coagulation, along with intensive supportive care, may be necessary.
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PMID:Acute necrotizing dermatitis and septicemia after application of a d-limonene-based insecticidal shampoo in a cat. 1236 86

An approach for the replacement of the distal ascending aorta-proximal arch and acute dissection is described. During the operation, the patient's entire body was continuously perfused, the aortic arch was excluded from the arterial circulation, and the aorta was not clamped at any time. To achieve continuous body perfusion, we independently cannulated the right axillary and the left femoral arteries. The right atrium was cannulated for systemic venous return, and the right radial artery was used for arterial blood pressure monitoring. The myocardium was protected with retrograde cardioplegia, and the body was protected with moderate hypothermia. Vascular clamps were placed to the proximal innominate, left carotid, and left subclavian arteries without discontinuing perfusion of the right axillary artery. A temporary clamp was applied to the femoral line, the aorta was transected, and a large Foley catheter was inserted through the true aortic lumen. The Foley bulb was positioned in the proximal descending thoracic aorta and distended with saline until the aortic blood return ceased. The femoral line clamp was removed from the cannula, and the entire body was perfused during the completion of the distal aortic anastomosis. At the completion of the anastomosis, the Foley bulb was slightly deflated. Once the inserted graft was filled with blood, a large vascular clamp was applied to the graft, and the previously placed clamps were removed from the arch branches. The femoral line was removed, and the body was perfused and rewarmed via the axillary cannulation. Following completion of the proximal graft-aortic anastomosis, the heart was reperfused, and all cannulas were removed in the usual fashion. Rapid recovery characterized the patient's initial postoperative course; however, multiple organ failure secondary to pump-induced inflammatory response followed. Aggressive medical management resulted in complete patient recovery. No neurologic deficits were observed, and the patient regained full cognitive function. This report describes a simple approach to facilitate repair of the aortic arch and minimize postoperative organ failure.
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PMID:Repair of acute ascending aorta-arch dissection with continuous body perfusion: a case report. 1261 31

Hemorrhage is the most common cause of shock in patients with polytrauma, leading to cellular hypoxia and death. A large body of experimental and clinical research has greatly expanded our knowledge of cellular mechanisms and clinical outcomes in resuscitation of patients with hypovolemic shock. However, the fundamental principles of fluid resuscitation have not changed during the past few decades. Aggressive resuscitation to correct tissue hypoperfusion within 24 hours of injury is associated with improved clinical outcomes. Initial volume expanders of choice are crystalloid solutions, with blood and blood products used for patients who are hemodynamically unstable, patients with Class III and Class IV hemorrhage, and patients with ongoing uncontrolled sources of bleeding. The incidence of immunologic and infectious complications associated with blood transfusions in resuscitation of patients with polytrauma has not been shown to be any higher than in other clinical settings. Massive resuscitations, however, are associated with specific complications such as hypothermia, coagulopathy, and abdominal compartment syndrome. Novel blood substitutes, hypertonic saline, and minimally invasive hemodynamic monitoring techniques have the potential of optimizing fluid resuscitation in patients with polytrauma. Additional research using standardized animal models and randomized clinical trials is needed.
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PMID:Fluid resuscitation and blood replacement in patients with polytrauma. 1518 31

Exposing vertebrates to pathogenic organisms or inflammatory stimuli, such as bacterial lipopolysaccharide (LPS), activates the immune system and triggers the acute phase response. This response involves fever, alterations in neuroendocrine circuits, such as hypothalamo-pituitary-adrenal (HPA) and -gonadal (HPG) axes, and stereotypical sickness behaviors that include lethargy, anorexia, adipsia, and a disinterest in social activities. We investigated the hormonal, behavioral, and thermoregulatory effects of acute LPS treatment in a seasonally breeding songbird, the white-crowned sparrow (Zonotrichia leucophrys gambelii) using laboratory and field experiments. Captive male and female sparrows were housed on short (8L:16D) or long (20L:4D) day lengths and injected subcutaneously with LPS or saline (control). LPS treatment activated the HPA axis, causing a rapid increase in plasma corticosterone titers over 24 h compared to controls. Suppression of the HPG axis occurred in long-day LPS birds as measured by a decline in luteinizing hormone levels. Instead of a rise in body temperature, LPS-injected birds experienced short-term hypothermia compared to controls. Birds treated with LPS decreased activity and reduced food and water intake, resulting in weight loss. LPS males on long days experienced more weight loss than LPS males on short days, but this seasonal effect was not observed in females. These results paralleled seasonal differences in body condition, suggesting that modulation of the acute phase response is linked to energy reserves. In free-living males, LPS treatment decreased song and several measures of territorial aggression. These studies highlight immune-endocrine-behavior interrelationships that may proximately mediate life-history tradeoffs between reproduction and defense against pathogens.
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PMID:Hormonal, behavioral, and thermoregulatory responses to bacterial lipopolysaccharide in captive and free-living white-crowned sparrows (Zonotrichia leucophrys gambelii). 1596 47

The new CPR guidelines are based on a scientific consensus which was reached by 281 international experts. Chest compressions (100/min, 4-5 cm deep) should be performed in a ratio of 30:2 with ventilation (tidal volume 500 ml, Ti 1 s, FIO2 if possible 1.0). After a single defibrillation attempt (initially biphasic 150-200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min. Endotracheal intubation is the gold standard; other airway devices may be employed as well depending on individual skills. Drug administration routes for adults and children: first choice IV, second choice intraosseous, third choice endobronchial [epinephrine dose 2-3x (adults) or 10x (pediatric patients) higher than IV]. Vasopressors: 1 mg epinephrine every 3-5 min IV. After the third unsuccessful defibrillation attempt amiodarone IV (300 mg); repetition (150 mg) possible. Sodium bicarbonate (1 ml/kg 8.4%) only in excessive hyperkalemia, metabolic acidosis, or intoxication with tricyclic antidepressants. Consider atropine (3 mg) and aminophylline (5 mg/kg). Thrombolysis during spontaneous circulation only in myocardial infarction or massive pulmonary embolism; during CPR only during massive pulmonary embolism. Cardiopulmonary bypass only after cardiac surgery, hypothermia or intoxication. Pediatrics: best improvement in outcome by preventing cardiocirculatory collapse. Alternate chest thumps and chest compression (infants), or abdominal compressions (>1-year-old) in foreign body airway obstruction. Initially five breaths, followed by chest compressions (100/min; approximately 1/3 of chest diameter): ventilation ratio 15:2. Treatment of potentially reversible causes (4 "Hs", "HITS": hypoxia, hypovolemia, hypo- and hyperkaliemia, hypothermia, cardiac tamponade, intoxication, thrombo-embolism, tension pneumothorax). Epinephrine 10 microg/kg IV or intraosseously, or 100 microg (endobronchially) every 3-5 min. Defibrillation (4 J/kg; monophasic oder biphasic) followed by 2 min CPR, then ECG and pulse check. Newborns: inflate the lungs with bag-valve mask ventilation. If heart rate<60/min chest compressions:ventilation ratio 3:1 (120 chest compressions/min). Postresuscitation phase: initiate mild hypothermia [32-34 degrees C for 12-24 h; slow rewarming (<0.5 degrees C/h)]. Prediction of CPR outcome is not possible at the scene; determining neurological outcome within 72 h after cardiac arrest with evoked potentials, biochemical tests and physical examination. Even during low suspicion for an acute coronary syndrome, record a prehospital 12-lead ECG. In parallel to pain therapy, aspirin (160-325 mg PO or IV) and in addition clopidogrel (300 mg PO). As antithrombin, heparin (60 IU/kg, max. 4000 IU) or enoxaparine. In ST-segment elevation myocardial infarction, define reperfusion strategy depending on duration of symptoms until PCI (prevent delay>90 min until PCI). Stroke is an emergency and needs to be treated in a stroke unit. A CT scan is the most important evaluation, MRT may replace a CT scan. After hemorrhage exclusion, thrombolysis within 3 h of symptom onset (0.9 mg/kg rt-PA IV; max 90 mg within 60 min, 10% of the entire dosage as initial bolus, no aspirin, no heparin within the first 24 h). In severe hemorrhagic shock, definite control of bleeding is the most important goal. For successful CPR of trauma patients, a minimal intravascular volume status and management of hypoxia are essential. Aggressive fluid resuscitation, hyperventilation, and excessive ventilation pressure may impair outcome in severe hemorrhagic shock. Despite bad prognosis, CPR in trauma patients may be successful in select cases. Any CPR training is better than nothing; simplification of contents and processes remains important.
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PMID:[The new 2005 resuscitation guidelines of the European Resuscitation Council: comments and supplements]. 1691 4

Experiments were performed on Norwegian rats selected over more than 59 generations for high and low levels of high-affective defensive aggressivity and on highly aggressive (offensive) Tg8 mice with irreversible monoamine oxidase A knockout. There were significant differences in the functional state and expression of 5-HT(1A) receptors between highly aggressive and non-aggressive animals. Functional activity assessed in terms of hypothermia evoked by a 5-HT(1A) agonist was significantly greater in non-aggressive rats and mice than in aggressive animals. The high level of functional activity in non-aggressive rats coincided with a greater level of expression of 5-HT(1A) receptors in the midbrain. The level of 5-HT(1A) receptor mRNA in aggressive mice was unchanged in the midbrain and hypothalamus and was increased in the frontal cortex and amygdaloid complex. These results led to the conclusion that 5-HT(1A) receptors play a significant role in the mechanisms of genetic predisposition to aggressive behavior.
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PMID:Involvement of brain serotonin 5-HT1A receptors in genetic predisposition to aggressive behavior. 1765 35

Neurotensin (NT) is a versatile neuropeptide involved in analgesia, hypothermia, and schizophrenia. Although NT is released from and acts upon brain regions involved in social behaviors, it has not been linked to a social behavior. We previously selected mice for high maternal aggression (maternal defense), an important social behavior that protects offspring, and found significantly lower NT expression in the CNS of highly protective females. Our current study directly tested NT's role in maternal defense. Intracerebroventricular (i.c.v.) injections of NT significantly impaired defense in terms of time aggressive and number of attacks at all doses tested (0.05, 0.1, 1.0, and 3.0 microg). Other maternal behaviors, including pup retrieval, were unaltered following NT injections (0.05 microg) relative to vehicle, suggesting specificity of NT action on defense. Further, i.c.v. injections of the NT receptor 1 (NT1) antagonist, SR 48692 (30 microg), significantly elevated maternal aggression in terms of time aggressive and attack number. To understand where NT may regulate aggression, we examined Fos following injection of either 0.1 microg NT or vehicle. Thirteen of 26 brain regions examined exhibited significant Fos increases with NT, including regions expressing NT1 and previously implicated in maternal aggression, such as lateral septum, bed nucleus of stria terminalis, paraventricular nucleus, and central amygdala. Together, our results indicate that NT inversely regulates maternal aggression and provide the first direct evidence that lowering of NT signaling can be a mechanism for maternal aggression. To our knowledge, this is the first study to directly link NT to a social behavior.
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PMID:Neurotensin inversely modulates maternal aggression. 1911 4

Idiopathic hypothalamic dysfunction is a rare disorder presenting at age 3-7 years. Severe hypothalamic and brainstem dysfunction leads to death in 25% of patients. The disease is presumed to be autoimmune, or in some cases paraneoplastic. No successful treatment has been reported. Patient V. developed hyperphagia, hypersomnia, and extreme aggression at age 7 years, accompanied by episodes of hyperthermia, hypothermia, sinus bradycardia, hypernatremia, hyponatremia, persistent hyperprolactinemia, hypothyroidism, and growth-hormone deficiency. At age 9 years, a diagnosis of idiopathic hypothalamic dysfunction was rendered, and immunoglobulin therapy was commenced. Nine courses of immunoglobulins, at a dose of 2 g/kg every 4 weeks, were administered. Reproducible improvements in behavior and no further episodes of hyponatremia or hypernatremia and sinus bradycardia were evident. The endocrinologic abnormalities and poor thermoregulation remained. Administration of immunoglobulins during late stages of idiopathic hypothalamic dysfunction led to improvement in some but not all signs. Assuming an autoimmune basis for this disorder, treatment during early stages of disease should be more effective. To facilitate such early treatment, increased awareness of this disorder is necessary, to allow for early diagnosis.
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PMID:Immunoglobulin therapy in idiopathic hypothalamic dysfunction. 1966 46

The review concentrates on the role of different types and subtypes of 5-HT receptors in physiological and behavioural effects of the brain neurotransmitter serotonin. Specifically it describes: 1) the effects of 5-HT1A and 5-HT1B receptors on aggressive behavior, sexual arousal, food and water consumption; 2) the data showing reciprocal effect of 5-HT2A, 5-HT2C receptor agonists; 3) interaction of 5-HT3 and 5-HT1A-receptors in 5-HT3-induced hypothermia. The review provides converging lines of evidence that: different types and subtypes of 5-HT receptors are involved in the regulation of various kinds of behavior as additive as well as opposite factors providing neuroplasticity, compensatory and adaptive mechanism.
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PMID:[Polymorphism in 5-HT receptors as the background of serotonin functional diversity]. 2096 63


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