- Expert consensus on the evaluation and diagnosis of combat injuries of the Chinese People's Liberation Army. [Journal Article]
- MMMil Med Res 2018 Feb 13; 5(1):6
- The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discu...
The accurate assessment and diagnosis of combat injuries are the basis for triage and treatment of combat casualties. A consensus on the assessment and diagnosis of combat injuries was made and discussed at the second annual meeting of the Professional Committee on Disaster Medicine of the Chinese People's Liberation Army (PLA). In this consensus agreement, the massive hemorrhage, airway, respiration, circulation and hypothermia (MARCH) algorithm, which is a simple triage and rapid treatment and field triage score, was recommended to assess combat casualties during the first-aid stage, whereas the abbreviated scoring method for combat casualty and the MARCH algorithm were recommended to assess combat casualties in level II facilities. In level III facilities, combined measures, including a history inquiry, thorough physical examination, laboratory examination, X-ray, and ultrasound examination, were recommended for the diagnosis of combat casualties. In addition, corresponding methods were recommended for the recognition of casualties needing massive transfusions, assessment of firearm wounds, evaluation of mangled extremities, and assessment of injury severity in this consensus.
- Using polyethylene plastic bag to prevent moderate hypothermia during transport in very low birth weight infants: a randomized trial. [Journal Article]
- JPJ Perinatol 2018; 38(4):332-336
- CONCLUSIONS: Placing VLBW infants in polyethylene plastic bags during transport reduces the occurrence of hypothermia, especially moderate hypothermia.
- Effects of bilateral pallidal deep brain stimulation on chorea after pulmonary thromboendarterectomy with deep hypothermia and circulatory arrest: a case report. [Journal Article]
- ANActa Neurochir (Wien) 2018; 160(2):393-395
- A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation,...
A 41-year-old man was diagnosed with chronic pulmonary thromboembolism and underwent pulmonary thromboendarterectomy (PTE) with deep hypothermia and circulatory arrest. Five days after the operation, chorea emerged in the lower extremities. The patient was referred to our hospital for disabling chorea 16 years after PTE. Neurological examination revealed choreatic movements in the four extremities. Brain magnetic resonance images indicated atrophy in the bilateral head of the caudate nuclei. The patient underwent deep brain stimulation (DBS) of the bilateral globus pallidus interna (GPi). Continuous GPi-DBS diminished the choreatic movements. GPi-DBS may be a treatment option for sustained choreatic movements after PTE.
- Between fire and ice: refractory hypothermia and warmth-induced pain in inherited erythromelalgia. [Case Reports]
- BCBMJ Case Rep 2017 Jul 26; 2017
- Inherited erythromelalgia (IEM) is a well-described pain disorder caused by mutations of sodium channel Nav1.7, a peripheral channel expressed within dorsal root ganglion and the sympathetic ganglion...
Inherited erythromelalgia (IEM) is a well-described pain disorder caused by mutations of sodium channel Nav1.7, a peripheral channel expressed within dorsal root ganglion and the sympathetic ganglion neurons. Clinically, IEM is characterised by paroxysmal attacks of severe pain, usually in the distal extremities, triggered by warmth or exercise. Pain is not adequately treated by existing pharmacological agents. Individuals with IEM classically cool their limbs for relief, in some cases resulting in tissue injury. We describe a patient from a family with IEM due to the L858F mutation of Nav1.7 who presented with refractory hypothermia due to overcooling. This presentation of refractory hypothermia necessitating warming strategies, complicated by severe warmth-induced pain, posed a substantial therapeutic challenge. We report our experience in overcoming hypothermia lasting 3 weeks in a child with IEM, discuss possible pathophysiological mechanisms underlying this unusual complication and suggest potential therapeutic interventions.
- Neuromuscular function during knee extension exercise after cold water immersion. [Journal Article]
- JPJ Physiol Anthropol 2017 Jun 23; 36(1):28
- CONCLUSIONS: The lower shift of EMG frequency would be connected with the decrease in the nerve and muscle fibers conduction velocity. To compensate for the impairment of each muscle fibers function, more muscle fibers might be recruited to maintain the working load. This might result in the greater amplitude of EMG after the cold immersion.
- The effects of foot cooling on postural muscle responses to an unexpected loss of balance. [Journal Article]
- HMHum Mov Sci 2017; 54:240-247
- The purpose of this study was to examine the role of foot sole somatosensory information during reactive postural control. Twenty young adults (22.0±1.4y) participated in this study. Baseline skin se...
The purpose of this study was to examine the role of foot sole somatosensory information during reactive postural control. Twenty young adults (22.0±1.4y) participated in this study. Baseline skin sensitivity from the foot sole was assessed using Semmes-Weinstein monofilaments. Postural muscle responses, in the form of electromyographic (EMG) onset latencies and amplitudes, were then obtained while participants recovered their balance while standing on a moveable platform that could translate in either the forward or backward direction. Following these baseline measures, the participant's foot soles were immersed in a 0-2°C ice-water bath for 12min followed by a 3min re-immersion period. At the completion of foot cooling, foot sole sensitivity and postural muscle responses to the balance perturbations were re-assessed. Results indicated that the foot cooling protocol reduced foot sole sensitivity and remained reduced throughout the duration of the experiment (p<0.001). The reduction in foot sole somatosensation resulted in the soleus EMG onset latency being delayed by 3ms (p=0.041) and the soleus and medial gastrocnemius EMG amplitudes increasing by 14-23% (p=0.002-0.036) during the balance perturbation trials. While the magnitude of these results may suggest that foot cooling has a minor functional consequence on reactive postural control, it is likely that the results also reflect the ability of the central nervous system to rapidly adapt to situations with altered somatosensory feedback.
- Surface heparinization and blood compatibility modification of small intestinal submucosa (SIS) for small-caliber vascular regeneration. [Journal Article]
- BMBiomed Mater Eng 2017; 28(3):213-222
- CONCLUSIONS: Heparin was attached to the SIS surface after hypothermia plasma treatment. Hydrophilicity and antithrombogenicity of heparinized SIS were clearly increased. The heparinized SIS vascular graft showed great potential for replacement of defective small-caliber vessels.
- ACR Appropriateness Criteria®Sudden Onset of Cold, Painful Leg. [Practice Guideline]
- JAJ Am Coll Radiol 2017; 14(5S):S307-S313
- Acute limb ischemia (ALI) requires urgent diagnosis and treatment to prevent limb loss. Invasive digital subtraction arteriography (DSA) is the gold standard for diagnosing ALI. DSA is the only diagn...
Acute limb ischemia (ALI) requires urgent diagnosis and treatment to prevent limb loss. Invasive digital subtraction arteriography (DSA) is the gold standard for diagnosing ALI. DSA is the only diagnostic modality that permits simultaneous treatment of acute arterial occlusion. Noninvasive imaging with MRA or CT angiography may also be appropriate before treatment, especially when the diagnosis of ALI is in doubt or where DSA is unavailable. Other imaging and noninvasive physiologic tests may prove important for longer term management but are less recommended in the acute setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Acellular Hypothermic Extracorporeal Perfusion Extends Allowable Ischemia Time in a Porcine Whole Limb Replantation Model. [Journal Article]
- PRPlast Reconstr Surg 2017; 139(4):922e-932e
- CONCLUSIONS: The authors demonstrated the feasibility and superiority of ex vivo hypothermic oxygenated machine perfusion for preservation of amputated limbs over conventional static cold storage and herewith a substantial extension of the allowable ischemia time for replantation after traumatic amputation. This approach could also be applied to the field of transplantation, expanding the potential pool of viable donor vascularized composite allografts.
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- Recover of peripheral nerve function after prolong hypothermic cardiac arrest in a porcine model with extra corporeal life support. [Journal Article]
- JTJ Therm Biol 2017; 64:41-47
- CONCLUSIONS: Reanimation after three hours of hypothermic cardiac arrest using ECLS was possible with no or, if present, minor damage to the two nerves tested.