BPLS C1

 DWM Going on a vegan diet accelerates weight loss and reduces harmful belly fat, new research suggests.

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"The beginning is the most important part of the work."

-- Plato

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Heather Calluna vulgaris 'Dark Beauty' Dark Green Foliage Cerise/Ruby Red Flowers

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 3 SHOCKS TILL 30C  

ADR GIVEN 8 MINLY TILL 30C

Resuscitation drugs

Drugs are often ineffective and will undergo reduced metabolism; so these are withheld below 30 C then given with twice the time interval between doses until either normothermia is approached (35 C) or circulation restored. So, adrenaline would be given about every 8-10 minutes once the core temperature is above 30 C.

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TULIPS

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Hypothermia is defined as a core temperature below 35 C,

 with mild hypothermia classified as 32-35 C, 

moderate 30-32 C 

and severe disease below 30 C

Correlation of Core Temperature and Physiological Changes
Grade	C		Physiological Changes
Mild	35		Maximum shivering, impaired judgment, confusion
	34		Tachycardia, tachypnoea, increased SVR, cold diuresis
	33		Bradycardia, respiratory depression, hyperglycaemia, dysarthria, ataxia
Moderate	32		Stupor, lethargy, arrest of shivering thermogenesis
	31		Atrial arrhythmia, Osborn J-waves on ECG, worsening bradycardia
	30		Insulin ineffective, decreased oxygen consumption
	29		Progressive decreased level of consciousness, pulse, respiratory rate
Severe	28		Increased susceptibility for ventricular fibrillation, pulse rate and oxygen consumption decreased by 50%
	27		Loss of reflexes and voluntary movement, hypoglycaemia
	26		Acid-base disturbances, no response to pain
	25		Cerebral blood flow decreased by 2/3, pulmonary oedema, apnoea
	24		Hypotension
	23		Corneal and oculocephalic reflexes absent
	22		Maximum risk for ventricular fibrillation, oxygen consumption 25% of normal
Profound	20		Lowest resumption of cardiac activity, pulse 20% of normal
	19		Asystole

Note that malignant arrhythmias are unlikely to be hypothermia-induced at temperatures above 32 C 

Youre not dead until youre warm and dead.

The lowest recorded neurologically intact survival following hypothermic cardiac arrest (in this case associated with immersion) is 13.7 C

Resuscitation drugs

Drugs are often ineffective and will undergo reduced metabolism; so these are withheld below 30 C then given with twice the time interval between doses until either normothermia is approached (35 C) or circulation restored. So, adrenaline would be given about every 8-10 minutes once the core temperature is above 30 C.

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BG 18.69: No human being does more loving service to me than they; nor shall there ever be anyone on this earth more dear to me.

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It is a wholesome and necessary thing for us to turn again to the earth, and in the contemplation of her beauties to know of wonder and humility. ~ Rachel Carson 

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Hypomimia in Parkinson's Disease

European Journal of Neurology

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TAKE-HOME MESSAGE

• The authors studied 89 patients with Parkinson's disease to assess clinical correlates of hypomimia (decreased facial expression) and its responsiveness to levodopa. They observed that those with hypomimia had worse MDS-UPDRS, Part III, “off-medication” scores and worse apathy; they also found that hypomimia improved with levodopa therapy. Its improvement mirrored the change effected by levodopa on axial motor symptoms.

• This is an interesting study of a specific symptom in Parkinson's disease. The study findings may be clinically useful in patient assessment.

– Omar Iqbal Khan, MD

Abstract

This abstract is available on the publisher's site.

Access this abstract now 

BACKGROUND AND PURPOSE

Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.

METHODS

We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.

RESULTS

Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.

CONCLUSION

Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

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Hypomimia in Parkinson's Disease

European Journal of Neurology

 Save Recommend

 Share 

 Get Topic Alerts

TAKE-HOME MESSAGE

• The authors studied 89 patients with Parkinson's disease to assess clinical correlates of hypomimia (decreased facial expression) and its responsiveness to levodopa. They observed that those with hypomimia had worse MDS-UPDRS, Part III, “off-medication” scores and worse apathy; they also found that hypomimia improved with levodopa therapy. Its improvement mirrored the change effected by levodopa on axial motor symptoms.

• This is an interesting study of a specific symptom in Parkinson's disease. The study findings may be clinically useful in patient assessment.

– Omar Iqbal Khan, MD

Abstract

This abstract is available on the publisher's site.

Access this abstract now 

BACKGROUND AND PURPOSE

Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.

METHODS

We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.

RESULTS

Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.

CONCLUSION

Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.

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Karr  Some people are always grumbling because roses have thorns; I am thankful that thorns have roses."

////////////////////////////////////BK Maintaining a state of inner calmness protects me from becoming a slave to my emotions. It also helps me to keep a cool head when I see others becoming heated or angry.

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Before acting, one should reflect, “Is this for the benefit of myself and others?” In the middle of an action, one should reflect, “Is what I am doing for the benefit of myself
and others?” And after any action, “Is what I just did for the benefit of myself and others?”

—Sylvia Boorstein, “Dear Abbey Dharma Fall 2011”

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