Frostbite and Hypothermia

2015 ◽  
Author(s):  
Jeffrey I. Schneider
Keyword(s):  
Body Temperature ◽  
Heat Loss ◽  
Pleural Cavity ◽  
The Body ◽  
Ice Crystals ◽  
Homeless Population ◽  
Outdoor Sports ◽  
Increased Risk ◽  
Long Term Consequences

Frostbite and hypothermia are becoming increasingly common as the popularity of extreme and outdoor sports rises and the homeless population increases. Advanced age is also associated with an increased risk of frostbite and hypothermia; thus, their incidence will likely continue to increase as the population ages. Frostbite occurs when there is sufficient heat loss to produce ice crystals within either superficial or deep flesh. Hypothermia is defined as an involuntary drop in body temperature to below 35°C, but a useful functional definition is a decrease in temperature that results in an inability of the body to maintain its natural functions. This review details the assessment and stabilization, diagnosis, and treatment and disposition for frostbite and hypothermia. Figures show factors that may predispose individuals to developing frostbite, long-term consequences of severe frostbite, and an approach for pleural cavity lavage. Tables list factors that increase the risk of frostbite, degrees of frostbite, three phases of frostbite, and staging of hypothermia. This review contains 3 highly rendered figures, 4 tables, and 71 references.

scholarly journals Psychosocial emergency care in times of COVID-19: the Essen University Hospital concept for corona-infected patients, their relatives, and medical staff

2020 ◽  
Author(s):  
Vanessa Rentrop ◽  
Johanna Sophie Schneider ◽  
Alexander Bäuerle ◽  
Florian Junne ◽  
Nora Dörrie ◽  
...  
Keyword(s):  
Medical Staff ◽  
Online Training ◽  
University Hospital ◽  
High Psychological Distress ◽  
Increased Risk ◽  
Psychosocial Emergency ◽  
Low Threshold ◽  
Long Term Consequences ◽  
The University

Abstract Due to the SARS CoV-2-virus (COVID-19), anxiety, distress, and insecurity occur more frequently. In particular, infected individuals, their relatives, and medical staff face an increased risk of high psychological distress as a result of the ongoing pandemic. Thus, structured psychosocial emergency concepts are needed. The University hospital of Essen has taken up this challenge by creating the PEC concept to reduce psychosocial long-term consequences for infected patients, relatives, and medical staff at the university hospital. The concept includes professional medical as well as psychological support to convey constructive coping strategies and the provision of adequate tools such as the low-threshold online training program (CoPE It), which is accessible via the webpage www.cope-corona.de.

Perioperative Temperature Regulation

2004 ◽  
Vol 5 (2) ◽  
pp. 27-30
Author(s):  
J. Hegarty
Keyword(s):  
Body Temperature ◽  
Heat Loss ◽  
Core Body Temperature ◽  
The Body ◽  
Surgical Patients ◽  
Temperature Management ◽  
Perioperative Nurses ◽  
Anaesthetic Care ◽  
Life Threatening ◽  
Patient At Risk

The regulation of body temperature is one of a variety of mechanisms, which play a part in maintaining a stable internal environment in the body thus enabling the body to function optimally. It is crucial that the core body temperature is maintained within a narrow (36–37.5°C) range [Luckmann, 1997]. Thermoregulation in the operating theatre and post anaesthetic care unit is often an underemphasized concern for surgical patients. Anaesthesia and surgery commonly cause substantial alterations in the temperature of surgical patients.Unnecessary heat loss, hypothermia, the typical variation, results from a combination of anaesthetic-induced impairment of thermoregulatory control, a cool, operating room environment and other factors exclusive to surgery and anaesthesia. Estimates of the incidence of inadvertent perioperative hypothermia range from 60% to 90% of all surgical cases [Bernthal, 1999, Litwack, 1995], when this condition is defined as a body temperature below 36°C (degrees Celsius) 96.8°F (degrees Fahrenheit) (Arndt, 1999). Hypothermia apart from causing a very unpleasant sensation of cold, places the patient at risk of developing life-threatening events, which include altered cardiac performance, delayed emergence from anaesthesia and increased rates of morbidity and mortality. Although the aim of temperature management by intraoperative medical and nursing staff is prevention of heat loss, the objective of post anaesthetic recovery room staff is usually the restoration of normothermia. Thus, perioperative nurses need to be aware of the need to monitor patient's temperature, be familiar with different patient warming/rewarming methods and be alert for potential problems that can arise from hypothermia.

scholarly journals The Long and Short of It: The Role of Telomeres in Fetal Origins of Adult Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Stephanie E. Hallows ◽  
Timothy R. H. Regnault ◽  
Dean H. Betts
Keyword(s):  
Intrauterine Growth Restriction ◽  
The Body ◽  
Premature Aging ◽  
Fetal Origins ◽  
Maternal Malnutrition ◽  
Adult Disease ◽  
Increased Risk

Placental insufficiency, maternal malnutrition, and other causes of intrauterine growth restriction (IUGR) can significantly affect short-term growth and long-term health. Following IUGR, there is an increased risk for cardiovascular disease and Type 2 Diabetes. The etiology of these diseases is beginning to be elucidated, and premature aging or cellular senescence through increased oxidative stress and DNA damage to telomeric ends may be initiators of these disease processes. This paper will explore the areas where telomere and telomerase biology can have significant effects on various tissues in the body in IUGR outcomes.

scholarly journals PREMATURE OVARIAN FAILURE, ITS CONSEQUENCES, MORTALITY AND IMPACT ON THE CARDIOVASCULAR SYSTEM

2021 ◽  
Vol 9 (1) ◽  
pp. 147-156
Author(s):  
S.V. Lopukhov ◽  
◽  
E.V. Filippov ◽  
Keyword(s):  
Cardiovascular Diseases ◽  
Premature Ovarian Failure ◽  
Correct Diagnosis ◽  
Vascular Diseases ◽  
Ovarian Failure ◽  
Pharmacological Therapy ◽  
The Body ◽  
Risk Of Death ◽  
Increased Risk

This review focuses on the topic of premature ovarian failure (POF) as highly relevant in modern medicine (up to 2% of women in the population suffer from this disease). However, patients with premature ovarian failure not only are still not receiving any treatment, but even making this diagnosis is very difficult. Even after a correct diagnosis is made, these patients are not followed up, despite the fact they have already developed a hormonal imbalance. These women develop two groups of complications: short-term complications associated with a rapid estrogen deficiency in the body, and much more dangerous long-term complications affecting multiple organs and even systems. But in the meanwhile, women with premature ovarian failure are under increased risk of death from all causes, in particular from coronary heart disease (CHD), respiratory diseases, genitourinary diseases and from external causes. And this is despite the fact that cardio-vascular diseases (CVD) are already the leading cause of death among women worldwide. It is women with POF that are at the highest risk of development of cardiovascular diseases, compared to women with normal menopause. These patients, therefore, constitute one of the most important groups to be targeted by screening and prevention strategies primarily for cardiovascular diseases. These strategies should include the use of risk stratification tools to identify women that need lifestyle modifying and pharmacological therapy to prevent development of such diseases in them. This is the only way to maintain a high quality of life in these women over the long term.

scholarly journals Increased risk of chronic fatigue and hair loss following COVID-19 in individuals with hypohidrotic ectodermal dysplasia

2021 ◽  
Author(s):  
Verena Hennig ◽  
Wolfgang Schuh ◽  
Antje Neubert ◽  
Dirk Mielenz ◽  
Hans-Martin Jäck ◽  
...  
Keyword(s):  
Hair Loss ◽  
Ectodermal Dysplasia ◽  
Genetic Disorder ◽  
Control Group ◽  
Hypohidrotic Ectodermal Dysplasia ◽  
Control Subjects ◽  
Eccrine Glands ◽  
Increased Risk ◽  
Long Term Consequences

Abstract Background Hypohidrotic ectodermal dysplasia (HED) is a group of genodermatoses in which deficient ectodysplasin A signalling leads to maldevelopment of skin appendages, various eccrine glands, and teeth. Individuals with HED often have disrupted epithelial barriers and, therefore, were suspected to be more susceptible to coronavirus infection. Methods 56 households with at least one member who had coronavirus disease of 2019 (COVID-19) were enrolled in a longitudinal study to compare the course of illness, immune responses, and long-term consequences of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection in HED patients (n = 15, age 9–52 years) and control subjects of the same age group (n = 149). Results In 14 HED patients, mild or moderate typical COVID-19 symptoms were observed that lasted for 4–45 days. Fever during the first days sometimes required external cooling measures. The course of COVID-19 was similar to that in control subjects if patients developed antibodies blocking the SARS-CoV-2 spike protein. Five out of six HED patients with completely abrogated ectodysplasin A signalling (83%) suffered from chronic, in two cases very severe fatigue following COVID-19, while only 25% of HED patients with residual activity of this pathway and 21% of control subjects recovering from COVID-19 experienced postinfectious fatigue. Hair loss after COVID-19 was also more frequent among HED patients (64%) than in the control group (13%). Conclusions HED appears to be associated with an increased risk of long-term consequences of a SARS-CoV-2 infection. Preventive vaccination against COVID-19 should be recommended for individuals affected by this rare genetic disorder.

scholarly journals The Influence of Radiant Heat and Air Movement on the Cooling of the Kata-Thermometer

1933 ◽  
Vol 33 (3) ◽  
pp. 330-348 ◽  
Author(s):  
T. Bedford ◽  
C. G. Warner
Keyword(s):  
High Temperature ◽  
Body Temperature ◽  
Heat Loss ◽  
Radiant Heat ◽  
The Body ◽  
Reliable Estimate ◽  
Air Velocity ◽  
Total Heat Loss ◽  
True Rate ◽  
True Value

The factor of the kata-thermometer as deduced from the relationF = 0·27θ × cooling time in secondsis not constant, but increases as θ decreases. The relation between F and θ is shown, and it is recommended that the factor should always be corrected to the value corresponding to a temperature of 60° F.The rate of heat-loss calculated from the factor determined by the still air method is not the true value, but under-estimates it. If the true value is required it can be obtained with reasonable accuracy by increasing the still air value of the factor by 20 per cent, in the case of the body-temperature kata, and 31 per cent, in the case of the high-temperature instrument. For ordinary use however, it is recommended that the still air factor should continue to be used.Observations were made in still air with standard kata-thermometers and also with silvered instruments. From these observations, and from determinations of the emissivity of the bulbs, the heat loss by radiation was estimated. The remainder after deducting the radiation loss from the total heat loss gave the loss by convection. Estimations of the convection loss from the silvered and plain katas corresponded closely. An equation is given for the convection loss in still air.The whirling arm method was used for investigating the effects of air velocities up to 1 m. per sec., corrections being made for swirl. The equation deduced from these observations on the standard body-temperature katas was practically identical with the equation of Hill, Vernon and Hargood-Ash. An equation of similar form was found for the silvered body-temperature kata-thermometers, and equations are also given for the high-temperature instruments. When the true rate of heat-loss is used it is found that one equation can be made to fit the observations with both high-temperature and body-temperature instruments, whether the bulb surfaces are of glass or silver.It is shown that in places where the temperature of the surrounding surfaces differs from the air temperature, a much more reliable estimate of the air velocity can be obtained if a silvered kata is used instead of the plain glass instrument.A method is given for measuring the emission of radiation from the surroundings by means of ordinary and silvered kata-thermometers, and it is shown that estimates so made correspond, to within 1 per cent., with the values obtained by direct thermopile measurements.

Physiological genetics of dietary restriction: uncoupling the body temperature and body weight responses

2007 ◽  
Vol 293 (4) ◽  
pp. R1522-R1527 ◽  
Author(s):  
Brad A. Rikke ◽  
Thomas E. Johnson
Keyword(s):  
Body Weight ◽  
Genetic Variation ◽  
Body Temperature ◽  
Metabolic Rate ◽  
Dietary Restriction ◽  
The Body ◽  
Strain Variation ◽  
Long Term Effects ◽  
Difficult Challenge

Numerous physiological and molecular changes accompany dietary restriction (DR), which has been a major impediment to elucidating the causal basis underlying DR's many health benefits. Two major metabolic responses to DR that potentially underlie many of these changes are the body temperature ( Tb) and body weight (BW) responses. These responses also represent an especially difficult challenge to uncouple during DR. We demonstrate in this study, using two recombinant inbred (RI) panels of mice (the LXS and LSXSS) that naturally occurring genetic variation serves as a powerful tool for modulating Tb and BW independently during DR. The correlation coefficient between the two responses was essentially zero, with R = −0.04 in the LXS and −0.03 in the LSXSS, the latter averaged across replicate cohorts. This study is also the first to report that there is highly significant ( P = 10−10) strain variation in the Tb response to DR in the LXS (51 strains tested), with strain means ranging from 2 to 4°C below normal. The results suggest that the strain variation in the Tb response to DR is largely due to differences in the rate of heat loss rather than heat production (i.e., metabolic rate). This variation can thus be used to assess the long-term effects of lower Tb independent of BW or metabolic rate, as well as independent of food intake and motor activity as previously shown. These results also suggest that murine genetic variation may be useful for uncoupling many more responses to DR.

A Growing Dilemma: Antenatal Corticosteroids and Long-Term Consequences

2020 ◽  
Author(s):  
Elizabeth V. Asztalos ◽  
Kellie E. Murphy ◽  
Stephen G. Matthews
Keyword(s):  
At Risk ◽  
Preterm Birth ◽  
Developmental Disorders ◽  
Safety Data ◽  
Fetal Brain ◽  
Endocrine Function ◽  
Antenatal Corticosteroids ◽  
Increased Risk ◽  
Long Term Consequences

Objective A single course of synthetic antenatal corticosteroids is standard care for women considered to be at risk for preterm birth before 34 weeks of gestation. While the intended target is the fetal lung, the fetal brain contains remarkably high levels of glucocorticoid receptors in structures critical in the regulation of behavior and endocrine function. Negative programming signals may occur which can lead to permanent maladaptive changes and predispose the infant/child to an increased risk in physical, mental, and developmental disorders. Methods Framed around these areas of concerns for physical, mental, and developmental disorders, this narrative review drew on studies (animal and clinical), evaluating the long-term effects of antenatal corticosteroids to present the case that a more targeted approach to the use of antenatal corticosteroids for the betterment of the fetus urgently needed. Results Studies raised concerns about the potential negative long-term consequences, especially for the exposed fetus who was born beyond the period of the greatest benefit from antenatal corticosteroids. The long-term consequences are more subtle in nature and usually manifest later in life, often beyond the scope of most clinical trials. Conclusion Continued research is needed to identify sufficient safety data, both short term and long term. Caution in the use of antenatal corticosteroids should be exercised while additional work is undertaken to optimize dosing strategies and better identify women at risk of preterm birth prior to administration of antenatal corticosteroids. Key Points

scholarly journals Second Malignant Neoplasms (SMN) in Myeloma Patients Post Stem Cell Transplant (SCT)

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1839-1839
Author(s):  
Samar Kulkarni ◽  
John Murray ◽  
Jim Cavet ◽  
Mike Dennis ◽  
Adrian Bloor ◽  
...  
Keyword(s):  
Stem Cell ◽  
Solid Tumours ◽  
Malignant Neoplasms ◽  
High Dose ◽  
Cell Transplant ◽  
Treatment Needs ◽  
Increased Risk ◽  
Long Term Consequences

Abstract Introduction: Recent developments in management of patients with myeloma have resulted in longer survival. Availability of newer class of agents for treatment has prolonged survival, improved quality of life and achieved better disease control. Use of SCT, either autologous (AutoSCT) and to a lesser extent allogeneic (AlloSCT) still forms an important aspect of myeloma treatment pathway. Improved survivorship mandates evaluation of long term consequences and risk of SMN is one of the most important long-term consequences affecting overall outcome. Aim: Estimate the risk of SMN post SCT in patients with Myeloma. Methods and Materials: Analysis includes 779 patients who received SCT for myeloma from January 2002 to December 2019. Data was collected using case records, electronic patient records, transplant database and information from referring hospitals. Follow-up was updated to June 2020. Results: Analysis includes 779 patients with myeloma (M: 488, F:291; median age:59yr, range: 26-75) receiving AutoSCT (n=716) or AlloSCT (n=63). Conditioning for AutoSCT was high dose melphalan in majority (n=714, 99.7%). AlloSCT conditioning was RIC (n=40/63, 63.5%) or MAC (n=23/63, 36.5%). TBI was part of conditioning in 51/779 (6.5%). There was no difference in demographics between two groups. Results: Median follow-up was 46 mo (range: 0.2-220). Second malignancy was identified in 48 of 779 cases (6.0%). SMN developed in 6/63 (10%) AlloSCT and 42/716 (6%) AutoSCT patents (p=0.25). SMN types were haematological (n=21), lymphoma (n=6) and solid tumours (n=21). MDS was the only haematological SMN in this series. Secondary MDS developed in 20/21 of AutoSCT as compared to 1/63 in AlloSCT (p=0.01). Non-haematological SMN were breast (n=3), upper GI (n=3), lower GI (n=2), hepato-billiary (n=2), prostate (n=3), skin (n=5), and unknown primary (n=1). SMN incidence was higher with increasing follow-up (2002-2014, 8%; 2015-2017, 2.8%, 2018-2019, 0%, p=0.002). There was no association with development of SMN and gender, age at transplant, type of stem cell source or transplant conditioning. Incidence of SMN was significantly higher for all sites as compared to general population. Cumulative incidence of SMN was 5% at 5 yr, and 15% at 10 yr for AutoSCT patients. Conclusion: Myeloma patients are at increased risk of SMN and need monitoring for long term side effects. Development of MDS post AutoSCT is the commonest SMN post AutoSCT but there is increased incidence of solid tumours as well. Impact of new modalities of treatment needs long term monitoring. Disclosures Bloor: Novartis: Honoraria; Kite, a Gilead Company: Honoraria.

scholarly journals Autophagy: The Potential Link between SARS-CoV-2 and Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5721
Author(s):  
Parham Habibzadeh ◽  
Hassan Dastsooz ◽  
Mehdi Eshraghi ◽  
Marek J. Łos ◽  
Daniel J. Klionsky ◽  
...  
Keyword(s):  
Immune Escape ◽  
Autophagic Flux ◽  
Cancer Treatments ◽  
Future Directions ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Potential Link ◽  
Long Term Consequences ◽  
Risk Of Cancer

COVID-19 infection survivors suffer from a constellation of symptoms referred to as post-acute COVID-19 syndrome. However, in the wake of recent evidence highlighting the long-term persistence of SARS-CoV-2 antigens in tissues and emerging information regarding the interaction between SARS-CoV-2 proteins and various components of the host cell macroautophagy/autophagy machinery, the unforeseen long-term consequences of this infection, such as increased risk of malignancies, should be explored. Although SARS-CoV-2 is not considered an oncogenic virus, the possibility of increased risk of cancer among COVID-19 survivors cannot be ruled out. Herein, we provide an overview of the possible mechanisms leading to cancer development, particularly obesity-related cancers (e.g., colorectal cancer), resulting from defects in autophagy and the blockade of the autophagic flux, and also immune escape in COVID-19 survivors. We also highlight the potential long-term implications of COVID-19 infection in the prognosis of patients with cancer and their response to different cancer treatments. Finally, we consider future directions for further investigations on this matter.

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