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Case presentationProf. Bruno: A 80-year-old woman was found unconscious in the street from a passer-by. It was a cold January morning, and the patient had slept outdoor. She was a homeless known in the Emergency Department (ED) as an alcohol abuser.When she was admitted to the ED, she presented with stupor and apathy. She spoke very slowly, and her speech patterns were vague and slurred. Physical examination revealed that the skin was very cold, even on the torso; and there was marked pallor. The rectal body temperature was 29°C.She had an abnormally slow rate of breathing (8 breaths/ min), and the non-invasive SO 2 was 86% on room air, and 96% after the administration of Oxygen by mask (6 L min -1 ). Blood pressure was 85/50 mmHg, and the pulse was 40 beats/min, and very weak. The 12-lead ECG showed sinus bradycardia at about 40 beats/min, and there were prominent J waves (Osborn Wave). Hemogasanalytic values were normal. A Glasgow Coma Scale (GCS) score was 10. The patient underwent oro-tracheal intubation to provide airway protection. The finger-stick glucose was normal (108 mg %). The laboratory tests were within normal ranges except for a hyponatremia (120 mmol/L). We hypothesize the hyponatremia was due to volume depletion.Our working diagnosis was accidental hypothermia. We immediately removed her wet cold clothing, and we covered the patient with an electric blanket. She was given warm saline fluids intravenously. Because she was classified as severe hypothermia with a high risk for cardiac arrest, she underwent extra-corporeal treatment by emergency haemodialysis to actively rewarm her blood rapidly outside the body. In this way it was possible to restore normal body temperature rapidly. This invasive method of rewarming permitted us to restore a normal core temperature providing safe treatment.The patient left the hospital after several; days in good health. We advised her to avoid sleeping outside, to adequately cover her body including extremities and particularly the head. Differential diagnosisDr. Caroselli, Dr. Pisani: There are many causes of hypothermia. Often decreased thermogenesis is secondary to an endocrinologic failure such as hypopituitarism, hypoadrenalism, or myxedema, it may be due to alcohol or drug intoxication.Among metabolic disorders, a frequent cause of hypothermia includes hypoglycaemia that may occur from a glycogen store depletion. Blood glucose determination is

These data show that the SAA-102 device satisfies ESH, AAMI, and BHS protocols for both SBP and DBP and may be recommended for everyday use for BP monitoring at home and in clinical practice.

Abstract. In this paper, we propose a framework for seamless conceptual modeling of both data and processes, and the seamless integration of temporalities for both clinical data and clinical tasks. Moreover, we apply our approach to model the clinical pathway for managing patients with ROSC (Return Of Spontaneous Circulation) in a real ICU clinical setting.

The authors describe a case of syringomyelia associated with Chiari I malformation in a patient in whom acute symptomatic exacerbation occurred after cervical spine trauma. The authors review the various factors in the pathogenesis of this unusual sequence of events.