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

A series of 100 patients with gastroschisis and omphalocele is presented. It is emphasized that gastroschisis generally has a strikingly homogeneous clinical presentation, while the omphalocele has a more heterogeneous clinical presentation, varying from the smallest to the largest, nearly incorrectable type. The main problem in the two groups is the problem of the closure of the defect. In gastroschisis there are, in addition, two problems related to the length of the intestinal tract and the tendency to peritonitis and septicaemia. In omphalocele, however, the major problem is the associated anomalies. The experience from the present material indicates that greater efforts must be used in the future in trying to avoid hypothermia, both during transportation and during operation. Furthermore, greater efforts must be made in closing the abdominal wall defect primarily in both groups of patients. More liberal use of respirator and total parenteral nutrition, mainly by peripheral veins, has obviously contributed to the improvement in our results from 1 60% mortality rate in the first nine-year period to a 37% mortality rate in the last nine-year period in the omphalocele group. Our best results have been obtained during the last 3 years with 2 deaths in the last 12 patients who all were treated by primary closure. In the gastroschisis group a survival rate of 69% in the whole series and of 74% in those who were primarily completely closed must be looked upon as progress in the light of earlier reports of survival rates of 36% to 43%.
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PMID:Gastroschisis and omphalocele. 16 May 85

A retrospective study was undertaken over an eight-year period to assess the mortality rate of 66 newborns who had undergone surgery in our clinic because of peritonitis. The mortality rate for the patients admitted in poor condition was 95.2 percent, whereas it was 45.5 percent for those in good condition. There was a 100 percent mortality associated with newborns that had hypothermia and with those that had severe respiratory difficulties, whereas it was 92.3 percent for low-birth-weight infants and 86.5 percent for dehydrated infants. All babies with sclerema neonatorum died. The newborns with white blood cell counts under 5,000/mm3 also did not survive (83.3%). Etiologically, congenital megacolon, meconium ileus and spontaneous gastrointestinal perforations were the most frequent anomalies leading to death (100%). In the newborns with gastrointestinal perforations, most deaths occurred in patients with perforations of the cecum, duodenum and stomach (100%). Mortality seemed to be greater in patients with complications (77.3%), and it rose to 83.3 percent for patients who had to undergo a repeat operation due to complications. The overall mortality rate was found to be 71.2 percent.
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PMID:Neonatal peritonitis. 148 83

Fever is a complex and important nonspecific, host defense mechanism against infection. The generation of the heat necessary to increase body temperature may involve thermogenesis in brown adipose tissue. To investigate whether the febrile response to Escherichia coli peritonitis involves thermogenesis in brown adipose tissue, we assessed whole rat oxygen consumption and brown adipose tissue mitochondrial guanosine 5'-diphosphate binding. Non-lethal doses of E. coli, 1 x 10(6) to 1 x 10(8) colony forming units, induced a fever for greater than 8 h. In contrast, a dose of 1 x 10(9) colony forming units resulted in a progressive hypothermia culminating in death. A 48% increase in oxygen consumption (p less than 0.05) in E. coli-infected rats occurred almost immediately, preceded the development of the fever, and was sustained throughout the fever. There was a highly significant correlation (r = 0.736, p less than 0.01) between oxygen consumption and body temperature for both control and infected animals. Guanosine 5'-diphosphate binding assessed by multi-point Scatchard analysis of [3H]guanosine 5'-diphosphate binding to isolated mitochondria was increased by 45.4 +/- 7.3% at 1.75 h and by 31.9 +/- 9.0% at 3.5 h (p less than 0.05). The greater increase was during the rising phase of the fever. Unexpectedly, a lethal dose of 5 x 10(9) colony forming units of E. coli also increased guanosine 5'-diphosphate binding sites by 54.4 +/- 14.2% (p less than 0.05) despite a hypothermia of -1.71 +/- 0.29 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Escherichia coli peritonitis activates thermogenesis in brown adipose tissue: relationship to fever. 165 79

Local abdominal hypothermia in intensive therapy of peritonitis in children checked abdominal inflammation, prevented the onset of hyperthermic reactions, promoted early stabilization of central hemodynamic parameters and early normalization of humoral immunity and led to certain clinical improvement. Taking into consideration the above data as well as possible indications and contraindications one can recommend local abdominal hypothermia for intensive therapy of generalized suppurative peritonitis in children.
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PMID:[Local abdominal hypothermia in the intensive treatment of children with diffuse suppurative peritonitis]. 214 14

Planned relaparotomy (temporary abdominal closure) was studied prospectively in 20 trauma patients. Four died in the first 24 hours from hypothermia, coagulopathy, shock (three), and septic shock (one). The 16 survivors had a Velcro-like prosthetic placed to facilitate abdominal closure and re-entry. Prosthetic was necessary in eight because bowel edema precluded fascial closure, and useful for removal of packing (three) and for the management of peritonitis (five). The prosthetic did not open spontaneously, nor was it associated with evisceration or bowel fistula. Temporary abdominal closure (TAC) permitted reappraisal and staged repair of intra-abdominal pathology, including bowel resection and anastomosis. TAC identified 14 problems early: bleeding (five), bile leaks (two), GI complications (six), liver necrosis (one). Five patients developed superficial wound infections, and three went on to develop fascial necrosis.
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PMID:Temporary abdominal closure (TAC) for planned relaparotomy (etappenlavage) in trauma. 219 Nov 42

Peritonitis due to Candida albicans is rare in the newborn infant. Three low birthweight, extremely ill premature infants who were severely hypothermic at the time of admission developed perforation of the gastrointestinal tract. C. albicans was cultured from the peritoneal fluid in each case. In view of the rareness of C. albicans peritonitis in newborns, this cluster of infants suggests a relationship between severe neonatal hypothermia, and bowel perforation with peritonitis due to this fungus.
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PMID:Necrotizing bowel disease with candida peritonitis following severe neonatal hypothermia. 223 92

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

Atresia coli was identified in 26 calves. In calves with abdominal distension, progressive depression, and the absence of feces since birth, atresia coli should be suspected. Surgery was performed on 24 calves, involving decompression of the distended large intestine followed by colonic anastomosis. Nine calves were subsequently discharged; 3 of those calves reached breeding age. As an adult, 1 of the calves produced 5 offspring unaffected by atresia coli. Early postoperative mortality was associated with hypothermia, peritonitis, and ischemic necrosis of the large intestine. Calves with visible signs of peritonitis at surgery had a poor prognosis. Four calves had motility disturbances of the colon after surgery. These were characteristic of a functional obstruction and were unresponsive to treatment. Surgery was most successful in calves that were bright, alert, and ambulatory.
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PMID:Atresia coli in calves: 26 cases (1977-1987). 275 84

A series is presented of 83 patients surgically explored for massive bowel infarction. Old men with previous heart disease and symptoms of peripheral atherosclerosis were primarily affected. Clinical presenting features were abdominal pain (100 per cent), peritonitis (57 per cent), shock (34 per cent) and hypothermia (26 per cent). A third-space syndrome with metabolic acidosis and uraemia was the most common physiological derangement. Age was the only factor that appeared to have influenced the surgeon's decision to perform massive bowel resection (71 years in non-resected versus 64 years in resected patients, P less than 0.006). The overall mortality rate was 71 per cent. Forty-four patients underwent massive bowel resection (mean length of remaining small bowel 60 +/- 40 cm) and twenty-four (54 per cent) survived the procedure. Axillary temperature was higher in survivors (36.7 degrees C versus 36.1 degrees C, P less than 0.03). Early postoperative total plasma protein and albumin concentrations were also higher in survivors (57 versus 46 g/l, P less than 0.005; 27 versus 22 g/l, P less than 0.02). Patients with previous symptoms of atherosclerotic disease and high pre-operative blood urea levels also had a bad prognosis. Survivors had a mean hospital stay of 57 days and parenteral nutrition had to be maintained for a mean of 34 days. The survival rate achieved with massive resection justifies this surgical approach in selected patients with massive bowel infarction.
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PMID:Mesenteric infarction: an analysis of 83 patients with prognostic studies in 44 cases undergoing a massive small-bowel resection. 339 20

Echoviruses cause neonatal disease following intrauterine and intrapartum acquisition of the organism or by nosocomial infection. Dizygous twins apparently became infected following transplacental transmission of echovirus 11. At 5 days of age, both twins experienced poor feeding, lethargy and hypothermia, and evidence of coagulopathy and hepatitis. During the sixth week of illness, the convalescence of twin A was complicated by peritonitis and sepsis, and the infant died. Pathologic findings included scattered foci of dystrophic myocardial calcification, distortion of hepatic architecture with fibrous connective tissue surrounding regenerative nodules and large foci of dystrophic calcification, and adrenal hemorrhagic necrosis and calcification. Twin B recovered without sequelae. The disease in twin A was unusual because of the extensive myocardial involvement. Also of interest was the variability of disease in twins who presumably had received a similar inoculum of organism by the same route.
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PMID:Dissimilar manifestations of intrauterine infection with echovirus 11 in premature twins. 634 39


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