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Rheumatology (Oxford, England) Nov 2022Chilblains were first described over a hundred years ago as cutaneous inflammatory lesions, typically on the digits, occurring on cold exposure. Chilblains can be... (Review)
Review
Chilblains were first described over a hundred years ago as cutaneous inflammatory lesions, typically on the digits, occurring on cold exposure. Chilblains can be primary, or secondary to a number of conditions such as infections, including COVID-19, and immune-mediated inflammatory disorders (IMIDs) with SLE being the commonest. Chilblain lupus erythematosus (CHLE) was first described in 1888 as cold-induced erythematous lesions before the terms 'chilblains' or 'perniosis' were coined. Diagnostic criteria exist for both chilblains and CHLE. Histopathologically, CHLE lesions show interface dermatitis with perivascular lymphocytic infiltrate. Immunofluorescence demonstrates linear deposits of immunoglobulins and complement in the dermo-epidermal junction. This narrative review focuses on chilblains secondary to immune-mediated inflammatory disorders, primarily the epidemiology, pathogenesis and treatment of CHLE.
Topics: Humans; Chilblains; COVID-19; Lupus Erythematosus, Discoid; Dermatitis; Diagnosis, Differential; Lupus Erythematosus, Cutaneous
PubMed: 35412601
DOI: 10.1093/rheumatology/keac231 -
PloS One 2016A longstanding goal in regenerative medicine is to reconstitute functional tissues or organs after injury or disease. Attention has focused on the identification and... (Comparative Study)
Comparative Study
BACKGROUND
A longstanding goal in regenerative medicine is to reconstitute functional tissues or organs after injury or disease. Attention has focused on the identification and relative contribution of tissue specific stem cells to the regeneration process. Relatively little is known about how the physiological process is regulated by other tissue constituents. Numerous injury models are used to investigate tissue regeneration, however, these models are often poorly understood. Specifically, for skeletal muscle regeneration several models are reported in the literature, yet the relative impact on muscle physiology and the distinct cells types have not been extensively characterised.
METHODS
We have used transgenic Tg:Pax7nGFP and Flk1GFP/+ mouse models to respectively count the number of muscle stem (satellite) cells (SC) and number/shape of vessels by confocal microscopy. We performed histological and immunostainings to assess the differences in the key regeneration steps. Infiltration of immune cells, chemokines and cytokines production was assessed in vivo by Luminex®.
RESULTS
We compared the 4 most commonly used injury models i.e. freeze injury (FI), barium chloride (BaCl2), notexin (NTX) and cardiotoxin (CTX). The FI was the most damaging. In this model, up to 96% of the SCs are destroyed with their surrounding environment (basal lamina and vasculature) leaving a "dead zone" devoid of viable cells. The regeneration process itself is fulfilled in all 4 models with virtually no fibrosis 28 days post-injury, except in the FI model. Inflammatory cells return to basal levels in the CTX, BaCl2 but still significantly high 1-month post-injury in the FI and NTX models. Interestingly the number of SC returned to normal only in the FI, 1-month post-injury, with SCs that are still cycling up to 3-months after the induction of the injury in the other models.
CONCLUSIONS
Our studies show that the nature of the injury model should be chosen carefully depending on the experimental design and desired outcome. Although in all models the muscle regenerates completely, the trajectories of the regenerative process vary considerably. Furthermore, we show that histological parameters are not wholly sufficient to declare that regeneration is complete as molecular alterations (e.g. cycling SCs, cytokines) could have a major persistent impact.
Topics: Animals; Barium Compounds; Chlorides; Cobra Cardiotoxin Proteins; Cold Injury; Cytokines; Elapid Venoms; Fibrosis; Freezing; Green Fluorescent Proteins; Macrophages; Mice; Mice, Inbred C57BL; Mice, Transgenic; Models, Animal; Muscle Development; Muscle, Skeletal; Myoblasts; Necrosis; Neovascularization, Physiologic; Regeneration; Satellite Cells, Skeletal Muscle; Stem Cells; Vascular Endothelial Growth Factor Receptor-2
PubMed: 26807982
DOI: 10.1371/journal.pone.0147198 -
International Journal of Environmental... Oct 2021Nonfreezing cold injury (NFCI) is a modern term for trench foot or immersion foot. Moisture is required to produce a NFCI. NFCI seldom, if ever, results in loss of... (Review)
Review
Nonfreezing cold injury (NFCI) is a modern term for trench foot or immersion foot. Moisture is required to produce a NFCI. NFCI seldom, if ever, results in loss of tissue unless there is also pressure necrosis or infection. Much of the published material regarding management of NFCIs has been erroneously borrowed from the literature on warm water immersion injuries. NFCI is a clinical diagnosis. Most patients with NFCI have a history of losing feeling for at least 30 min and having pain or abnormal sensation on rewarming. Limbs with NFCI usually pass through four 'stages.' cold exposure, post-exposure (prehyperaemic), hyperaemic, and posthyperaemic. Limbs with NFCI should be cooled gradually and kept cool. Amitriptyline is likely the most effective medication for pain relief. If prolonged exposure to wet, cold conditions cannot be avoided, the most effective measures to prevent NFCI are to stay active, wear adequate clothing, stay well-nourished, and change into dry socks at least daily.
Topics: Cold Injury; Cold Temperature; Humans; Immersion Foot; Water
PubMed: 34639782
DOI: 10.3390/ijerph181910482 -
Annual Review of Entomology Jan 2023Winter provides many challenges for insects, including direct injury to tissues and energy drain due to low food availability. As a result, the geographic distribution... (Review)
Review
Winter provides many challenges for insects, including direct injury to tissues and energy drain due to low food availability. As a result, the geographic distribution of many species is tightly coupled to their ability to survive winter. In this review, we summarize molecular processes associated with winter survival, with a particular focus on coping with cold injury and energetic challenges. Anticipatory processes such as cold acclimation and diapause cause wholesale transcriptional reorganization that increases cold resistance and promotes cryoprotectant production and energy storage. Molecular responses to low temperature are also dynamic and include signaling events during and after a cold stressor to prevent and repair cold injury. In addition, we highlight mechanisms that are subject to selection as insects evolve to variable winter conditions. Based on current knowledge, despite common threads, molecular mechanisms of winter survival vary considerably across species, and taxonomic biases must be addressed to fully appreciate the mechanistic basis of winter survival across the insect phylogeny.
Topics: Animals; Seasons; Insecta; Cold Temperature; Cold Injury
PubMed: 36206770
DOI: 10.1146/annurev-ento-120120-095233 -
Ugeskrift For Laeger Jan 2022Thermal burns are by far the most frequent and account for approx. 90% of all burns, while frostbites, chemical and electrical burns (CB) cover the remaining approx.... (Review)
Review
Thermal burns are by far the most frequent and account for approx. 90% of all burns, while frostbites, chemical and electrical burns (CB) cover the remaining approx. 10%. This review gives an overview of the treatment of corrosions and frostbites. CB and frostbites are relatively rare and prompt initiation of proper treatment is essential for both. CB should be diluted as soon as possible, preferably with a neutralizing solution. Treatment of systemic hypothermia comes before management of peripheral frostbite. Frostbites involve thawing in warm water, followed by vasodilation, thrombolysis and amputation if indicated.
Topics: Amputation, Surgical; Burns; Corrosion; Frostbite; Humans; Hypothermia
PubMed: 35060476
DOI: No ID Found -
Sports Health 2016Hypothermia and frostbite injuries occur in cold weather activities and sporting events. (Review)
Review
CONTEXT
Hypothermia and frostbite injuries occur in cold weather activities and sporting events.
EVIDENCE ACQUISITION
A PubMed search was used to identify original research and review articles related to cold, frostbite, and hypothermia. Inclusion was based on their relevance to prevention and treatment of cold-related injuries in sports and outdoor activities. Dates of review articles were limited to those published after 2010. No date limit was set for the most recent consensus statements or original research.
STUDY DESIGN
Clinical review.
LEVEL OF EVIDENCE
Level 5.
RESULTS
Frostbite and hypothermia are well-documented entities with good prevention strategies and prehospital treatment recommendations that have changed very little with time. A layered approach to clothing is the best way to prevent injury and respond to weather changes. Each athlete, defined as a participant in a cold weather sport or activity, will respond to cold differently depending on anthropometric measurements and underlying medical risk factors. An understanding of wind-chill temperatures, wetness, and the weather forecast allows athletes and event coordinators to properly respond to changing weather conditions. At the first sign of a freezing cold injury, ensure warm, dry clothes and move to a protected environment.
CONCLUSION
Cold injuries can be prevented, and cold weather activities are safe with proper education, preparation, and response to changing weather conditions or injury.
Topics: Cold Temperature; Frostbite; Humans; Hypothermia; Risk Factors; Wind
PubMed: 26857732
DOI: 10.1177/1941738116630542 -
Dermatology Online Journal Nov 2017Exploring the mountains is a highly rewarding past time; however, certain high-altitude exposures can lead to dermatologic manifestations. In this review article, the... (Review)
Review
Exploring the mountains is a highly rewarding past time; however, certain high-altitude exposures can lead to dermatologic manifestations. In this review article, the authors will describe cold, solar, and severe weather that one may experience when spending time outdoors. Factors such as increased ultraviolet radiation, temperature extremes, and low partial pressure of oxygen, along with human physiologic parameters also contribute to disease severity and presentation. This review article will address the diagnosis, treatment, and prevention of high-altitude dermatology exposures.
Topics: Altitude; Cold Injury; Dermatology; Humans; Mountaineering; Skin Diseases; Ultraviolet Rays; Weather
PubMed: 29447629
DOI: No ID Found -
Experimental Physiology Mar 2023
Topics: Humans; Cold Injury; Acclimatization; Cold Temperature
PubMed: 36807674
DOI: 10.1113/EP091139 -
International Journal of Environmental... Sep 2021Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of morbidity in cold climate zones and high altitude. The direct effects of... (Review)
Review
Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of morbidity in cold climate zones and high altitude. The direct effects of sub-zero temperatures lead to tissue freezing, electrolyte shifts and pH alterations, microvascular damage, and eventually to cell death. Upon rewarming, inflammatory reperfusion injury and thrombosis may lead to further tissue damage. Several studies and various case reports show that many patients suffer from long-term sequelae such as vasomotor disturbances (associated with susceptibility to refreezing), and neuropathic and nociceptive pain, as well as damage to skeletal structures. There are still many uncertainties regarding the pathophysiology of these sequelae. It has been shown that the transient receptor potential channel (TRP) family plays a role in cold allodynia. Botulinum Toxin type A (BTX-A) injections have been reported to be beneficial in vasomotor and neuropathic disturbances secondary to frostbite. Epidural sympathetic block has been used for short-term treatment of frostbite induced chronic pain. Furthermore, amitriptyline, gabapentinoids, and duloxetine may have some benefits. Frostbite arthritis clinically resembles regular osteoarthritis. In children there is a risk of epiphyseal cartilage damage leading to bone deformities. Despite some promising therapeutic concepts, the scarcity of data on frostbite long-term sequelae in the literature indicates the need of more in-depth studies of this pathology in all its aspects.
Topics: Cold Temperature; Freezing; Frostbite; Humans; Rewarming
PubMed: 34574580
DOI: 10.3390/ijerph18189655