Background & Aim: The aim of this study was to compare hypothermia patients with and without an Osborn wave (OW) in terms of physical examination findings, laboratory results, and clinical survival.
Methods: The study was carried out retrospectively on hypothermic patients. The hypothermic patients were divided into two groups. Group 1 comprised patients with OW on electrocardiogram (ECG), and Group 2 comprised patients without OW on ECG. The Mann-Whitney U test was used to compare the two groups, and the relationships between the variables and the presence of OW and mortality were analyzed with ANOVA. A value of p < 0.05 was considered statistically significant.
Results: OW was detected on ECG of 41.9% of the patients (Group 1). The mean body temperature was 30.8 ± 4.1 °C in Group 1 and 33.3 ± 1.6 °C in Group 2 (p = 0.106). The mean creatinine level was 1.01 ± 0.6 mg/dl in Group 1 and 0.73 ± 0.5 mg/dl in Group 2 (p = 0.046). The mean bicarbonate level was 15.9 ± 3.8 mmol/l in Group 1 and 18.6 ± 3.5 mmol/l in Group 2 (p = 0.038). A relationship was determined between the presence of OW and pH, bicarbonate, and creatinine levels (p = 0.026; 0.013; 0.042, respectively). The mortality rate was 69.2% in Group 1 and 77.8% in Group 2 (p = 0.689).
Conclusion: Although there is a relationship between the decrease in bicarbonate levels, changes in kidney functions that cause acidosis, and the presence of OW, it has no effect on mortality. The presence of OW in hypothermic patients is insufficient to make a decision regarding mortality.
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http://dx.doi.org/10.1016/j.ajem.2018.08.049 | DOI Listing |
JAMA Psychiatry
November 2024
Department of Psychiatry, Washington University in St Louis, St Louis, Missouri.
Importance: Adolescent cannabis use has been consistently posited to contribute to the onset and progression of psychosis. However, alternative causal models may account for observed associations between cannabis use and psychosis risk, including shared vulnerability for both cannabis use and psychosis or efforts to self-medicate distress from psychosis spectrum symptomology.
Objective: To test 3 hypotheses that may explain cannabis-psychosis risk associations by modeling psychosis spectrum symptom trajectories prior to and after cannabis initiation across adolescent development (approximately 10-15 years of age).
Am J Med
December 2024
Department of Cardiology, Buda Hospital of the Hospitaller Order of St. John of God, Budapest, Hungary. Electronic address:
Emerg Med Clin North Am
August 2024
Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA. Electronic address:
Although a rare diagnosis in the Emergency Department, hypothermia affects patients in all environments, from urban to mountainous settings. Classic signs of death cannot be interpreted in the hypothermic patient, thus resulting in the mantra, "No one is dead until they're warm and dead." This comprehensive review of environmental hypothermia covers the clinical significance and pathophysiology of hypothermia, pearls and pitfalls in the prehospital management of hypothermia (including temperature measurement techniques and advanced cardiac life support deviations), necessary Emergency Department diagnostics, available rewarming modalities including extracorporeal life support, and criteria for termination of resuscitation.
View Article and Find Full Text PDFCureus
May 2024
Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Ehime, JPN.
The 12-lead electrocardiographic findings in hypothermia include the presence of J waves; prolongation of the PR, QRS, and QT intervals; and atrial and ventricular dysrhythmias. Among these findings, the J wave, known as the Osborn wave, is considered pathognomonic. In 1953, the J wave was reported as a specific response to hypothermia in dogs, representing the current at the site of injury instead of a widening of the QRS complex that occurs caused by a conduction delay.
View Article and Find Full Text PDFJ Ultrasound
December 2024
Graduate School of Health Sciences, Morinomiya University of Medical Sciences, 1-26-16 Nankoukita Suminoe Ward, Osaka, Osaka Prefecture, 559-8611, Japan.
Background: Identification of the relationship between valgus stress in the medial elbow and ulnar nerve strain during maximum external rotation of the shoulder is pivotal for the prevention and management of ulnar neuropathies. In this observational cross-sectional study, we aimed to determine the changes in ulnar nerve stiffness under valgus stress at different nerve entrapment sites.
Methods: Twenty healthy baseball players participated in the study.
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