It is now common for parents to measure tympanic temperatures in children. The objective of this study was to assess the diagnostic accuracy of these measurements.
Parents and then nurses measured the temperature of 60 children with a tympanic thermometer designed for home use (home thermometer). The reference standard was a temperature measured by a nurse with a model of tympanic thermometer commonly used in hospitals (hospital thermometer). A difference of >or= 0.5 degrees C was considered clinically significant. A fever was defined as a temperature >or= 38.5 degrees C.
The mean absolute difference between the readings done by the parent and the nurse with the home thermometer was 0.44 +/- 0.61 degrees C, and 33% of the readings differed by >or= 0.5 degrees C. The mean absolute difference between the readings done by the parent with the home thermometer and the nurse with the hospital thermometer was 0.51 +/- 0.63 degrees C, and 72 % of the readings differed by >or= 0.5 degrees C. Using the home thermometer, parents detected fever with a sensitivity of 76% (95% CI 50-93%), a specificity of 95% (95% CI 84-99%), a positive predictive value of 87% (95% CI 60-98%), and a negative predictive value of 91% (95% CI 79-98 %). In comparing the readings the nurse obtained from the two different tympanic thermometers, the mean absolute difference was 0.24 +/- 0.22 degrees C. Nurses detected fever with a sensitivity of 94% (95 % CI 71-100 %), a specificity of 88% (95% CI 75-96 %), a positive predictive value of 76% (95% CI 53-92%), and a negative predictive value of 97% (95%CI 87-100 %) using the home thermometer. The intraclass correlation coefficient for the three sets of readings was 0.80, and the consistency of readings was not affected by the body temperature.
The readings done by parents with a tympanic thermometer designed for home use differed a clinically significant amount from the reference standard (readings done by nurses with a model of tympanic thermometer commonly used in hospitals) the majority of the time, and parents failed to detect fever about one-quarter of the time. Tympanic readings reported by parents should be interpreted with great caution.
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Although the environmental stresses to which man is subjected on the ground are less than those commonly encountered in aviation or under water, they may still exceed an individual's powers of adaptation. Extremes of temperature, commonly encountered in the Arctic or the tropics, may occur in regions of normally temperate climate and lead to failure of temperature regulation, resulting in hypothermia, frostbite, heat exhaustion, or heat stroke. High mountains impose additional hazards due to high winds and lack of oxygen, and deep mines are dangerous work-places because of high temperature and humidity. Some physiological acclimatization occurs in extreme natural environments and the dangers may be reduced by appropriate clothing, diet and behaviour.
The adjustment of sleep-wake patterns and the circadian temperature rhythm was monitored in nine Royal Norwegian Air-force volunteers operating P-3 aircraft during a westward training deployment across nine time zones. Subjects recorded all sleep and nap times, rated nightly sleep quality, and completed personality inventories. Rectal temperature, heart rate, and wrist activity were continuously monitored. Adjustment was slower after the return eastward flight than after the outbound westward flight. The eastward flight produced slower readjustment of sleep timing to local time and greater interindividual variability in the patterns of adjustment of sleep and temperature. One subject apparently exhibited resynchronization by partition, with the temperature rhythm undergoing the reciprocal 15-h delay. In contrast, average heart rates during sleep were significantly elevated only after westward flight. Interindividual differences in adjustment of the temperature rhythm were correlated with some of the personality measures. Larger phase delays in the overall temperature waveform (as measured on the 5th day after westward flight) were exhibited by extraverts, and less consistently by evening types.
BACKGROUND AND PURPOSE: Body temperature is considered crucial in the management of acute stroke patients. Recently hypothermia applied as a therapy for stroke has been demonstrated to be feasible and safe in acute stroke patients. In the present study, we investigated the predictive role of admission body temperature to the long-term mortality in stroke patients. METHODS: We studied 390 patients with acute stroke admitted within 6 hours from stroke onset. Admission clinical characteristics (age, sex, admission stroke severity, admission blood glucose, cardiovascular risk factor profile, and stroke subtype) were recorded for patients with hypothermia (body temperature 37 degrees C). Univariately the mortality rates for all patients were studied by Kaplan-Meier statistics. To find independent predictors of long-term mortality for all patients, Cox proportional-hazards models were built. We included all clinical characteristics and body temperature as a continuous variable. RESULTS: Patients with hyperthermia had more severe strokes and more frequently diabetes, whereas no difference was found for the other clinical characteristics. For all patients mortality rate at 60 months after stroke was higher for patients with hyperthermia (73 per 100 cases versus 59 per 10 cases, P=0.001). When body temperature was studied in a multivariate Cox proportional-hazards model, a 1 degrees C increase of admission body temperature independently predicted a 30% relative increase (95% CI, 4% to 57%) in long-term mortality risk. For 3-month survivors we found no association between body temperature and long-term survival when studied in a multivariate Cox proportional hazard model (hazards ratio, 1.11 per 1 degrees C; 95% CI, 0.82 to 1.52). CONCLUSION: Low body temperature on admission is considered to be an independent predictor of good short-term outcome. The present study suggests that admission body temperature seems to be a major determinant even for long-term mortality after stroke. Hypothermic therapy in the early stage in which body temperature is kept low for a longer period after ictus could be a long-lasting neuroprotective measure.