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Temperature Regulation
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Frostbite is the most severe form of cold injury and is due to the freezing of peripheral tissues. Damage to tissues is by cell dehydration and mechanical effects of ice crystals, associated with an increase in permeability of blood vessels. In mild forms, only the skin freezes, but the muscle and tendons may also freeze in severe cases. There is loss of fluid from the circulation on thawing, and the increased haematocrit in the blood vessels of affected tissues can reduce blood flow and cause gangrene.
Frostbite
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
This patient has frostbite. Frostbite damages tissue by two mechanisms: (a) direct cellular damage from extracellular ice crystal formation with cell membrane damage causing intracellular dehydration and (b) epidermal ischemia as a consequence of inflammatory mediator release, endothelial injury, and emboli in the microvasculature causing progressive microvascular thrombosis and hypoxia to affected tissues.
Arterial disorders
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Frostbite is caused by exposure to cold. It is seen both in climbers at high altitudes and in the elderly or the vagrant during cold weather (Figure56.24). Cold injury damages the wall of the blood vessel, which causes swelling, and leakage of fluid together with severe pain. When the pain disappears, a waxy appearance remains; blistering and then gangrene follow. Treatment is gradual rewarming, analgesics and delayed conservative amputation after demarcation of devitalised tissue.
Human vulnerability and variability in the cold: Establishing individual risks for cold weather injuries
Published in Temperature, 2022
François Haman, Sara C. S. Souza, John W. Castellani, Maria-P. Dupuis, Karl E. Friedl, Wendy Sullivan-Kwantes, Boris R. M. Kingma
The main causes of NFCI are the sustained exposure to cooling temperatures between 25°C and 10°C and/or wet conditions. The feet are the most at risk; however, NFCI can affect any body part. Overall, NFCI diagnosis is based on comprehensive history, general examination, and injury classification. NFCI are classified in four different stages according to the exposure duration to cold temperatures, skin color, and other specific symptoms. In case of suspected NFCI, the patient should be first evacuated from the cold and/or wet environment if possible and subsequently receive immediate and additional management. Prevention is still the major way of avoiding long-term consequences such as cold sensitivity. Frostbite is mainly related to the exposure to temperatures close to tissue freezing point (−0.55°C). The diagnosis of frostbite starts with a clinical approach and is followed by the injury classification. Frostbite can be clinically differentiated into superficial (first and second levels.) and deep (third and fourth levels). Imaging exams to evaluate the level of tissue damage should be performed in deep cases of frostbite. Although there are different treatments available (e.g. iloprost and tPA), the first management is highly determinant of prognosis. Clearly, preventing and mitigating risks of CWI is key when exposed to cold conditions. Much work remains to clearly understand how individual morphological, physiological, and psychological differences can modulate cold responses and the risk of developing cold weather injuries.
Exploring the frostbite healing potential of hyaluronic acid based hydrogel of Manuka honey through in-silico antithrombotic and anti-platelet studies of major phytoconstituents and in-vivo evaluation in Wistar rat model
Published in Drug Development and Industrial Pharmacy, 2021
Kumud Joshi, Bhaskar Mazumder, Pronobesh Chattopadhyay, Danswrang Goyary, Madhubanti Das, Sanjai Kumar Dwivedi
HA possess a significant antiplatelet activity and MH is rich in polyphenols and flavonoids and both of them possess significant wound healing activity. Polyphenols and flavonoids are natural compounds with significant antioxidant activity and are used in wound healing. Frostbite is a wound associated with ischemic injury and is associated with significant thrombosis. The resolution of thrombosis is very important for the treatment of frostbite. The in-silico docking study was performed which focused on investigating the anti-thrombotic and anti-platelet activity of some major phyto-compounds of MH from natural sources. The results reveal that leptosin of MH forms a stable protein-ligand complex with the target proteins as compared to the drug aspirin. Thus, the comparative in-silico molecular docking analysis of the phytochemicals and drug aspirin against the target proteins proves that leptosin can be a good drug candidate having anti-thrombotic and anti-platelet activity. These studies suggest that the major constituents of MH possess a significant antithrombotic activity and can be useful in countering microvascular thrombosis in frostbite.
Comparison of procedure-related complications between percutaneous cryoablation and radiofrequency ablation for treating periductal hepatocellular carcinoma
Published in International Journal of Hyperthermia, 2020
Seong Eun Ko, Min Woo Lee, Hyunchul Rhim, Tae Wook Kang, Kyoung Doo Song, Dong Ik Cha, Hyo Keun Lim
CA procedures were performed by one of the five interventional radiologists. After local anesthesia with or without conscious sedation, cryoprobes (IceSphere1.5® needle, straight type; Galil Medical, Yokneam, Israel) were percutaneously placed to the index tumor under US or fusion imaging guidance. One to three cryoprobes were used depending on the tumor size and morphology. According to the manufacturers’ recommendation, two CA cycles, including freezing (10 min), thawing (7 min), refreezing (10 min), and rethawing (3 min), were routinely used. The aim of CA and the guiding method for CA were the same as those for RFA. During the procedure, the ice-ball formation was continuously monitored with the real-time US. Therefore, the operators could decide whether the ablative margin was insufficient as the ice-ball was clearly demarcated on US. In cases in which the ablative margin was insufficient, additional CA was performed after needle repositioning. Procedures were completed when the iceball induced by CA on US was large enough to cover the entire tumor and the surrounding liver [10]. During the procedure, warm saline-soaked gauze was used to protect the overlying skin from frostbite. After the procedure, cryoprobes were gently removed as tract ablation was not applicable to a cryoprobe.