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    Isolated psychosis during exposure to very high and extreme altitude - characterisation of a new medical entity.
    Psychol Med 2017 Dec 5:1-8. Epub 2017 Dec 5.
    Department of Psychiatry,Psychotherapy and Psychosomatics,University Hospital of Psychiatry II,Medical University Innsbruck,Innsbruck,Austria.
    Background: Psychotic episodes during exposure to very high or extreme altitude have been frequently reported in mountain literature, but not systematically analysed and acknowledged as a distinct clinical entity.

    Methods: Episodes reported above 3500 m altitude with possible psychosis were collected from the lay literature and provide the basis for this observational study. Dimensional criteria of the Diagnostic and Statistical Manual of Mental Disorders were used for psychosis, and the Lake Louise Scoring criteria for acute mountain sickness and high-altitude cerebral oedema (HACE). Read More

    The effect of gamma irradiation on the properties of cucumber.
    J Food Sci Technol 2017 Dec 24;54(13):4277-4283. Epub 2017 Oct 24.
    Department of Nuclear Engineering, Faculty of New Sciences and Technologies, University of Isfahan, Esfahān, Iran.
    In this study, the effect of gamma irradiation on the shelf life and properties of cucumber was investigated. These properties include weight reduction, fruit density, juice, tissue firmness, total soluble solids (TSS), total titratable acidity, chlorophyll and vitamin C, pH, marketability, flavor, frostbite and fungal effects. For this purpose, cucumbers were irradiated with dose of 2, 2. Read More

    Relevance of TRPA1 and TRPM8 channels as vascular sensors of cold in the cutaneous microvasculature.
    Pflugers Arch 2017 Nov 21. Epub 2017 Nov 21.
    Section of Vascular Biology and Inflammation, School of Cardiovascular Medicine and Research, BHF Cardiovascular Centre of Research Excellence, King's College London, Room 3.74, FWB, 150 Stamford Street, London, SE1 9NH, UK.
    Cold exposure is directly related to skin conditions, such as frostbite. This is due to the cold exposure inducing a vasoconstriction to reduce cutaneous blood flow and protect against heat loss. However, a long-term constriction will cause ischaemia and potentially irreversible damage. Read More

    Bone Scan in Evaluation of Bone Viability in Severe Frostbite of the Hand.
    Indian J Nucl Med 2017 Oct-Dec;32(4):367-368
    Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA.
    A 39-year-old male presented to the emergency department (ED) with frostbite to the fingers of both hands. In the ED, he received warm baths, acetylsalicylic acid, clopidogrel, and heparin. A three-phase bone scintigraphy with technetium-99m-methylene diphosphonate revealed absent radiotracer uptake in distal phalanges of both hands. Read More

    Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2012-June 2017.
    MSMR 2017 Oct;24(10):12-21
    From July 2016 through June 2017, a total of 387 members of the active (n=328) and reserve (n=59) components had at least one medical encounter with a primary diagnosis of cold injury. Among active component service members, the total number of cold injuries in the 2016-2017 cold season was the lowest since 1999 and the overall incidence rate was lower than in any of the previous four cold seasons. Frostbite was the most common type of cold injury. Read More

    BET 1: Does the use of emollients prevent frostbite to the face?
    Emerg Med J 2017 Nov;34(11):763-764
    Belgian Red Cross-Flanders, Mechelen, Belgium.
    A short cut review was carried out to establish whether routine use of emollients on the face reduced the incidence of frostbite in cold environments. 126 papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Read More

    Analytical expressions for estimating endurance time and glove thermal resistance related to human finger in cold conditions.
    J Therm Biol 2017 Oct 21;69:334-340. Epub 2017 Sep 21.
    Foolad Institute of Technology, Fooladshahr, Isfahan 84916 63763, Iran.
    Frostbite is considered the severest form of cold injury and can lead to necrosis and loss of peripheral appendages. Therefore, prediction of endurance time of limb's tissue in cold condition is not only necessary but also crucial to estimate cold injury intensity and to choose appropriate clothing. According to the previous work which applied a 3-D thermal model for human finger to analyze cold stress, in this study, an expression is presented for endurance time in cold conditions to prevent cold injury. Read More

    BET 2: Treatment of frostbite with iloprost.
    Emerg Med J 2017 Oct;34(10):689-690
    Oregon Health & Science University, Portland, Oregon, USA and Manchester Royal Infirmary, Manchester, UK.
    A short cut review was carried out to establish whether an infusion of iloprost can be used to treat frostbite to reduce the risk of needing an amputation. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. Read More

    Medical Encounters During a Joint Canadian/U.S. Exercise in the High Arctic (Exercise Arctic Ram).
    Mil Med 2017 Sep;182(9):e1764-e1768
    Tactical Research Unit, Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD 4226.
    The Arctic Ram Exercise was conducted in February 2016, near Resolute Bay on Cornwallis Island in Nunavut, Canada, to demonstrate the ability of the Canadian Armed Forces (CAF) to rapidly deploy to the arctic as an immediate response team. This report describes medical problems experienced by the 187 CAF and 28 U.S. Read More

    Iatrogenic Full-Thickness Frostbite Injury Caused by the Use of a Conductive Cooling Device.
    J Burn Care Res 2017 Aug 31. Epub 2017 Aug 31.
    From the *Lewis Katz School of Medicine at Temple University, Philadelphia, PA; †Albert Einstein Healthcare Network, Philadelphia, PA; ‡Temple Burn Center, Philadelphia, PA.
    Reports of iatrogenic cold thermal injuries are rare in the literature. Conductive cooling devices, typically employed for their neuroprotective effects, use conductive hydrogel pads to achieve rapid and precise temperature control approaching the level of water immersion. Despite a number of built-in safeguards, prolonged or improper use of these devices can lead to significant thermal injury. Read More

    Delayed treatment of frostbite with hyperbaric oxygen: a report of two cases.
    Undersea Hyperb Med 2017 Jul-Aug;44(4):365-369
    Maasstad Hospital, Department of Burn and Trauma Surgery, Rotterdam, The Netherlands.
    Frostbite is an injury caused by the freezing of tissue, causing varied levels of tissue damage and necrosis. Case reports have shown a positive effect of hyperbaric oxygen (HBO₂) in such injuries, in acute cases as well as delayed (up to 21 days) presentation with complications. In this case report we present the course of hyperbaric treatment of two patients (a brother and sister, age 58 and 62) who sustained frostbite injuries to both feet 28 days earlier while hiking in the Himalayas. Read More

    The evolution of the Helsinki frostbite management protocol.
    Burns 2017 Nov 1;43(7):1455-1463. Epub 2017 Aug 1.
    Helsinki Burn Centre, Department of Plastic Surgery, Töölö Hospital, Helsinki University Hospital, University of Helsinki, Finland.
    Background: Severe frostbite can result in devastating injuries leading to significant morbidity and loss of function from distal extremity amputation. The modern day management approach to frostbite injuries is evolving from a historically very conservative approach to the increasingly reported use of early interventional angiography and fibrinolysis with tPA. The aim of this study was to evaluate the results of our frostbite treatment protocol introduced 3 years ago. Read More

    Amputations in the burn unit: A retrospective analysis of 82 patients across 12 years.
    Burns 2017 Nov 1;43(7):1449-1454. Epub 2017 Aug 1.
    Department of Burns, Third Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia Institute of Burn Research, Baotou, Inner Mongolia, China. Electronic address:
    Background: The aim of this study is to analyze the data of amputees in the burn center of the Inner Mongolia region and to provide instructive suggestions for a preventative reduction of the amputation rate.

    Methods: Between 2004 and 2016, all patient medical profiles were reviewed to extract data of patients with major amputation. Demographic data, mechanism of injury, location and level of amputation were recorded. Read More

    Intra-arterial Thrombolysis for Extremity Frostbite Decreases Digital Amputation Rates and Hospital Length of Stay.
    Cardiovasc Intervent Radiol 2017 Dec 12;40(12):1824-1831. Epub 2017 Jul 12.
    Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health System, Michigan Medicine, 1500 East Medical Center Drive, Ann Arbor, MI, 48109, USA.
    Purpose: To report outcomes of intra-arterial thrombolysis versus non-thrombolytic management of severe frostbite with respect to digital amputation rates and hospital length of stay (LOS).

    Materials And Methods: Seventeen patients with severe frostbite were identified from 2000 to 2017. Eight (47%) patients with mean age of 40 years underwent intra-arterial thrombolysis and served as the treatment group. Read More

    Role of 99mTc MDP Bone Scan in Delineation of Ischaemic Zone in Cases of Severe Frostbite.
    Indian J Nucl Med 2017 Jul-Sep;32(3):203-207
    Department of Nuclear Medicine, Army Hospital Research and Referral, New Delhi, India.
    Frostbite or cold burn is the medical condition in which localized damage is caused to exposed skin and subcutaneous tissue due to freezing. Frostbite most likely involves body parts farthest from the heart and those with large exposed areas. At or below 0 °C (32 °F), blood vessels close to the skin start to constrict, and blood is shunted away from the extremities via the physiological feedback action of glomus bodies. Read More

    [The forensic medical assessment of the causes and conditions of the formation of the chilling injury].
    Sud Med Ekspert 2017;60(3):42-49
    Bureau of Forensic Medical Expertisem Moscow Health Department, Moscow, Russia, 107023; Federal state budgetary institution 'Russian Federal Centre of Forensic Medical Expertise', Ministry of Health of the Russia, Moscow, Russia, 125284.
    The authors present the data of the literature publications and theoretical considerations concerning the causes and conditions behind the formation of the chilling injury. It is demonstrated that the chilling injury develops as a consequence of a disturbance in the relationship between the hypothermic protection of the organism and the cooling potential of its environment. The thermal balance of the human organism depends not only on the natural mechanisms of physical and chemical thermoregulation but also on the character of artificial thermoregulation including the man-made means of cold protection. Read More

    Observation of the effect of targeted therapy of 64-slice spiral CT combined with cryoablation for liver cancer.
    World J Gastroenterol 2017 Jun;23(22):4080-4089
    Qiao-Huan Yan, Department of Geriatrics, the First Hospital of Handan, Handan 056001, Hebei Province, China.
    Aim: To observe the effect of targeted therapy with 64-slice spiral computed tomography (CT) combined with cryoablation for liver cancer.

    Methods: A total of 124 patients (142 tumors) were enrolled into this study. According to the use of dual-slice spiral CT or 64-slice spiral CT as a guide technology, patients were divided into two groups: dual-slice group (n = 56, 65 tumors) and 64-slice group (n = 8, 77 tumors). Read More

    Early Mobilization in Lower Extremity Frostbite Injury: Preliminary Experience at a Single Burn Center.
    J Burn Care Res 2017 May 26. Epub 2017 May 26.
    From the Department of Surgery, Hennepin County Medical Center, Minneapolis, MN.
    Cold exposure that leads to frostbite puts patients at high risk for extremity amputations. Recent treatment advances, such as thrombolytic administration, have decreased amputation rates. However, little is known about patient outcomes with early mobilization of affected limbs. Read More

    [Skin diseases associated with environmental factors].
    Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017 Jun;60(6):605-617
    Abteilung Allergologie, Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225, Langen, Deutschland.
    Background: Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease.

    Objectives: Provide an overview of non-allergic skin diseases associated with environmental factors.

    Materials And Methods: Review of current scientific evidence for associations of non-allergic skin diseases with environmental exposures: irritation, chemicals, infection, UV-radiation, temperature. Read More

    A Retrospective Chart Review of Chronic Wound Patients Treated with Topical Oxygen Therapy.
    Adv Wound Care (New Rochelle) 2017 May;6(5):143-152
    Angie Purvis, LLC, Evergreen, Colorado.
    Objective: Topical oxygen devices are Food and Drug Administration (FDA) cleared for the following indications for use of various etiologies: skin ulcerations due to diabetes, venous stasis, postsurgical infections and gangrenous lesions, decubitus ulcers; amputations/infected stumps; skin grafts; burns; and frostbite. The goal of this study was to understand the impact of topical oxygen therapy (TOT) on patient outcomes, including amputation and healing rates. Approach: This retrospective chart review included records collected between January 1, 2007, and July 18, 2016, from male and female patients ranging in age from 4 years to 105 years. Read More

    Thermal perception thresholds among workers in a cold climate.
    Int Arch Occup Environ Health 2017 May 11. Epub 2017 May 11.
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, 901 87, Umeå, Sweden.
    Purpose: To investigate whether exposure to cold could influence the thermal perception thresholds in a working population.

    Methods: This cross-sectional study was comprised of 251 males and females and was carried out at two mines in the northern part of Norway and Sweden. The testing included a baseline questionnaire, a clinical examination and measurements of thermal perception thresholds, on both hands, the index (Digit 2) and little (Digit 5) fingers, for heat and cold. Read More

    Battlefield Trauma-Induced Hypothermia: Transitioning the Preferred Method of Casualty Rewarming.
    Wilderness Environ Med 2017 Jun 5;28(2S):S82-S89. Epub 2017 May 5.
    Department of Surgery, Center for Translational Injury Research, University of Texas Health Science Center, Houston, Texas (Holcomb).
    For centuries, cold and wet weather has affected military combat operations leading to tremendous loss of manpower caused by cold-weather-related injuries including trench foot, frostbite, and hypothermia. The initial battlefield management of hypothermia in military personnel had not advanced significantly following many wars and conflicts until 2006. The aim of this review is to: 1) provide an overview of trauma-induced hypothermia (TIH); 2) highlight the Department of Defense strategy for the implementation of a hypothermia clinical management program for battlefield (prehospital) casualties; 3) highlight the research and development of the Hypothermia Prevention and Management Kit (HPMK) as the preferred field rewarming system for battlefield TIH; and 4) emphasize how the HPMK can be easily transitioned to the civilian sector for active rewarming of both accidental and TIH patients. Read More

    Stress injuries and autophagy in mouse hippocampus after chronic cold exposure.
    Neural Regen Res 2017 Mar;12(3):440-446
    Institute of Neurobiology, College of Life Science, Henan University, Kaifeng, Henan Province, China.
    Cold exposure is an external stress factor that causes skin frostbite as well as a variety of diseases. Estrogen might participate in neuroprotection after cold exposure, but its precise mechanism remains unclear. In this study, mice were exposed to 10°C for 7 days and 0-4°C for 30 days to induce a model of chronic cold exposure. Read More

    A new treatment for frostbite sequelae; Botulinum toxin.
    Int J Circumpolar Health 2017 ;76(1):1273677
    e Department of Radiology , University Hospital North Norway, Tromsø , Norway.
    Frostbite sequelae are a relevant occupational injury outcome for soldiers in arctic environments. A Caucasian male soldier suffered frostbite to both hands during a military winter exercise. He developed sensory-motor disturbances and cold hypersensitivity. Read More

    Frostbite.
    Emerg Med Clin North Am 2017 May;35(2):281-299
    Department of Vascular Surgery, University Hospital Coventry and Warwickshire NHS Trust, Warwick Medical School and Coventry University, Coventry, UK.
    Deep frostbite is a thermal injury associated with significant morbidity. Historically, this has been associated with military personnel; however, increasingly it is becoming an injury that afflicts the civilian population. The use of intravenous iloprost or intra-arterial thrombolytics has led to promising tissue salvage. Read More

    Neurovascular hand symptoms in relation to cold exposure in northern Sweden: a population-based study.
    Int Arch Occup Environ Health 2017 Apr 11. Epub 2017 Apr 11.
    Department of Public Health and Clinical Medicine, Umeå University, 901 87, Umeå, Sweden.
    Purpose: To describe the self-reported ambient cold exposure in northern Sweden and to relate the level of cumulative cold exposure to the occurrence of sensory and vascular hand symptoms. We hypothesize that cold exposure is positively related to reporting such symptoms.

    Methods: A questionnaire about cold exposure and related symptoms was sent out to 35,144 subjects aged 18-70 years and living in northern Sweden. Read More

    Frostbite following cryolipolysis treatment in a beauty salon: a case study.
    J Wound Care 2017 Apr;26(4):188-190
    Specialty Registrar in Plastic Surgery, Department of Plastic Surgery, St John's Hospital, Edinburgh, Scotland, UK.
    This case study describes frostbite, a previously unreported complication following cryolipolysis, which resulted in substantial necrosis of the flank. Medical attention was not sought until one week after treatment. On examination, two distinct areas of significant frostbite in the left flank with surrounding erythema were revealed. Read More

    Cold Injuries.
    Hand Clin 2017 May;33(2):257-267
    The University of Chicago Medicine, 5841 South Maryland Avenue, MC 6035, Chicago, IL 60637, USA. Electronic address:
    New treatments of frostbite have led to unprecedented salvage of extremities including fingers and toes. Success is predicated on prompt institution of time-sensitive protocols initiated soon after rewarming, particularly the use of thombolytics. Unfortunately, in the urban setting, most patients are not candidates for these treatment modalities. Read More

    A 3D thermal model to analyze the temperature changes of digits during cold stress and predict the danger of frostbite in human fingers.
    J Therm Biol 2017 Apr 6;65:153-160. Epub 2017 Mar 6.
    Foolad Institute of Technology, Fooladshahr, Isfahan 84916-63763, Iran.
    The existing computational models of frostbite injury are limited to one and two dimensional schemes. In this study, a coupled thermo-fluid model is applied to simulate a finger exposed to cold weather. The spatial variability of finger-tip temperature is compared to experimental ones to validate the model. Read More

    Microangiography to Monitor Treatment Outcomes Following Severe Frostbite Injury to the Hands.
    J Burn Care Res 2017 Mar 15. Epub 2017 Mar 15.
    From the Hennepin County Medical Center, Minneapolis, Minnesota.
    Frostbite injury causes direct damage to tissues following exposure to temperatures below their freezing point causing tissue death potentially leading to serious amputations. After rewarming, a variety of treatment options have been employed to avoid amputation. This case report details the use of indocyanine green fluorescence microangiography to monitor the clinical progression of perfusion following hyperbaric oxygen therapy (HBOT) for severe frostbite injury. Read More

    Sport Injuries of the Ear and Temporal Bone.
    Clin Sports Med 2017 Apr;36(2):315-335
    Department of Otorhinolaryngology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA. Electronic address:
    In cases of head trauma, the ear should be evaluated in all of its components. A good understanding of otologic and skull base anatomy enables a thorough trauma assessment of this complex anatomic region. Auricular laceration, abrasion, avulsion, hematoma, frostbite, otitis externa, exostosis, tympanic membrane perforation, ossicular discontinuity, perilymphatic fistula, labyrinthine concussion, temporal bone fracture, facial nerve paresis, and sensorineural hearing loss are a few of the more common otologic injuries seen in active patients. Read More

    The Use of Thrombolytic Therapy in the Treatment of Frostbite Injury.
    J Burn Care Res 2017 Sep/Oct;38(5):e877-e881
    From the Department of Pharmacy, Loyola University Medical Center, Maywood, Illinois.
    Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. Read More

    Use and Effectiveness of Ethyl Chloride for Hand Injections.
    J Hand Surg Am 2017 Mar;42(3):175-181.e1
    Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH.
    Purpose: Limited literature supports using ethyl chloride topical spray as an anesthetic for hand injections whereas documented risks include frostbite, skin irritation, and inhalation toxicity. We hypothesize that ethyl chloride spray imparts no benefit to patients' perception of pain or anxiety for routine hand injections.

    Methods: We first surveyed all members of the American Society for Surgery of the Hand to discern the prevalence of ethyl chloride use during routine injections. Read More

    High Altitude Dermatology.
    Indian J Dermatol 2017 Jan-Feb;62(1):59-65
    Department of Dermatology, Military Hospital, Ahmedabad, Gujarat, India.
    Approximately, 140 million people worldwide live permanently at high altitudes (HAs) and approximately another 40 million people travel to HA area (HAA) every year for reasons of occupation, sports or recreation. In India, whole of Ladakh region, part of Northwest Kashmir, Northern part of Sikkim and Tenga valley of Arunachal are considered inhabited areas of HAA. The low quantity of oxygen, high exposure of ultraviolet (UV) light, very low humidity, extreme subzero temperature in winter, high wind velocity, make this region difficult for lowlanders as well as for tourists. Read More

    Burns and frostbite in the Red Army during World War II.
    Mil Med Res 2017 8;4. Epub 2017 Feb 8.
    Department of Thermal Injuries of the S.M. Kirov Military Medical Academy, Major of Medical Service, Zagorodnyy Prospect, 47, 190013 Saint-Petersburg, Russia.
    The start of World War II (WWII) led to the deployment of combat troops in several continents. Destruction and many casualties among both the military and civilians became an inevitable consequence. A large amount of people injured were in need of life-saving treatment and a speedy return to duty. Read More

    Assessing the effectiveness of topical betamethasone to treat chronic chilblains: a randomised clinical trial in primary care.
    Br J Gen Pract 2017 Mar 13;67(656):e187-e193. Epub 2017 Feb 13.
    Department of Primary and Community Care, Gender and Women's Health; Radboud University Medical Centre, Nijmegen, the Netherlands.
    Background: GPs prescribe topical corticosteroids to patients with chronic chilblains despite poor evidence for their effectiveness. The authors of the current study therefore decided to assess the effectiveness of topical steroids in a primary care setting.

    Aim: To assess the effectiveness of topical application of betamethasone valerate 0. Read More

    The use of intravenous tPA for the treatment of severe frostbite.
    Burns 2017 Aug 31;43(5):1088-1096. Epub 2017 Jan 31.
    Department of Surgery, Division of Critical Care, Trauma and Burn, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH 43210, USA. Electronic address:
    Objective: tPA and anticoagulation for treatment of severe frostbite have been reported suggesting differences in imaging techniques, route of tPA administration and management of patients after tPA infusion. This is a report of our results following a protocol of Tc-99m scanning, intravenous tPA administration, followed by either systemic anticoagulation or antiplatelet therapy.

    Methods: Patients admitted to our burn center between February 13, 2015 and February 13, 2016 for frostbite who met inclusion criteria were treated with Tc-99m scan and intravenous tPA followed by systemic anticoagulation or antiplatelet therapy. Read More

    The effectiveness of regional cooling for paclitaxel-induced peripheral neuropathy.
    J Pharm Health Care Sci 2016 15;2:33. Epub 2016 Nov 15.
    Department of Pharmacy, Iwate Medical University Hospital, 19-1 Uchimaru, Morioka, Iwate, 020-8505 Japan ; Department of Clinical Pharmaceutics, School of Pharmacy, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694 Japan.
    Background: There are currently no promising therapies available to treat or prevent peripheral neuropathy (PN) induced by anticancer drugs in a cumulative dose-dependent manner. In this study, we investigated the efficacy of regional cooling of hands and feet in preventing paclitaxel (PTX)-induced PN.

    Methods: Patients with gynecologic cancer who received a tri-weekly cycle of chemotherapy including PTX at doses of 150-175 mg/m2 were included in this study. Read More

    Dull Brains and Frozen Feet: A Historical Essay on Cold.
    Wilderness Environ Med 2016 Dec 3;27(4):526-532. Epub 2016 Nov 3.
    Endocrinology and Nuclear Thyroidology, Richmond, VA. Electronic address:
    This essay will review historical and medical aspects of cold exposure, hypothermia, and frostbite during the Napoleonic era. The 19th century writings of Dominique Jean Larrey, Pierre Jean Moricheau-Beaupré, and others are used to provide an evocative supporting narrative to illustrate some of the cold illnesses, physiology, and theory of both an earlier era and the present time. Medical care for over a century followed the how but not the why of treating frostbite and hypothermia slowly with snow or cold water rather than heat. Read More

    Effect of sodium nitrite on local control of contracting skeletal muscle microvascular oxygen pressure in healthy rats.
    J Appl Physiol (1985) 2017 Jan 27;122(1):153-160. Epub 2016 Oct 27.
    Department of Kinesiology, Kansas State University, Manhattan, Kansas; and
    Exercise intolerance characteristic of diseases such as chronic heart failure (CHF) and diabetes is associated with reduced nitric oxide (NO) bioavailability from nitric oxide synthase (NOS), resulting in an impaired microvascular O2 driving pressure (Po2mv; O2 delivery/O2 utilization) and metabolic control. Infusions of the potent NO donor sodium nitroprusside augment NO bioavailability yet decrease mean arterial pressure (MAP) thereby reducing its potential efficacy for patient populations. To eliminate or reduce hypotensive sequelae, [Formula: see text] was superfused onto the spinotrapezius muscle. Read More

    Update: Cold weather injuries, active and reserve components, U.S. Armed Forces, July 2011-June 2016.
    MSMR 2016 Oct;23(10):12-20
    From July 2015 through June 2016, a total of 447 members of the active (n=383) and reserve (n=64) components had at least one medical encounter with a primary diagnosis of cold injury. The numbers of affected individuals in both components were the lowest since the 2011-2012 cold season, when the total was 394. In the active component, the service-specific incidence rates for each of the four services were lower than the respective rates for the previous (2014-2015) cold season. Read More

    Effects of low-frequency pulsed electromagnetic fields on plateau frostbite healing in rats.
    Wound Repair Regen 2016 Nov 12;24(6):1015-1022. Epub 2016 Oct 12.
    The Department of Ultrasound, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China.
    Plateau frostbite (PF) treatments have remained a clinical challenge because this condition injures tissues in deep layers and affected tissues exhibit unique pathological characteristics. For instance, low-frequency pulsed electromagnetic field (PEMF) can affect tissue restoration and penetrate tissues. Therefore, the effect of PEMF on PF healing should be investigated. Read More

    A retrospective cohort study examining treatments and operative interventions for frostbite in a tertiary care hospital.
    CJEM 2017 Mar 22;19(2):88-95. Epub 2016 Sep 22.
    *University of Ottawa, Faculty of Medicine,Ottawa Hospital Research Institute,Ottawa,ON.
    Background: Frostbite is a common yet challenging injury to both diagnose and treat. McCauley's frostbite treatment protocol consists of 12 treatments that might well represent the standard of care. However, its effectiveness in preventing operative intervention has yet to be examined. Read More

    Nifedipine vs Placebo for Treatment of Chronic Chilblains: A Randomized Controlled Trial.
    Ann Fam Med 2016 Sep;14(5):453-9
    Department of Primary and Community Care, Unit Gender and Women's Health, Radboud University Medical Center, Nijmegen, The Netherlands.
    Purpose: Nifedipine is commonly prescribed for the treatment of chilblains (pernio, perniosis) on the basis of observational studies and a single small, older clinical trial. We aimed to confirm the proposed superiority of oral nifedipine 60 mg per day over placebo for treatment of chronic chilblains in primary care.

    Methods: We performed a randomized, placebo-controlled, double-blind, crossover trial, closely following the design of the older trial. Read More

    Initial Experience: Alleviation of Pain with Percutaneous CT-Guided Cryoablation for Recurrent Retroperitoneal Soft-Tissue Sarcoma.
    J Vasc Interv Radiol 2016 Dec 9;27(12):1798-1805. Epub 2016 Sep 9.
    Departments of Interventional Oncology Guangzhou, China. Electronic address:
    Purpose: To evaluate the pain-alleviating effect of computed tomography (CT)-guided percutaneous cryoablation for recurrent retroperitoneal soft-tissue sarcomas (RPSs).

    Materials And Methods: Data from 19 men and 20 women (median age, 50.3 y) with recurrent malignant RPS who underwent percutaneous cryoablation were reviewed retrospectively. Read More

    Severe Pulmonary Fibrosis as the First Manifestation of Interferonopathy (TMEM173 Mutation).
    Chest 2016 Sep;150(3):e65-71
    Pediatric Pulmonology Department, Hôpital Femme-Mère-Enfant, Hospices civils de Lyon, UMR5558, Lyon, France. Electronic address:
    We report three cases of pulmonary disease suggesting fibrosis in two familial and one sporadic case. Pulmonary symptoms were associated with various clinical features of systemic inflammation and vasculitis involving the skin, and appeared at different ages. A strong interferon signature was found in all three cases. Read More

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