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

Several years ago neonatal necrotizing enterocolitis (NNE) was commonly seen in an open ward for premature babies at Baragwanath Hospital, which was affected by recurrent outbreaks of gastro-enteritis and Salmonella infections. Since outbreaks of infection have been prevented, NNE has been uncommon, in spite of a high incidence of babies of low birth weight, many of who experience neonatal shock from anoxia and hypothermia, conditions considered as predisposing to NNE. The animal experimental work on the protective function of breast milk against NNE is discussed, and it is suggested that the low incidence of NNE at this hospital is due to the establishment of breast milk banks and the encouragement of breast feeding for all neonates.
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PMID:Necrotizing enterocolitis in Black neonates. 84 69

Necrotizing enterocolitis continues to be a perplexing problem in the newborn and, in particular, the premature. Its pathogenesis is controversial, although there are well established clinical risk factors. Three patients had necrotizing enterocolitis while under close clinical observation and monitoring, despite the fact that these patients were not at high risk for necrotizing enterocolitis. All three had necrotizing enterocolitis after hypothermia and total circulatory arrest--a complication which until now has not been reported. Because of the close monitoring, these patients provide a unique clinical setting which eliminates most of the etiologic factors that have been implicated in the pathogenesis of necrotizing enterocolitis. The onset of necrotizing enterocolitis shortly after total circulatory arrest and the selective ischemic organ damage observed suggest local perfusion inadequacy. The authors postulate that splanchnic vasoconstriction as a result of marked sympathetic stimulation contributes to this local ischemia and subsequent necrotizing enterocolitis.
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PMID:Necrotizing enterocolitis after cardiac surgery: a local ischemic lesion?. 84 68

Three patients, 1-11 months of age, who underwent open heart surgery with cardiopulmonary bypass and profound hypothermia, developed necrotizing enterocolitis postoperatively leading to death. Pneumatosis intestinalis and portal vein gas were demonstrated radiographically. Necrotizing enterocolitis has not been previously reported as a complication of cardiopulmonary bypass and profound hypothermia.
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PMID:Necrotizing enterocolitis after open heart surgery employing hypothermia and cardiopulmonary bypass. 97 61

Necrotizing enterocolitis (NEC) occurred in 2 neonates with pulmonary atresia and intact ventricular septum. Both infants underwent open heart surgery for the insertion of a right ventricular outflow tract patch under profound hypothermia, surface cooling and a fibrillating heart, without circulatory arrest. In both patients the development of NEC preceded both the cardiac catheterization study and open heart surgery. Urgent repair of the cardiac lesion was undertaken in an attempt at improving the critical bowel wall ischemia. Postoperatively, exacerbation of the NEC reached an advanced stage rapidly leading to the death of the patients. Recommendations regarding the management of future cases exhibiting this potentially lethal combination of disease are presented.
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PMID:Necrotizing enterocolitis in pulmonary atresia with intact ventricular septum. 241 76

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

In the feline intestine studies have implicated superoxide (O.-) and other oxygen derived free radicals as initiators of injury as measured by increased capillary permeability during the reperfusion period. Biochemical mechanisms of this free radical generation include: xanthine oxidase dependent O.- production, hydrogen peroxide (H2O2) formation by superoxide dismutase (SOD), hydroxyl radical (OH-) production via the Haber-Weiss reaction, and lipid radical formation from membrane peroxidation. Pathological consequences of these events include inflammatory neutrophil infiltration, damage to the collagen and mucosal basement membrane, increased capillary permeability, edema, cell degeneration and necrosis. Animal models of neonatal necrotizing enterocolitis (NNEC) indicate that intestinal injury occurs after the etiologic factors (hypothermia, hypoxia) are removed. In order to determine the role of active oxygen species in the pathogenesis of NNEC, weanling hamsters and neonatal piglets were cold stressed and activities of pro/antioxidant enzymes were determined, and histopathologic and ultrastructural studies were performed. Cold stressed weanling hamsters showed a 55.7% (P less than 0.05) decrease in xanthine dehydrogenase/xanthine oxidase activity ratio. Light microscopy revealed scattered colonic mucosal erosions and submucosal edema in 50% of cold stressed animals. Transmission electron microscopy demonstrated degeneration of colonic mucosal epithelial cells, enlarged intracellular spaces, cytoplasmic vacuolization, and nuclear membrane swelling. The colonic serosa was also edematous and infiltrated with bacteria. Large intestinal tissue from cold stressed neonatal piglets showed a significant increase (P less than 0.05) in Mn and Cu, Zn, SOD, CAT, GSH-Red, total GSH, and Glc6-PD at 0 and 12 hrs. post stress.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intestinal post-ischemic reperfusion injury: studies with neonatal necrotizing enterocolitis. 259 24

The core body temperature of unanesthetized neonatal piglets was lowered 4 +/- 1 degrees C for 4.5 h. Although systolic blood pressure, arterial blood gases, and pH were similar in hypothermic and control animals, grossly evident small intestinal injury occurred in 94% of hypothermic piglets but in none of the controls (p less than 0.01). The histopathology of the intestinal lesions in the experimental animals was characteristic of ischemic injury and ranged from superficial mucosal necrosis to transmural infarct. The lesions were more frequent in the mid- and distal small bowel and involved the muscularis propria only in the distal small bowel. The location and histopathologic characteristics of the bowel lesions in these animals support the concept that mild hypothermia could be a pathogenetic factor in the ischemic bowel lesions of human neonatal necrotizing enterocolitis.
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PMID:Intestinal ischemic injury following mild hypothermic stress in the neonatal piglet. 357 94

We introduced a rapid rewarming technique as part of standard therapy in 16 newborn infants with effects of severe environmental hypothermia. On admission, mean rectal temperature was 31.0 +/- 2.7 degrees C, mean gestational age was 33.4 +/- 4.5 weeks, and mean birth weight was 1.76 +/- 0.71 kg. Thirteen infants were admitted within 30 hours of delivery, and the remainder at 2 to 3 weeks of age. Infants were rewarmed under a radiant warmer. The mean time required to reach a rectal temperature of 36.5 degrees C was 3.96 +/- 2.37 hours. Major medical entities encountered included thrombocytopenia (eight patients), metabolic acidosis (eight), respiratory distress (eight), renal failure (six), apnea (four), patent ductus arteriosus (four), seizures (four), intracranial hemorrhage (three), infection (three), and necrotizing enterocolitis (two). No complications could be attributed to the rapid rewarming technique. Of three infants who died, all weighed less than 1.25 kg at birth. This 81% survival is in contrast to the high mortality (25% to 50%) noted previously among infants treated by gradual rewarming.
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PMID:Improved prognosis in severely hypothermic newborn infants treated by rapid rewarming. 647 Aug 70

The perinatal histories of 50 very low birthweight infants weighing 1500 g, or less, with necrotizing enterocolitis were compared with those of the remaining 325 very low birthweight infants who were admitted to this hospital during a four year study period. Many factors previously reported to be associated with necrotizing enterocolitis were found with equal frequency in both groups of babies. The only adverse factor which was more frequently present in patients with necrotizing enterocolitis was hypothermia on admission to hospital. Those infants who developed severe necrotizing enterocolitis also had a higher incidence of polycythaemia. A further controlled study which examined feeding practices showed that the timing, type, and volume of milk feeding were not different in infants with necrotizing enterocolitis and matched controls. Prematurity is clearly the greatest risk factor which predisposes to the development of necrotizing enterocolitis and most of the factors previously implicated in the aetiology may simply represent the descriptive characteristics of a population of sick, very low birthweight infants.
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PMID:Perinatal risk factors for necrotizing enterocolitis. 654 88

Fourteen patients diagnosed of neonatal necrotizing enterocolitis (NNE) admitted into the neonatal unit since August 1977 are presented. They were matched to a control group of 130 newborn infants born during that same period of time for sex, weight and gestational age. All patients were formula fed except for three who followed mixed feeding. NNE was closely associated to hypothermia (p less than 0.005), respiratory distress (p less than 0.001) and umbilical catheterization (p less than 0.005). Umbilical catheters introduced for reasons other than distress did not increase the incidence of NNE. Low birth weight infants were more frequently affected than those weighing over 2,500 gm (ratio, 27:1). Evolution was lethal in six cases. The remaining eight are presently under follow up with no evidence of disease.
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PMID:[Hypothermia, respiratory distress and umbilical catheterization as risk factors in necrotizing enterocolitis (author's transl)]. 733 38


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