Tympanic Temperature Research Articles

Diurnal Variation in Anaerobic Performance: Effect of Core Body Temperature

The purpose of this study was to investigate the effects of circadian rhythm on anaerobic performance and body temperature determined through three different methods. Ten elite male taekwondo athletes (average age: 23.9±2.7 years, height: 178.7±4.9 cm, body mass: 72.1±7.8 kg, training experience: 12.5±4.9 years) participated in the study. The body temperatures of the participants were measured in the morning of the first day, (between 09:00-10:00 a.m.), and in the early evening (between 16:00-17:00 p.m.) through three different methods (Core body temperature, tympanic temperature, and skin surface temperature). The participants performed Wingate test (WT) both in the morning and in the early evening. Core body temperature was significantly higher in early evening than it was in the morning (p 0.05). However, there was no significant difference between morning and early evening for peak power, mean power, and fatigue index values (p>0.05). As a result, a significant increase was observed in core body temperature in early evening compared to morning, but this increase did not show a positive effect on anaerobic performance.

소방용 개인보호장비 및 공기호흡기 착용에 따른 반복 소방활동이 체온 및 스트레스 호르몬에 미치는 영향

The aim of this study is to examine the effects of body temperature(tympanic and skin temperature) and stress hormone(serotonin, cortisol, ACTH) wearing firefighters" personal protective equipment(PPE) with self contained breathing apparatus(SCBA) in repetitive firefighting. Fifteen male students(Age: 23.87±0.64 yrs, Height: 177.53±4.09 cm, Weight: 73.65±11.64) participated in this study. Each participants performed under the 2 different treatments[PPE(10.8 kg)/ PPE+SCBA(22.1 kg)]. Main results were as follows: Main results were as follows: First, tympanic temperature showed significant difference in main effect of time and interaction effect of treatment and time. Secondly, mean skin temperature showed significant difference in main effect of time and interaction effect of treatment and time. Thirdly, Cortisol and serotonin showed significant difference in main effect of time. There were no significant differences between the two treatments all times. Lastly, ACTH showed significant difference in main effect of time and interaction effect of treatment and time. It is suggested that PPE+SCBA can induce increase body temperature, responses of cortisol and serotonin which may negatively influence on firefighting. Further research on physiological variables during various firefighting tasks should also be carried out. In addition, continuous study on the reducing weight of fire protective equipments is necessary for the safety of firefighter.

Comparison of different wheelchair seating on thermoregulation and perceptual responses in thermoneutral and hot conditions in children

We examined the effects of 4 different wheelchair seatings on physiological and perceptual measures in 21 healthy, pre-pubertal children (9 ± 2 years). Participants were able-bodied and did not regularly use a wheelchair. Participants sat for 2 h in Neutral (∼22.5 °C, ∼40%RH) and Hot (∼35 °C, ∼37%RH) conditions. Four seating technologies were: standard incontinent cover and cushion (SEAT1); standard incontinent cover with new cushion (SEAT2) were tested in Neutral and Hot; new non-incontinent cover with new cushion (SEAT3); new incontinent cover and new cushion (SEAT4) were tested in Neutral only. Measurements included skin blood flow (SkBF), sweating rate (SR) and leg skin temperature (TlegB) on the bottom of the leg (i.e. skin-seat interface), heart rate (HR), mean skin temperature, tympanic temperature, thermal comfort, and thermal sensation. During Neutral, SkBF and TlegB were lower (∼50% and ∼1 °C, respectively) and SR higher (∼0.5 mg cm−2·min−1) (p < 0.05) with SEAT3 compared to all other seats. SkBF was ∼30% lower (p < 0.05) for SEAT2 and SEAT4 compared to SEAT1. No other differences were observed between SEATs (all p > 0.05). During Hot, HR and temperatures were higher than in Neutral but there were no differences (p > 0.05) between SEATs. New cover and cushion improved thermoregulatory responses during Neutral but not Hot. An impermeable incontinent cover negated improvements from cushion design. Seat cover appears more important than seat cushion during typical room conditions.

Effect of change in ambient temperature on core temperature of female subjects during the daytime and its sex differences.

Tympanic temperature (Tty), skin temperature, and regional dry heat loss were measured continuously in eight female subjects under three conditions: (1) stepwise increases in ambient temperature (Ta) from 26°C at 09:00 to 30°C at 18:00, (2) steady Ta at 28°C from 09:00 to 18:00, and (3) stepwise decreases in Ta from 30°C at 09:00 to 26°C at 18:00. Oxygen consumption, body weight loss, thermal sensation, and comfort levels were periodically recorded. The Tty increased significantly (p < 0.01) from 36.1 ± 0.36°C to 36.6 ± 0.23°C at 18:00 under condition 1 but remained virtually unchanged under conditions 2 and 3. Thermal comfort was observed at 15:00 and 17:00 under condition 3, whereas subjects reported that they felt slightly cool at 15:00. The rate of body heat storage (S), changes in Tty, mean skin temperature ([Formula: see text]sk), and mean body temperature during each period were calculated, and confirmed that changes in [Formula: see text]sk was correlated with S. Diurnal changes in core temperature (Tc) appeared to be more dependent on diurnal rhythm than on changes in Ta, except when Ta increased continuously. Thus, it may be difficult to predict diurnal changes in women's Tc using a body-heat-balance equation during thermal transient.

Feasibility and Safety of Transnasal High Flow Air to Reduce Core Body Temperature in Febrile Neurocritical Care Patients: A Pilot Study.

Fever is an important determinant of prognosis following acute brain injury. Current non-pharmacologic techniques to reduce fever are limited and induce a shivering response. We investigated the safety and efficacy of a novel transnasal unidirectional high flow air device in reducing core body temperature in the neurocritical care unit (NCCU) setting. This pilot study included seven consecutive patients in the NCCU who were febrile (> 37.5°C) for > 24h despite standard non-pharmacologic and first-line antipyretic agents. Medical grade high flow air was delivered transnasally using a standard continuous positive airway pressure machine with a positive pressure of 20cmH2O for 2h. Core esophageal and tympanic temperature were continuously monitored. Mean age was 40 ± 14yo, and 72% (5/7 patients) were men. Five patients had intracerebral or intraventricular hemorrhage, one subject had transverse myelitis, and the remaining patient had anoxic brain injury due to a cardiac arrest. After 2h of cooling, core temperature was significantly lower than the baseline pre-cooling temperature (37.3 ± 0.5°C vs. 38.4 ± 0.6°C; p < 0.002). Mean transnasal airflow rate was 57.5 ± 6.5 liters per minute. Five of the seven subjects were normothermic at the end of the 2-h period. One subject with severe hyperthermia (39.7°C) and the other with multiple interruptions to therapy due to technical reasons did not cool. The core temperature within 30min of cessation of airflow increased and was similar to the pre-cooling baseline temperature (38.3 ± 0.4°C vs. 38.4 ± 0.6°C, p = NS). Rate of core cooling was 0.6 ± 0.15°C per hour at this flow rate. No shivering response was observed. No protocol-related adverse events occurred. High flow transnasal air in a unidirectional fashion lowers core body temperature in febrile patients in the NCCU setting. No adverse events were seen, and the process showed no signs of shivering or any other serious side effects during short-term exposure. This pilot study should inform further investigation.

Thermal and cardiovascular responses and thermal sensation during hot-water bathing and the influence of room temperature.

The aim of the present study was to clarify physical risks during hot-water bathing by measuring thermal and cardiovascular responses and thermal sensation. Young men and women (n = 7 and 5, respectively) participated in the present study, which consisted of two trials mimicking bathing behavior at room temperature of 25 °C and 15 °C. Participants bathed in 41 °C water for 20 min to the subclavian level. Before bathing, participants rested fully clothed for 15 min and then rested for 15 min without clothes. After bathing, they rested without clothes for 15 min and afterwards rested fully clothed for another 15 min. Tympanic temperature (Tty), heart rates (HR), mean skin temperature (Tsk), mean arterial pressure (MAP), and laser-Doppler flow at the chest and forehead (LDFhead and LDFchest) were evaluated. Thermal perception was assessed with a visual analogue scale. Mean Tsk in the 15 °C trial decreased during the period without clothing while MAP increased. The value remained unchanged in the 25 °C trial. During bathing, Tty, mean Tsk, HR, LDFhead, and LDFchest increased in both trials, and MAP decreased to similar levels. Relative change in LDFchest was greater in the 15 °C trial than in the 25 °C trial. Participants felt cold when they were without clothes at 15 °C; however, the thermal perception during bathing was similar between the two trials. Greater changes in cardiovascular and thermal responses were observed during the bathing behavior. In addition, bathing in cold room augmented the changes, which may induce some physical risks during bathing.

Head cooling during sleep improves sleep quality in the luteal phase in female university students: A randomized crossover-controlled pilot study.

Although selective head-cooling has been reported to decrease scalp and tympanic temperature and improve sleep quality, whether head-cooling during sleep can improve sleep quality in women during the luteal phase has not been elucidated. This randomized, controlled crossover open trial aimed to investigate the effect of head cooling during sleep on sleep quality in women during the luteal phase. Female university students aged 19–25 years with increased daytime sleepiness during the luteal phase were recruited by poster advertisement at their university from May to June 2016 and from May to June 2017. Fourteen women aged 19–22 years participated in this study. The temperature-controllable cooling sheet containing tubes filled with circulating water was used for head-cooling, and the head-cooling and the controlled temperature were set at 25°C and 35°C, respectively. Electroencephalogram data were obtained using a single-channel portable electroencephalogram device. The difference in sleep-related variables and tympanic temperature between head-cooling and control were analyzed using a linear mixed model. The proportion of arousal was lower with head cooling than with the control. In contrast, the proportion of non-REM3 and the delta power were higher with head cooling than with the control. The proportion of non-REM2 and non-REM3 among sleep EEG stages were positively and negatively correlated with the mean tympanic temperature during sleep, respectively. However, arousal and REM were not correlated with tympanic temperature. We considered the reduction of arousal time by head-cooling might be related to scalp temperature rather than tympanic temperature. Further, our results suggested that head-cooling also improved subjective sleep comfort. In conclusion, head-cooling during sleep could improve sleep quality in young women during the luteal phase.

Vaccination with an inactivated canine influenza H3N2 virus vaccine is safe and elicits an immune response in cats.

ObjectivesThe aim of this study was to evaluate safety and seroconversion when an inactivated H3N2 canine influenza virus (CIV) vaccine was administered to cats.MethodsTwenty 7–8-week-old seronegative cats were randomly assigned to two groups of 10 animals each. Cats in treatment group T01 were subcutaneously administered two doses of an adjuvanted placebo 3 weeks apart to serve as non-immunized controls. Cats in treatment group T02 were subcutaneously administered with two doses of H3N2 CIV vaccine at 3 weeks apart. All animals were actively monitored for 5 days after each injection for local and systemic reactions. Tympanic temperatures were recorded the day before and 5 days after each vaccination. Blood samples for serology were collected prior to each vaccination (days –1 and 20), and 7 and 14 days post-second vaccination.ResultsMinor vocalization was observed in both control and vaccinated animals after the first and second dose administration. The only injection site reaction observed was mild swelling in one control cat, which resolved within 24 h. Transient fevers (39.5–39.7°C) that resolved within 24 h post-injection were observed in both treatment groups (T01 = 3/10 and T02 = 5/10). All vaccinated, but no control, animals successfully seroconverted within 14 days of second vaccination, with H3N2 CIV-specific hemagglutination inhibition (HAI) titers ranging from 32 to 128.Conclusions and relevanceCats vaccinated subcutaneously with an inactivated H3N2 CIV vaccine had similar rates of adverse events post-vaccination as the control group. Increased HAI titers provided evidence of post-vaccination seroconversion with the H3N2 CIV-vaccinated group.

Finger Temperature: A Psychophysiological Assessment of the Attentional State.

Attention is a key cognitive phenomenon that is studied to understand cognitive disorders or even to estimate workloads to prevent accidents. Usually, it is studied using brain activity, even though it has many psychophysiological correlates. In the present study, we aim to evaluate if finger temperature, as a surrogate of peripheral vasoconstriction, can be used to obtain similar and complementary information to electroencephalography (EEG) brain activity measurements. To conduct this, 34 participants were recruited and submitted to performing four tasks—one as a baseline, and three attentional tasks. These three attentional tasks measured sustained attention, resilience to distractors, and attentional resources. During the tasks, the room, forehead, tympanic, and finger temperatures were measured. Furthermore, we included a 32-channel EEG recording. Our results showed a strong monotonic association between the finger temperature and the Alpha and Beta EEG spectral bands. When predicting attentional performance, the finger temperature was complementary to the EEG spectral measurements, through the prediction of aspects of attentional performance that had not been assessed by spectral EEG activity, or through the improvement of the model’s fit. We also found that during the baseline task (non-goal-oriented task), the spectral EEG activity has an inverted correlation, as compared to a goal-oriented task. Our current results suggest that the psychophysiological assessment of attention is complementary to classic EEG approach, while also having the advantage of easy implementation of analysis tools in environments of reducing control (workplaces, student classrooms).

Effect of intraoperative warming on delirium during emergence from general anesthesia in elderly patients

Objective To evaluate the effect of intraoperative warming on delirium during emergence from general anesthesia in elderly patients. Methods Eighty elderly patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective total hip replacement, were assigned to routine group (group R, n=40) and warming group (group W, n=40). The non-operated site was covered using the sterile cloth, and no other active warming measurements were given in group C. Fluid was infused and warmed to 37 ℃, the non-operated site was covered using the forced-air warming system, and the temperature of the forced-air warming system was maintained at 38-42 ℃ in group W. The tympanic membrane temperatures was recorded at 5 min after anesthesia induction, at 30, 60 and 90 min after beginning of surgery, at the end of surgery and at 30 min after emergence from anesthesia, and the difference between monitored values and monitored values on admission to operating room (△T) was recorded at each time point. The intraoperative volume of fluid infused, operation time, extubation time, duration of postanesthesia care unit stay and development of delirium during emergence and shivering were recorded. Results Compared with group R, △T was significantly decreased at 60 and 90 min after beginning of surgery, the incidence of delirium during emergence and shivering was decreased, the extubation time and duration of postanesthesia care unit stay were shortened in group W (P<0.05). Conclusion Intraoperative warming can decrease the development of delirium during emergence from general anesthesia and is helpful in improving the quality of recovery from anesthesia in elderly patients. Key words: Body temperature; Aged; Anesthesia recovery period; Delirium

Unique temperature patterns in 24-h continuous tympanic temperature in tuberculosis.

Body temperature monitoring in most healthcare institutions is limited to checking the presence or absence of fever. Our present study evaluated the 24h continuous tympanic temperature pattern in patients with fever in order to detect typical patterns seen in tuberculosis (TB). This observational study was conducted on 81 undifferentiated fever patients whose recordings were stored using the TherCom device. Unique temperature patterns were analysed and compared. TB patients exhibited a unique temperature pattern, namely a slow temperature elevation followed by slow temperature fall seen in 78.5% (22/28) compared to 24.52% (13/53) of non-TB patients. Recognition of this pattern may therefore be useful as a valuable diagnostic aid in the early diagnosis of TB.

The effects of novel α2-adrenoreceptor agonist dexmedetomidine on shivering in patients underwent caesarean section.

Objective: Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia (CSEA).Methods: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, n=50) and meperidine positive control group (Group M, n=50). Primiparas experienced shivering that continued to cord clamping were treated with dexmedetomidine (0.5 μg/kg) or meperidine (0.5 mg/kg) after cord clamping. The primary outcome measures were incidence of nausea, vomiting, and respiratory depression. Secondary outcome measures were shivering score, vital signs including blood pressure, heart rate and O2 saturation, tympanic temperature, and sedation score.Results: Dexmedetomidine provided similar anti-shivering effects as meperidine in patients after caesarean delivery under CSEA, evidenced as all shivering primiparas responded to either dexmedetomidine or meperidine treatment within 15 min. However, incidence of nausea and vomiting were significantly lower after dexmedetomidine treatment, accompanied with more stable blood pressure. Dexmedetomidine also provided well regulation of tympanic temperature and good sedation.Conclusion: Selective α2-adrenoreceptor agonist dexmedetomidine has a better safety profile compared with meperidine for anti-shivering in primiparas undergoing caesarean delivery. Dexmedetomidine could be a better choice for anti-shivering in patients requiring caesarean section. The mechanism of anti-shivering for dexmedetomidine may relate to well regulation of temperature and good sedation.

Milk yield and hair coat characteristics of Holstein cows in a hot environment.

This study was conducted to evaluate the effects of hair coat characteristics on thermophysiological variables and body surface temperatures (BST), measured with infrared thermography, as well as milk yield of Holstein cows in a hot environment. Physiological and milk yield variables were assessed using 103 pluriparous Holstein cows. Also, hair angle (HA), density of hair coat (D), diameter of hair (HD), hair length (HL), weight of hair coat (Wt), and coat thickness (CT) were recorded. Biplot analysis (principal components analysis) revealed that HL was closely associated with Wt, CT, and HD and all these variables had a positive association with rectal temperature. Both CT and HL were found to be negatively associated with shoulder and neck temperature; tympanic temperature showed no association with BTS. Cows with short hair coat (length < 17mm) did not produce more milk in 305days than cows with longer hair coat (9673 ± 1604 vs. 9277 ± 817; P = 0.12). On the other hand, milk fat percentage at the middle of lactation was higher (P < 0.01) in cows with longer hair relative to cows with coat hair < 17mm (3.71 vs. 3.35%, respectively). In conclusion, physical characteristics of the coat of Holstein cows were not associated with the 305-day milk yield but cows with longer hair produced a greater milk fat percentage at the middle of lactation compared to cows with short hair.

Fatores de risco para hipotermia pós‐operatória em sala de recuperação pós‐anestésica: estudo piloto prospectivo de prognóstico

BackgroundHypothermia occurs in up to 20% of perioperative patients. Systematic postoperative temperature monitoring is not a standard of care in Brazil and there are few publications about temperature recovery in the postoperative care unit. Design and settingMulticenter, observational, cross‐sectional study, at Hospital de Base do Distrito Federal and Hospital Materno Infantil de Brasília. MethodsAt admission and discharge from postoperative care unit, patients undergoing elective or urgent surgical procedures were evaluated according to tympanic temperature, vital signs, perioperative adverse events, and length of stay in postoperative care unit and length of hospital stay. Results78 patients, from 18 to 85 years old, were assessed. The incidence of temperatures <36°C at postoperative care unit admission was 69.2%. Spinal anesthesia (p<0.0001), cesarean section (p=0.03), and patients who received morphine (p=0.005) and sufentanil (p=0.003) had significantly lower temperatures through time. During postoperative care unit stay, the elderly presented a greater tendency to hypothermia and lower recovery ability from this condition when compared to young patients (p<0.001). Combined anesthesia was also associated to higher rates of hypothermia, followed by regional and general anesthesia alone (p<0.001). ConclusionIn conclusion, this pilot study showed that perioperative hypothermia is still a prevalent problem in our anesthetic practice. More than half of the analyzed patients presented hypothermia through postoperative care unit admission. We have demonstrated the feasibility of a large, multicenter, cross‐sectional study of postoperative hypothermia in the post‐anesthetic care unit.

An acute dose of inorganic dietary nitrate does not improve high-intensity, intermittent exercise performance in temperate or hot and humid conditions

PurposeDietary nitrate (NO3−) has repeatedly been shown to improve endurance and intermittent, high-intensity events in temperate conditions. However, the ergogenic effects of dietary NO3− on intermittent exercise performance in hot conditions have yet to be investigated.MethodsIn a randomised, counterbalanced, double-blind crossover study, 12 recreationally trained males ingested a nitrate-rich beetroot juice shot (BRJ) (6.2 mmol NO3−) or a nitrate-depleted placebo (PLA) (< 0.004 mmol NO3−) 3 h prior to an intermittent sprint test (IST) in temperate (22 °C, 35% RH) and hot conditions (30 °C, 70% RH). The cycle ergometer IST consisted of twenty maximal 6 s sprints interspersed by 114 s of active recovery. Work done, power output, heart rate and RPE were measured throughout; tympanic temperature was measured prior to and upon completion.ResultsThere were no significant effects of supplement on sprint performance in either temperate or hot, humid conditions (p > 0.05). There was a reduced peak (BRJ: 659 ± 100W vs. PLA: 693 ± 139W; p = 0.056) and mean power (BRJ: 543 ± 29W vs. PLA: 575 ± 38W; p = 0.081) following BRJ compared to PLA in the hot and humid condition, but this was not statistically significant. There was no effect of supplement on total work done irrespective of environmental condition. However, ~ 75% of participants experienced performance decreases following BRJ in the hot and humid environment. No differences were observed between trials for tympanic temperature measured at the conclusion of the exercise trial.ConclusionIn conclusion, an acute dose of inorganic dietary NO3− does not improve repeated-sprint performance in either temperate, or hot and humid conditions.

Performance and carcass characteristics of steers fed with two levels of metabolizable energy intake during summer and winter season

Climate change is producing an increase on extreme weather events around the world such as flooding, drought and extreme ambient temperatures impacting animal production and animal welfare. At present, there is a lack of studies addressing the effects of climatic conditions associated with energy intake in finishing cattle in South American feed yards. Therefore, two experiments were conducted to assess the effects of environmental variables and level of metabolizable energy intake above maintenance requirements (MEI) on performance and carcass quality of steers. In each experiment (winter and summer), steers were fed with 1.85 or 2.72 times of their requirements of metabolizable energy of maintenance. A total of 24 crossbred steers per experiment were used and located in four pens (26.25 m2/head) equipped with a Calan Broadbent Feeding System. Animals were fed with the same diet within each season, varying the amount offered to adjust the MEI treatments. Mud depth, mud scores, tympanic temperature (TT), environmental variables, average daily gain, respiration rates and carcass characteristics plus three thermal comfort indices were collected. Data analysis considered a factorial arrangement (Season and MEI). In addition, a repeated measures analysis was performed for TT and respiration rate. Mean values of ambient temperature, solar radiation and comfort thermal indices were greater in the summer experiment as expected (P<0.005). The mean values of TT were higher in steers fed with higher MEI and also in the summer season. The average daily gain was greater during summer v. winter (1.10±0.11 v. 0.36±0.06) kg/day, also when steers were fed 2.72 v. 1.85 MEI level (0.89±0.12 v. 0.57±0.10) kg/day. In summer, respiration rate increased in 41.2% in the afternoon. In winter, muddy conditions increased with time of feeding, whereas wind speed and rainfall had significant effects on TT and average daily gain. We conclude that MEI and environmental variables have direct effects on the physiology and performance of steers, including TT and average daily gain, particularly during the winter. In addition, carcass characteristics were affected by season but not by the level of MEI. Finally, due to the high variability of data as well as the small number of animals assessed in these experiments, more studies on carcass characteristics under similar conditions are required.

New Tympanic Membrane Temperature Shows Good Correlation with the Esophageal Temperature &amp;lt;br/&amp;gt;—Accuracy of a Noncontact Continuous Tympanic Thermometer

Background: An ear-fitting thermometer probe “NIPRO CE THERMO®” (Nipro Corporation, Osaka, Japan, new CE thermo) for both ears was newly developed in 2017. Since new release, we have never investigated about an accuracy of the new CE thermo. In this time, the accuracy of the CE thermo was investigated. Methods: The correlation between the tympanic membrane temperature, measured using the new CE thermo, and the esophageal temperature of 30 patients (right ear: 16 patients, left ear: 14 patients) was measured in the prospective observational study. Results: A good correlation (r = 0.721) and no measurement error (within 1˚C in mean ± 2SD) between the two temperatures were observed using Bland-Altman analysis. The correlation and measurement error for each ear yielded the same results. Conclusion: The tympanic membrane temperature, measured using the new CE thermo, showed good correlation with the esophageal temperature and could be used as a central temperature in the perioperative period.

Effect of isothermic dialysis on intradialytic hypertension

The primary outcome was incidence of intradialytic hypertension (IDH) during standard and cooler isothermic dialysate temperatures. Two pair of haemodialysis sessions were done at 37°C (SHD) and at isothermic temperature (IHD). All the four dialysis were done on the same time of the day to negate the changes due to circadian variation in body temperature. Axillary and tympanic temperatures were measured before start of the dialysis and dialysis temperature was adjusted as per axillary temperature. Sixty patients were enrolled and completed the study. The mean delivered dialysate temperature in the intervention group was 36.5 ± 0.2 achieving a 0.5 ± 0.2°C between-group separation. The incidence of IDH and intradialytic hypotension while on SHD and IHD were 79/120 (66%) vs 44/120 (37%), odds ratio (OR) 3.3, 95% confidence interval (CI) (1.96–5.65) and 45/120 (38%) vs 14/120 (12%), OR 4.5, 95% CI (2.3–8.7), respectively. The 4 h time averaged mean systolic blood pressure (SBP) at IHD and SHD were 154 ± 1.7 and 157.2 ± 1.1 mmHg, respectively, the mean difference in SBP being −3.4 mmHg to −3.1 mmHg, 95% CI, P < 0.001. The standard deviation, a measure of BP variability was lower at IHD than at SHD (P < 0.001). In a subgroup analysis during IHD there was a significant reduction of both SBP and diastolic BP during the entire duration of dialysis in 35 out of 60 patients (systolic 4 h mean 154.96 ± 2.22 vs 164.32 ± 1.99 mmHg), (diastolic 4 h mean 79.24 ± 0.82 vs 82.54 ± 0.68 mmHg) – (rANOVA for systolic and diastolic <0.001). This phenomenon of cooler dialysis causing reduction of BP was reproduced in the same group of patients when the IHD was repeated another time (systolic 4 h mean 157.95 ± 1.88 vs 160.65 ± 1.47), (diastolic 4 h mean 79.27 ± 0.74 vs 82.03 ± 1.07) rANOVA for systolic and diastolic <0.001. The incidence of IDH can be reduced significantly by reducing the dialysate temperature to patients' body temperature. Hypertension during dialysis is related to heat gain during dialysis.

04 Using electronic patient records collected by ambulance personnel to detect disease outbreaks

BackgroundThe introduction of electronic patient records in the ambulance service allows to use these to monitor the population. Most patients are discharged at scene therefore this data represents a new source for syndromic disease surveillance. The accessibility and extent of the records allows to apply early event detection (EED) systems to monitor the prehospital population. Here such a system is applied to tympanic temperature readings to detect seasonal influenza.MethodTympanic temperature readings, are recorded for all patients and were used to determine daily and weekly numbers of pyretic patients. A method adapted from Singh et al. (2016) based on case ratios (CR) was used to detect the start of the seasonal influenza outbreak. This method does not rely on thresholds, and was applied in a sliding manor as EED system.ResultsThe data represented annually 15.96% of the population, focused on the elderly. It matched the progress of seasonal influenza cases from sentinel surveillance programs. For the season 2016/17 an increase in cases was detected with an estimated specificity and sensitivity of 99.7% and 100%, up to 9 weeks before sentinel surveillance programs. Furthermore, an unanticipated outbreak of Escherichia coli was detected.ConclusionIt was shown, disease outbreaks can be monitored using prehospital tympanic temperature data. Thus, making the ambulance service an ideal source for syndromic surveillance. The method used was effective and can be easily deployed to monitor specific syndromes to distinguish between infectious agents. The method is easily adapted to sample rates and noisiness of the data to prevent false alarms.

Effect of fasting during Ramadan on thermal stress parameters.

High process temperatures associated with industrial operations augment risk of heat stress and illness, particularly during summer months in the Gulf Region. Lack of hydration and nutrition during day time, during Ramadan can subject workers to even greater risk of heat stress and illness. To examine the physiological effects of prolonged fasting in thermally challenging conditions. Longitudinal measurements were carried out on employees during fasting in Ramadan in three departments of an aluminium smelter. After informed consent, physiological parameters were measured at 4-hour intervals. Average heart rate and urine specific gravity increased in the first 4 hours of shift work, while tympanic temperature did not rise significantly. Moreover, in the second 4 hours of shift work, urine specific gravity stabilized compared to the first 4 hours. Robust workplace measures are needed for industries with high process temperatures, located in the Gulf Region, in order to minimize the enhanced risk of heat stress and illness during Ramadan.