An evaluation of the Swiss staging model for hypothermia using case reports from the literature.

BACKGROUND: Core body temperature is used to stage and guide the management of hypothermic patients, however obtaining accurate measurements of core temperature is challenging, especially in the pre-hospital context. The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia. The proposed temperature range for clinical stage 1 is <35-32 °C (95-90 °F), for stage 2, <32-28 °C (<90-82 °F) for stage 3, <28-24 °C (<82-75 °F), and for stage 4 below 24 °C (75 °F). However, the evidence relating these temperature ranges to the clinical stages needs to be strengthened. METHODS: Medline was used to retrieve data on as many cases of accidental hypothermia (core body temperature <35 °C (95 °F)) as possible. Cases of therapeutic or neonatal hypothermia and those with confounders or insufficient data were excluded. To evaluate the Swiss staging model for hypothermia, we estimated the percentage of those patients who were correctly classified and compared the theoretical with the observed ranges of temperatures for each clinical stage. The number of rescue collapses was also recorded. RESULTS: We analysed 183 cases; the median temperature for the sample was 25.2 °C (IQR 22-28). 95 of the 183 patients (51.9 %; 95 % CI = 44.7 %-59.2 %) were correctly classified, while the temperature was overestimated in 36 patients (19.7 %; 95 % CI = 13.9 %-25.4 %). We observed important overlaps among the four stage groups with respect to core temperature, the lowest observed temperature being 28.1 °C for Stage 1, 22 °C for Stage 2, 19.3 °C for Stage 3, and 13.7 °C for stage 4. CONCLUSION: Predicting core body temperature using clinical indicators is a difficult task. Despite the inherent limitations of our study, it increases the strength of the evidence linking the clinical hypothermia stage to core temperature. Decreasing the thresholds of temperatures distinguishing the different stages would allow a reduction in the number of cases where body temperature is overestimated, avoiding some potentially negative consequences for the management of hypothermic patients.

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Temppuja ja teoriaa

Suomen psykologisen seuran nuorten tutkijoiden jaoksen (NuTu) kevätseminaarin aiheena oli 6.3.2007 tutkimuksen ja käytännön yhdistäminen kliinisen psykologin työssä. Aiheesta alusti HYKS:stä Peijaksen sairaalan johtava psykologi Petri Näätänen.

Kyseenalainen kirja vai kyseenalainen arvostelu?

Keskustelua kirja-arvostelusta: Huldén L. 2003: Kyseenalainen teos Suomen mesipistiäisistä - Luonnon tutkija 107: s. 136-143 ja kirjasta: Söderman, G. & Leinonen, R. 2003: Suomen mesipistiäiset ja niiden uhanalaisuus

Constituintes químicos voláteis e não-voláteis de Cochlospermum vitifolium (Willdenow) Sprengel

The essential oils from leaves, root bark and root wood of Cochlospermum vitifolium were investigated for the first time. The oils were obtained by hydrodistillation and analyzed by GC/MS. The main volatile constituents were beta-caryophyllene (8.2 - 46.5%), beta-bisabolene (11.5 - 29.3%), gamma-muurolene (28.4%), alpha-humulene (26.0%), 1-hydroxy-3-hexadecanone (16.2 - 19.5%) and beta-pinene (10.6%). Phytochemical analysis of the root bark and root wood extracts yielded excelsin, pinoresinol, narigenin, aromadendrin, galic acid and a triacylbenzene, along with beta-sitosterol and stigmasterol and their D-glucosides. The structures of all compounds were determined by analyses of the spectroscopic data (NMR and MS), and comparison with the literature.

Caracterización del proceso de adsorción de 3-cloro fenol desde solución acuosa sobre carbon activado por calorimetria de inmersión

The immersion enthalpy of activated carbon in 3-chlorophenol solutions, of 100 mg L-1, is determined at different pH values between 3 and 11 with results between 37.6 and 21.2 J g-1. The 3-chlorophenol adsorbed quantities on the activated carbon during the calorimetric experience, are between 1.13 and 2.19 mg g-1, for different pH values of the solution. The 3-chlorophenol adsorbed quantity and the immersion enthalpy decrease by increasing of the pH solution, while increasing the adsorbed quantity increases the immersion enthalpy value.

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Kirjallisuusarvostelu

Etnografinen tutkimusprosessi

Kirjallisuusarvostelu

Sarasuon hiilikaasudynamiikka muuttuvissa kosteusolosuhteissa

Seloste väitöskirjasta: Fen ecosystem carbon gas dynamics in changing hydrological conditions. Dissertationes Forestales 67.

Tieteen ja isänmaan nimessä

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