Hypothermia reduces cerebral metabolism and CBF, with resultant reduction in CBV and ICP. It may also be neuroprotective by decreasing the release of excitotoxic amino acids. Despite initial enthusiasm reported with the therapeutic use of moderate hypothermia in a single-center trial, a multicenter, randomized controlled trial could not demonstrate any beneficial effects, although a subset of patients aged less than 45 years, who were admitted hypothermic and randomized to hypothermia, had better results than patients who were rendered normothermic . A new trial focusing on younger patients commenced in 2003. Despite the lack of proof of definitive benefits, most studies demonstrate a favorable ICP response to hypothermia. Moreover, the beneficial effects of therapeutic hypothermia on neurological outcome were recently demonstrated in patients who suffered cardiac arrest from sudden ventricular fibrillation. For now, therapeutic hypothermia should be used as an effective and useful adjunct for the control of ICP.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.