Showing papers in "Irish Journal of Medical Science in 1996"
TL;DR: The results suggest that hypertensive patients may have increased lipid peroxidation and reduced protection from vitamins C and E and contribute to the propensity in such patients to develop atherosclerosis.
Abstract: Lipid peroxidation is a free radical process which is implicated in the formation of atherosclerosis. Vitamins C and E are important natural antioxidants which inhibit lipid peroxidation and a high intake of these vitamins, particularly vitamin E, is related to a reduced incidence of ischaemic heart disease. Hypertension is an independent risk factor for atherosclerosis and its relationship to antioxidant status is undetermined. In this study, we investigated free radical activity by measuring plasma malondialdehyde (MDA) using high-performance liquid chromatography (HPLC), vitamin C status measured as plasma ascorbic acid and vitamin E status measured as plasma lipid standardized α-tocopherol and erythrocyte α-tocopherol. We compared 28 patients with essential hypertension to 31 healthy subjects. Results showed that in comparison with the healthy subjects, the hypertensive patients had significantly higher plasma MDA levels (0.95 α 0.28 vs 0.69 α 0.21 μmol/l, mean μ SD, p<0.001) and significantly lower levels of plasma ascorbic acid (34.83 μ 12.88 vs 51.76 μ 13.34 μmol/L, p<0.01). In addition, erythrocyte α-tocopherol concentration, which may reflect vitamin E protection in cell membranes, was significantly lower in hypertensive patients when compared with the normotensive controls (3.87 α0.53 vs 4.82 α 1.01 μmol/l, p<0.001), although plasma α-tocopherol levels were similar in the two groups (25.07 α 10.45 vs 23.96 α 6.07 μlmol/1). Our results suggest that hypertensive patients may have increased lipid peroxidation and reduced protection from vitamins C and E. This may contribute to the propensity in such patients to develop atherosclerosis.
60 citations
TL;DR: Management of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion, is conservative when possible, with surgery indicated only for complications.
Abstract: Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.
57 citations
TL;DR: The results suggest that ESWT causes new bone formation locally, however such exuberant callus formation does not equate with accelerated fracture healing and in fact implies a delay in the remodelling process.
Abstract: We studied the effects of extracorporeal shock wave therapy (ESWT) on the healing potential of osteotomies in rabbit radii. The results of sequential low dose shock wave therapy were compared prospectively with natural healing in the radii of New Zealand white rabbits. Our results suggest that ESWT causes new bone formation locally. However such exuberant callus formation does not equate with accelerated fracture healing and in fact implies a delay in the remodelling process.
36 citations
TL;DR: All trauma deaths need peer review rather than solely relying upon ASCOT and TRISS probabilities to identify “unexpected” deaths for detailed review, as poor communication within the Area Trauma System was the greatest contributor to avoidable deaths.
Abstract: Survival and mortality outcomes for trauma patients admitted to Liverpool Hospital, Sydney were analysed to determine the adequacy of trauma care. TRISS and ASCOT survival probabilities and peer review were utilised to determine if deaths were avoidable. Evaluation methods were compared for assessment of care. During the study period 2205 trauma patients were admitted, 518 of which fulfilled the study entry criteria. There were 38 deaths. The age and Injury Severity Score (ISS) of survivors was 34 ±18 years, 9.8 ±9 (mean±sd) compared to age and ISS for nonsurvivors 37 ± 22 years and 45 ± 22*, *p 0.5 in 16 and 18 patients respectively. TRISS and ASCOT had low positive predictive value (25%) in identifying avoidable deaths. The Z Score was 1.79. The standardised mortality ratio (SMR) was 1.16. The Effectiveness (E) value for outcome was 0.91. Poor communication within the Area Trauma System was the greatest contributor to avoidable deaths. All trauma deaths need peer review rather than solely relying upon ASCOT and TRISS probabilities to identify “unexpected” deaths for detailed review.
35 citations
TL;DR: In 34.83% of the injuries foul play was given as the major cause, followed by “Lack of fitness”, “Poor kit or boots” and “Previous injury” (all 11.24%).
Abstract: School football injuries were studied over the seven months of one season on 150 males aged 16.94±0.82 years. Training averaged 4.13±1.47 hours per week and matches 1.84±0.60 hours per week. Mean time injured was: 0.51±1.7 days in hospital, 34.27±37.08 days off sport and 13.98±5.22 days of restricted activity. There were 136 match and 63 training injuries giving 175.98 injuries per 10000 hours of matches and 31.06 injuries per 10000 hours of training. Injuries were treated as follows: hospital 83, general practitioners 51, physiotherapists 28, no treatment 38. The most common injuries were: ankle sprain (11.6% of the total), hamstring strain (6.5%), contusion (6.5%) back strain (6%) knee sprain (5.0%), finger sprain (5.0%), other muscle strains (5.0%), fracture of the wrist (5.0%), dislocation of the finger (4.5%), overuse injury of the back (4.0%), tenosynovitis (3.5%), fracture of the ankle (3.0%). Thirteen injuries were to goal-keepers, 85 to backs, 31 to mid-field players and 70 to forwards. In 34.83% of the injuries foul play was given as the major cause. This was followed by “Lack of fitness”, “Poor kit or boots” and “Previous injury” (all 11.24%). The most common minor cause was “Poor state of the pitch” (17.42% of injuries).
30 citations
TL;DR: The results of the study suggests that injury prevention programmes should be targeted to a wider range of sports, to females as well as to males, and that rehabilitation programmes need to be improved.
Abstract: A literature review suggested that both acute and overuse injuries were common in body contact sports. This hypothesis was tested on a group of 266 Irish adolescents in an investigation that examined the incidence of injury amongst these individuals over a twelve month period. The mean age of the subjects was:- males 14.3 ± 0.85 years and females 14.1 ± 0.90 years. The responses of the subjects to a questionnaire on their sporting involvement, training and sports injuries were analysed. A total of 230 injuries were incurred by the subjects during the twelve month period: 181 of these were to males. However, the number of injuries per hour of participation was similar in the two sexes. Subjects involved in body contact sports incurred the highest number of overuse injuries. The injury rate per 10,000 hours of participation was highest in badminton (70.85 injuries per 10,000 hours), gymnastics (68.18), rugby (59.77) and basketball (56.22). The rate of overuse injuries was high in swimming, badminton and athletics. The most common injuries were ankle sprain and overuse injuries of the knee and thigh. Recurrence of old injuries was found to be common. The results of the study suggests that injury prevention programmes should be targeted to a wider range of sports, to females as well as to males, and that rehabilitation programmes need to be improved.
30 citations
TL;DR: A prospective, randomised, controlled trial to determine for ourselves whether PR is a safe and acceptable procedure and feels that narrowing the selection criteria for PR may further improve the success rate.
Abstract: Pneumatic retinopexy (PR) is a technique for repairing certain retinal detachments which is easier to perform than conventional sceral buckling (SB) surgery but has comparable results. We performed a prospective, randomised, controlled trial to determine for ourselves whether PR is a safe and acceptable procedure. Twenty patients presenting consecutively with retinal detachments which fulfilled the selection criteria were randomised to have their detachments repaired by either PR or SB, ten patients in each group. The suitable patients had a single retinal break or small group of breaks of not greater than one clock hour in size, situated within the superior eight clock hours of retina. Patients with significant proliferative vitreoretinopathy or other fundus disorders were excluded. All patients in the PR group had local anaesthesia while all those in the SB group had general anaesthesia. Successful reattachment of the retina was achieved with one or more procedures in 90 percent of the PR group and in 100 percent of the SB group. We feel that narrowing the selection criteria for PR may further improve the success rate.
23 citations
TL;DR: A retrospective review of 55 consecutive patients referred with suspected thoracic aortic dissection to a medical cardiology department was performed, finding contrast aortography was equally sensitive and more specific than computed tomography for detection of dissection.
Abstract: Spontaneous thoracic aortic dissection carries a high mortality despite progress in diagnosis and treatment. Early and accurate diagnosis is paramount and dependent on clinical and diagnostic imaging skills. A retrospective review of 55 consecutive patients referred with suspected thoracic aortic dissection to a medical cardiology department was performed. Clinical follow up was complete to November 1995. Median age was 68 years (range 30–93), with 37 males, 18 females. Presenting complaints included interscapular chest pain in 23 (42 per cent), neurological deficit in 2 (4 per cent), and limb ischaemia in 8 (15 per cent). On examination 34 (62 per cent) patients had hypertension, 5 (9 per cent) a pulse deficit and 10 (18 per cent) aortic incompetence. Electrocardiography confirmed myocardial infarction in 1. Chest X-ray showed a widened mediastinum in 37 (67 per cent) patients. Dissection was confirmed in 35 (64 per cent) patients (13-DeBakey Type 1, 6-Type II, 14-Type III); 10 had nondissecting aneurysm. Contrast aortography was equally sensitive (84 per cent) and more specific (100 per cent vs 80 per cent) than computed tomography for detection of dissection. Surgical repair was performed on 24 patients with concomitant coronary artery bypass grafting in 6. At follow up 33 patients were alive. Clinical diagnosis of thoracic aortic dissection or aneurysm may be difficult. Frequently more than one imaging modality may be required in order to provide all of the necessary information for optimal patient management.
20 citations
TL;DR: Several lines of evidence implicateHelicobacter pylori infection in gastroduodenal inflammation, suggesting that specific T-cell responses may be down-regulated by an enhanced TH2 reaction, which may be involved in the immunopathogenesis of chronicH.
Abstract: Several lines of evidence implicateHelicobacter pylori (H. pylori) infection in gastroduodenal inflammation. However, the exact pathogenesis ofH. pylori infection is not fully understood. T-helper (TH) lymphocytes may be subdivided into TH1 and TH2 cells based on the distinct patterns of cytokine production. TH1 reaction is associated with immunity or resistance to infection, while TH2 reaction is associated with the progression or persistence of infection. The production of interferon-γ (INF-γ) and interleukin 2 (IL-2), which are type 1 cytokines, is decreased inH. pylori infection. Enhanced production of type 2 cytokines (IL-4) and (IL-6) is observed in individuals withH. pylori infection. Suppressed proliferative responses of peripheral blood and gastric lymphocytes have also been demonstrated in patients withH. pylori colonisation, suggesting that specific T-cell responses may be down-regulated by an enhanced TH2 reaction. Suppressed TH1 and enhanced TH2 responses inH. pylori infection may be involved in the immunopathogenesis of chronicH. pylori infection.
20 citations
TL;DR: The sensitivity of the methicillin resistant strains to the other antibiotics tested was generally low except for fusidic acid and mupirocin, both of which retain good activity against methiillin resistantS.
Abstract: The sensitivity ofStaphylococcus aureus (S aureus) to methicillin, penicillin, gentamicin, erythromycin, ciprofloxacin, fusidic acid and mupirocin was tested in 1152 clinical isolates from nine hospital microbiology departments In all cases standard methods for culture and sensitivity were employed using either the Stokes’ or a modified Stokes’ method for susceptibility testing The isolates were recovered from 1150 patients (606 men, 544 women; mean age: 41 years) and only those deemed relevant to the patient’s clinical condition were included Of the total 1152 isolates, 454 were regarded as hospital acquired, 506 were community acquired and the source of the remaining 192 isolates was unknown The overall percentages ofS aureus sensitive to the tested antibiotics were as follows: methicillin 85%, penicillin 8%, gentamicin 89%, ciprofloxacin 85%, erythromycin 80%, fusidic acid 96%, mupirocin 98% The sensitivity of the methicillin resistant strains to the other antibiotics tested was generally low except for fusidic acid and mupirocin, both of which retain good activity against methicillin resistantS aureus (MRSA) Participating investigators
19 citations
TL;DR: HRCT in CF patients correlates well with pulmonary function at time of scanning and at follow-up, and with clinical progress, suggesting there may be a role for CT in the identification of adolescent/adult patients who can be expected to need aggressive therapy in the future.
Abstract: Objective: To assess the correlation between HRCT and pulmonary function in patients with CF. Further, to assess the prognostic value of HRCT in these patients.
TL;DR: One stage re-implantation can result in a good clinical outcome and eradication of infection, while Resection arthroplasty is a necessary option in a minority of patients, however, while successful in eradicating infection may result inA poor functional outcome.
Abstract: Nineteen patients underwent one stage surgical management of infected hip prostheses over a five year period. Thirteen were male and six were female. The mean age was 64 years (Range 49–82). The mean time interval between primary and revision surgery was 26 months (Range 6 months-16 years). One stage re-implantation was performed in 15 patients and excision arthroplasty in 4 patients. The mean duration of follow up was 4 years, 5 months (Range 2—7 years). Patients were assessed, radiologically and clinically using the Harris hip score.
TL;DR: It is concluded that Ramstedt’s pyloromyotomy for infantile hypertrophic pyloric stenosis can be performed with acceptable morbidity and minimal mortality in a general surgical unit.
Abstract: This article describes a 22 year experience of a general surgical unit in the treatment of infantile hypertrophic pyloric stenosis (I HPS). The hospital course of 229 IHPS patients is reviewed. The male:female ratio was 3.6:1, median age 6 weeks (range 2-26 weeks) with a positive family history in 8.3%. The diagnosis of IHPS was established clinically by palpation of a “pyloric tumour” during a pre operative test meal/clinical examination in 92.6%; in the remainder, the diagnosis was made radiologically.
TL;DR: It is most likely that leuprorelin acetate is responsible for the emergence of pseudotumor cerebri, and because of the risk of permanent loss of eyesight, it is strongly advised to verify eye parameters conscientiously during leuprarelin treatment.
Abstract: Leuprorelin acetate is a synthetic nona-peptide analogue of the naturally occurring gonadotrophin releasing hormone LH-RH (hypothalamus), used in the treatment of sterility, endometriosis or prostatic cancer. In a 35 year old woman, treated with leuprorelin acetate, after 5 months treatment, the side-effects (hot flushes, sweating, sleeping disorders), appeared to be rather unbearable. Medication was ended. The endocrine reversion to the normal physiological balance was association with high fever (38.9 degrees C) during an 8 day period. Increasing scotomas resulted in a gradual loss of eyesight in one eye, associated with a normal visual acuity. Unilateral papilloedema was observed, indicating the possibility of tumor cerebri. Fluorescein angiography demonstrated an intense leakage of the right optic disc. No signs of retinal vascular malformations were seen. The eye pressure was normal. No signs of hemorrhages were observed. Visual field examination showed an enlarged blind spot with a few scotomas above the centre of fixation. CT scan of the brain was normal, the cerebrospinal fluid (CSF) was normal, indicated by IgG production. Six months after ending the leuprorelin acetate treatment, the eyesight was spontaneously 100% recovered. It is most likely that leuprorelin acetate is responsible for the emergence of pseudotumor cerebri. As described by Prof. Sidi et al(1), leuprorelin strongly induces increased liquor pressure, being the intermediate mechanism between hormonal treatment and an ante grade mechanical force, on the optic nervus. Because of the risk of permanent loss of eyesight, it is strongly advised to verify eye parameters conscientiously during leuprorelin treatment.
TL;DR: A case of colovesical fistula caused by chronic perforation of sigmoid colon diverticulum due to a swallowed chicken bone appears to be the fifth case of its kind ever reported in the literature.
Abstract: We report a case of colovesical fistula caused by chronic perforation of sigmoid colon diverticulum due to a swallowed chicken bone. This appears to be the fifth case of its kind ever reported in the literature.
TL;DR: An assessment of possible roles of taurine in the aetiology of psoriasis is discussed and increasing evidence proposing possible roles for taurines in maintaining normal neutrophil function coupled with previously observed anti-inflammatory effects of t aurinein vitro is proposed.
Abstract: Neutrophil taurine was measured in 30 subjects presenting with chronic stable plaque-type psoriasis. The taurine concentration expressed per 5 x 10(6) cells was significantly lower (p < 0.002) in these subjects compared to neutrophil taurine measured in 20 control subjects. In view of increasing evidence proposing possible roles for taurine in maintaining normal neutrophil function coupled with previously observed anti-inflammatory effects of taurine in vitro, an assessment of possible roles of taurine in the aetiology of psoriasis is discussed.
Journal Article•
TL;DR: The discovery of H. pylori is the most important development in gastroduodenal disease this century and it has completely changed our understanding of conditions that occur in the upper gastrointestinal tract.
Abstract: The discovery of H. pylori is the most important development in gastroduodenal disease this century. It has completely changed our understanding of conditions that occur in the upper gastrointestinal tract. Eradication of the bacterium will cure peptic ulcer disease, decrease the symptoms of non-ulcer dyspepsia and may prevent gastric cancer. There has been an exponential increase in the amount of research in this area in recent years and, consequently, there is considerable confusion as to how H. pylori-related conditions should be managed. It is hoped that these guidelines will clarify some of these issues.
TL;DR: NymphalIxodes ricinus, the tick vector of Lyme borreliosis, were collected from the edges of paths in Muckross Demesne, Killarney National Park, Co.
Abstract: NymphalIxodes ricinus, the tick vector of Lyme borreliosis, were collected from the edges of paths in Muckross Demesne, Killarney National Park, Co. Kerry, Ireland. Examination of some of these nymphs by indirect immunofluorescence showed an infection prevalence of 12% withBorrelia burgdorferi sensu Iato, the spirochaete agent of Lyme borreliosis. Gerbils (Meriones unguiculatus) were infected by infesting them with other nymphs from the same batch. Subsequently uninfected laboratory larvae were applied to the gerbils and the contents of the resulting infected engorged ticks were then placed in media and the spirochaetes cultured. The spirochaetes were identified asB. burgdorferi sensu Iato by indirect immunofluorescence using monoclonal antibodies and they were further characterised by polymerase chain reaction and pulsed-field gel electrophoresis. Both of these latter techniques showed that spirochaetes in all samples belonged to the genomic species,Borrelia garinii.
TL;DR: There is an overall reluctance, particularly within the male population to accept suppository analgesia, and patients from higher socio-economic groups may be more willing to accept what they perceive to be less traditional forms of treatment.
Abstract: Four hundred surgical patients were questioned preoperatively to ascertain their attitudes to suppository analgesia. Given a choice, 82 per cent of patients expressed a preference for intramuscular administration of diclofenac, with 18 per cent choosing a suppository. Males were more likely than females to choose an intramuscular injection. Males choosing a suppository were more likely to belong to a higher socio-economic group while females choosing a suppository were more likely to be married. Twenty-three per cent of patients who initially opted for intramuscular administration changed to suppository administration when the possibility of pain or discomfort at the injection site was explained. Females who changed to suppository administration were more likely to belong to a higher socio-economic group and to be married. Twenty-seven per cent of patients choosing an intramuscular injection expressed concern if a suppository were to be inserted without consent. Eleven per cent of patients choosing a suppository expressed similar concern. There is an overall reluctance, particularly within the male population to accept suppository analgesia. Patients from higher socio-economic groups may be more willing to accept what they perceive to be less traditional forms of treatment.
TL;DR: This series represents an initial experience and illustrates that ankle arthroscopy provides a safe and effective method of diagnosis and treatment with few complications and further advances in instrumentation and distraction techniques will reduce the need for open arthrotomy and should expand the indications for the procedure.
Abstract: Ankle arthroscopy has grown in popularity over the past decade as a diagnostic and therapeutic procedure. We assessed 24 patients who underwent ankle arthroscopy during the two year period 1991-1993. In 18 cases a mini-arthrotomy was performed based on the arthroscopic findings. All patients were reviewed at an average of 26 months and a detailed evaluation was carried out according to an objective scoring system which grades five parameters; pain, swelling, stiffness, limp, and activity level. Twenty-two patients (92%) had good or excellent results. There were two complications transient tarsal tunnel syndrome and reflex sympathetic dystrophy. There were no neurovascular complications. This series represents an initial experience and illustrates that ankle arthroscopy provides a safe and effective method of diagnosis and treatment with few complications. Further advances in instrumentation and distraction techniques will reduce the need for open arthrotomy and should expand the indications for the procedure.
TL;DR: Results show that midnight Cortisol, dexamethasone suppression tests and 24-hour urinary free Cortisol are misleading in patients with tuberculosis on rifampicin (R) and should not be employed for investigating such patients for Cushing’s syndrome.
Abstract: Rifampicin(R) is a potent enzyme inducer which is now widely used to treat many conditions. We have investigated its effect on adrenal function tests in 18 adults with tuberculosis on rifampicin (R) and isoniazid (INH) as in-patients. Midnight Cortisol was above 250 nmol/l in 11 patients with a mean + (SD) of 340 + 193 nmol/l. The morning serum Cortisol following 1 and 4 mg dexamethasone overnight was abnormal in 88.9 per cent and 83.3 per cent respectively. The respective mean values + (SD) were 350 + 179 and 336 + 279 nmol/l. The mean 24-hour urinary free Cortisol + SD was 513 + 375 nmol and was above normal in 6 (33.3 per cent) patients. These results show that midnight Cortisol, dexamethasone suppression tests and 24-hour urinary free Cortisol are misleading in patients with tuberculosis on (R) and should not be employed for investigating such patients for Cushing’s syndrome.
TL;DR: Examination of human AIDS brains obtained at post mortem for infection by human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV) and for dual infection of cells by both viruses found astrocytes and neurons were both singly and doubly infected with HIV and HCMV.
Abstract: We have examined 26 human AIDS brains obtained at post mortem for infection by human immunodeficiency virus (HIV) and human cytomegalovirus (HCMV), and for dual infection of cells by both viruses. The techniques used were enzyme-linked immunocytochemistry for HCMV andin situ hybridisation using a cDNA probe for HIV. Using these techniques, HCMV infection was detected in 14 brains, HIV infection in 14 brains, and coinfection with HIV and HCMV in 7 brains. Four caes of dual HIV/HCMV infection were found where no colocalisation could be detected. In randomly chosen dually infected areas 19.2% of infected cells were coinfected with both viruses. Although cells identified morphologically as macrophages were the most common infected cell type, astrocytes and neurons were both singly and doubly infected with HIV and HCMV. Complete clinical data were available for 4 of the 7 cases with coinfection and each had AIDS dementia complex.
Journal Article•
TL;DR: These guidelines will clarify some of the issues in the amount of confusion as to how H. pylori-related conditions should be managed.
TL;DR: Advances since Dr. Donald’s unpleasant experience twenty years ago include recognition of pain relief as the primary approach to postoperative agitation, and the ready use of IV opioids with acceptance of related mild hypercarbia.
Abstract: Advances since Dr. Donald’s unpleasant experience twenty years ago1 include recognition of pain relief as the primary approach to postoperative agitation, and the ready use of IV opioids with acceptance of related mild hypercarbia. The use of neuraxial analgesic techniques, although controversial, ensures superior analgesia. The introduction of NSAIDs providing analgesia without sedation is a further benefit. Early tracheal extubation is a new trend which appears to improve patient comfort.
TL;DR: Three cases of HELLP syndrome are presented which illustrate its varied clinical presentation, the difficulty in making a diagnosis and the management problems.
Abstract: Three cases of HELLP syndrome are presented which illustrate its varied clinical presentation, the difficulty in making a diagnosis and the management problems. The cases varied in severity; all showed thrombocytopenia and abnormal liver function tests, but in one case the blood pressure remained within “normal limits” whereas another patient suffered grand mal seizures due to hypertensive encephalopathy.
TL;DR: Developing a culture of evidence based medicine in general practice must integrate quantitative and qualitative research, epidemiology and psychology and the skills of public health and family medicine.
Abstract: Evidence based medicine is seductive in its simplicity and few would argue with the philosophical concept. The reality of its application in primary care is rather different. It is difficult to find evidence supporting many clinical management decisions, it may be difficult to interpret evidence when it is available, and it may be difficult to apply this evidence in the consultation. Clinical decisions may be influenced at many levels through health policy, audit, protocols, and guidelines, but the individual doctor patient relationship remains at the core of general practice. Developing a culture of evidence based medicine in general practice must integrate quantitative and qualitative research, epidemiology and psychology and the skills of public health and family medicine.
TL;DR: Warmed peritoneal lavage is an efficient, cost effective approach which is easily performed without specialist equipment, and involves minimal risk to the patient.
Abstract: Severe hypothermia is associated with serious patient morbidity and mortality. The groups most frequently affected are the elderly, the very young and substance abusers. We describe three such cases which were successfully treated using warmed peritoneal dialysis. Two patients recovered completely and were left with no long term deficits. The third patient recovered from the acute event, but succumbed later to an underlying medical condition. Warmed peritoneal lavage is an efficient, cost effective approach which is easily performed without specialist equipment, and involves minimal risk to the patient.