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

To focus attention on the problem of infant mortality in Lebanon, data were compiled on infant mortality from 1978 to 1986 at the American University of Beirut Medical Center. Causes of death are analyzed for 602 males and 398 females. 54.9% deaths occurred at 1 month of age and 77.4% died within the 1st year. Autopsies were performed on .7%. 37.7% of all neonatal deaths were due to neonatal diseases such as hyaline membrane disease, asphyxia neonatorum, immaturity, necrotizing enterocolitis, hemorrhage, hemolysis, meconium aspiration, and kernicterus. Better prenatal care would reduce this group, or the administration of corticosteroids to the mother 24-48 hours prior to delivery, as well as rapid resuscitation at birth and prevention of the 5 curses: hypoxemia, hypoglycemia, hypothermia, hypotension, and acidosis. Although unavailable in Lebanon, administration of surfactants through an endotracheal tube would also help. Infections constitute 25.1% of deaths; many are preventable through adequate public health measures and strict personal hygiene, i.e., diseases such as sepsis, pneumonia, meningitis, gastroenteritis, hepatitis, encephalitis, and 1-2 cases of the following: diphtheria, measles, peritonitis, tetanus, tuberculosis, cytomegalis inclusion, herpes, parathyphoid, pertussis, poliomyelitis, and shigellosis. Congenital diseases were 21.6%. In utero diagnosis could prevent some diseases and in utero treatment is possible for hydrocephalus and hydronephrosis. Screening programs postnatally could lead to treatment. 5.9% were malignancies such as leukemia, lymphoma, brain tumors, histocytosis, Wilm's tumor, Ewing sarcoma, and Hodgkin's disease. Early diagnosis is critical if mortality is to be reduced in this group, but medical advances are still needed. 2.9% are miscellaneous diseases such as poisoning, rheumatic diseases, marasmus, Reye's syndrome, nephrosis, rickets, and epilepsy. Most of these diseases are preventable, except for rheumatic inflammation of the heart. Recommended necessary steps to reduce infant mortality are: prenatal care, diagnosis and screening, intrauterine surgery; resuscitation and intensive care centers with modern equipment and trained personnel; national vaccination and screening programs; adequate public health measures and hygiene; parental education; and well-equipped hospitals to serve all regardless of income level.
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PMID:Pediatric mortality: an avoidable tragedy. 251 28

One hundred children with meningococcal infection diagnosed from January 1, 1985, to February 29, 1988, were reviewed. Clinical manifestations ranged from fever alone to fulminant septic shock with purpura fulminans. Twenty-nine percent of the children presented without skin lesions. Of the 55 patients with meningitis, 6 lacked cerebrospinal fluid abnormalities on initial lumbar puncture but cerebrospinal fluid cultures were positive. An overall case fatality rate of 10% was noted with the following poor prognostic indicators identified: hypothermia; seizures or shock on presentation; a total peripheral white blood cell count less than 5000/mm3; a platelet count less than 100,000/mm3; and the development of purpura fulminans. Meningococcal infections remain an important cause of morbidity and mortality in children. Infections caused by Neisseria meningitidis (including meningitis) should be considered even in the absence of skin lesions or cerebrospinal fluid abnormalities.
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PMID:Meningococcal infections in children: a review of 100 cases. 265 60

An analysis of the causes of death in the neonatal nursery of the Port Moresby General Hospital in Papua New Guinea from 1982-1985 is presented, and conclusions were enumerated. The nursery has beds for 24 babies, subdivided into intensive care, infection and growing areas. Dormitory space for 12 mothers is available, and breast feeding is encouraged, whether by sucking, cup or tube: no bottle feeding is done. Up to 9 sisters staff the unit. A total of 2948 infants were admitted, including 831 cesarean births. 343 deaths occurred. 80 deaths were previable babies less than 1000 g. The neonatal mortality was 10/1000. The most common causes of death were septicemia or meningitis (24%), perinatal asphyxia (20%), respiratory distress syndrome (15%), congenital abnormalities (12%), meconium aspiration 7%, apnea of prematurity (7%). Other causes included pneumonia, hypothermia, intrauterine infection syndrome, cerebral hemorrhage and kernicterus. Note that hypothermia can occur in tiny babies, even in the tropics. Both respiratory distress and jaundice appear to be rare in melanesians compared to caucasians. Infections were due to tetanus, E. coli, S. aureus a Strep. faecalis, rather than the Group B hemolytic Strep. more often seen in the West. It was concluded that several inexpensive measures can be put in place to markedly enhance survival: train birth attendants to prevent perinatal asphyxia; maintain body temperature by available means; feed adequately, using expressed breast milk if necessary; maintain oxygenation properly using simple equipment such as a nasal catheter or perspex head box; prevent infection by scrupulous hand washing, cord care and overall cleanliness; manage neonatal jaundice.
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PMID:Neonatal care in perspective: results of neonatal care at Port Moresby. 347 16

We studied 385 episodes of nosocomial bloodstream infections occurring over 45 months to ascertain if the etiologic organisms were independent predictors of death and morbidity. Independent predictors of death included respiratory failure, oliguria, metabolic acidosis, hypotension, increased age, antibiotic therapy in cases where susceptibility data were unknown, and infection with Pseudomonas aeruginosa. If parameters associated with septic shock were excluded, increased age, severity of disease, and infection with Candida spp. or P. aeruginosa predicted death. Infection with P. aeruginosa, Enterococcus, and Klebsiella pneumoniae predicted hypotension; severity of disease, polymicrobial infection, and infection with Candida spp., Enterococcus, Enterobacter, or Serratia marcescens predicted oliguria; infection with Candida spp. or P. aeruginosa, increased age, severity of disease, and inability to meet hospital financial obligations without assistance predicted respiratory failure. Inability to meet hospital financial obligations without assistance and severity of disease predicted hypothermia; infection with Candida spp. or P. aeruginosa and sex (male) predicted metabolic acidosis.
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PMID:Etiologic organisms as independent predictors of death and morbidity associated with bloodstream infections. 361 32

Infection, particularly of the respiratory tract, was present in 80 of 138 children with neonatal hypothermia. The most common lesion was right upper lobe atelectasis and was probably due to aspiration pneumonia. In children older than 3 days infection elsewhere, mainly owing to Escherichia coli bacilli, was common.
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PMID:Infection in neonatal hypothermia. 633 37

Hypothermia in infants is associated with considerable morbidity and mortality. Infection is thought to occur frequently and to carry a poor prognosis in infants with hypothermia. The medical records of 51 infants less than 3 months of age hospitalized from 1976 through 1981 with rectal temperatures of 34 degrees C or less were reviewed. Infections were diagnosed in 27 of the 51 infants. Infections were associated significantly with the presence of bradycardia, anemia, abnormal leukocyte counts, abnormal serum glucose levels, and uremia, especially if two or more of these variables were present. Morbidity and mortality were higher among infected than among noninfected infants. No rapid reliable indicators for the presence or absence of infection in an individual infant with hypothermia were found despite the differences noted between the two groups. Until new techniques for the detection of bacterial infections became available, we suggest that antibiotics be given to all infants younger than 3 months of age with hypothermia on admission to the hospital.
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PMID:Infections in hypothermic infants younger than 3 months old. 671 5

Bacteriologic examination of blood, urine, CSF, and gastric aspirate was performed in 88 babies admitted with hypothermia (rectal temperature less than 35 degrees C) during the neonatal period. Infection was common in infants older than 3 days (late-onset hypothermia). In 36 of the 44 (81.8%) infected babies, the gastric aspirate was abnormal, whereas it was abnormal in only three of the 23 (13%) not infected. Infection was much less common in babies younger than 3 days (early-onset hypothermia), and in these the gastric aspirate was mostly normal. Two babies had RDS-like symptoms, and streptococci were cultured from the gastric aspirate. Examination of the gastric aspirate is a quick, efficient method of diagnosing severe infection, not only immediately after birth but throughout the neonatal period.
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PMID:Sepsis and hypothermia in the newborn infant: value of gastric aspirate examination. 687 29

Sixteen pregnant queens were inoculated orally with tissue cysts of Toxoplasma gondii, and fetal membranes and offspring were examined for T gondii infection by bioassay in mice. Queens appeared clinically normal, although all shed T gondii oocysts. Toxoplasma gondii was isolated from tissues of 7 of 33 fetuses or kittens from 5 litters (at 13, 23, 26, 27, and 29 postinoculation days) from 8 queens euthanatized between 10 and 31 postinoculation days. Infection with T gondii was found in kittens from all 8 litters from the 8 queens that were allowed to undergo parturition and nurse their kittens. A total of 43 kittens were born to these 8 queens. Toxoplasma gondii was isolated from tissues of 26 of 40 kittens bioassayed; in 3 kittens, tissues were not available for bioassay. Toxoplasmosis was severe in full-term kittens born to 5 queens; all 25 kittens from these litters died or were ill by 24 days of age. Anorexia, lethargy, hypothermia, and sudden death were the most common manifestations. Cytologic examination of peritoneal fluid aspirate samples and determination of hepatic-associated enzyme concentrations in affected kittens, as well as measurement of anti-T gondii antibodies in serum of kittens and queens, were helpful in the diagnosis of neonatal toxoplasmosis. Transplacental transfer of anti-T gondii antibodies was not observed in cats. Toxoplasma gondii oocysts were found in fecal samples of 3 kittens from different litters at 16, 24, and 63 days of age.
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PMID:Diagnosis of induced toxoplasmosis in neonatal cats. 760 11

False aneurysm of the ascending aorta is a rare and life-threatening complication of open heart surgery, usually occurring late after operation. Echocardiography, especially transesophageal echocardiography, is a non-invasive method of examination which can be very helpful in its diagnosis. Deep hypothermia and circulatory arrest allow a bloodless field during surgery and provide an adequate patient protection. Infection is a very well known predisposing factor, but cystic medial necrosis of the aortic wall also seems to play a role in this complication. We report three cases, two of them had cystic medial necrosis and the presence of infection could be proved in none.
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PMID:False aneurysm of the ascending aorta following aortic valve replacement. 801 42

The mouse adapted strain of influenza A/FM/1/47 virus, FM-MA, has increased virulence due to mutations in HA, M1 and at least one other, unmapped, genome segment. Genetic reassortants that differ due to the HA or M1 mutations were used to define the role of these mutations in pathogenesis. Pathological changes in lungs of infected mice were assessed by hematoxylin phloxine saffron (HPS) staining, and viral infection was measured by fluorescent antibody staining of thin sections and flow cytometry of lung parenchymal cells. HA played a role in bronchiolar pathology by increasing necrosis of bronchiolar epithelium, peribronchiolar lymphocytes, and airway obstruction. The HA mutation was shown to be responsible for a 0.2 unit decreased in the pH optimum of fusion and controlled resistance to alpha and beta inhibitors of hemagglutination. Both these changes in biology may confer a replicative advantage in bronchioles seen in the first day of infection. Thus the HA mutation may have conferred a survival advantage in the extracellular lung environment. The M1 mutation resulted in improved growth in the lung and cultured cells and was associated with increases in recruitment of macrophages, spread of infection into the alveoli of the lung and interstitial pneumonia. Sequence analysis indicated that the unmapped mutation in the control of FM-MA virulence is either the K482-->R substitution in the PB2 protein or the D538-->G substitution in the PB1 protein. One or other of these mutations results in a growth advantage in infected lung but not in cultured cells as well as a further increased recruitment and infection of macrophages in the lung. Infection with virulent strains of influenza that induced increases in macrophage recruitment caused hypothermia in the mouse.
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PMID:Mutations in the hemagglutinin and matrix genes of a virulent influenza virus variant, A/FM/1/47-MA, control different stages in pathogenesis. 887 38


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