Is It Time for a Randomized Controlled Trial of Hypothermia for Mild Hypoxic-Ischemic Encephalopathy?

The time is right to perform a randomized controlled trial (RCT) of neuroprotection for neonates with mild hypoxic-ischemic encephalopathy (HIE). According to published reports, more than 600 infants with mild HIE have undergone hypothermia at 33.5 °C for 72 hours.1-6 Data on neuroimaging findings following cooling for mild HIE from these reports are now becoming available. Depending on the cohort evaluated, whether retrospective or prospective, and whether infants received cooling or not, 11%-40% of infants with mild HIE have brain injury a nd watershed injury is seen more frequently than basal ganglia or thalamus injury.
Source: The Journal of Pediatrics - Category: Pediatrics Authors: Tags: Commentary Source Type: research

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PMID: 32066150 [PubMed - in process]
Source: Annals of Internal Medicine - Category: Internal Medicine Authors: Tags: Ann Intern Med Source Type: research
We describe the successful resuscitation of a 23-year-old previously healthy man who had drowned. After prolonged submersion, hypothermia, severe hypernatraemia, a prolonged time to return of spontaneous circulation was possible using a combination of extr...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Drowning, Suffocation Source Type: news
Conclusions: Although a larger hypothermia/ischemia ratio was associated with good functional outcome after out-of-hospital cardiac arrest in this cohort, this association is primarily driven by duration of time to return of spontaneous circulation. Tailoring duration of targeted temperature management based on duration of time to return of spontaneous circulation or patient characteristics requires prospective study.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research
Survival after pre-hospital cardiac arrest (PHCA) remains low. Pre-hospital therapeutic hypothermia (PTH) is believed to improve patient's outcomes, but data on efficacy and safety remains scarce. Herein, we aimed to assess the influence of PTH on survival, neurological outcome, and adverse effects in patients with PHCA.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Abstract Obesity results from energy imbalance, when energy intake exceeds energy expenditure. Brown adipose tissue (BAT) drives non-shivering thermogenesis which represents a powerful mechanism of enhancing the energy expenditure side of the energy balance equation. The best understood thermogenic system in BAT that evolved to protect the body from hypothermia is based on the uncoupling of protonmotive force from oxidative phosphorylation through the actions of uncoupling protein 1 (UCP1), a key regulator of cold-mediated thermogenesis. Similarly, energy expenditure is triggered in response to caloric excess, and...
Source: The Biochemical Journal - Category: Biochemistry Authors: Tags: Biochem J Source Type: research
ConclusionsThese data indicate that, under the conditions studied here: (1) SPCs exhibit less lethality than MA and MDMA; (2) SPCs impair thermoregulation; (3) effects of SPCs on temperature appear to be independent of effects on lethality.
Source: Pharmacology Biochemistry and Behavior - Category: Biochemistry Source Type: research
CONCLUSION: The measurements show that 28% of the patients were below recommended preoperative temperature on arrival at the operating theatre. Further research is needed to study the development of body temperature perioperatively as well as at what point reheating interventions should be introduced. PMID: 32053433 [PubMed - in process]
Source: British Journal of Nursing - Category: Nursing Authors: Tags: Br J Nurs Source Type: research
AbstractA 5-mo-old severely malnourished 3.5  kg boy was brought to the emergency department with hypoglycemia, bradycardia, bradypnea, and hypothermia. His findings were likely due to severe malnutrition secondary to parental neglect. Resuscitation with dextrose containing intravenous fluids was promptly started. On day 2 of admission, refee ding was initiated. From that time, he had multiple hypoglycemic episodes along with hypophosphatemia, hypomagnesemia, and hypokalemia. Hypoglycemia was associated with the initiation of enteral feeding and an increase in calories and amounts of enteral feeding. Hypoglycemia asso...
Source: Indian Journal of Pediatrics - Category: Pediatrics Source Type: research
Publication date: May 2020Source: Biomedicine &Pharmacotherapy, Volume 125Author(s): Yiyu Yin, Jian Wang, Xiaodong Zhao, Xiaole Wu, Huaxin Zou, Zhenfang Qin, Junhua CaoAbstractObjectiveTo investigate the relationship between FOXO3 overexpression and NLRP3 and explore the effect of FOXO3 on necrotizing colitis.Methods100 clean grade newborn SD (Sprague Dawley) rats were randomly divided into 4 groups: NEC group, NEC + FOXO3a group, NEC + NC group and control group. NEC rat model was established by hypoxia + hypothermia stimulation; HE staining was used for detection of the inflammation of intestinal tissue. The histolog...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Abstract We assessed the ability of high-risk criteria developed by Boston Health Care for the Homeless Program to identify increased mortality during a 10-year cohort study (January 2000-December 2009) of 445 unsheltered adults. To qualify as high-risk for mortality, an individual slept unsheltered for six consecutive months or longer plus had one or more of the following characteristics: tri-morbidity, defined as co-occurring medical, psychiatric, and addiction diagnoses; one or more inpatient or respite admissions; three or more emergency department visits; 60 years old or older; HIV/AIDS; cirrhosis; renal fail...
Source: Journal of Health Care for the Poor and Underserved - Category: International Medicine & Public Health Authors: Tags: J Health Care Poor Underserved Source Type: research
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