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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Auditory brainstem responses (ABRs) provide a way to evaluate central nervous system function in young, confused, uncooperative or comatose patients. Auditory brainstem responses represent activity in or around the vestibulocochlear (VIII) cranial nerve, cochlear nucleus, superior olivary complex, lateral lemniscus, and inferior colliculus. Many factors affect recording of the auditory brainstem response. These factors include technical factors, chronic alcoholism, demyelinating diseases, ototoxic drugs, barbiturates, hearing loss, otitis media, and hypothermia.
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PMID:Problems in interpreting abnormal auditory brainstem responses in comatose patients. 384 67

A major goal of pharmacogenetic research on alcoholism remains the identification of some "marker" that could predict the liability of a particular individual for a genetic susceptibility to develop alcoholism. The present paper presents evidence that the severity of withdrawal from physical dependence on ethanol varies widely among inbred strains of mice, and that withdrawal severity is negatively genetically correlated with initial sensitivity and magnitude of tolerance to ethanol hypothermia. These correlations are supported by differences in hypothermic response between replicate lines of mice genetically selected for susceptibility and resistance to ethanol withdrawal seizures. The genetic relationships reported suggest that the effects of ethanol on thermoregulation in mice may offer a predictive marker for susceptibility to ethanol physical dependence.
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PMID:Genetic correlations with ethanol withdrawal severity. 668 10

Five patients with accidental hypothermia are reported. Admission rectal temperatures ranged from 24 degrees C to 31.7 degrees C and two patients had suffered circulatory arrest. Ages ranged between 25 and 77 and predisposing factors included alcoholism, gluterthimide poisoning, pancreatitis and cerebro-vascular accident. Along with respiratory and circulatory management in an intensive care unit the patients were actively rewarmed by peritoneal dialysis with fluid at 37 degrees C. Rewarming was rapid, smooth and free of complications. All five patients made a good recovery.
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PMID:Warm peritoneal dialysis in the management of accidental hypothermia: report of five cases. 694 12

Hypoglycemia is but one of a number of causes of hypothermia, but is important to keep in mind as a possible precipitating or concurrent event even in those cases in which there are other obvious explanations for decreased body temperature (exposure, alcoholism, starvation, sepsis or hypothyroidism). Hypoglycemia may occur in as many as 40 percent of very cold patients, and be clinically unrecognized because symptoms are masked by the hypothermia itself. Although serum glucose levels are depressed, a cold-induced renal tubular glycosuria may occur. Glucose in the urine, therefore, cannot be used as assurance of hyperglycemia in a hypothermic patient. And, although cold protects against serious end organ damage from hypoglycemia by decreasing tissue metabolic need for glucose, a serum specimen should be drawn for glucose determination in all hypothermic patients and a 50 percent glucose solution immediately given intravenously. If this is not done, serum glucose levels may plummet as the patient is rewarmed and begins to shiver.
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PMID:Hypoglycemia and accidental hypothermia in an alcoholic population. 723 90

Accidental hypothermia, a core temperature below 34 degrees C., is frequently fatal, particularly in the ill and elderly. Traditional treatment methods result in reported mortalities of between 45 and 100 per cent. Despite these terrible statistics, advocates of slow rewarming persist. They cite the shock and vascular collapse which can occur with peripheral dilation as reasons to avoid rapid external rewarming. Isolated successes using internal core rewarming, such as hemodialysis or cardiopulmonary bypass, are spectacular but not practical in the usual clinical situation. By combining methods used for the resuscitation of burn injury with the treatment principles for frostbite, a highly effective treatment protocol results. Agressive fluid resuscitation, rapid immersion rewarming and careful systematic monitoring have been used to treat ten consecutive patients without a single death. Concomitant problems of alcoholism, stroke, myxedema, tuberculosis and paraplegia were also treated. Rapid external rewarming by immersion can result in a low mortality in patients with severe hypothermia.
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PMID:Accidental hypothermia treated without mortality. 740 8

Hypothermia in the elderly is a medical emergency with mortality varying from 32-80%. Its most frequent predisposing factors, as reported in the current literature, are extremes of age, cold environment and alcoholism. In the Negev (southern region of Israel, mostly desert area) the mean temperature range during November-March is 9.6 to 15.2 degrees C and during April-October, 16-25.9 degrees C. The records of all patients with hypothermia, aged 65 and above admitted over a 5-year period (1984-1988) were reviewed (44 admissions of 39 patients of whom 23 were females). 34 were admitted during the winter months and 10 during the rest of the year. Important associated or predisposing conditions included infections in 54.5%, renal failure in 29.5% and diabetes mellitus in 29.5%. Alcoholism (13.6%) was relatively infrequent. Those of Asian or African origin appeared to be at greater risk, constituting 73% of admissions, but only 47% of the elderly population of the Negev. The annual incidence of up to 4/1000 of elderly patients admitted to our medical wards, which serve a population of 350000, indicates that hypothermia is not rare in this desert region.
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PMID:[Hypothermia in the elderly in the Negev]. 781 22

Realizing that miracle drugs that can reverse severe brain damage have not yet been identified, studies in recent years have focused on identifying risk factors for head trauma and resuscitative events that might impede or improve outcome. Risk factors for poor outcome include advanced age, alcoholism, delay in transfer and operation, management errors and technical mistakes. Quality assurance programmes, now established in all United States hospitals, may be flawed in that assessments of preventable trauma deaths are often based on unsubstantiated subjective case review methods. Studies of the cerebral effects of anaesthetic agents have reconfirmed the detrimental effects of nitrous oxide in the trauma victim. Ketamine, a N-methyl D-aspartate receptor antagonist, has shown surprising cerebral protective effects in animal models. Appropriate fluid therapy after head injury requires avoidance of sugar-containing solutions, maintenance of normovolaemia and consideration of use of hypertonic solutions to maintain vascular volume. Although hypothermia continues to be an appealing means of affording brain protection after head injury, the degree and duration have still not been established. Establishment of the airway in the neck injured patient should be by careful endotracheal tube placement which causes less cervical movement than mask ventilation and less risk of infection or trauma than the nasotracheal route.
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PMID:Perioperative management of the head trauma patient. 797 24

The purpose of this study was to determine if the ketone body beta-hydroxybutyrate (beta-HBA) is a useful positive marker for sudden deaths in chronic alcoholics, thought to be due to hypoglycemia. Beta-HBA can be reliably measured in postmortem samples of vitreous humour and urine. In fatalities where there is a history of chronic alcoholism and routine investigations, including autopsy and routine toxicology, yield only a fatty liver as positive findings, a raised level of beta-HBA can be used as an indicator for alcoholic ketosis. Alcoholic ketosis is often associated with antemortem hypoglycemia. Caution should be observed in attributing the significance of ketosis exclusively to alcohol in those conditions where it would otherwise be expected (i.e. diabetic ketoacidosis and chronic starvation). A measurement of this marker of alcoholic ketosis may also help in the investigation of cases where hypothermia or alcohol withdrawal fits are suspected.
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PMID:The investigation of beta-hydroxybutyrate as a marker for sudden death due to hypoglycemia in alcoholics. 830 32

Genetic differences in sensitivity to ethanol's aversive effects may play an important role in the development of alcohol-seeking behavior and alcoholism. The present study examined the development of ethanol-induced conditioned taste aversion in 20 BXD/Ty recombinant inbred strains of mice and their progenitor inbred strains, C57BL/6J (B6) and DBA/2J (D2). Adult male mice were given 1-hr access to a saccharin-flavored solution every 48 hr for 12 days. After all but the first and last saccharin access periods, they received ethanol injections (0, 2, or 4 g/kg, i.p.). Separate groups of unpaired control mice received 4 g/kg of ethanol 1 hr after water access. Saline control mice were also used for examining preference across a wide range of saccharin concentrations (0.019 to 4.864% w/v). As expected, saccharin consumption during taste conditioning declined over conditioning trials in a dose-dependent manner, indicating development of ethanol-induced conditioned taste aversion. Correlational analyses using strain means from recently published papers indicated no significant genetic correlation between taste conditioning and two phenotypes thought to reflect ethanol reinforcement or reward (ethanol drinking, conditioned place preference). However, there were significant genetic correlations between taste conditioning at the high dose and sensitivity to ethanol-induced hypothermia, rotarod ataxia, and acute withdrawal. Quantitative trait locus (QTL) analyses of strain means indicated that taste aversion was associated (p < 0.01) with genetic markers on nine chromosomes (1, 2, 3, 4, 6, 7, 9, 11, and 17). These QTLs were located near several candidate genes, including genes encoding several different acetylcholine receptor subunits, the delta opioid receptor, and two serotonin receptors (1B and 1D). QTLs for saccharin preference were located on several of the same chromosomes (2, 3, 4, 6, and 11). Two of these saccharin QTLs overlap candidate genes influencing sensitivity to sweet or bitter taste stimuli. In general, these findings support the conclusion that multiple genes influence ethanol-induced conditioned taste aversion. Some of these genes appear to influence taste sensitivity, whereas others appear to mediate sensitivity to aversive pharmacological effects of ethanol.
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PMID:Ethanol-induced conditioned taste aversion in BXD recombinant inbred mice. 975 38

Hot, humid conditions in tropical regions generally rule out any risk of hypothermia due to cold exposure. In this report, we describe a case of severe hypothermia involving a core temperature of 26 degrees C in a 61-year-old man living in Gabon. Parkinson's disease and chronic alcoholism may have been predisposing factors. The patient was treated by active and passive rewarming (intestinal irrigation with warm water). Sudden circulatory collapse occurred during treatment but the final outcome was successful. This case demonstrates that hypothermia can occur in tropical areas. Emergency diagnosis may be difficult in Black Africa where adequate temperature monitoring equipment is rarely available. Standard mercury thermometers do not allow measurement of temperatures lower than 34 degrees C. African physicians should be aware of the possibility of potentially life-threatening hypothermia and be prepared to initiate proper treatment and surveillance in intensive care.
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PMID:[Severe hypothermia in a tropical setting]. 979 96


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