Autopsy in California

From information complied from death certificates registered in 1952 and 1962 an examination was made of California''s autopsy performance and the characteristics of deaths in which autopsy was done. The data indicated that California had an overall autopsy rate of 37 per cent of total deaths in 1962, probably higher than any other state. In the decade reviewed, there was a 62 per cent absolute increase in autopsies and a 7 per cent increase relative to total deaths.Substantial increases in the proportion of deaths in which autopsy was done were found for physician-certified deaths in both metropolitan and nonmetropolitan counties and for coroner-certified deaths in nonmetropolitan counties. For all but two of forty-five selected natural causes of death there were increases in the proportion of deaths in which autopsy was done.Seventy per cent of deaths occurred in some type of facility. About one-half of all deaths occurred in general hospitals, and autopsy was done in 42 per cent of such cases.The dual factors of a high autopsy rate and overrepresentation of deaths brought to autopsy in white males, ages 35-64, support the validity of a reported decline in California''s death rate for arteriosclerotic heart disease.     

Studies on cold pressor response of subjects who suffered from frostbite at high altitude

Seven lowlander soldiers who had 1st to 3rd degree of frostbite and 8 lowlander soldiers who recovered from high altitude pulmonary oedema were tested for cold pressor response at 260 m, 26°C, 6.8°C and 4,085 m, 26°C, 6.8°C. 8 lowlander soldiers (Control subjects) of comparable age group were tested for their cold pressor response at 260 m, 26°C and 3,300 m, 26°C. Another group of control subjects from the laboratory were also tested at 2,121 m, 26°C. There was a highly significant decrease in cold pressor response of the frostbite subjects at 260 m, 26°C and a very significant increase at 260 m, 6.8°C as compared to non-frostbite subjects. The subjects who recovered from high altitude pulmonary oedema did not show significant differences as compared with the control subjects. The results suggest certain basic physiological differences in regulation of supply of blood to the extremities under condition of general and local cold exposure.     

Cold tolerance of the harlequin ladybird Harmonia axyridis in Europe

As an essential aspect of its invasive character in Europe, this study examined the cold hardiness of the harlequin ladybird Harmonia axyridis. This was done for field-collected populations in Belgium overwintering either in an unheated indoor or an outdoor hibernaculum. The supercooling point, lower lethal temperature and lower lethal time at 0 and −5 °C were determined. Possible seasonal changes were taken into account by monitoring the populations during each winter month. The supercooling point and lower lethal temperature remained relatively constant for the overwintering populations in the outdoor hibernaculum, ranging from −17.5 to −16.5 °C and −17.1 to −16.3 °C, respectively. In contrast, the supercooling point and lower lethal temperature of the population overwintering indoors clearly increased as the winter progressed, from −18.5 to −13.2 °C and −16.7 to −14.1 °C, respectively. A proportion of the individuals overwintering indoors could thus encounter problems surviving the winter due to premature activation at times when food is not available. The lower lethal time of field populations at 0 and −5 °C varied from 18 to 24 weeks and from 12 to 22 weeks, respectively. Morph type and sex had no influence on the cold hardiness of the overwintering adults. In addition, all cold tolerance parameters differed greatly between the laboratory population and field populations, implying that cold tolerance research based solely on laboratory populations may not be representative of field situations. We conclude from this study that the strong cold hardiness of H. axyridis in Europe may enable the species to establish in large parts of the continent.     

Effects of high altitudes on finger cooling test in Japanese and Tibetans at Qinghai Plateau

The influences of both hypobaric hypoxia and cold on peripheral circulation were studied using the finger cooling test (measurement of the decrease in finger temperature, measured at the dorsal surface of the finger, during immersion of the hand in 0° C water for 20 min) at Qinghai Plateau. The same test was carried out at simulated altitudes in a 25° C climatic chamber to separate the hypobaric hypoxia influence from that of cold. In Japanese subjects at Qinghai Plateau there was a significant difference between finger skin temperatures (FSTs) during 20 min of 0° C water immersion at altitudes of 2260 m and 4860 m by ANOVA. Mean finger skin temperature during the 20-min immersion (5–20 min, MST) measured at 4860 m was significantly lower than that at 2260 m. In Tibetan subjects, there was also a significant difference between FSTs at 2260 m and at 4860 m by ANOVA. MST at 4860 m tended to be lower than that at 2260 m. In the 25° C climatic chamber, there was a significant difference between FSTs of Japanese expedition members at 2000 m and at 4000 m by ANOVA. MST was higher at 4000 m than at 2000 m, contrary to the data obtained in Qinghai. In conclusion, the higher skin temperature in response to local cold immersion, which would have been caused by stronger hypobaric hypoxia, must have been masked by the lower ambient temperature.     

Impact of control for air pollution and respiratory epidemics on the estimated associations of temperature and daily mortality

We assessed the influence of control for air pollution and respiratory epidemics on associations between apparent temperature (AT) and daily mortality in Mexico City and Monterrey. Poisson regressions were fit to mortality among all ages, children (ages 0–14 years) and the elderly (ages 65 years). Predictors included mean daily AT, season, day of week and public holidays for the base model. Respiratory epidemics and air pollution (particulate matter <10 m in aerodynamic diameter and O₃) were added singly and then jointly for a fully adjusted model. Percent changes in mortality were calculated for days of relatively extreme temperatures [cold (10–11°C) for both cities and heat (35–36°C) for Monterrey], compared to days at the overall mean temperature in each city (15°C in Mexico City, 25°C in Monterrey). In Mexico City, total mortality increased 12.4% [95% confidence interval (CI) 10.5%, 14.5%] on cold days (fully adjusted). Among children, the adjusted association was similar [10.9% (95% CI: 5.4%, 16.7%)], but without control for pollution and epidemics, was nearly twice as large [19.7% (95% CI: 13.9%, 25.9)]. In Monterrey, the fully adjusted heat effect for all deaths was 18.7% (95% CI: 11.7%, 26.1%), a third lower than the unadjusted estimate; the heat effect was lower among children [5.5% (95% CI: –10.1%, 23.8%)]. Cold had a similar effect on all-age mortality as in Mexico City [11.7% (95% CI: 3.7%, 20.3%)]. Responses of the elderly differed little from all-ages responses in both cities. Associations between weather and health persisted even with control for air pollution and respiratory epidemics in two Mexican cities, but risk assessments and climate change adaptation programs are best informed by analyses that account for these potential confounders.     

Environmental temperature and mortality from acute myocardial infarction

Mortality from acute myocardial infarction (MI) over the 5 year period 1982–1987 in Brown County, Wisconsin, was analyzed to assess the relationship with environmental temperature. Deaths occurrring on the day of and the day following a significant snowfall as well as deaths occuring in health care facilities were eliminated from consideration because the focus was upon temperature, not snowfall or events within a hospital. These criteria resulted in the inclusion of 1,802 days and 926 cases of acute MI. The mean temperature on the day of death was obtained from climatological data and were grouped into six categories covering a range of temperatures from<–17.8°C (0°F) to 16.1°C (61°F). The number of deaths in each category was tabulated. The effect of temperature, sex, and age were analyzed by regression analysis. The results indicated a linear increase in mortality as mean daily temperature decreased over the temperature range. The inverse temperature effect was most pronounced in males over the age of 60. These results indicate that cold temperatures appear to be associated with an increased mortality from myocardial infarction.     

The physiology of hypothermia in the black-capped Chickadee,Parus atricapillus

Summary The shivering, body temperature, and metabolic response to stable and decreasing ambient temperature were measured in winter acclimatized Black-capped Chickadees,Parus atricapillus. Shivering activity, measured by duration and amplitude of bursts, increased curvilinearly from thermoneutral temperatures of 27°C down to 0°C. This parabolic shivering response may be a major component of the curvilinear response of metabolism to decreasing ambient temperature.Birds exposed to 0°C exhibited metabolism 32–45% lower than predicted for a 12-g homeotherm and body temperatures 10°C below the pre-experimental nocturnal body temperature. This hypothermia was not the result of a breakdown in thermoregulation, but was a controlled effort serving to reduce overnight energy expenditure. It is suggested that (1) hypothermia was achieved by decreased shivering by pectoral muscles during exposure to decreasing ambient temperatures, (2) the rate of body temperature decline was moderated by intermittent and reduced bursts during the cooling period, and (3) body temperature was maintained at a particular level during exposure to a stable low ambient temperature by intense bursts lasting one to three minutes.The physiology of hypothermia in chickadees is similar to torpor; however, chickadees did not arouse to a normal diurnal body temperature in the laboratory, and their hypothermia was not induced by inanition or prolonged exposure to cold, as reported for other species capable of torpor.     

Factors affecting the daily rhythm of body temperature of captive mouse lemurs (<Emphasis Type="Italic">Microcebus murinus</Emphasis>)

Microcebus murinus, a small nocturnal Malagasy primate, exhibits adaptive energy-saving strategies such as daily hypothermia and gregarious patterns during diurnal rest. To determine whether ambient temperature (T_a), food restriction and nest sharing can modify the daily body temperature (T_b) rhythm, T_b was recorded by telemetry during winter in six males exposed to different ambient temperatures (T_a=25, 20, 15°C) and/or to a total food restriction for 3 days depending on social condition (isolated versus pair-grouped). At 25°C, the daily rhythm of T_b was characterized by high T_b values during the night and lower values during the day. Exposure to cold significantly decreased minimal T_b values and lengthened the daily hypothermia. Under food restriction, minimal T_b values were also markedly lowered. The combination of food restriction and cold induced further increases in duration and depth of torpor bouts, minimal T_b reaching a level just above T_a. Although it influenced daily hypothermia less than environmental factors, nest sharing modified effects of cold and food restriction previously observed by lengthening duration of torpor but without increasing its depth. In response to external conditions, mouse lemurs may thus adjust their energy expenditures through daily modifications of both the duration and the depth of torpor.     

Effects of hot ground water on a small swamp-stream in Nova Scotia,Canada

We examined the effects of hot spring water (35–45 °C) on the ecology of a small, intermittant swamp-stream in Nova Scotia, Canada. Temperatures diminished quickly with distance downstream from the hot spring because of abundant inflow of cold ground water (<10 °C), but elevated temperature effects were detectable 130 m downstream. The brook below the hot spring supported a dense mat of the cyanobacterium Oscillatoria (10 m) followed by the green alga Vaucheria taylorii (40 m). Herbaceous vegetation below the algal zones was also altered by the hot water inflow, even where the temperature increase was slight. The structure of the sparse community of benthic invertebrates was sharply different at sites of different stream temperature: only oligochaete worms, ostracods, chironomids, and a single species of snail thrived at the warmest sites; cold downstream sites supported a typical headwater stream community. Mass loss from decomposing leaves of speckled alder was fast at all sites and strongly correlated with water temperature. The changes in community composition and decomposition rate in response to added heat persisted even where the temperature increase was small, indicating a tight coupling of ecosystem structure and function with the physical environment.     

Effects of growth temperature on transport and membrane viscosity in Streptococcus faecalis

A shift in the growth temperature of Streptococcus faecalis from 37 to 10°C resulted in an 18% increase in the proportion of unsaturated fatty acids. Electron spin resonance spectra of spin-labeled membranes and extracted phospholipids indicated viscosity changes consistent with the alterations in fatty acid composition. Growth temperature had no significant effect on the active transport of leucine and alanine; uptake rates assayed at 10 or 35°C were essentially the same in cells grown at either 10 or 37°C. The relative rapidity of amino acid transport, which presumably contributes to the ability of S. faecalis to thrive in cold environments, is evidently unrelated to adaptive changes in the viscosity of membrane lipids.Abbreviations doxyl 4-4-dimethyloxazolidine-N-oxyl - proxyl 2,2-disubstituted 5,5-dimethylpyrrolidine-N-oxyl     

Physiological significance of behavioral hypothermia in hypoglycemic frogs (Rana catesbeiana)

Hypoxia elicits a number of compensatory responses in animals, including behavioral hypothermia. The hypothesis that hypoglycemia induces hypothermia in the bullfrog Rana catesbeiana was tested and that this behavioral response would be beneficial. Frogs equipped with a temperature probe were tested in a thermal gradient (10–40°C). Insulin (15 IU kg⁻¹) caused significant reduction of body temperature, from 25.0 to 17.8°C. A non-metabolizable glucose analogue, 2-deoxy-d-glucose (2-DG, 50 mg kg⁻¹),which blocks intracellular glucose utilization, was also injected and caused a similar drop in body temperature, despite an increase in plasma glucose levels. To assess the possible benefits of hypoglycemia-induced hypothermia, the effects of insulin and 2-DG injections were measured on plasma glucose concentration and on oxygen consumption of frogs equilibrated at 10, 20 and 30°C. The plasma glucose was elevated at higher temperatures and so was oxygen consumption. The insulin caused a significant reduction of plasma glucose concentration (about 1.22 μMol ml⁻¹) whereas 2-DG caused a significant increase (about 0.70 μMol ml⁻¹) at 30°C. Both drugs caused a reduction of oxygen consumption (approximately 0.388 and 0.382 ml min⁻¹ kg at 30°C after insulin and 2-DG injection, respectively). No effect of either insulin or 2-DG was observed when the animals were equilibrated at 10°C. In conclusion, hypothermia may be a beneficial response to hypoglycemia in frogs.     

Changes in Photosynthesis in Inbred Maize Lines with Different Degrees of Chilling Tolerance Grown at Optimum and Suboptimum Temperatures

The effects of growth temperature on changes in net photosynthetic rate (PN) and the chlorophyll fluorescence induction parameter Fv/Fm were investigated after cold stress in inbred maize lines with different degrees of cold tolerance. There was no significant difference between lines grown at optimum temperatures of 25/23 and 20/18 °C as regards PN and Fv/Fm determined at the growth temperature, but these parameters were lower for plants grown at a suboptimum temperature of 15/13 °C. After cold treatment, the decrease in PN was more pronounced in chilling-sensitive lines. The higher the growth temperature was, the more pronounced decrease occurred in PN and Fv/Fm. Thus at low growth temperature both damaging and adaptive processes occur.     

Heterosis in crosses between lines of Drosophila melanogaster selected for adaptation to different environments

Summary Experiments were designed to examine whether heterosis would occur in crosses of Drosophila melanogaster populations adapted to 18 °C or 28 °C environments. Crosses were examined in parental environments, an intermediate environment (23 °C) and a mixed environment (alternating 18°/28°C). Parental populations did not show divergence for larval viability, cold shock or high temperature mortalities when tested in a common environment. However, the 28 °C population was less fecund than the 18 °C population, but had higher larval competitive ability and higher adult longevity. Heterosis for viability, cold shock mortality and high temperature mortality occurred in crosses between a population adapted to 18 °C and another adapted to 28 °C, but not in crosses between two populations adapted to the same temperature. The results suggest that, in the absence of drift, heterosis is expected in crosses between lines or populations with different histories of selection but not between lines with the same selection histories.     

Magnesium deficiency: an unrecognized cause of convulsions, arrhythmias, and neuromuscular impairment

Hypoglycemia is but one of a number of causes of hypothermia, but is important to keep in mind as a possible precipitating or concurrent event even in those cases in which there are other obvious explanations for decreased body temperature (exposure, alcoholism, starvation, sepsis or hypothyroidism). Hypoglycemia may occur in as many as 40 percent of very cold patients, and be clinically unrecognized because symptoms are masked by the hypothermia itself. Although serum glucose levels are depressed, a cold-induced renal tubular glycosuria may occur. Glucose in the urine, therefore, cannot be used as assurance of hyperglycemia in a hypothermic patient. And, although cold protects against serious end organ damage from hypoglycemia by decreasing tissue metabolic need for glucose, a serum specimen should be drawn for glucose determination in all hypothermic patients and a 50 percent glucose solution immediately given intravenously. If this is not done, serum glucose levels may plummet as the patient is rewarmed and begins to shiver.     

Response and tolerance of toxigenic Vibro cholerae O1 to cold temperatures

Survival and tolerance at cold temperatures, the differentially expressed cellular proteins, and cholera toxin (CTX) production were evaluated in Vibrio cholerae O1. Rapid loss of culturability and change to distinct coccoid morphology occurred when cultures of V. cholerae O1 were exposed to 5°C directly from 35°C. Also, cultures of V. cholerae first exposed to 15°C for 2 h and then maintained at 5°C failed to exhibit an adaptive response, instead a rapid loss of viable plate count was noticed. Results from Western blot experiments revealed the absence of a major cold shock protein, CS7.4. Also, a decreased level of CTX was noticed in V. cholerae O1 cultures exposed to 5 or 15°C after first being exposed to 15°C for 2 h, followed by transfer to 5°C. Reduced expression of CTX at cold temperatures, compared to the cultures maintained at 35°C, may be a result of decreased cellular metabolic activity. When V. cholerae O1 cultures were exposed to 15°C for 2 h, elevated expressions of 8, 26 and 194 kDa, and decreased expression of 28 and 183 kDa proteins occurred. It is suggested that these differentially expressed cold-responsive proteins are involved in regulating culturability and conversion to a coccoid cell morphology in V. cholerae O1.     

Post-Neonatal Sudden Unexplained Death in a California Community

To gain further insight into the problem of infant sudden death, a study was undertaken to investigate a complete series of cases of infant sudden unexplained death that occurred during a seven-year period in Sacramento County. Needed information was abstracted from autopsy records, Medical Examiner''s records and death certificates. The average death rate for the seven-year period was 1.7 for 1,000 live births. Average age at time of death was 2.8 months. There were no records of sudden death among infants over the age of eight months.Higher than average death rates were observed within many of the low socioeconomic areas of Sacramento County. Also, sudden unexplained deaths appeared to occur more frequently in the winter months than in the spring, summer or fall. In over half the cases the infants had a cold, the sniffles, or other respiratory tract congestion within two weeks of the date of death, which seems to support the oft-quoted contention concerning the possibility of nasal obstruction which could initiate the fatal apnea. An additional notable finding was the very frequent occurrence of petechial hemorrhage in the thymus, heart, and lung tissues.The unique age distribution of these deaths in combination with the high frequency of low socioeconomic groups and the frequency of minor respiratory ailment would suggest approaches that can be taken to identify infants at high risk and thus initiate effective community health programs for prevention.     

Cold tolerance of first-instar nymphs of the Australian plague locust, Chortoicetes terminifera

The cold tolerance of first-instar nymphs of the Australian plague locust, Chortoicetes terminifera, was examined using measures of total body water content, supercooling point and mortality for a range of sub-zero temperature exposure regimes. The supercooling points for starved and fed nymphs were −13.1 ± 0.9 and −12.6 ± 1.6 °C, and freezing caused complete mortality. Above these temperatures, nymphs were cold tolerant to different degrees based on whether they were starved or given access to food and water for 24 h prior to exposure. The rate of cooling also had a significant effect on mortality. Very rapid cooling to −7 °C caused 84 and 87% mortality for starved and fed nymphs respectively, but this significantly decreased for starved nymphs if temperature declined by more ecologically realistic rates of 0.5 and 0.1 °C min⁻¹. These results are indicative of a rapid cold hardening response and are discussed in terms of the likely effects of cold nights and frost on first-instar nymphal survival in the field.     

Freezing tolerance in Draba chionophila,a ‘miniature’ caulescent rosette species

Summary Freezing tolerance as a cold resistance mechanism is described for the first time in a plant growing in the tropical range of the Andean high mountains. Draba chionophila, the plant in which freezing tolerance was found, is the vascular plant which reaches the highest altitudes in the Venezuelan Andes (approximately 4700m). Night cycles of air and leaf temperature were studied in the field to determine the temperature at which leaf freezing began. In the laboratory, thermal analysis and freezing injury determinations were also carried out. From both field and laboratory experiments, it was determined that freezing of the leaf tissue, as well as root and pith tissue, initiated at a temperature of approximately-5.0°C, while freezing injury occurred at approximately-12.0°C for the pith, and below-14.0°C for roots and leaves. This difference in temperature suggests that the plant still survives freezing in the-5.0 to-14.0°C range. Daily cycles of leaf osmotic potential and soluble carbohydrate concentration were also determined in an attempt to explain some of the changes occurring in this species during the nighttime temperature period. A comparison between Andean and African high mountain plants from the point of view of cold resistance mechanisms is made.     

The use of a complex thermohygrometric index in predicting adverse health effects in Athens

Mortality and morbidity indices are known to depend on changes in meteorological conditions. In Athens, severe adverse health effects following extreme heat conditions have been reported. The usefulness has been investigated of the complex thermohygrometric index (THI), a simple index based on maximum daily temperature and relative humidity, in predicting the health effects of specific meteorological conditions. The values of THI were found to correlate well with more complex bioclimatic indices; the THI could successfully replace temperature and humidity in predicting the daily number of deaths through multiple linear regression modelling. Thus the introduction of THI levels more than 28.5° C and between 26.5 and 28.5° C, through dummy variables, in a regression model explained 40% of the variability in the number of deaths during the months of July and August. During days with THI values less than 26.5° C the mean number of deaths was 33.5, compared to 41.8 when THI was between 26.5 and 28.5° C. The daily number of deaths increased to 108.2 when THI exceeded 28.5° C. From this study, the exact level of THI at which public health measures must be taken was not clear and more work is needed to identify it. However, given its simplicity, the use of THI for predicting meteorological conditions which are adverse to health would appear to be promising in preventive medicine and in health services planning.