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

Accidental, homicidal and suicidal drowning comprise a special challenge to the clinician and preventive medicine advocate, alike. In South-east Asia and Australasia, accidental immersion accidents rank highly among the causes of preventable child trauma. Bath-tub and bucket drownings affect infants and toddlers under the age of 12 months, and some 10 percent of fatal bucket-tub immersions affecting infants are the result of child abuse. Immersion accidents in the sea have special characteristics, not specifically as a result of differences in water osmolarity, but related to hypothermia, secondary lung complications, and immersion times. Swimming pool drownings are the major cause of preventable death affecting pre-school children in some regions of Australasia. Resuscitation of the near-drowned child is topical because, (a) of controversies about the optimality of mouth-to-nose expired air resuscitation (EAR) in infants under six months of age; (b) of controversies about the degree of brain damage among child survivors following intensive care salvage; and (c) the difficulties of having "every parent a first-aider". A major study of childhood immersions (The Brisbane Drowning Study has shown that of all survivors, some 70 percent will be completely normal, 30 percent will suffer some selective deficit (with wide disparities on sub-scale scores on formal IQ testing), and 3 percent will live in a permanent vegetative state. Vigorous preventative campaigns using the triad of (a) public media education and campaigns, (b) better safety standards and safety devices, and (c) safety legislation, can reduce both the population risk and the individual clinical severity of immersion accidents.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Medical aspects of drowning in children. 141 98

Problems encountered regarding the examination in forensic pathology are variable, even if the field of interest in limited to trauma alone. The most important problem appears to be the establishment of a causal relationship between the trauma and the death of the victim. From the materials I have contributed concerning examinations in forensic medicine, the problems inherent in the examination of the victim of traumatic shock may be introduced. The results from animal studies, which have been attempted to provide an experimental background to support the observations, are also discussed. My personal opinions on several trial cases in which there was a disagreement of opinion regarding the examination results will also be expressed. 1. Distinguishing death due to traumatic shock from death due to disease In the "Yacht school" incident, children with emotional disturbances and youths with a history of misconduct were treated with training which included physical punishment. Autopsy findings were compared between a 13-year old boy who was concluded to have died of traumatic shock from numerous beatings and a 21-year old youth who died of hemorrhagic pneumonia. In my opinion, a causative role of injury in the death was found in both cases. 2. Shock due to tourniquet This autopsy case concerns a 23-year-old male who entered a yoga training center, was tightly bound with a rope and died on the 8th day. Histological examination revealed thrombus formation in the small blood vessels and leukocyte agglutination within the blood vessels of the alveolar wall, suggesting DIC. While these findings were thought to be almost indistinguishable from those found in traumatic shock, the background conditions, including hunger, dehydration and hypothermia cannot be neglected in the evaluation. 3. Child abuse In one incident, a mother and her lover beat a 25-month old girl every day until her death. The original examination concluded that the cause of death was traumatic shock due to multiple trauma over the entire body caused by both adults. A second examination concluded that the cause of death was delayed suffocation due to binding of the chest and compression against a mattress. Based on an overall evaluation of the circumstances at the time of detection (including photographic evidence) as well as the contents of the statement made by the lover, I inferred that the head-down hanging of the child in the bathtub by the lover was directly related to the cause of death. In my opinion, the liability of the two adults in the crime was not the same.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Problems regarding the examination in forensic medicine]. 262 31

Child abuse and neglect, though existing in India, has not come to light because of underlying social constraints like poverty, malnutrition and infection. With an intention to study the problem of physical abuse in neglected children, patients admitted to the pediatric wards of our institution, predominantly with some form of physical abuse were specifically looked for from January 1976 onwards. Over a period of 4 1/2 years, 18 such cases were encountered. Most of the babies were less than four weeks of age, were predominantly females, were quite often premature or malnourished, and rarely had a physical deformity. These babies were deserted and later were found by police or social workers in gutters, dustbins, garbage tins, railway platforms, etc. The spectrum of abuse and injuries included newborn babies with intact placenta, at times lacerated, strangling marks on the throat, multiple bruises, bleeding from the umbilicus, avulsion of the scalp with severe bleeding, shock as a result of environmental stress (i.e., hypothermia), evidence of infection, rat bite marks, and fractures. The morbidity was very high, ultimately resulting in 88.9% mortality over varying periods of time, maximum survival being 22 days. The motive behind this abuse always was an unwanted baby.
Child Abuse Negl 1982
PMID:Physical abuse of abandoned children in India. 689 98

The majority of patients requiring hospital treatment for burns are infants and toddlers. Most cases are scald injuries involving less than 15 % of the body surface area. The risk of hypothermia during transport and acute treatment of patients in this age group is very high and therefore appropriate measures should be taken to minimize this risk. The frequency of child abuse at this age is higher than in older children and hence a detailed investigation of accident details should rule out this eventuality. Innovations in the field of wound treatment such as the use of allogenic or autogenic keratinozytes promise to be very effective especially in this age group. In order to avoid the development of scars with cosmetic and functional deficits, it is important to judge the correct point of time to perform a split-thickness skin graft during the further treatment. In this age group, the donor site for the split-thickness skin graft should be the scalp if possible and furthermore the grafts should not be expanded. These two simple measures can improve the cosmetic and functional outcome in infants and toddlers substantially.
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PMID:[Treatment of scald injuries in infants and toddlers: the Zurich concept]. 1798 81

Pediatric abusive head trauma is a challenging subject across many disciplines. Of particular importance is the identification of mimics of abuse, so cause and manner of death can be properly assigned. We present the case of suspected child abuse involving an infant who presented unresponsive to the hospital with hypoglycemia, hypothermia, and bilateral parietal fractures. An autopsy revealed fractures associated with organizing scalp hemorrhage and gross leptomeningeal congestion and hemorrhage. The fractures were circular with external displacement, rounded margins, and subperiosteal new bone formation indicative of healing. Birth records revealed vacuum assist and cesarean section delivery. Although vacuum extraction-related injuries are typically cephalohematomas and/or linear fractures, the outbending and circular morphology of the fractures are consistent with vacuum extraction. Moreover, microscopic neuropathological examination revealed hemorrhagic purulent leptomeningitis. This unique case demonstrates the importance of considering birth trauma in the determination of cause and manner of death of an infant.
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PMID:A Unique Type of Birth Trauma Mistaken for Abuse. 2860 24