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

Hyperthermia has recently been recognized as a manifestation of hypoglycemia. We describe two episodes of hypoglycemia associated with nausea, vomiting, chills, and impaired consciousness which were followed by marked hyperthermia. We suggest that the hyperthermia may result from excessive reaction to preceding hypothermia caused by the hypoglycemia. We would like to alert the clinician to the possibility of a previous, severe hypoglycemic episode in any diabetic patient with hyperthermia and coma.
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PMID:Marked hyperthermia as a manifestation of hypoglycemia in long-standing diabetes mellitus. 115 46

One of the important medicinal properties of ginger is known to remove chills caused by common cold and to warm body. In the present study, acetone extract of ginger at 100 mg/kg p.o. significantly inhibited serotonin (5-HT) induced hypothermia. Therefore, the active constituents of ginger were further examined. The acetone extract was functioned into 4 fractions by column chromatography. Fractions 1 and 2 showed significant activity. Fraction 2 was further purified and [6]-shogaol which was obtained from fraction 2-2, at 10 mg/kg p.o. was shown to inhibit 5-HT induced hypothermia. Anticathartic activity is known to be one of the medicinal effects of ginger. In the present study, acetone extract of ginger at 75 mg/kg p.o., significantly inhibited 5-HT induced diarrhea. In order to clarify the active constituents, the acetone extract was fractionated into 4 fractions by silica gel chromatography. Fractions 2 and 3, which was especially effective, were further purified and [6]-shogoal, [6]-dehydrogingerdione, [8]- and [10]-gingerol were found to have an anticathartic action. [6]-Shogaol was more potent than [6]-dehydrogingerdione, [8]- and [10]-gingerol.
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PMID:[The effect of ginger on serotonin induced hypothermia and diarrhea]. 207 39

Sepsis, an important cause of hospital mortality, continues to be a diagnostic and therapeutic challenge. To define more clearly the impact of encephalopathy on the course of sepsis, the various clinical signs of sepsis, blood culture results, and mortality rates were examined in relation to mental status in septic patients. Patients were classified as having an acutely altered mental status due to sepsis (AAMS), preexisting altered mental status (PAMS), or normal mental status (NMS). Twenty-three (307/1333) percent of the study patients had an acutely altered sensorium secondary to sepsis. Patients with AAMS had a higher mortality (49%) than patients with PAMS (41%) or patients with NMS (26%) (p less than .000001). Multivariate analysis disclosed that altered mental status, hypothermia, hypotension, thrombocytopenia, and the absence of shaking chills were independent predictors of increased mortality in the sepsis syndrome. Patients with Gram-negative bacteremia (28%) were as likely to have AAMS as patients with Gram-positive bacteremia (25%) or patients with negative blood cultures (23%). In summary, alterations in mental status are common in septic patients, and are associated with significantly higher mortality.
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PMID:Impact of encephalopathy on mortality in the sepsis syndrome. The Veterans Administration Systemic Sepsis Cooperative Study Group. 237 91

Oesophageal temperature was recorded after induction of anesthesia, and further, at one, two and three hours. Temperature in the operation hall was continuously monitored. In relation to the temperature in the operating hall the effects on the patient were of three kinds: 1. operating halls with low temperatures (under 21 degrees C) where all the patients become hypothermic; 2. operating halls with an intermediate temperature (21-24 degrees C), where 67% of the patients remain normothermic; 3. operating halls with high temperatures (above 24 degrees C) where all the patients remain normothermic, although these temperatures are uncomfortable for the medical personnel, and increase the septic risk of the patient. When the oesophageal temperature of the patients falls by 0.5 degrees C chills will occur in 40% of the patients. Thermal falls of less than 0.5 degrees C will also determine chills but in only 10.5% of the cases. Immediate postanesthesia chills are also recorded in normothermic patients, but there is a direct relationship between the temperature in the operating hall, the degree of hypothermia and the frequency of chills, while the site of the surgery or the duration of the operation have but an unsignificant influence on intra-anesthetic temperature.
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PMID:[Intra-anesthetic hypothermia]. 253 99

An increasing proportion of the U.S. population resides in nursing homes (NHs). No surveillance system exists for infections in these facilities. To determine the incidence and types of infections in NH residents, and to identify predictors of death among residents with infections, we initiated a surveillance system at 13 NHs in California during a 6-month period from October 1989 through March 1990. The study included 1754 residents, among whom 835 infections were identified during the study period. The most common infections were urinary tract infections (UTIs; 286, 34.2%), respiratory tract infections (RTIs; 259, 31%), and skin infections (150, 17.9%). Of the 259 residents with respiratory tract infections, 69 (27%) had pneumonia. Antimicrobials were prescribed for 646 (77%) of the infectious episodes. Residents with pneumonia were more likely to die than residents with other infections (4 of 69 versus 12 of 766; P = 0.04). Symptoms of altered body temperature (fever, hypothermia, chills) and change in mental status also were associated with an increased risk of a fatal outcome (10 of 260 versus 6 of 575; P = 0.01) and (7 of 127 versus 9 of 708; P = 0.004). This study suggests that the most common infections among NH residents are UTIs, RTIs, and skin infections. Pneumonia, symptoms of fever, and mental status changes all were associated with increased mortality. The frequency of infections among NH residents and their impact on resident outcome highlights the need for infectious disease surveillance in this population.
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PMID:Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes. 796 43

The perioperative period is a time of thermal instability for older surgical patients. Beyond the elder persons vulnerability to intraoperative heat loss and hypothermia, the surgical procedure initiates host responses that affect body temperature. Technology and drug therapies often deliberately or inadvertently alter thermal balance. Alterations range from mild hypothermia to shaking febrile chills. A reasoned approach to preventing or caring for each of these alterations is based on an understanding of the dynamics of heat loss or heat gain. Early recognition of problems and appropriate action by perioperative nurses may forestall more serious consequences.
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PMID:Perioperative problems: threats to thermal balance in the elderly. 908 21

The safety of the blood transfusion therapy has dramatically increased over the last few years because of improvements in donor screening, testing of donated blood and pre-transfusion tests. However blood transfusion can never be seen as a risk free procedure. The risks to which the patients receiving blood are exposed are infectious, immunologic and other non infectious, non immunologic hazards. Transmission of viral, bacterial and protozoal infections is probably the greatest concern associated with allogeneic blood transfusion. While the risk of transmitting viruses is now very small, there is an increasing concern regarding bacterial contamination of donated blood. Among immunological sequelae, beside alloimmunization, are fever and chills, allergic and acute hemolytic reactions, the last being the currently most important cause of deaths associated with blood transfusion. Moreover allogeneic blood transfusion may lead to immunosuppression, which may increase the risk of infection and cancer recurrence. Other non infective pulmonary edema and physical and biochemical alterations (such as hypothermia, electrolyte and acid base disturbances).
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PMID:Transfusion risks and limitations. 1038 6

Irinotecan (Camptosar) is an active chemotherapeutic agent for lung, gastric, esophageal, and colorectal cancers and a potent radiosensitizer. This phase I study was designed to assess the maximum tolerated dose of weekly irinotecan combined with concurrent radiotherapy for patients with locally advanced, unresectable gastric, gastroesophageal junction, or esophageal cancer. Patients who received previous chemotherapy (excluding irinotecan) or who experienced recurrent cancer after surgery were eligible for this protocol. The total dose of radiation did not exceed 50.4 Gy (28 fractions of 1.8 Gy each). The starting dose level of irinotecan was 30 mg/m2 infused over 90 minutes given weekly for 5 weeks. Subsequent dose levels were increased in 10 mg/m2 increments to 40, 50, 60, and 70 mg/m2. Of 15 patients who have been enrolled to date, all are evaluable for toxicities and 12 for response. Major hematologic toxicities (grade 3/4) were neutropenia, chills, hemorrhage, and anemia. Grade 3/4 gastrointestinal toxicities included nausea, vomiting, dehydration, anorexia, and constipation. Other severe nonhematologic toxicities included fatigue, hypotension, and hypothermia, as well as cardiovascular toxicities. There was no severe diarrhea and no treatment-related deaths. Of the 12 evaluable patients, 7 (58%) responded, including 2 complete responses; 4 (30%) had no change and 1 had progressive disease. Survival ranged from 1 month to 15 months, with a median survival of 8 months. When the total dose of irinotecan given concurrently with radiotherapy was higher than 250 mg/m2, patients experienced significantly more severe grade 3/4 toxicities than with lower doses (P = .04), with no improvement in response rate. It was concluded that weekly doses of irinotecan of up to 60 mg/m2 with concurrent radiotherapy given over 5 weeks was feasible and demonstrated good response. This regimen did not cause severe diarrhea or pneumonitis, but neutropenia and fatigue were major toxicities. The study continues to accrue.
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PMID:Phase I study of irinotecan and concurrent radiation therapy for upper GI tumors. 1120 Jan 47

Exposure to cold can produce a variety of injuries that occur as a result of man's inability to adapt to cold. These injuries can be divided into localized injury to a body part, systemic hypothermia, or a combination of both. Body temperature may fall as a result of heat loss by radiation, evaporation, conduction, and convection. Hypothermia or systemic cold injury occurs when the core body temperature has decreased to 35 degrees C (95 degrees F) or less. The causes of hypothermia are either primary or secondary. Primary, or accidental, hypothermia occurs in healthy individuals inadequately clothed and exposed to severe cooling. In secondary hypothermia, another illness predisposes the individual to accidental hypothermia. Hypothermia affects multiple organs with symptoms of hypothermia that vary according to the severity of cold injury. The diagnosis of hypothermia is easy if the patient is a mountaineer who is stranded in cold weather. However, it may be more difficult in an elderly patient who has been exposed to a cold environment. In either case, the rectal temperature should be checked with a low-reading thermometer. The general principals of prehospital management are to (1) prevent further heat loss, (2) rewarm the body core temperature in advance of the shell, and (3) avoid precipitating ventricular fibrillation. There are two general techniques of rewarming--passive and active. The mechanisms of peripheral cold injury can be divided into phenomena that affect cells and extracellular fluids (direct effects) and those that disrupt the function of the organized tissue and the integrity of the circulation (indirect effects). Generally, no serious damage is seen until tissue freezing occurs. The mildest form of peripheral cold injury is frostnip. Chilblains represent a more severe form of cold injury than frostnip and occur after exposure to nonfreezing temperatures and damp conditions. Immersion (trench) foot, a disease of the sympathetic nerves and blood vessels in the feet, is observed in shipwreck survivors or in soldiers whose feet have been wet, but not freezing, for long periods. Patients with frostbite frequently present with multisystem injuries (e.g., systemic hypothermia, blunt trauma, substance abuse). The freezing of the corneas has been reported to occur in individuals who keep their eyes open in high wind-chill situations without protective goggles (e.g., snowmobilers, cross-country skiers).
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PMID:Cold injuries. 1571 18

It is the position of the American College of Sports Medicine that exercise can be performed safely in most cold-weather environments without incurring cold-weather injuries. The key to prevention is use of a comprehensive risk management strategy that: a) identifies/assesses the cold hazard; b) identifies/assesses contributing factors for cold-weather injuries; c) develops controls to mitigate cold stress/strain; d) implements controls into formal plans; and e) utilizes administrative oversight to ensure controls are enforced or modified. The American College of Sports Medicine recommends that: 1) coaches/athletes/medical personnel know the signs/symptoms and risk factors for hypothermia, frostbite, and non-freezing cold injuries, identify individuals susceptible to cold injuries, and have the latest up-to-date information about current and future weather conditions before conducting training sessions or competitions; 2) cold-weather clothing be chosen based on each individual's requirements and that standardized clothing ensembles not be mandated for entire groups; 3) the wind-chill temperature index be used to estimate the relative risk of frostbite and that heightened surveillance of exercisers be used at wind-chill temperatures below -27 degrees C (-18 degrees F); and 4) individuals with asthma and cardiovascular disease can exercise in cold environments, but should be monitored closely.
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PMID:American College of Sports Medicine position stand: prevention of cold injuries during exercise. 1709 37


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