Heat exchange in men and women following intravenous injection of endotoxin

Modelling the Efficacy of Febrile Heating in Infected Endotherms

Fever is a response to infection characterised by an increase in body temperature. The adaptive value of this body temperature increase for endotherms is unclear, given the relatively small absolute temperature increases associated with endotherm fever, its substantial metabolic costs, and the plausibility for pathogens to adapt to higher temperatures. We consider three thermal mechanisms for fever's antimicrobial effect: (1) direct growth inhibition by elevating temperature above the pathogens optimal growth temperature; (2) further differentiating the host body from the wider environment; and (3) through increasing thermal instability of the pathogen environment. We assess these by modelling their effects pathogen on temperature dependent growth, finding thermal effects can vary from highly to minimally effective depending on pathogen species. We also find, depending on the specification of a simple physical model, intermittent heating can inhibit pathogen growth more effectively than continuous heating with an energy constraint.

Non-contact infrared assessment of human body temperature: The journal Temperature toolbox

The assessment of human internal/core temperature (T core) is relevant in many scientific disciplines, but also for public health authorities when attempting to identify individuals with fever. Direct assessment of T core is often invasive, impractical on a large scale, and typically requires close contact between the observer and the target subject. Non-contact infrared thermometry (NCIT) represents a practical solution in which T core can potentially be assessed from a safe distance and in mass screening scenarios, by measuring skin temperature at specific anatomical locations. However, the COVID-19 pandemic has clearly demonstrated that these devices are not being used correctly, despite expert guided specifications available in International Standard Organization (ISO) documents. In this review, we provide an overview of the most pertinent factors that should be considered by users of NCIT. This includes the most pertinent methodological and physiological factors, as well as an overview on the ability of NCIT to track human T core. For practical use, we provide a checklist based on relevant ISO standards which are simple to follow and should be consulted prior to using NCIT for assessment of human T core. Our intention is for users of NCIT to adopt this checklist, which may improve the performance of NCIT for its ability to track T core.

Living history: Elsworth R. Buskirk

In 2005, the American Physiological Society (APS) initiated the Living History of Physiology Archival Program to recognize senior members who have made significant contributions during their career to the advancement of the discipline and the profession of physiology. Subsequently, the leadership of the APS Section of Environmental and Exercise Physiology selected Prof. Elsworth R. Buskirk of Pennsylvania State University to be profiled in Advances in Physiology Education.

Thermoregulation and fever in normal persons and in those with spinal cord injuries

Thermoregulation and fever are primarily mediated through the hypothalamus and its effector mechanisms. In persons with complete spinal cord injuries above T-6, thermoregulation is substantially impaired because of the interruption of neuronal pathways to and from the hypothalamus. These same pathways are important in the production of fever in response to infections, and injury to these pathways in patients with high-level spinal cord injuries should diminish their ability to mount a febrile response. In clinical practice, however, measurements of body temperature are used to make decisions in patients with spinal cord injuries in a manner similar to that in patients without spinal cord injuries. In this article, we review the literature on thermoregulation and fever in normal persons and in those with complete spinal cord injuries and propose possible mechanisms for fever in persons with high-level spinal cord injuries.

Nimesulide in the treatment of fever: a double-blind, crossover clinical trial

A double-blind, crossover clinical trial was carried out in subjects with fever, to assess the activity of three antipyretic drugs. Eighteen in-patients with body temperature (axillary) above 38 degrees C were given a single dose of nimesulide 100 mg, acetylsalicylic acid 500 mg, and dipyrone 500 mg, orally according to an incomplete balanced block design. Significant improvement was recorded with nimesulide and dipyrone, which gave similar results. Acetylsalicylic acid normalized body temperature in a few patients. Safety was very satisfactory. No local or systemic side-effects were noted.

Molecular mechanisms in endotoxin fever

Two important concepts are presented in this review. First, endotoxin fever, like all fevers, is mediated by a host product, leukocytic pyrogen (LP). The mechanism by which LP production is initiated by endotoxin is discussed and evidence is provided which clearly distinguishes the biological and physical differences between LP and endotoxins. The second concept is that many of the molecular and neurochemical mechanisms by which LP causes fever by its action on the hypothalamic thermoregulatory center are also observed when endotoxins are introduced into the central nervous system. Thus, there may be experimental and clinical situations in which endotoxins can directly affect the hypothalamus and initiate fever. Although this bi-modal effect of endotoxin on the production of fever can occur, the importance of LP in mediating endotoxin and other fevers cannot be overstated.

Molecular basis of fever in humans

This review presents several areas of research on the pathogenesis of fever in humans and updates new information concerning the role of fever in host defense mechanisms. Fever is mediated by a polypeptide of phagocytic cell origin called leukocytic pyrogen. Several agents and disease processes are associated with the synthesis and release of leukocytic pyrogen. Although the original studies on leukocytic pyrogen suggested that the neutrophil was the primary source, recent experiments indicate the mononuclear phagocyte to be the major producer of leukocytic pyrogen. The mechanism by which human monocytes are stimulated to produce leukocytic pyrogen is discussed, including the effects of corticosteroids, estrogens and antipyretics on the synthesis of leukocytic pyrogen in vitro. The ability of leukocytic pyrogen to alter the hypothalamic thermoregulatory center by increasing arachidonic acid metabolite levels is the most likely mechanism by which leukocytic pyrogen initiates fever. Antipyretics prevent the synthesis of certain cyclooxygenase metabolites, which accounts for their ability to reduce fever. Studies on the chemical and physical properties of human leukocytic pyrogen are reviewed and form the basis for current experiments on the similarities between leukocytic pyrogen and lymphocyte activating factor. These studies suggest that leukocytic pyrogen, in addition to producing fever, also stimulates non-hypothalamic cells involved in aspects of the acute-phase response. In this regard, leukocytic pyrogen may be an important mechanism for host defenses. Hyperthermia may also be beneficial to the host but is distinct from fever; the role of leukocytic pyrogen as well as hyperthermia as a defense mechanism is discussed.