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

Of 125 newborn infants with tetanus studied clinically, 75 died. Hypothermia and bronchopneumonia were the commonest events leading to death. A sudden drop in the amount of sedation required, loss of or diminished tetanal signs, and hypothermia usually indicated the onset of bronchopneumonia. A later series of 108 cases with 75 deaths (54 necropsies) formed the basis of a pathological study. Pulmonary pathology was found in 46 out of the 54 necropsies: mainly pulmonary haemorrhage, aspiration pneumonia, and bronchopneumonia, particularly of the right upper lobe. Adrenal haemorrhage and renal vein thrombosis also occurred.
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PMID:Cause of death in tetanus neonatorum: study of 233 cases with 54 necropsies. 87 51

During a four-year prospective study at a referral hospital, 61 patients with neonatal tetanus were encountered and the contribution of continuous intravenous diazepam was noted. The over-all incidence during the study was 21.8/1000, with a mortality rate of 8.2 per cent. Signs associated with fatal outcome were hypothermia, generalized rigidity and opisthotonus. The mean dose of diazepam used was 25.8 mg/kg/day, in combination with sodium phenobarbitone (mean dose 10.7 mg/kg/day). The results suggest that high-dose intravenous (continuous) diazepam is effective, economical and feasible for reducing mortality in neonatal tetanus. Side-effects were minimal.
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PMID:Neonatal tetanus: incidence and improved outcome with diazepam. 159 98

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

To evaluate the hypothesis that depressed neuromuscular transmission causes dithiobiuret (DTB)-induced muscle weakness in rats, the temporal development of impaired treadmill performance and deficits in the nerve-elicited muscle contractions were compared during daily treatment with the toxicant (DTB, 1 mg/kg/day X 6 days). Diminished treadmill test performance after 4 days of treatment marked the initial detection of impaired motor function. At this time fading (loss of tension during tetanus) of gastrocnemius contractions elicited in response to 100-Hz sciatic nerve stimulation occurred in DTB-treated rats but not in controls. After 5 and 6 days of treatment, treadmill failure became complete, tetanic fade worsened dramatically, and peak contractile tension measured during trains of nerve stimulation (10-250 Hz) decreased progressively. Appearing by Day 6 were marked body weight loss, dehydration, hypothermia, and a depression in serum concentrations of thyroid hormones. Total oxygen content of the blood was not reduced at any time during treatment, and serum concentrations of glucose, sodium, potassium, calcium, chloride, and phosphorus in DTB-treated rats on Day 6 were similar to those of control animals. Therefore, hypoxia, hypoglycemia, or a serum electrolyte imbalance do not initiate or modulate the neuromuscular toxicity. Light microscopic evaluation of liver, kidney, lung, thyroid, and other organs in intoxicated rats was unremarkable and in skeletal muscles and selected sites of brain, spinal cord, and sciatic nerve no morphologically significant lesions were observed. Even when DTB-intoxicated rats were maintained in a state of flaccid muscle weakness for 5 continuous days, peripheral nerve lesions proximal to the intramuscular nerves were not detected. Thus, depressed neuromuscular transmission appears to be the primary cause of the flaccid muscle weakness and no evidence was obtained that nonneural effects of DTB initiate or modulate this effect.
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PMID:Temporal analysis of dithiobiuret neurotoxicity in rats and assessment of potential nonneural causes. 311 11

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

When phenothiazines and barbiturates fail to control the spasms of tetanus, total paralysis induced by muscle relaxants may be the only way of keeping the patient alive. The hazards of this technique are illustrated in this report of a patient with severe tetanus who was totally paralyzed for 26 days. Cardiac arrest, ileus, atelectasis, anemia, and limb contractures were among the problems dealt with. Devoted nursing care, an experienced medical team, respirators, minute ventilation meters, an airway pressure alarm, a hypothermia unit, a cardiac monitor pacemaker and facilities for determining blood-gas tensions were all necessary in the successful treatment of this patient. It is suggested that patients with severe tetanus should be transferred, under anesthesia and artificially ventilated, to hospitals possessing all these facilities.
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PMID:Severe tetanus: its complications and management. 584 93

South Africa is unique in many ways, including the state of health of its children. Discussion focuses on vital statistics -- perinatal and infant mortality rates, disease profiles, nutritional status; and demographic and socioeconomic data -- African communities, Indian communities, coloured communities, and social expenditure. The perinatal mortality rate for africans in Natal and Kwa Zulu varies from 19.7-51.9/1000 in the smaller hospitals. At the main teaching hospital in Durban, the King Edward viii, it was 75.8/1000 in 1980. The most common causes of death in the rural babies weighing more than 1500 gm were septicemia, asphyxia, meconium aspiration, and tetanus neonatorum. In those under 1500 mg the most common causes were respiratory distress, intracranial hemorrhage, and hypothermia. The main causes of the high perinatal mortality among Africans at King Edward viii Hospital were amniotic fluid infection syndrome, abruptio placenta, hypoxia, hypertension, and congenital syphilis. Accurate data for infant mortality rates for Africans are unavailable. Available data show considerable variation. The official infant mortality rates given by the State Health Department for 1975 for the country as a whole were 20.1/1000 for whites, 100.2/1000 for Africans, 104.0/1000 for coloureds, and 34.7/1000 for Asians. Black children under age 5 make up 16% of the total population but account for 55% of total deaths, whereas white children of this age make up 11% of the population and account for only 7% of total deaths. Of the 7688 admissions of African children to King Edward viii Hospital in 1980, more than 80% were due to infections, and the overall mortality in these patients was 20%. The percentage of children below the 3rd centile for weight was 6-12% for infants under 1 year old, 20-55% in children aged 1-6 years, and 30-70% in school age children. The percentage stunted (below 3rd centile for height) varied from 22-66% in preschool children. At King Edward viii Hospital, approximately 40% of children admitted are malnourished. In the main the majority of blacks are poor, illiterate, and living in overcrowded conditions. Many are unemployed or employed away from home, which causes serious disruption of family life with such consequences as teenage pregnancies and malnutrition. The mortality rates, disease profiles, and socioeconomic status of the whites in Sourh Africa are similar, and often superior, to those in Western countries. The reason for this discrepancy in the state of health and socioeconomic development of population groups is the government's policy of separate but unequal development; the policy of apartheid that reserves 87% of the land for 16% of the people, the white minority.
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PMID:The health of children in South Africa: some food for thought. 614 93

105 consecutively admitted neonates with tetanus were screened for sepsis to determine the prevalence of sepsis in neonatal Tetanus (NNT) patients and identify the bacterial pathogens causing septicaemia in them. The presence of omphalitis, poor colour, hypothermia and hyperthermia were found to be sensitive predictors of septicaemia in NNT patients. 50 bacterial pathogens were isolated from 50 babies. Klebsiella pneumoniae (20.7%), and Enterobacter cloacae (19.0%) were the leading gram negatives, while staphylococcus aureus (19.2%) was the prevalent gram positive organism isolated. Antimicrobial susceptibility profile heavily favours ofloxacin but a combination of cloxacillin and gentamicin is recommended as first line. Ceftazidime with about 60% susceptibility across board is the favoured cephalosporin.
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PMID:Bacteria causing septicaemia in neonates with tetanus. 981 79

Hypothermia in clinical use is for protection of the brain during cardiac surgery and resuscitation of post-traumatic brain injury or focal brain ischemia. In the present study, effects of hypothermia on evoked potential, long-term potentiation (LTP) in hippocampal CA1, electroencephalogram (EEG) and cerebral blood flow (CBF) were studied with use of anesthetized rats. In addition to brain function, the changes in systemic blood pressure, heart rate, respiratory metabolism by means of the artery blood gas analysis and end tidal carbon dioxide concentration (ETCO2) were studied. After obtaining baseline recordings of evoked potential at 37 degrees C of brain temperature, rats were cooled by the iceslash-blanket method and were maintained at either 28 degrees C or 32 degrees C. Ninety minutes later, the animals were re-warmed up to 37 degrees C. When temperature was stabilized at 28 degrees C or 32 degrees C, the high-frequent stimulation (tetanus) was delivered. Responses were recorded for 60 minutes following the tetanic stimulation. Both heart rate and mean arterial pressure increased by cooling. CBF was reduced by cooling to 49.0 +/- 6.2% at 28 degrees C and 72.9 +/- 6.9% at 32 degrees C from the baseline. The amplitude of population spike in the hippocampal CA1 region increased to 194.6 +/- 10.6% (28 degrees C) and 168.4 +/- 6.9% (32 degrees C) by cooling. After re-warming, the amplitude was reduced to 146.8 +/- 12.9% in 28 degrees C group and to 131.9 +/- 9.7% in 32 degrees C group, but a significant difference from the baseline remained. The latency increased to 135.48 +/- 2.70% at 28 degrees C and 115.55 +/- 2.26% at 32 degrees C by cooling but recovered to the baseline levels by re-warming. LTP in the hippocampal CA1 was observed at 32 degrees C but not at 28 degrees C. These findings suggest that hypothermia may increase hippocampal synaptic transmission and may not disturb its plasticity at 32 degrees C.
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PMID:[Effects of mild and moderate hypothermia on cerebral function and cerebral circulation of the rat in vivo]. 1049 55

Seventy nine traditional birth attendants (TBAs) of Raipur Rani community development block, Haryana were interviewed to assess the effectiveness of continuing training in changing their knowledge and practices regarding maternal and newborn care. Seventy three percent of them reported participation in continuing training sessions. However, analysis of attendance register showed that only 35.4% had attended more than 50% sessions in year 1993. Most (83.5%) of the TBAs gave advice to pregnant women for increased food intake, 47% advised tetanus toxoid, 16.5% for more rest, and 31.6% for iron tablets. Many of them were aware of maternal complications i.e. anaemia (64.6%), oedema (26.6%), bleeding per veginum (39.2%), abnormal presentation (77.2%) and high fever (48.1%). Risks to newborn like low birth weight, fever, cough/rapid breathing and hypothermia were known to 20.2%, 31.6%, 17.7% and 1.3% of the TBAs respectively. Knowledge regarding causes of low birth weight baby like 'weak' mother, less diet in pregnancy, short birth interval and preterm delivery were reported by 69.6%, 63.3%, 12.6% and 3.8% respectively. About two fifth of TBAs advised referral to hospital in case of prolonged labour and 88.6% for very low birth weight babies. Disposable Dai Kit and weighing machine were available with 32% and 73% TBAs. Significantly higher proportion of TBAs participating in continuing training advised tetanus toxoid vaccination, appropriate feeding practices of the newborn, hospital referral in case of prolonged labour and were less inclined to advise injection to speed up labour. Therefore, efforts should be made to increase the attendance of TBAs in continuing training sessions so as to sustain modern maternal and newborn care practices acquired after initial training.
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PMID:Effect of continuing training on knowledge and practices of traditional birth attendants about maternal and newborn care. 1143 75


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