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)

After long-standing malnutrition a 15-month-old boy with signs of kwashiorkor was admitted in a moribund state with serious hyponatraemic dehydration, hypothermia, somnolence, and signs of a pontine disconnection syndrome. Folic acid levels were below the detection level in the presence of normal cobalamin levels. MRI of the brain showed global volume loss and signal abnormalities on the T2-weighted images suggestive for central pontine myelinolysis (CPM). Brainstem acoustic evoked responses have remained normal. The serious metabolic and nutritional derangements required substitution of folic acid, vitamins and trace elements as well as slow correction of hyponatraemic dehydration with return of the sodium level over a period of four days. This therapeutic regimen resulted in complete neurological recovery. Follow-up MRI documented normalisation of the initial pathologic findings. The hypothesis was put forward linking the pathogenesis of CPM with the combination of folate depletion and superimposed hyponatraemic dehydration. The previously acquired folate depletion could affect normal appositional function of myelin basic protein molecules due to insufficient methylation of arginine in position 107. The subsequent development of intramyelinic edema and CPM will then be triggered by the superimposed hyponatraemic dehydration. The verification of this hypothesis requires further investigations.
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PMID:Central pontine myelinolysis associated with acquired folate depletion. 920 15

This article draws attention to the consequences of severe malnutrition for child survival in developing countries and the international efforts to effectively deal with nutrition problems. Severe malnutrition in developing countries affects an estimated 69 million children under 5 years of age. The most severe form of malnutrition results in marasmus and kwashiorkor and adult growth deficiencies, which affect the ability to work and, for women, the ability to bear normal-weight children. Severely malnourished children, even with treatment, die. The Public Health Nutrition Unit at the London School of Hygiene and Tropical Medicine developed a set of 10 guidelines for the care of severely malnourished children in order to prevent high mortality of malnourished children during treatment. Care varies between the first 1-2 days, days 2-7, and weeks 2-6. During the first several days, the child needs to be stabilized by preventing and treating hypoglycemia, hypothermia, and dehydration. During days 2-7, it is time to treat infections and start cautious feeding. During weeks 2-6, it is time to rebuild wasted tissues and prepare for follow-up. During all three time periods, there is a need to correct the imbalance of electrolytes, correct deficiencies of micronutrients, and provide stimulation and play. Iron supplementation is not provided until the second week. The 1992 International Conference on Nutrition identified the need to develop resources, such as strengthening existing capabilities and improving appropriate training. The WHO and UNICEF initiative on Integrated Management of Child Care uses the treatment guidelines and will be preparing training programs to teach relevant skills for the treatment of childhood illness and malnutrition. Training materials are being developed. The final phase will include the establishment of centers for training in the treatment of severely malnourished children.
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PMID:Reducing mortality rates in severely malnourished children. 1229 76