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

Cocaine injected intraperitoneally into rats resulted in a dose-dependent hypothermia. Intracerebral injection of smaller doses also produced a fall in body temperature. In rabbits and guinea-pigs, cocaine produced hyperthermia, in mice and chicks it produced hypothermia while inconsistent changes were produced in goats. Pre-treatment of rats with 6-hydroxydopamine, alpha-methyl-m-tyrosine or haloperidol significantly antagonized the cocaine hypothermia. Pre-treatment of the rats with either hyoscine or methscopolamine resulted in some but non-significant attenuation of the cocaineinduced hypothermia. Pre-treatment with p-chlorophenylalanine, however, did not modify the cocaine hypothermia. Pargyline pre-treatment significantly antagonized the hypothermic action of cocaine. It is suggested that cocaine may cause the release of noradrenaline centrally or it may potentiate its action by interfering with the uptake mechanism. It is also possible that cocaine may have a direct effect on the heat regulating centre in the hypothalamus.
West Afr J Pharmacol Drug Res 1975 Jun
PMID:Hypothermic effect of cocaine in rats. 13 13

It is recognized that postoperative mortality, infarction and the need for inotropic support are increased following myocardial revascularization in highrisk patients. Operations were carried out in 57 such patients in whom one or more of the following factors were present: ventricular dysfunction-ejection fraction less than 0.4 (17), unstable (8) or preinfarction angina (29), evolving infarction (8), recent infarction (less than two weeks before) (5) and refractory ventricular tachyarrhythmia (4). Combined risk factors were present in nine patients. The following principles were utilized to minimize ischemic injury: (1) avoidance of prebypass hypertension and hypotension, (2) avoidance of extreme hemodilution, (3) avoidance of ventricular fibrillation, (4) maintenance of beating empty heart, when possible, (5) the limiting of ischemic periods to less than 12 minutes (hypothermia 32 degrees C) and (6) repaying myocardial oxygen debt with total (vented) bypass, when necessary. The following results were obtained: inotropic support was required in five patients (9 percent), "new" postoperative infarction occurred in five patients (9 percent) and one patient died (2 percent). These results are comparable to those reported in good-risk patients, and indicate that optimal myocardial protection will allow safe revascularization in a high-risk patient.
West J Med 1976 Apr
PMID:Myocardial revascularization in high-risk coronary patients. 126 12

Causes of death in 8 of 235 drunkenness offenders each followed up for two years, have been described. The subjects followed up were a heterogenous population of alcohol abusers. The majority were alcohol dependent irregular heavy drinkers. The main causes of death were suicide, road traffic accident, domestic accident, liver cirrhosis, hypothermia (from exposure) and ischaemic heart disease. More than one cause of death was listed in all cases. Chronic alcoholism was frequently listed. Depression was another sub-ordinate cause of death. The overall observed rate of mortality was 30 times the expected rate which was many times higher than those reported by earlier workers for alcoholics generally. These findings were discussed and it was concluded that drunkenness offenders are a particular at risk sub group of alcoholics. In view of the appreciable post mortem blood alcohol levels, it was further concluded that chronic alcoholism and the actual state of being drunk were the two major causes of death in this group of alcohol abusers.
West Afr J Med
PMID:Causes of mortality in drunkenness offenders followed-up for 2 years. 130 84

Anorexia nervosa and bulimia nervosa are prevalent illnesses affecting between 1% and 10% of adolescent and college age women. Developmental, family dynamic, and biologic factors are all important in the cause of this disorder. Anorexia nervosa is diagnosed when a person refuses to maintain his or her body weight over a minimal normal weight for age and height, such as 15% below that expected, has an intense fear of gaining weight, has a disturbed body image, and, in women, has primary or secondary amenorrhea. A diagnosis of bulimia nervosa is made when a person has recurrent episodes of binge eating, a feeling of lack of control over behavior during binges, regular use of self-induced vomiting, laxatives, diuretics, strict dieting, or vigorous exercise to prevent weight gain, a minimum of 2 binge episodes a week for at least 3 months, and persistent overconcern with body shape and weight. Patients with eating disorders are usually secretive and often come to the attention of physicians only at the insistence of others. Practitioners also should be alert for medical complications including hypothermia, edema, hypotension, bradycardia, infertility, and osteoporosis in patients with anorexia nervosa and fluid or electrolyte imbalance, hyperamylasemia, gastritis, esophagitis, gastric dilation, edema, dental erosion, swollen parotid glands, and gingivitis in patients with bulimia nervosa. Treatment involves combining individual, behavioral, group, and family therapy with, possibly, psychopharmaceuticals. Primary care professionals are frequently the first to evaluate these patients, and their encouragement and support may help patients accept treatment. The treatment proceeds most smoothly if the primary care physician and psychiatrist work collaboratively with clear and frequent communication.
West J Med 1992 Dec
PMID:Eating disorders. A review and update. 147 50

The reduction of both the severe CNS-disturbances (major CNS-handicaps) as a whole and the infantile cerebral palsies (ICP), epilepsies, and mental retardations (oligophrenias) especially, can be attributed to the comprehensively improved pre-, intra- and postnatal care since the 60/70-ies. The best indicator is the decreasing ICP, because 60% of this disturbance is caused perinatally. It is closely associated with cerebral hemorrhages. In several centers, in Sweden and in West-Australia, an isolated recrudescence of ICP was noted. This fact is probably caused by a very active management of respirator therapy in some perinatological centers. However, today there is an effective therapy of several potential causes of perinatal cerebral lesions, i.e. hypoglycemia, hypothermia, asphyxia, RDS, and hyperbilirubinemia. The therapy of these diseases is simultaneously a prevention of the possible consecutive cerebral lesion as well. In the past, only two causes for CNS-disturbances have scarcely been influenced: cerebral hemorrhage, and nosocomial infections. Conclusions for the strategy of the further perinatal care can be deduced from these analyses: prevention of the extremely preterm deliveries, improvement of the perinatal care, prevention of cerebral hemorrhages and nosocomial infections, and responsible ethical decision about the application of the respirator therapy in the individual case.
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PMID:[Neuropsychiatric disorders in very-low-birthweight newborn infants (VLBW-infants)--before and after the introduction of modern perinatal medicine. 3. Discussion of trends in quality of survival (CNS morbidity) and conclusions]. 267 94

This study was presented in part at the annual meeting of the Wilderness Medical Society at Aspen, Colorado, in August 1986 and at "Mountain Medicine 1987," Leavenworth, Washington, in November 1987. We questioned 220 injured rock climbers or their partners seen consecutively at the Yosemite (California) Medical Clinic over 3 (1/2) years regarding details of their accidents. Injury type and location were extracted from medical records and severity quantified. The National Park Service rescued 27% of the climbers. Injured climbers were characteristically male (88%) and experienced (mean 5.9 years) and typically fell while leading climbs (66%). Among 451 injuries, 50% were to the skin or subcutaneous tissues, while 28% involved the lower extremity and were predominantly fractures. In terms of each climber's most severe injury (n = 220), 45% involved the lower extremities (30% from the ankle alone). Head injury or hypothermia caused 12 of 13 fatalities, showing the lowest case-fatality rate reported to date among injured climbers (6%). Rescue personnel successfully managed airways in victims of head injuries, anticipated and treated complications of hypothermia, and stabilized fractures. Victims requiring immediate extensive surgical intervention or blood transfusion usually died before rescue could be effected.
West J Med 1988 Aug
PMID:Rock-climbing injuries in Yosemite National Park. 324 32

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

In West Germany, the antihistaminic diphenhydramine is marketed as a non-prescription hypnotic. Results of toxicological screening in cases of drug overdose indicate that poisoning with diphenhydramine represents a substantial part (4.5%) of the total number of intoxications. A total of 136 cases of diphenhydramine poisoning in 1982-1985 were evaluated with respect to age, ingested dose, plasma level, and clinical symptomatology. All patients had taken diphenhydramine with suicidal intent. Two-thirds of the patients were aged 14-30 years. In about 50% of the cases, between 6 and 40 times a therapeutic dose was ingested. Diphenhydramine plasma levels showed a wide range (0.1-4.7/micrograms/ml) due to differences in ingested dose and time between ingestion and admission to hospital. Impaired consciousness was the most common symptom. Psychotic behavior similar to catatonic stupor--often combined with anxiety--was highly specific for diphenhydramine poisoning. Further symptoms included hallucinations, mydriasis, tachycardia, and less frequently diplopia, respiratory insufficiency, and seizures. Primary treatment included gastric lavage, administration of activated charcoal and sodium sulfate. In one case, hemodialysis and ultrafiltration were performed which had only limited effect on diphenhydramine plasma elimination kinetics. This patient died of diphenhydramine overdose and extreme hypothermia. All intoxications except the one mentioned before had an uncomplicated clinical course. In vitro experiments indicate that diphenhydramine may be almost completely removed from the plasma compartment by hemoperfusion. Routine analysis of urine samples in diphenhydramine overdose led to the identification of 4 previously unknown metabolites and artifacts of diphenhydramine.
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PMID:Clinical symptomatology of diphenhydramine overdose: an evaluation of 136 cases in 1982 to 1985. 358 86

Resuscitation of a neonate requires both immediate cardiopulmonary resuscitation and extended intensive care. Initial resuscitation of the neonate, as for adults, must include support of the airway, breathing and circulation. Because of the unique physiology of a newborn infant, some aspects of drug therapy differ significantly from their counterparts in the resuscitation of adults, and hypoglycemia and hypothermia pose special threats to a distressed neonate. Epinephrine and atropine can be administered via an endotracheal tube, but vascular access, which is most easily obtained by cannulating an umbilical vessel, is required for administering other drugs. Initial drug therapy, including glucose, oxygen and bicarbonate, is intended to restore metabolic homeostasis. Bicarbonate administration must be preceded by adequate alveolar ventilation. Drugs used to increase cardiac output early in resuscitation include those that increase heart rate, increase preload or improve myocardial function. Other drugs used in extended intensive care may also improve cardiac output, alter the distribution of the circulation or alter pulmonary function or gas exchange. These agents will be reviewed in a subsequent article.
West J Med 1986 Jun
PMID:The pharmacology of neonatal resuscitation and cardiopulmonary intensive care. Part I--Immediate resuscitation. 372 30

The muskoxen (Ovibos moschatus), a native of Greenland and the Canadian North West Territories, give birth in late April, and the newborn calves are known to tolerate an ambient temperature (Ta) of -35 degrees C. At birth the calves weigh about 8 kg, increasing in weight with 0.6 kg . day-1 for the first 30 days. With a deep body temperature (DBT) of 39.5 degrees C (range 37.7-41.3 degrees C) the newborn calves are consequently able to maintain a thermogradient of at least 70 degrees C between body core and the environment. The calves use primarily two modes of thermal protection: High metabolic heat production and prime fur insulation. Metabolic rate was about 3.5 W . kg-1 at thermoneutrality in calves aged from 8 h to 7 days. Lower critical temperature at this age was about -7 degrees C and a drop in Ta to -30 degrees C increased metabolism to about 5.3 W . kg-1. Upper critical temperature at age 4-7 days is as low as 20 degrees C, while it in calves aged only 18-24 h appears to be even lower. The calves possess great amounts of brown adipose tissue (BAT) at birth. Mitochondria from the BAT deposits were isolated and found to be in an extremely loose-coupled state with a great capacity for thermogenesis. Skeletal muscle contained very few mitochondria and is hardly employed in aerobic non-shivering thermogenesis. Calves shiver visibly while drying just after birth, but are normally not seen shivering thereafter. The conductance value for the dry pelt of newborn calves averaged 3.2 W . m-2 . 0 degrees C-1 (n = 4). Wetting of the pelt with ice-water at a Ta of 3 degrees C increased conductance to 8.8 W . m-2 . 0 degrees C-1. The conductance of the pelt was also influenced by wind, being 10 W . m-2 . C-1 at a wind-speed of 10 m . sec-1. The legs of the newborn calves are heavily furred and countercurrent circulation is not present, subcutaneous temperature just above the hooves being +29.8 degrees C at Ta of -24 degrees C as compared to 37.5 degrees C on the back. The newborn calves could cope with a Ta of -30 degrees C without apparent problems under experimental conditions, but they suffered hypothermia when exposed to a Ta of -33 degrees C in combination with wind of 10 m . sec-1.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Modes of thermal protection in newborn muskoxen (Ovibos moschatus). 652 90


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