Tympanic Temperature Research Articles

A protocol for an observational cohort study of heat strain and its effect on fetal wellbeing in pregnant farmers in The Gambia

Introduction: Climate change predictions indicate that global temperatures are likely to exceed those seen in the last 200,000 years, rising by around 4°C above pre-industrial levels by 2100 (without effective mitigation of current emission rates). In regions of the world set to experience extreme temperatures, women often work outside in agriculture even during pregnancy. The implications of heat strain in pregnancy on maternal health and pregnancy outcome are not well understood. This protocol describes a study to assess the physiological response of pregnant women to environmental heat stress and the immediate effect this has on fetal wellbeing. Methods and analysis: The study will be performed in West Kiang district, The Gambia; a semi-arid zone in West Africa with daily maximum temperatures ranging from approximately 32 to 40°C. We will recruit 125 pregnant women of all ages who perform agricultural work during their pregnancy. Participants will be followed every two months until delivery. At each study visit fetal growth will be measured by ultrasound scan. During the course of their working day we will take the following measurements: continuous maternal physiological measurements (heart rate, respiratory rate, chest skin temperature and tri-axis accelerometer data); intermittent maternal tympanic core temperature, four point skin temperature, blood pressure; intermittent fetal heart rate and, if eligible, umbilical artery doppler; intermittent environmental measurements of air temperature, humidity, solar radiation and wind speed. Venous blood and urine will be collected at beginning and end of day for biomarkers of heat strain or fetal distress and hydration status.

A protocol for an observational cohort study of heat strain and its effect on fetal wellbeing in pregnant farmers in The Gambia

Introduction: Climate change predictions indicate that global temperatures are likely to exceed those seen in the last 200,000 years, rising by around 4°C above pre-industrial levels by 2100 (without effective mitigation of current emission rates). In regions of the world set to experience extreme temperatures, women often work outside in agriculture even during pregnancy. The implications of heat strain in pregnancy on maternal health and pregnancy outcome are not well understood. This protocol describes a study to assess the physiological response of pregnant women to environmental heat stress and the immediate effect this has on fetal wellbeing. Methods and analysis: The study will be performed in West Kiang district, The Gambia; a semi-arid zone in West Africa with daily maximum temperatures ranging from approximately 32 to 40°C. We will recruit 125 pregnant women of all ages who perform agricultural work during their pregnancy. Participants will be followed every two months until delivery. At each study visit fetal growth will be measured by ultrasound scan. During the course of their working day we will take the following measurements: continuous maternal physiological measurements (heart rate, respiratory rate, chest skin temperature and tri-axis accelerometer data); intermittent maternal tympanic core temperature, four point skin temperature, blood pressure; intermittent fetal heart rate and, if eligible, umbilical artery doppler; intermittent environmental measurements of air temperature, humidity, solar radiation and wind speed. Venous blood and urine will be collected at beginning and end of day for biomarkers of heat strain or fetal distress and hydration status.

Applicability of the model presented by Australian Bureau of Meteorology to determine WBGT in outdoor workplaces: A case study

The present study was aimed to investigate the applicability of the model presented by Australian Bureau of Meteorology (ABM) to determine the WBGT index recommended by the ISO in outdoor workplaces. This cross-sectional study was carried out on 12 construction materials mines in three districts of Tehran Province, Iran with different climatic conditions. The physiological parameters of all workers (175 men) and environmental variables at 33 work stations were monitored simultaneously at 9 am, 12 pm and 15. According to ISO 7243, heat stress was measured by the formula and also the WBGT index was calculated based on the model presented by the ABM. A significant relationship was found between measured and calculated values of WBGT in the three mentioned periods (P < .001) and the highest correlation was observed at 12 pm (r = 0.931). The significant relationships were observed between heat stress indices and all physiological parameters (P < .05). The highest correlation was found between the parameters of the oral temperature, tympanic temperature and the HR with measured and calculated WBGT, respectively (P < .05). simplicity, no need for sophisticated measuring equipment, and low cost can make the model a screening tool for assessing occupational heat stress in the studied outdoor mines.

Physical and perceptual cooling: Improving cognitive function, mood disturbance and time to fatigue in the heat.

This study investigated the effects of menthol swilling and crushed ice ingestion on cognitive function, total mood disturbance (TMD), and time to fatigue (TTF). Twelve male long-distance runners completed three counterbalanced running trials (3×30minutes at 65% VO2peak and a TTF run at 100% VO2peak ) in hot, humid conditions (35.3±0.3°C, 59.2±2.5% relative humidity). Trials consisted of precooling with crushed ice ingestion and mid-cooling by menthol swilling (MIX), precooling with water ingestion and mid-cooling by menthol swilling (MENTH), and control (CON). Swilling with either 25mL of menthol solution or placebo occurred upon entry to the heat, at 15-minute intervals during the run and prior to the TTF run. Core temperature, forehead skin temperature, tympanic temperature, perceived thermal sensation, and TMD were significantly lower with MIX compared with MENTH and CON (P<.05). Thirst was satiated in MIX compared with CON; however, MENTH did not have a significant effect. After 90minutes of running and post-TTF run, fewer errors occurred in the executive control task (P<.05), as well as decision-making and working memory (P>.05; d=0.5-0.79) between MIX and CON; however, MENTH had no effect compared with CON. The TTF run was significantly longer with MENTH (34.38%; P=.02) and MIX (39.06%; P=.001) compared with CON, with no difference between MENTH and MIX (P=.618). The physical reduction in core and internal head temperature seen with crushed ice ingestion may lead to improvements in cognitive function; however, both MENTH and MIX were sufficient for improving exercise performance.

Hyperprolactinemia Impaired the Effects of Lipopolysaccharide on Both Body Temperature and Sickness Behavior in Virgin Female Rats

Objective: Previously we observed an attenuation of body temperature in lactating rats treated with lipopolysaccharide (LPS) compared with virgin saline-treated females. We proposed that high levels of prolactin (PRL) during lactation may induce this attenuation because PRL has a suppressive effect on inflammation. In the present study, we induced hyperprolactinemia in female virgin rats to investigate the effects of PRL on body temperature and sickness behavior induced by LPS. Methods: To induce hyperprolactinemia, female rats in the estrous phase received domperidone 3 times/day for 5 days and an LPS injection (D + LPS group). Two other groups were treated with saline solution for 5 days, and one of them received a saline injection (S + S group) and the other LPS (S + LPS group). Tympanic temperature was assessed 0, 2, 4, 6, 8, 10, 24, 48, 72, and 96 h after treatment. Body weight gain and food and water consumption were observed 24, 48, 72, and 96 h after treatment. Results: Hyperprolactinemia impaired LPS-induced hypothermia and hyperthermia phases of body temperature. Body weight gains in the S + LPS group and the D + LPS group were similar. A decrease in food consumption was observed in the D + LPS rats at 72 and 96 h compared to the S + LPS group. Conclusion: Hyperprolactinemia impaired the body temperature increase induced by LPS and several signs of sickness behavior, suggesting that febrile responses to LPS can be modulated by the physiological state. These phenomena may have adaptive value for reproduction.

Effects on performance of active and passive hypoxia as a re-warm-up routine before a 100-metre swimming time trial: a randomized crossover study.

Passive and active hypoxia could be used as a tool during a transitional phase to maintain the effects of warm-up and optimize athletic performance. Our purpose was to evaluate and compare the effects of four different re-warm-up strategies, i.e. rest in normoxia (RN) at FiO2 = 20.9%, rest in hypoxia (RH) at FiO2 = 15%, active (5 minutes dryland-based exercise circuit) in normoxia (AN) and active in hypoxia (AH), during the transitional phase, on subsequent 100 m maximal swimming performance. Thirteen competitive swimmers (n = 7 males; n = 6 females; age: 15.1±2.1 years; height: 164.7±8.8 cm; weight: 58.1±9.7 kg; 100 m season’s best time 72.0±11.8 s) completed a 20-minute standardized in-water warm-up followed by a 30-minute randomized transitional phase and 100 m freestyle time trial. Compared to AH (73.4±6.2 s), 100 m swim time trials were significantly (p = 0.002; η2 = 0.766) slower in RN (75.7±6.7 s; p = 0.01), AN (75.2±6.7 s; p = 0.038) and RH (75.0±6.4 s; p = 0.009). Moreover, compared to AH (36.3±0.4ºC), tympanic temperature was significantly lower (p<0.001; η2 = 0.828) at the end of the transitional phase in passive conditions (RN: 35.9±0.6; p = 0.032; RH: 36.0±0.4; p = 0.05). In addition, countermovement jump height at the end of the transitional phase was significantly higher in active than in passive conditions (p = 0.001; η2 = 0.728). A dryland-based circuit under hypoxia could be useful to swimmers, once it has attenuated the decline in tympanic temperature during a 30-minute transitional phase after warm-up, improving 100 m swimming performance in young amateur swimmers.

Cardiovascular reactions for whole-body thermal therapy with a hot pack and Waon therapy

Background Waon therapy (WT) is the predominant thermal therapy for chronic heart failure in Japan, involving use of a far-infrared dry sauna. As sauna therapy requires certain equipment not readily available in hospitals, we tested the use of whole-body hot pack thermal therapy (HPTT). We compared the magnitude of skin vasodilation post-HPTT with that post-WT. Methods We recruited 19 healthy men (age [mean ± S.D.]: 26.8 ± 4.6 years) and employed a simple randomized crossover design. The HPTT required subjects to remain in a supine position on a bed for at least 10 min. Hot packs were then applied on the back, lower abdomen, and popliteal regions for 15 min (warming phase). Participants continued bed rest for 30 min (heat-retention phase) after removal of the hot pack. WT was performed as previously described. Blood pressure (BP), heart rate (HR), tympanic temperature (TT), and peak and average flow velocity of the right radial artery (PFV and AFV, respectively) and right brachial artery (BA) diameter were measured during HPTT and WT. Results HR, TT, PFV, and AFV persistently and significantly increased during warming and heat-retention phases of HPTT. In WT, HR and TT significantly increased during warming but decreased and plateaued during heat-retention. BP did not change significantly after either therapy; however, BA was dilated equally in both (HPTT: 3.70 ± 0.57 ⇒ 4.05 ± 0.59 mm, p = .001; WT: 3.63 ± 0.63 ⇒ 3.93 ± 0.61 mm, p < .001). Conclusion HPTT may be equivalent to WT with respect to vasodilation response of the skin.

Does magnetic resonance imaging increase core body temperature in children? Results of the administration of propofol and ketofol: a randomized clinical study.

Magnetic resonance imaging (MRI) may cause a temperature increase in the imaging area, while intravenous anesthetics may develop a tendency for hypothermia, especially in the pediatric population. The effect of different anesthetics on core body temperature in children during these procedures remains controversial. We examined the effect of propofol and ketofol on core body temperatures in a pediatric population during MRI. Our hypothesis was that the increase in body temperature will be more prominent in pediatric patients receiving ketofol than in those receiving propofol. This was a randomized, prospective, double-blind study in pediatric patients aged 6 months to 10 years. The patients were American Society of Anesthesiologist (ASA) physical class I-II who had undergone MRI under anesthesia at the Cerrahpasa School of Medicine, MRI Area, between August 2014 and February 2016. Patients were assigned to one of two groups: Group I (propofol group) and Group II (ketofol group). MRIs were performed with a 1.5 Tesla (T) device. Bilateral tympanic membrane temperature measurements before and after the procedure were performed. Body temperature decreased in both groups after MRI. Clinically significant hypothermia or hyperthermia was not observed in any of the patients. Temperature monitoring is not necessary for every patient being imaged. However, temperature changes should be closely monitored in high-risk patients.

Postoperative hypothermia and associate factors at Debre Berhan comprehensive specialized hospital 2019: A cross sectional study

BackgroundHypothermia is a core body temperature less than 36 °C (96.8 °F). It is a common incident in the immediate postoperative period. Postoperative hypothermia is associated with prolong hospital, post-anesthetic care unit or intensive care unit (ICU) stay, surgical site infection, postoperative blood transfusions, pressure ulcers, decrease patient comfort and satisfaction, subjective discomfort and mortality, cardiovascular complications, and increase cost. In an effort to decrease the occurrence of postoperative hypothermia, it would be helpful to identify and correct significant associated factors. ObjectiveThe objective of this study was to determine the incidence of postoperative hypothermia and identify associated factors. MethodA Hospital based cross-sectional study was undertaken. All postoperative (N = 410) patients that underwent scheduled or emergency surgery were included. Tympanic membrane temperature was measured before surgery and on arrival at recovery room. Analysis was done using SPSS version 22.00 and binary logistic regression was utilized to identify associated factors. ResultThe incidence of postoperative hypothermia immediately at recovery room was 130 (31.71%). From these, 57 (43.85%) and 73 (56.15%) were mild and moderate respectively with no severe hypothermia noticed. The multivariate logistic regression indicated that age >50 [(AOR = 4.91; 95% CI, 1.23; 8.98)], ASA II [AOR = 4.02; 95% CI (1.53–9.56)], ASA III [AOR = 6.04; 95% CI (2.04–15.05)], major surgical procedures [AOR = 3.03; 95% CI (1.27–8.79)], general anesthesia [AOR = 6.32; 95% CI (2.41–13.03)] and coexisting disease [AOR = 3.12; 95% CI (1.02–8.27)] were are significantly associated with postoperative hypothermia. Conclusion and recommendationThe incidence of postoperative hypothermia in recovery room was high. Age greater than 50 years old, high ASA physical status, operation done under general anesthesia, major operations and coexisting disease were strongly associated with postoperative hypothermia. All perioperative surgical team should participate to reduce the occurrence of postoperative hypothermia with early prediction and diagnosis for better outcome of patient.

Safe Conduct of Professional Examinations During the COVID-19 Pandemic in Hong Kong: A Descriptive Study

Background: Many medical schools and specialist accreditation bodies worldwide have cancelled or postponed professional examinations due to the COVID-19 pandemic. In Hong Kong, final-year medical students are not required to sit public examinations to qualify; rather rely on internal assessment. We therefore proceeded to administer all scheduled final-year statutory examinations during the months of April and May 2020. Methods: All 206 graduating medical students sat both written and objective structured clinical (OSCE) examinations under conditions of strict infection control, including self-reported health declaration forms (HDF), temperature screening and viral polymerase chain reaction (PCR) testing. Findings: Between 201 and 203 students who submitted a clean HDF were permitted to attend the examination venues. Fifteen (7·3%) students were found to have a tympanic temperature of ≥37·5°C on April 1, 2020, but their posterior oropharyngeal saliva samples taken on the same day were COVID-19 PCR-negative. Another 2 and 1 students were found to have a temperature ≥37·5°C on April 3, 2020 and April 9, 2020 respectively, but who were also tested COVID-19 PCR-negative. The tympanic temperatures of these 18 candidates were significantly higher than the rest throughout all examination days of the written (p≤0·0014) and OSCE (p≤0·039) examinations (except on April 15, 2020), suggestive of a higher basal body temperature. All staff members and participating patients with close contacts with the candidates/staff were free from COVID-19 before and after all examinations, up to 14 days post hoc. Interpretation: Rigorous clinical professional examinations could be safely conducted during the COVID-19 pandemic provided stringent infection control measures were followed. The choice of body temperature cutoff could significantly impact the assessment process for which we propose a number of mitigating measures for future reference. Funding Statement: None Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This cohort study was approved by HKUMed and designed by the investigators.

Use of handheld infrared thermometers in COVID-19 pandemic for mass screening: Understanding its implications through a case report.

Use of handheld infrared thermometers in COVID-19 pandemic for mass screening: Understanding its implications through a case report.

Comparison of the Effect of Cold Fluid and Crushed Ice Ingestion on Thermoregulatory Responses during Physical Activity in a Simulated Hot-Humid Environment

It has been reported that internal precooling via fluid ingestion is useful for hyperthermia prevention during exercise; however, its application in the occupational setting is unclear. This study aims to compare the effect of pre-cooling using cold fluid and crushed ice ingestion on thermoregulatory responses during simulated occupational activity in a hot and humid environment. Nine healthy males completed treadmill exercise for 30-min at an intensity of 65% of predetermined HRmax in a chamber set at 36.6±0.8℃ of air temperature and 72±6% of relative humidity. Before the exercise, they preceded ingested 7.5 ml kgSUP-1/SUP body mass of cold drink (4℃), crushed ice (-2℃), or mineral water (28℃) for pre-cooling. Ingesting crushed ice before the activity significantly lowered the pre-activity tympanic temperature than the cold beverage. Also, crushed ice ingestion showed more significant effects in lowering heart rate and improving heat sink at the post-activity phase compared to cold beverage ingestion. These findings suggest that crushed ice ingestion may be more practical to minimize physiological and subjective thermal strain during occupational activity than ingesting cold fluid.

Efficacy of rescue blanket versus conventional blanket in terms of preventing accidental hypothermia during patient transfer by emergency medical service: a randomized clinical trial

Objective: This study aimed to compare the efficacy of rescue blankets with conventional blankets in terms of preventing hypothermia in the pre-hospital setting. Methods: In this randomized clinical trial, patients older than 18 years old with Cold Discomfort Scale (CDS) &gt; 2, and those who were transferred to the emergency department (ED) by emergency medical service entered the study. Patients were randomly divided into two groups based on the type of transfer. In this regard, one group was transferred with rescue blankets and the other group was transferred with conventional blankets. The tympanic temperature in patients and CDS were recorded before the use of blanket (primary) and at the time of arrival in the ED (secondary). Results: Finally, 161 patients with the mean age of 45.31±19.8 years were included (63.4% were male). Totally, 88 cases (54.7%) were transferred with rescue blankets and 73 cases (45.3%) with conventional blankets. The mean of the primary tympanic temperatures in the rescue and conventional blanket groups were 36.20±0.84°C and 36.34±0.65°C, respectively (P=0.23). The mean of the primary CDS in rescue and conventional blanket groups were 6.55±1.95 and 5.89±2.29, respectively (P=0.05). Also, the mean of the secondary tympanic temperatures in the rescue and conventional blanket groups were 36.59±0.47°C and 36.76±0.48 °C, respectively (P=0.03). Besides, the mean of the secondary CDS in the rescue and conventional blanket groups were 2.64±2.80 and 2.41±1.29, respectively (P=0.48). Conclusion: According to the results, there is no significant difference in the tympanic temperature and CDS of the patients transferred with the rescue blanket compared with the conventional blanket.

Beta-blockers' effect on Levels of Lactate in patients with suspected sepsis - The BeLLa study.

In the assessment and management of septic patients in the emergency department (ED), serum lactate is often measured to stratify severity to guide decision making. Increased adrenergic drive has been postulated as a contributory factor for hyperlactatemia in sepsis. We aim to prospectively evaluate the effect of chronic beta-blocker use on serum lactate levels in sepsis at initial presentation to the ED. We conducted a prospective observational study at the ED of a tertiary care academic medical center in Singapore. One hundred and ninety-five ED patients who fulfilled all of the following: (1) age 45years and above, (2) tympanic temperature≥37.8°C or clinically suspected to have an infection, and (3) quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score≥1 were included in the study. Serum venous lactate was sampled within two hours from presentation to the ED. The primary outcome measure was the difference in initial serum venous lactate concentration at presentation to the ED in patients on chronic beta-blockers versus patients without. Seventy patients (35.9%) were on long-term beta-blocker therapy. The primary outcome of mean initial serum venous lactate concentration was similar between patients prescribed chronic beta-blocker therapy and patients without (1.78mmol/L versus 1.70mmol/L, p=.540). Chronic beta-blocker therapy also did not significantly affect mean initial serum venous lactate concentration across all subgroups of sepsis risk stratification. Long-term beta-blocker therapy did not significantly affect initial serum venous lactate concentration in ED patients with suspected sepsis.

Diurnal change in psychological and physiological responses to consistent relative humidity.

Diurnal changes in physiological and psychological responses to consistent relative humidity (RH) conditions were investigated in the present study. Lightly clothed six male and six female subjects participated in the first experiment at 40% and 50% RH, and seven male and seven female subjects participated in the second experiment at 60%, 70%, and 80% RH. Both experiments were conducted at 28°C air temperature (Ta) from 9:00-18:30. Skin temperatures, local heat flux rates and tympanic temperature (Tty) were monitored at 2-min intervals throughout the experimental period. Body weight loss and oxygen consumption rate were measured during the 9:30-10:30, 13:30-14:30, and 17:30-18:30 periods. Thermal sensation and thermal comfort responses were recorded at the same periods. The amount of heat loss was greater than metabolic heat production (M) in the male subjects but was well balanced with M in the female subjects. A morning increase in Tty at 50%-80% RH was observed, and mean skin temperature (T‾sk) at 70% and 80% RH was significantly higher (p<0.05) than Tsk at 40% and 50% RH in both subject groups. Although difference in the relationship between thermal sensation and T‾sk based on sex was confirmed, diurnal changes in thermal sensation were observed in both subject groups based on the responses of "warm" in the morning but "neutral" or "slightly warm" in the evening at 70% and 80% RH. This result demonstrates that high RH may be acceptable in the late afternoon and evening at 28°C and indicates that dynamic control of RH during the daytime (e.g., low RH in the morning and high RH in late afternoon) may be beneficial to save energy when using air-conditioning.

Effect of increasing dietary energy density during late gestation and lactation on sow performance, piglet vitality, and lifetime growth of offspring.

Genetic selection for hyperprolificacy in sows has resulted in a significant increase in the number of piglets born alive per litter but subsequently, decreased piglet vitality and growth. As a consequence, increasing sows' energy intake during lactation to help increase piglet vitality and growth is increasingly important. The objective of this study was to investigate the effect of increasing dietary energy density for lactating sows on weight and back-fat changes in sows, milk composition, and vitality and growth of progeny. Gestating sows (N = 100; Large White × Landrace) were randomly assigned to one of four energy dense diets at day 108 of gestation until subsequent service; 13.8 (LL), 14.5 (L), 15.2 (H), and 15.9 MJ DE/kg (HH). All diets contained 1.2% total lysine. Blood samples from sows were taken on day 108 of gestation and at weaning (day 26 of lactation) and colostrum (day 0) and milk samples (day 14) were collected during lactation. Sow lactation feed intakes were recorded daily. The number of piglets born per litter (total and live), piglet birth weight (total and live), intrauterine growth restriction (IUGR) traits and muscle tone were recorded in piglets at birth. Piglet tympanic ear temperature (TEMP) was recorded at birth and at 24 h. Pigs were weighed on days 1, 6, 14, 26, 33, 40, 54, 75, and 141 of life. Postweaning (PW) pigs were fed standard cereal-based diets. Pig carcass data were collected at slaughter (day 141). Lactation energy intake was higher for HH sows than for all other treatments (P < 0.01). Colostrum and milk composition and lactation feed intake were not affected by treatment. The number of piglets born per litter (total and live) and piglet birthweight (total and live) was similar between treatments. Piglets from LL sows had more IUGR traits (P < 0.01), while those from HH sows had better muscle tone (P < 0.01) than all other treatments. Piglets from LL sows (P < 0.01) and piglets from H sows (P < 0.01) had a higher 24 h TEMP than piglets from HH sows. H sows weaned a greater number of piglets than L sows (P < 0.05) and HH sows (P < 0.01), while L sows weaned lighter litters than H (P < 0.05) and LL sows (P < 0.05). Pig growth PW was unaffected by treatment. High energy dense diets increased energy intake in sows, without depressing appetite. Feeding an HH diet improved piglet muscle tone at birth, whereas feeding an H diet increased litter size at weaning. Inconsistent results were observed for other traits of piglet vitality and for preweaning litter growth performance.

Evaluating the Interchangeability of Forehead, Tympanic, and Axillary Thermometers in Italian Paediatric Clinical Settings: Results of a Multicentre Observational Study

PurposeThis study was conducted to investigate the interchangeability of infrared forehead, digital axillary, and infrared tympanic thermometers while identifying the most reliable non-invasive body temperature measurement method in paediatric settings. Design and methodsA multicentre observational study was conducted enrolling all children less than or equal to 14 years of age requiring a temperature measurement and after obtaining their parent's informed consent. Socio-demographic characteristics and temperature values in Celsius (°C) were simultaneously collected using forehead, axillary, and tympanic thermometers. ResultsA total of 433 children were enrolled, 57.5% were male and the mean age was 5.3 ± 3.9 years. The average value of tympanic temperature (37.05 °C) was higher than forehead (36.87 °C) and axillary (36.8 °C). The mean difference between axillary and forehead temperatures (−0.06 °C) was not statistically significant (p = 0.158). Comparing the measurements of each type of thermometer with the overall average of the three measurements recorded as the virtual gold standard, Bland Altman analysis highlighted tympanic with narrower 95% limits of agreement (+0.96 °C to −0.68 °C). The tympanic thermometer also had the highest percentage (81.6%) of differences falling within the maximum clinically acceptable difference (±0.5 °C). ConclusionsDifferences between paired measurements of the three investigated devices demonstrated the devices are not interchangeable. Measurements using the tympanic thermometer more closely resembled the reference temperature indicating its preferential use in paediatric clinical practice. Practice implicationsTo safely and consistently measure body temperature, nurses should not assume peripheral thermometers are interchangeable. It is essential to clinically validate all temperature values with clinical observations.

Hand heating lowers postprandial blood glucose concentrations: A double-blind randomized controlled crossover trial

ObjectivesExamine effect of single hand heating with and without negative pressure on fasting blood glucose (FBG) and postprandial blood glucose (PBG). DesignDouble-blind randomized controlled trial with crossover design. SubjectsFBG experiment: 17 healthy subjects (4 males). PBG experiment: 13 healthy subjects (1 males). InterventionsDevices included one providing heat only, one heat and negative pressure, and one acting as a sham. For the FBG experiment the devices were used for 30 min. For the PBG experiment the devices were used for one hour during an oral glucose tolerance test (OGTT). Outcome MeasuresBlood glucose measurements were used to determine change in FBG, peak PBG, area under the curve (AUC), and incremental AUC (iAUC). ResultsTemperature: Change in tympanic temperature was ≤ 0.15 °C for all trials. FBG: There was no effect on FBG. PBG: Compared to the sham device the heat plus vacuum and heat only device lowered peak blood glucose by 16(31)mg/dL, p = 0.092 and 18(28)mg/dL, p = 0.039, respectively. AUC and iAUC: Compared to the sham device, the heat plus vacuum device and heat only device lowered the AUC by 5.1(15.0)%, p = 0.234 and 7.9(11.1)%, p = 0.024 respectively and iAUC by 17.2(43.4)%, p = 0.178 and 20.5(34.5)%, p = 0.054, respectively. ConclusionsHeating a single hand lowers postprandial blood glucose in healthy subjects.

Clinical and epidemiological characteristics of imported dengue fever among inbound passengers: Infrared thermometer-based active surveillance at an international airport.

BackgroundDengue fever is endemic in tropical and subtropical areas, especially Southeast Asia. International air travel facilitates the spread of dengue across and within borders. To date, no predictive factors have been established for assessing risk of dengue among febrile travelers.MethodsSince 2006, Taiwan has operated a program of infrared thermometer–based non-contact active surveillance at Taoyuan International Airport (TPE). All inbound passengers from dengue-endemic countries who are febrile (tympanic temperature ≥38°C) undergo routine laboratory testing for dengue. We analyzed clinical and epidemiological characteristics of all tested passengers entering Taiwan via TPE in 2011 to identify the predictive factors of dengue infection.ResultsIn 2011, of the 3,719 febrile passengers from dengue-endemic countries, 74 (2.0%) had laboratory-confirmed dengue infection. Multivariable logistic regression analysis revealed that those who were aged ≥60 years (adjusted odds ratio [aOR], 8.7; 95% confidence interval [CI], 2.6–29.6) and had self-reported fever (aOR, 2.5; 95% CI, 1.5–4.1), skin rashes (aOR, 11.0; 95% CI, 3.4–35.1), or a tympanic temperature ≥39°C (aOR, 2.9; 95% CI, 1.7–4.9) were significantly more likely to have dengue (all p values < 0.05). Compared with travelers who stayed in dengue-endemic countries for ≤7 days, those who traveled 8–14, 15–21, 22–28, and ≥29 days were also more likely to be infected (aORs of 10.2, 14.9, 39.0 and 12.0, respectively).ConclusionThese clinical and epidemiological features can facilitate timely recognition and diagnosis of imported dengue in febrile inbound passengers and therefore help prevent domestic transmission of dengue virus.

PSII-9 Body core and skin temperatures in suckling piglets measured by infrared thermography and thermometry methods

Abstract Monitoring piglets’ temperatures after birth is crucial to prevent losses caused by hypothermia and ensure well-being. Rectal measuring, which is still considered the ‘gold standard’ for assessing core temperatures, takes time and requires fixation. Aim of this study was to evaluate the effectiveness of infrared thermography and thermometry in comparison to rectal temperatures. In one to seven days old piglets, rectal temperatures were measured with digital thermometers (DT) (Geratherm® GT-195-1) (n = 958), tympanic membrane temperatures with an infrared ear thermometer (IET) (ThermoScan® IRT6520) (n = 424), skin temperatures with infrared laser thermometers (ILT) (Eventek™ ET312) behind the ear (n = 671), an infrared camera (IC) (Optris® PI400) at six body locations (n≥488) or an infrared camera attachment (ICA) (FLIR ONE® for iOS) (n = 60). Devices’ reliability was tested. Correlations and differences (GLM) were estimated with SAS® 9.4. DT devices and repeated measurements showed no differences (n = 77). Repeated IET measurements at left and right ear were not different (n = 57). Temperatures decreased for ILT when measured from 10, 30, 50, and 100cm (P &amp;lt; 0.001; n = 360). Three ILT devices obtained different values (P &amp;lt; 0.001). At 10cm, means were different at left and right side (P &amp;lt; 0.001). For following results, the same device was used for all measurements (10cm, left). Highest correlations were found between DT and IET (r = 0.93; P &amp;lt; 0.001) and ILT (r = 0.81; P &amp;lt; 0.001). All infrared temperatures were lower (P &amp;lt; 0.001) than rectal temperatures (38.8°C), except IET (38.7°C). For IC, temperatures at inner thigh and lower abdomen correlated best with DT (0.59≤r≤0.62; P &amp;lt; 0.001). IET seems suited for assessing temperatures in piglets as it is reliable, with values comparable to DT. For IC, inner thigh and lower abdomen seem promising locations, but fixation is still required for both techniques. ILT is an option for estimating core temperatures at a short distance, but reliability needs to be considered.