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At least 757 records · Page 42Linked to original sources
PubMed1998

Prevalence of Raynaud's phenomenon in 2 ethnic groups in the general population of Estonia.

OBJECTIVE: To compare the prevalence of Raynaud's phenomenon (RP) in 2 genetically different ethnic groups in Estonia: Estonians, who are Finno-Ugric people, and Slavs, who are Indo-European people, and to investigate the risk factors of RP. METHODS: A random sample of 5248 Estonians and 4341 Slavs were surveyed by mail questionnaire (Phase I) for suspected RP. A subsample of 1739 subjects was interviewed and examined (Phase II) to make a formal diagnosis of RP, using the color charts, and to collect additional pertinent information. RESULTS: Of these 1739 subjects examined in Phase II, 226 women and 162 men were diagnosed to have RP. The age adjusted prevalence of RP was significantly higher among Slavs (women 11.4 +/- 1.3%, men 13.0 +/- 1.6%) compared to Estonians (women 7.8 +/- 1.0%, p = 0.023; men 8.2 +/- 1.5%, p = 0.031). Based on logistic regression analysis, the diagnosis of RP among women was associated with a Slavic ethnic origin, the presence of connective tissue disorders or cardiovascular diseases, a family history of RP, a history of dysphagia and frostbite, smoking, and a lower body mass index (BMI). Among men RP was associated with manual work, vibrating tool use, a history of frostbite and injuries to the fingers. older age, and a lower BMI. CONCLUSION: Our results revealed a significant difference in the prevalence of RP between 2 ethnic groups living in the same geographic region. The risk factors associated with RP show considerable sex differences, RP being mostly constitutional in women and occupational in men.

Adolescent↗
PubMed1975

Adaptation and failure of adaptation to extreme natural environments.

Although the environmental stresses to which man is subjected on the ground are less than those commonly encountered in aviation or under water, they may still exceed an individual's powers of adaptation. Extremes of temperature, commonly encountered in the Arctic or the tropics, may occur in regions of normally temperate climate and lead to failure of temperature regulation, resulting in hypothermia, frostbite, heat exhaustion, or heat stroke. High mountains impose additional hazards due to high winds and lack of oxygen, and deep mines are dangerous work-places because of high temperature and humidity. Some physiological acclimatization occurs in extreme natural environments and the dangers may be reduced by appropriate clothing, diet and behaviour.

Adaptation, Physiological↗
PubMed1994

Role of neutrophil-endothelial cell adhesion in inflammatory disorders.

Polymorphonuclear leukocytes are armed with an impressive arsenal of bactericidal agents that allow these cells to play a vital role in host defense against invading pathogens. However, these same agents can produce extensive cellular damage in host tissues when leukocytes are activated during inflammatory conditions. Recognition of this fact, when coupled with the observation that leukocyte adhesion to post-capillary venules is a critical first step in the inflammatory process, has led to the development of the concept that inhibition of neutrophil-endothelial cell adhesion (NECA) may represent a novel therapeutic strategy for the prevention of leukocyte-dependent injury in inflammatory conditions. Indeed, pharmacological or immunologic inhibition of NECA reduces cellular injury, dysfunction, and necrosis induced by ischemia/reperfusion, circulatory shock and resuscitation, organ transplantation, cardiopulmonary bypass, frostbite, and thermal trauma. NECA also appears to play an important role in the pathobiology of airway inflammation and asthma, pulmonary oxygen toxicity, arthritis, bacterial meningitis, and cerebral malaria. The aim of this review is to summarize the evidence implicating NECA in the pathogenesis of these inflammatory conditions.

Antibodies, Monoclonal↗
PubMed2005

One night in a snowbank: a case report of severe hypothermia and cardiac arrest.

Hypothermia < 28 degrees C is rarely compatible with life, with only a few cases described surviving such low temperatures. We present a case of a man who survived with a core body temperature below 21.0 degrees C after spending a night in a snowbank with an ambient temperatures as low as -20.0 degrees C. Prolonged CPR and early initiation of extracorporeal membrane oxygenation enabled survival without neurological deficit at hospital discharge. Frostbite was limited to both hands and all toes only; although the entire upper and lower extremity appeared to be deeply frozen on admission, amputation of both hands was inevitable and resulted in permanent disability.

Amputation, Surgical↗
PubMed2007

Environmental cold-induced injury.

More than 650 deaths from hypothermia occur each year in the United States. Even minor deviation from normal temperature leads to important symptoms and disability. The most significant risk factors are advanced age, mental impairment, substance abuse, and injury. This article examines the incidence of hypothermia, its detrimental effect on trauma patients, and methods of rewarming the hypothermic patient. It also looks at the controversial protective role hypothermia might play in shock, organ transplantation, cardiac arrest, and brain injury. Finally, it examines cold injuries, including frostbite, chilblain, and trench foot, and makes recommendations for their treatment.

Cold Temperature↗
PubMed1983

Management of the frostbitten hand.

Twenty cases of moderate and severe frostbite of the hands were analysed to establish trends in surgical treatment. Excision of large blisters and early mobilization in flamazine bags were found to be beneficial. In those patients whose initial skin changes did not extend to the base of the fingers only minor amputations were necessary. The small amounts of necrotic tissue did not interfere with hand movement and operation was therefore delayed until six or seven weeks, so that maximal digital length could be preserved. In contrast, those patients whose initial skin changes involved the whole length of the fingers or extended on to the hands, more proximal amputations were necessary and these amputations were performed at three to four weeks in order to remove the larger amounts of necrotic tissue and facilitate early mobilisation.

Adolescent↗
PubMed1988

Aloe vera.

We review the scientific literature regarding the aloe vera plant and its products. Aloe vera is known to contain several pharmacologically active ingredients, including a carboxypeptidase that inactivates bradykinin in vitro, salicylates, and a substance(s) that inhibits thromboxane formation in vivo. Scientific studies exist that support an antibacterial and antifungal effect for substance(s) in aloe vera. Studies and case reports provide support for the use of aloe vera in the treatment of radiation ulcers and stasis ulcers in man and burn and frostbite injuries in animals. The evidence for a potential beneficial effect associated with the use of aloe vera is sufficient to warrant the design and implementation of well-controlled clinical trials.

Aloe↗
PubMed1998

Psychophysical study of stinging pain evoked by brief freezing of superficial skin and ensuing short-lasting changes in sensations of cool and cold pain.

Psychophysical methods were used to investigate pain in human subjects elicited by controlled freezing of the skin using a novel vortex thermode. When cooling stimuli delivered with a small thermode (7 mm diameter) exceeded the normal cold pain threshold into the sub-zero temperature range (-5 to -11 degrees C), all subjects reported an intense, sharp stinging pain sensation which occurred suddenly and was readily differentiated from normal cold pain. The onset of this stinging 'freezing' pain was closely correlated with a sudden increase in skin temperature beneath the thermode of 4.77+/-0.86 degrees C (+/-SD) associated with the phase transition of supercooled water to ice. The mean intensity of freezing pain was rated as 1.7 times as intense as cold pain at threshold. Subjects' mean reaction-time latency to signal stinging pain following the onset of phase transition on the volar forearm was 687+/-220 ms, which was slower than that for mechanically evoked impact pain. Freezing pain is suggested to be mediated by A-delta fibers, based on estimates of conduction velocity and on the observation that the freezing pain took on a burning quality of slower onset during an A-fiber pressure block of nerve fibers. We also investigated changes in skin sensation following the freezing stimulus, and found that freezing led to (a) an immediate, significant decrease in the cold pain threshold (to higher temperatures), which recovered to baseline in < 16 min, (b) a concomitant change in the quality of cold pain from dull to burning, (c) a significant, parallel increase in the threshold for the perception of cooling (to lower temperatures) which frequently manifested as a complete loss of cold sensation, and (d) a mild heat pain hyperalgesia which was still present 24 h later. The changes in thermal sensitivity were not accompanied by consistent changes in mechanical sensitivity. These results indicate that a characteristic sharp, stinging pain is reliably evoked abruptly at the phase transition of supercooled skin water to ice The ensuing brief decrease in cold pain threshold with burning quality, coupled with decreased sensitivity to cold, are speculated to reflect a central disinhibition of C-fiber nociceptor input due to reduced cold fiber activity. These effects may be relevant to frostbite, and distinguish themselves from the more pronounced thermal and mechanical hyperalgesia seen following intense freeze lesion of the skin.

Adult↗
PubMed2000

Liquid ammonia injury.

The toxic effects of a gas depend on the time of exposure, concentration and its chemical nature. Pressurized liquids and gases exert an additional cold thermal injury and this may complicate the clinical picture. A patient who had an accidental exposure to liquid ammonia over a prolonged period, manifesting in cutaneous, respiratory and ocular damage in addition to a severe cold thermal injury (frostbite) with a fatal outcome is presented. The patient had flaccid quadriparesis and episodes of bradycardia, which has not been reported previously. These manifestations raise the possibility of the systemic toxicity in patients with prolonged exposure to ammonia.

Accidents, Occupational↗
PubMed1978

External ear injuries.

The unique shape of the external ear depends on the underlying cartilaginous framework. Injuries of the external ear are common. In dealing with lacerations, subperichondrial hematomas, perichondritis, burns and frostbite, particular care should be taken to maintain the cartilaginous framework and to prevent infection. In this way cosmetic deformities of the external ear can be prevented.

Burns↗
PubMed2003

Surgical management and strategies in the treatment of hypothermia and cold injury.

Increased participation in outdoor activities and the epidemic of homelessness have caused the incidence of cold injuries in the civilian population to rise dramatically over the last 20 years. Knowledge of the treatment is crucial for emergency physicians in rural and urban areas. Recent developments have significantly advanced the understanding of the pathophysiology of hypothermic and frostbite injuries. Together with improved rewarming techniques and use of radiological assessment of tissue viability, future advancements should allow for a more aggressive and active approach to the management of these injuries.

Energy Transfer↗
PubMedDate not supplied

Facial injury and airway threat from inhalant abuse: a case report.

Fluorinated hydrocarbons cause toxicity in humans via their dysrhythmogenic potential and their local physical effects on the skin and mucous membranes. The former is generally the more life-threatening toxic consequence. We present a case of fluorinated hydrocarbon injury resulting from an intentional inhalation exposure that created facial frostbite, which threatened the patient's airway. The clinical range and management of these tissue-toxic effects are reviewed.

Adolescent↗
PubMed2003

Emollients and the response of facial skin to a cold environment.

BACKGROUND: It is debated whether the use of emollients, in cold weather, constitutes a protective factor or a risk factor for frostbite. OBJECTIVES: To compare the effects of two emollients [oil in water (O/W) and petrolatum] on facial skin in response to cold exposure. METHODS: Fifteen volunteers participated in the experiment, consisting of 60 min in a cold room (-5 degrees C), preceded and followed by 30 min of acclimatization at room temperature. In the cold room, O/W was applied on one cheek and petrolatum on the other. The cheeks were exposed to wind, produced by a fan, to cool further the skin by the wind chill index. Skin temperature, redness, and transepidermal water loss (TEWL) were measured on both cheeks. RESULTS: Facial skin treated with O/W was significantly colder (up to 1.3 degrees C) than facial skin treated with petrolatum, but the difference disappeared within 20 min. Agreement between temperature measurements and subjective thermal sensations was poor (Cohen's kappa = -0.13). At no point did the paired skin redness and the paired TEWL values vary significantly. The TEWL levels were significantly lower 30 min after the cold exposure than before, but had reached pre-exposure levels the following day. CONCLUSIONS: This study demonstrates that for a duration exposure of 20 min, facial skin treated with O/W achieves a lower temperature than facial skin treated with petrolatum. The two emollients had in all other aspects the same effect on the response of facial skin to cold.

Adult↗
PubMed2003

Auricular ossificans (ectopic ossification of the auricle).

The petrified auricle is an unusual clinical entity in which the ear becomes partially or totally rigid, which may result from local trauma, inflammation, or systemic diseases. This process is most commonly secondary to ectopic calcification, but rarely ossification is responsible. Severe hypothermia (frostbite) is the most common cause of auricular ossificans. Only 9 cases of histologically proven ossification of the ear have been reported in the English-language literature. Because of its rarity, there is a paucity of articles addressing its treatment. We report a case of unilateral auricular ossificans believed to be secondary to cold injury. Ectopic ossification was detected on both radiologic and histologic examination. The previously reported cases are reviewed and possible causative factors are discussed.

Aged↗
PubMed1975

Isolation of Clostridium in human infections: evaluation of 114 cases.

One hundred fifty-two strains of Clostridium were isolated from 144 patients over a 14-month-peroid. These included 23 recognized species and 23 strains that were unclassified. Soft tissues or abscesses yielded 84 strains of Clostridium. Intraabdominal sites predominated, but clostridia were recovered from empyema, carcinoma, frostbite with gas gangrene, muscle abscess, aortic graft, and brain abscess. Blood cultures yielded 65 strains of Clostridium from 49 patients, representing 0.3% of 16,314 blood cultures (or 2.6% of 2,168 positive cultures). Clostridium perfringens was most common in blood, accounting for 37 isolates (57%). Clostridial bacteremia was often unrelated to the clinical setting and was found in alcoholics with aspiration or Streptococcus pneumoniae pneumonia, pulmonary tuberculosis, empyema, meningococcemia, and infantile gastroenteritis. In 20 of the 49 patients (41%), aerobic or other anaerobic bacteria were cultured concurrently from the blood. Thus, clostridial bacteremia should be interpreted with caution since there may be little correlation with the patient's clinical condition.

Abscess↗
PubMed1985

Distally based abductor digiti minimi muscle flap.

The abductor digiti minimi muscle flap is known as good tissue coverage for the lateral ankle and heel. For reconstruction of the distal portion of the foot, the distally based flap of this muscle can be useful, effectively utilizing the blood supply through the plantar arch communication. A case of frostbite of the right fifth toe is reported, which we successfully repaired with a distally based abductor digiti minimi muscle flap. In addition, some information on distally based use of the muscles of the foot is presented.

Adult↗
PubMed1986

The effects of cold upon bone growth: a preliminary study.

The effects of various degrees of cold injury upon bone growth were experimentally studied. Young rabbits' feet, rendered ischemic by the application of a tourniquet, were cooled down by immersion in either an ice bath at 0 degrees C or an alcohol bath at -20 degrees C. The bone injuries were assessed clinically, radiologically, and histologically. Prolonged exposures to low temperatures above freezing do not cause any bone damage. Brief exposures to temperatures between -20 degrees C and -15 degrees C affect bone growth by inducing premature arrest of the epiphyseal plate, destruction of the epiphysis, and reactive-endosteal and periosteal bone formation. These effects lead to a statistically significant shortening and widening of the affected bones, which can be demonstrated radiologically. Low temperatures have a primary direct lethal effect upon the highly sensitive chondrocytes of the epiphyseal growth plate. Bone damage is independent of associated soft-tissue injuries and not linked to frostbite of the extremity or to solidification of tissues.

Animals↗