Effect of heat stress on body temperature in healthy early postpartum dairy cows

Measurement of body temperature is the most common method for an early diagnosis of sick cows in fresh cow protocols currently used on dairy farms. Thresholds for fever range from 39.4 °C to 39.7 °C. Several studies attempted to describe normal temperature ranges for healthy dairy cows in the early puerperium. However, the definition of a healthy cow is variable within these studies. It is challenging to determine normal temperature ranges for healthy cows because body temperature is usually included in the definition. Therefore, the objectives of this study were to identify factors that influence body temperature in healthy dairy cows early postpartum and to determine normal temperature ranges for healthy cows that calved in a moderate (temperature humidity index: 59.8 ± 3.8) and a hot period (temperature humidity index: 74.1 ± 4.4), respectively, excluding body temperature from the definition of the health status. Furthermore, the prevalence of fever was calculated for both periods separately. A subset of 17 (moderate period) and 15 cows (hot period) were used for analysis. To ensure their uterine health only cows with a serum haptoglobin concentration ≤ 1.1 g/L were included in the analysis. Therefore, body temperature could be excluded from the definition. A vaginal temperature logger that measured vaginal temperature every 10 min was inserted from Day 2 to 10 after parturition. Additionally rectal temperature was measured twice daily. Day in milk (2 to 10), period (moderate and hot), and time of day had an effect on rectal and vaginal temperature. The prevalence of fever (≥ 39.5 °C) was 7.4% and 28.1% for rectal temperature in the moderate and hot period, respectively. For vaginal temperature (07.00 to 11.00 h) it was 10% and 33%, respectively, considering the same threshold and period. This study demonstrates that body temperature in the early puerperium is influenced by several factors (day in milk, climate, time of day). Therefore, these factors have to be considered when interpreting body temperature measures to identify sick cows. Furthermore, the prevalence of fever considering different thresholds is higher during hot than moderate periods. However, even in a moderate period healthy cows can exhibit a body temperature that is considered as fever. This fact clearly illustrates that fever alone should not be considered the decision criterion whether a cow is allocated to an antibiotic treatment, although it is the most important one that is objectively measurable.     

Effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute ischemic stroke PISA, a phase II double-blind, randomized, placebo-controlled trial [ISRCTN98608690]

Background

Body temperature is a strong predictor of outcome in acute stroke. In a previous randomized trial we observed that treatment with high-dose acetaminophen (paracetamol) led to a reduction of body temperature in patients with acute ischemic stroke, even when they had no fever. The purpose of the present trial was to study whether this effect of acetaminophen could be reproduced, and whether ibuprofen would have a similar, or even stronger effect.

Methods

Seventy-five patients with acute ischemic stroke confined to the anterior circulation were randomized to treatment with either 1000 mg acetaminophen, 400 mg ibuprofen, or placebo, given 6 times daily during 5 days. Treatment was started within 24 hours from the onset of symptoms. Body temperatures were measured at 2-hour intervals during the first 24 hours, and at 6-hour intervals thereafter.

Results

No difference in body temperature at 24 hours was observed between the three treatment groups. However, treatment with high-dose acetaminophen resulted in a 0.3°C larger reduction in body temperature from baseline than placebo treatment (95% CI: 0.0 to 0.6 °C). Acetaminophen had no significant effect on body temperature during the subsequent four days compared to placebo, and ibuprofen had no statistically significant effect on body temperature during the entire study period.

Conclusions

Treatment with a daily dose of 6000 mg acetaminophen results in a small, but potentially worthwhile decrease in body temperature after acute ischemic stroke, even in normothermic and subfebrile patients. Further large randomized clinical trials are needed to study whether early reduction of body temperature leads to improved outcome.     

Effects of lipopolysaccharide and acclimation temperature on induced behavioral fever in juvenile Iguana iguana

We examined the effects of acclimation temperature and two doses (2.5 and 25mgkg(-1)) of a pyrogen (lipopolysaccharide, LPS) on behavioral thermoregulation in juvenile green iguanas. Overall means of body temperatures for the three-day trial periods were compared among three groups of animals acclimated at 15, 25, and 34 degrees C. The responses of each group of animals to the two dosages of LPS and a control saline injection were examined. Within each treatment block, animals either chose high body temperatures characteristic of a fever response or chose low body temperatures characteristic of a hypothermic response. Thermoregulation was influenced by interaction effects between and among, and independent effects of, acclimation temperature, dose of LPS, and day. In some treatment blocks, individual lizard mass positively correlated with mean individual body temperature. Mean mass of lizards that chose higher body temperatures within a treatment block was higher than the mean mass of lizards that chose lower body temperatures. From these results, we concluded that LPS may induce two different behavioral thermoregulatory responses: fever or hypothermia. The actual amplitude and direction of body temperature change appears to be affected by acclimation temperature and possibly by mass or energy reserves of the animal. If the energy reserves are not sufficient to sustain the higher rate of metabolism associated with the higher body temperatures of a hyperthermic or feverish state, the animal may resort to hypothermia.     

超声引导下穿刺置管引流治疗肝脓肿的疗效分析

目的:探讨超声引导下穿刺置管引流治疗肝脓肿的临床疗效。方法:回顾性分析本院2012-2013年56例肝脓肿住院患者超声引导下穿刺置管引流治疗的临床资料。结果:56例患者行超声引导下穿刺置管引流治疗,其中3例多发脓肿行2次穿刺置管治疗,其余均一次穿刺置管成功,未出现出血、胆漏、周围脏器损伤等并发症,本组患者手术前后体温、白细胞数及脓肿面积比较均有统计学意义(P0.01)。24例体温升高患者中,21例术后3天内恢复正常,3例仍有升高;41例白细胞数升高患者中,29例术后3天内恢复正常,12例仍有增高;56例患者术后脓肿面积均明显减小,该组患者腹痛、肝区叩痛等临床症状均明显缓解。结论:超声引导下穿刺抽吸及置管引流治疗肝脓肿是一种简单方便、安全可靠、创伤小、明显有效的局部治疗方法,操作者需要充分作好术前准备,严格把握适应症,严谨操作步骤并结合全身抗生素治疗可以明显改善患者发热症状,有效降低患者白细胞及中性粒细胞,明显缩短治疗周期,提高治愈率。     

神经外科重症监护室发热及其治疗

发热是神经外科重症监护室(Neurosurgical intensive care unit,NICU)最常见的症状之一,它是人体对损伤的保护性反应,但同时又加重了机体的负担,从而恶化临床结局。NICU发热起因复杂并相互交错,仅少部分有特异性表现,并且总上而言处理困难。因此系统地了解发热的起因、处理以及预后是非常重要的。尽管过去的文献对于发热已有很好的研究,然而缺乏对NICU发热的系统性描述。我们通过回顾文献系统性地总结了NICU发热,旨在进一步增进对NICU发热的认识从而有利于临床诊治。     

Stress fever magnitude in laboratory-maintained California ground squirrels varies with season

A previous study demonstrated that California ground squirrels (Spermophilus beecheyi) living in the natural environment had, independent of season, a significantly higher mean diurnal body temperature (T(b)) (39.6 degrees C) than either summer (37.5 degrees C) or winter (36.5 degrees C) laboratory maintained animals. Based upon the previous study it has been suggested that California ground squirrels living in the natural environment may have an elevated set-point for body temperature in a manner analogous to a stress fever response. The present study was conducted to determine if season and/or duration of laboratory open-field exposure influenced the magnitude of laboratory open-field stress fever. If stress fever was involved to some extent in the higher body temperature observed in animals from the natural environment, laboratory maintained animals should exhibit a lower magnitude stress fever during the summer months and a higher magnitude stress fever during the winter months. It was hypothesized that laboratory maintained animals would exhibit the same set-point for stress fever T(b) independent of season, and that the duration of open-field exposure would not influence the magnitude of stress fever. Adult California ground squirrels were acclimated to an ambient temperature of 20+/-1.0 degrees C under either LD 14:10 (summer) or LD 10:14 (winter) photoperiod conditions and individuals from both photoperiod conditions were exposed for periods of 2, 4, and 6 h to an open-field arena. An analysis of the data with a two-factor ANOVA demonstrated that season (photoperiod) significantly influenced the magnitude of the stress fever response (1.1+/-0.1 degrees C for summer animals; 2.1+/-0.2 degrees C for winter animals) while there was no significant influence of open-field exposure duration on stress fever magnitude. These results demonstrate that although the set-point for body temperature in unstressed laboratory maintained California ground squirrels varies with season, the set-point for body temperature in open-field stressed animals does not vary with season. These data lend support to the hypothesis that something like stress fever may play some role in the higher body temperature observed in California ground squirrels living in the natural environment.     

PISA. The effect of paracetamol (acetaminophen) and ibuprofen on body temperature in acute stroke: Protocol for a phase II double-blind randomised placebo-controlled trial [ISRCTN98608690]

Background

During the first days after stroke, one to two fifths of the patients develop fever or subfebrile temperatures. Body temperature is a strong prognostic factor after stroke. Pharmacological reduction of temperature in patients with acute ischaemic stroke may improve their functional outcome. Previously, we studied the effect of high dose (6 g daily) and low dose (3 g daily) paracetamol (acetaminophen) in a randomised placebo-controlled trial of 75 patients with acute ischemic stroke. In the high-dose paracetamol group, mean body temperature at 12 and 24 hours after start of treatment was 0.4°C lower than in the placebo group. The effect of ibuprofen, another potent antipyretic drug, on body-core temperature in normothermic patients has not been studied.

Aim

The aim of the present trial is to study the effects of high-dose paracetamol and ibuprofen on body temperature in patients with acute ischaemic stroke, and to study the safety of these treatments.

Design

Seventy-five (3 × 25) patients with acute ischaemic stroke confined to the anterior circulation will be randomised to treatment with either: 400 mg ibuprofen, 1000 mg acetaminophen, or with placebo 6 times daily during 5 days. Body-temperatures will be measured with a rectal electronic thermometer at the start of treatment and after 24 hours. An infrared tympanic thermometer will be used to monitor body temperature at 2-hour intervals during the first 24 hours and at 12-hour intervals thereafter. The primary outcome measure will be rectal temperature at 24 hours after the start of treatment. The study results will be analysed on an intent-to-treat basis, but an on-treatment analysis will also be performed. No formal interim analysis will be carried out.     

Ibuprofen does not affect levels of tumor necrosis factor alpha and soluble tumor necrosis factor receptor types I and II in Gabonese children with uncomplicated Plasmodium falciparum malaria

We assessed the ability of ibuprofen to modulate tumor necrosis factor alpha (TNF-alpha), soluble tumor necrosis factor receptor type I (sTNFR-I), and soluble tumor necrosis factor receptor type II (sTNFR-II) responses during the treatment of fever in uncomplicated Plasmodium falciparum malaria, in a placebo-controlled, randomized, double-blind study of 50 pediatric patients in Lambaréné, Gabon. Treatment of the malaria involved the patients receiving intravenous quinine (12 mg/kg of quinine dihydrochloride every 12 h for 72 h) followed by a single dose of oral sulfadoxine/pyrimethamine (25 mg and 1.25 mg/kg). Fever was treated by mechanical treatment plus either ibuprofen (7 mg/kg every 8 h) or placebo during the hospitalization period. We determined serum concentrations of TNF-alpha, sTNFR-I, and sTNFR-II in peripheral blood throughout the treatment period in the two groups: ibuprofen and placebo groups. TNF-alpha levels were found to be positively correlated with body temperature. In contrast, TNF receptors levels did not differ between the two groups and the antipyretic effect of ibuprofen was not correlated with specific changes in sTNFR-I and sTNFR-II production. Our data suggest that TNF-alpha is involved in malarial fever, but soluble TNF receptors play no major role in fever modulation.     

Role of nitric oxide in hypoxia inhibition of fever.

Hypoxia causes a regulated decrease in body temperature (T(b)), and nitric oxide (NO) is now known to participate in hypoxia-induced hypothermia. Hypoxia also inhibits lipopolysaccharide (LPS)-induced fever. We tested the hypothesis that NO may participate in the hypoxia inhibition of fever. The rectal temperature of awake, unrestrained rats was measured before and after injection of LPS, with or without concomitant exposure to hypoxia, in an experimental group treated with N(omega)-nitro-L-arginine (L-NNA) for 4 consecutive days before the experiment and in a saline-treated group (control). L-NNA is a nonspecific NO synthase inhibitor that blocks NO production. LPS caused a dose-dependent typical biphasic rise in T(b) that was completely prevented by hypoxia (7% inspired oxygen). L-NNA caused a significant drop in T(b) during days 2-4 of treatment. When LPS was injected into L-NNA-treated rats, inhibition of fever was observed. Moreover, the effect of hypoxia during fever was significantly reduced. The data indicate that the NO pathway plays a role in hypoxia inhibition of fever.     

Scrotal heating stimulates panting and reduces body temperature similarly in febrile and non-febrile rams (Ovis aries)

It is known that heating the ram scrotum stimulates heat loss resulting in a decrease in body temperature and that during fever core temperature increases, but local scrotal thermoeffectors operate to maintain normal scrotal temperature. We have investigated whether scrotal warming influences core body temperature and the panting effector during fever generation. We measured rectal temperature, intrascrotal temperature, scrotal skin temperature and respiratory frequency in four adult Merino rams following intravascular injection of saline or lipopolysaccharide at an ambient temperature of 18-20 degrees C while scrotal skin temperature was maintained at 33 degrees C or elevated to 41 degrees C. Compared to maintaining normal scrotal temperature, heating the scrotum increased respiratory frequency and reduced rectal temperature by a similar amount following LPS as following saline. Fever was associated with decreased respiratory frequency compared to saline at both 33 and 41 degrees C scrotal temperature, suggesting that the fever was generated mainly by decreasing respiratory heat loss. We conclude that scrotal thermal afferent stimulation resulted in an offset for the set-point of body temperature regulation in both normothermic and febrile rams.     

Unbalanced thermoregulation in experimental autoimmune encephalitis induced in Lewis rats

Thermoregulation in patients suffering from multiple sclerosis (MS) is impaired and may result in either increases or decreases in body temperature. We have found that rat experimental autoimmune encephalitis (EAE), being a model of MS, is associated with body temperature disturbances as well.The purpose of the current study was to examine whether the altered body temperature in EAE-induced rats is due to either a deficit in thermoregulation or a controlled change in its set point.Subcutaneous injection of encephalitogenic emulsion into both pads of hind feet of the Lewis rats provoked EAE symptoms. Body temperature (Tb) of 6 rats was measured using biotelemetry system, and ambient temperature (Ta) preferred by 6 rats of another group was analyzed using thermal gradient system.Symptoms of EAE started 11 days postinjection and progressed quickly, culminating in a complete paralysis in rats placed in the gradient, which was associated with behavioural fever (accordingly, selected Ta raised to as much as 32.8 ± 0.5 °C vs 27.2 ± 0.6 °C in control rats). On the other hand, EAE rats, placed at a constant Ta of 24 °C, were able to generate fever (Tb of 37.8 ± 0.1 °C) at the start of the illness and then paralysis compromised fever (most likely due to an impairment of thermogenesis), which, surprisingly, resulted in recovery.We conclude that EAE onset in rats is associated with fever and its behavioural supporting leads to aggravation of the autoimmune neurotoxicity.     

Polysaccharide peptide induces a tumor necrosis factor-α-dependent drop of body temperature in rats

Polysaccharide peptide (PSP) extracted from the Coriolus versicolor mushroom is frequently suggested as an adjunct to the chemo- or radiotherapy in cancer patients. It improves quality of the patients' life by decreasing pain, fatigue, loss of appetite, nausea, and vomiting. However, the effect of PSP on body temperature has not thus far been studied, although it is well known that treatment with other polysaccharide adjuvants, such as lipopolysaccharides, may induce fever. The aim of the present study, therefore, was to investigate the influence of PSP on temperature regulation in rats. We report that intraperitoneal injection of PSP provoked a dose-dependent decrease of temperature in male Wistar rats equipped with biotelemetry devices to monitor deep body temperature (T_b). The response was rapid (i.e., with latency of 15–20 min), transient (lasting up to 5 h post-injection), and accompanied by a significant elevation of the blood tumor necrosis factor-α (TNF-α) level. Pretreatment of the rats with anti-TNF-α antibody prevented the PSP-induced drop in T_b. Based on these data, we conclude that rats may develop an anapyrexia-like response to the injection of peptidopolysaccharide rather than fever, and the response was TNF-α-dependent.     

Endotoxin fever in para-chlorophenylalanine (PCPA) treated newborn guinea pigs and kittens.

Guinea pigs aged 0–3 days responded to 0.2 μg icv. E. coli endotoxin with phasic changes in body temperature; two rises separated by a marked fall. This fall was diminished in PCPA treated animals. In 5–10 day-old kittens the otherwise monophasic endotoxin fever was modified by PCPA treatment; the rise was attenuated in the period corresponding to the transient temperature fall of guinea pigs.     

Fever as a cause of hypophosphatemia in patients with malaria

Hypophosphatemia occurs in 40 to 60% of patients with acute malaria, and in many other conditions associated with elevations of body temperature. To determine the prevalence and causes of hypophosphatemia in patients with malaria, we retrospectively studied all adults diagnosed with acute malaria during a 12-year period. To validate our findings, we analyzed a second sample of malaria patients during a subsequent 10-year period. Serum phosphorus correlated inversely with temperature (n = 59, r = -0.62; P<0.0001), such that each 1 degrees C increase in body temperature was associated with a reduction of 0.18 mmol/L (0.56 mg/dL) in the serum phosphorus level (95% confidence interval: -0.12 to -0.24 mmol/L [-0.37 to -0.74 mg/dL] per 1 degrees C). A similar effect was observed among 19 patients who had repeat measurements of serum phosphorus and temperature. In a multiple linear regression analysis, the relation between temperature and serum phosphorus level was independent of blood pH, PCO2, and serum levels of potassium, bicarbonate, calcium, albumin, and glucose. Our study demonstrates a strong inverse linear relation between body temperature and serum phosphorus level that was not explained by other factors known to cause hypophosphatemia. If causal, this association can account for the high prevalence of hypophosphatemia, observed in our patients and in previous studies of patients with malaria. Because hypophosphatemia has been observed in other clinical conditions characterized by fever or hyperthermia, this relation may not be unique to malaria. Elevation of body temperature should be added to the list of causes of hypophosphatemia.     

Hypothermic and antipyretic effects of centrally administered ACTH (1--24) and alpha-melanotropin

ACTH (1--24) and alpha-melanotropin (alpha-MSH), peptides previously shown to influence body temperature when administered centrally and to occur naturally in brain regions important to temperature control, were injected intracerebroventricularly (ICV) in rabbits. The peptides in doses of 1.25, 2.5 and 5.0 micrograms produced dose-related hypothermias in a 23 degrees C environment, and greater decreases in body temperature when the experiments were repeated in the cold (10 degrees C), but the largest dose had no effect on temperature in the heat (30 degrees C). These results indicate that the peptides do not reduce the central set-point of temperature control. Rather, they appear to selectively inhibit heat conservation and production responses. Five microgram of ACTH reversed vasoconstriction and inhibited rises in temperature caused by leukocytic pyrogen (LP) given IV and ICV. The same dose of alpha-MSH also reduced fever produced by IV and ICV LP, but the reduction was not as great as after ACTH. Both peptides (5 micrograms) also reduced temperature rises and vasoconstriction caused by ICV PGE2. ACTH reduced d-amphetamine-induced hyperthermia without altering vasoconstriction which suggests that this peptide can reduce temperature rises by inhibiting heat production alone. One of the most important findings was that the peptides are antipyretic in that they reduce fever at doses (0.25 microgram, ICV) that do not affect normal temperature. The powerful effects of these peptides on resting body temperature, hyperthermia and fever, together with their presence in brain tissue important to temperature control, suggest that the endogenous central peptides participate in thermoregulation, perhaps by limiting fever and influencing normal temperature.     

Antipyretic effect of arginine vasotocin in toads

Arginine vasotocin (AVT) is a nonmammalian analog of the mammalian hormone arginine vasopressin (AVP). These peptides are known for their antidiuretic and pressor effects. More recently, AVP has been recognized as an important antipyretic molecule in mammals. However, no information exists about the role of AVT in febrile ectotherms. We tested the hypothesis that AVT is an antipyretic molecule in the toad Bufo paracnemis. Toads equipped with a temperature probe were placed in a thermal gradient, and preferred body temperature was recorded continuously. A behavioral fever was observed after lipopolysaccharide (LPS) was injected systemically (200 microg/kg). Systemically injected AVT (300 pmol/kg) alone caused no significant change in body temperature, but abolished LPS-induced fever. Moreover, a smaller dose of AVT (10 pmol/kg), which did not affect LPS-induced fever when injected peripherally, abolished fever when injected intracerebroventricularly. We therefore conclude that AVT plays an antipyretic role in the central nervous system, by means of behavior, in an ectotherm, a fact consistent with the notion that AVT/AVP elicits antipyresis by reducing the thermoregulatory set point.     

Eicosanoid involvement in the regulation of behavioral fever in the desert locust,Schistocerca gregaria

The desert locust Schistocerca gregaria behaviorally thermoregulates in order to try and maintain a favoured "set point" body temperature. Locusts infected with the deuteromycete fungal pathogen Metarhizium anisopliae var acridumchoose a significantly elevated temperature. This "behavioral fever" greatly delays the progress of mycosis. We have confirmed this phenomenon and shown that desert locusts also fever when infected with the bacterial pathogen Serratia marcescens. Elevation in the prefered environmental temperature occurs also upon injection with laminarin and lipopolysaccharide (microbial cell wall components). Since such treatments also stimulate the immune system it would appear that "behavioral fever" is probably a feature of the immune response. The eicosanoid biosynthesis inhibitor dexamethasone prevented laminarin invoked fever. This effect was reversable by arachidonic acid. Therefore in common with the febrile response in mammals behavioral fever in insects may be mediated locally by circulating eicosanoids.     

α-MSH injected into the septal region reduces fever in rabbits

In previous research the concentration of α-MSH within the septal region of rabbits increased with fever. This finding raises the possibility that the septal concentration of this peptide, which reduces fever when given both peripherally and intracerebroventricularly, is important to limitation of fever. To test this idea, rabbits with cannulas in the septal region were made febrile by IV injections of leukocytic pyrogen (LP). Injection of α-MSH (1 μg bilaterally) into the septal region did reduce fever, consistent with the idea that the increase in septal α-MSH concentration which occurs naturally in fever limits the febrile response. We also noted late rises in body temperature when experimental and control septal injections were given close together in time. These increases in temperature were similar to those known to occur after injections into the primary temperature control in the PO/AH region. This commonality further strengthens the possibility that septal neurons are important to central modulation of body temperature.     

Endotoxin fever in capsaicin treated rats.

The fever elicited by 10 micrograms/kg intravenous E. coli endotoxin was significantly higher in capsaicin desensitized rats than in controls, but there was an upper limit to the rise in body temperature in both groups. Capsaicin desensitization permitted the participation of various heat producing mechanisms even if the initial body temperature was high. The fever course was characteristically biphasic, similar as in control rats, thus desensitization did not alter the factors mediating the various phases of the endotoxin response.