Background: Frostbite is a local cold injury that may lead to loss of tissue, and result in disability. It is normally a consequence of prolonged exposure of unprotected regions to subzero ambient temperatures, which causes impairment of the microcirculation. In Slovenia, the main risk group for frostbite injury are mountain climbers. Frostbite is classified as either a superficialreversible injury, or an irreversible deep tissue injury. Superficial frostbite is managed in out-patient clinics, whereas hospital treatment is required for deep frostbite. The success of frostbite management depends a great deal on the field first aid and emergency medical treatment, as well as on the subsequent hospital treatment. The present study reports of the success of a protocol for hospital treatment of frostbite (Planica Protocol), comprising the early diagnosis with three-phase bone scintigraphy (TS), administration of appropriate medications, particularly iloprost, and initiation of hyperbaric oxygen treatment (HBOT). Patients and methods: A total of 27 mountain climbers presented with frostbite injury between 2000 and2010. Of these, 16 suffered superficial injuries and were treated as outpatients. The remaining 11 mountaineers (2 females, and 9 males) suffered deep frostbite and were hospitalised. Frostbite injury was sustained at different altitudes (range: 2000 to 8848 meters above sea level) in the toes (n = 9; 82%) and fingers (n = 2; 18%). Some climbers (n = 9; 82%) received field first aid, and some (n = 9; 82%) also emergency medical treatment in thefield. On admission to hospital, patients received the following treatpatient clinics, whereas hospital treatment is required for deep frostbite. The success of frostbite management depends a great deal on the field first aid and emergency medical treatment, as well as on the subsequent hospital treatment. (Abstract truncated at 2000 characters)
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 30239193Displacement of blood to the lower portion of the body that follows a postural transition from recumbent to erect is augmented by a prolonged period of recumbency (bedrest). Information is scarce as to what extent this augmented blood-volume shift to dependent veins is attributable to increased distensibility of the veins. Accordingly, we studied the effect of 5 weeks of horizontal bedrest on the pressure-distension relationship in limb veins. Elevation of venous distending pressure was induced by exposure of the body except the tested limb to supra-atmospheric pressure with the subject seated in a pressure chamber with one arm, or supine with a lower leg, protruding through a hole in the chamber door. Diameter changes in response to an increase of intravenous pressure (distensibility) from 60 to about 140 mmHg were measured in the brachial and posterior tibial veins using ultrasonographic techniques. Prior to bedrest, the distensibility was substantially less in the tibial than in the brachial vein. Bedrest increased (P ( 0.01) pressure distension in the tibial vein by 86% from 7 ± 3% before to 13 ± 3% after bedrest. In the brachial vein, bedrest increased (P ( 0.05) pressure distension by 36% from 14 ± 5% before to 19 ± 5% after bedrest. Thus, removal of the gravity-dependent pressure components that act along the blood vessels in erect posture increases the distensibility of dependent veins.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 23694375We established a research infrastructure, which allows us to simulate high altitude conditions, by decreasing the fraction of oxygen in the atmosphere.
D.04 Initiative to set up a new research area in Slovenia
COBISS.SI-ID: 251433728