Luigi Guerri, an ordinary pharmacists who became the "first son" of pharmaceutical chemistry

Fever is a major symptom to characterize individual health status. Measurement of temperature is systematically made in everyday medical practice. In France, this measurement is generally assumed with a rectal glass mercury thermometer. In order to protect people and the environment, the "Conseil Supérieur d'Hygiène Publique de France" has approved recommendations to withdrawn medical use of mercury, specifically for thermometer. Rectal measurement is also debated since infectious risks are described. Thus, substitution of rectal glass mercury thermometer is on the agenda. New sites and techniques for measurement of temperature have been studied through a literature review, interview of experts and companies, and clinical research protocols. Cutaneous and axillary measurements are inaccurate and unsatisfactory. Two methods seems to be worth: oral measurement and tympanic measurement. Oral measurement is widespread in the world. This technique has some limits. Tympanic measurement is a new method in progress without these limits. Whatever the choice of the technique is, the substitution of rectal glass mercury thermometer requires training and awareness of staff and patients.     

The ear thermometer; not a good replacement for the rectal thermometer

OBJECTIVE: To compare the measurements of body temperature with the tympanic infrared thermometer and the digital rectal thermometer. DESIGN: Prospective, comparative. SETTING: Beatrix Hospital, Gorinchem, the Netherlands. PATIENTS AND METHODS: A total of 2057 almost simultaneous measurements of rectal and tympanic temperature were performed in 164 patients in 9 different wards. RESULTS: The mean difference between the two methods was 0.45 degree C with a standard deviation of 0.57 degree C. The tympanic temperature was lower than the rectal temperature. The differences ranged from -1.5 to 3.6 degrees C. The correlation coefficient was 0.69. If a rectal temperature > 37.8 degrees C was applied as the criterion of fever, the diagnosis was not made in 175/291 measuring moments (60%) with the tympanic thermometer. If a tympanic temperature > 37.8 degrees C was applied as the criterion of fever, the rectal thermometer failed to show fever in 16/132 measuring moments (12%). CONCLUSION: The low sensitivity of the tympanic measurement to establish fever renders the tympanic infrared thermometer unsuitable for use as a fever thermometer.     

Evaluation of ear temperature measurements in a geriatric department

We evaluated an infrared tympanic thermometer (Genius 3000A) by comparing it with parallel measurements with an electronic rectal thermometer (Philips HP 5316) on 121 patients admitted to a geriatric department. Rectal temperature was on average 0.14 degree C +/- (ISD) above the ear temperature. 95% of the differences are within the interval from -1.18 degrees C to 1.46 degrees C. The coefficient of determination was only 0.30. The tympanic thermometer, Genius 3000A, cannot be recommended for daily use on a geriatric ward.     

Unreliability of the infrared tympanic thermometer in clinical practice: a comparative study with oral mercury and oral electronic thermometers

BACKGROUND: This study was designed to determine the magnitude and frequency of measurement errors with infrared tympanic thermometers in the clinical setting. METHODS: In a convenience sample of 137 adult inpatients, we compared body temperatures measured by a Diatek 9000 Infrared Aural Thermometer and an IVAC 2090 CoreCheck Tympanic Thermometer between themselves, in right versus left ears, and against concurrently measured oral temperatures using both an electronic thermoprobe and conventional glass mercury thermometer. RESULTS: There was a significant between-brand difference of 0.6 degrees C (IVAC 相似文献   

Military medical subjects in the research of Academician P. K. Anokhin]

OBJECTIVE: To compare infrared thermometry with rectal thermometry as a method of assessing core body temperature in dogs and to assess the effect of otitis externa on external ear canal temperature (EECT). DESIGN: Prospective study. ANIMALS: 650 dogs without history or clinical signs of otitis externa and 85 dogs with recurrent or chronic otitis externa. PROCEDURE: Rectal temperature was measured, using a mercury thermometer. External ear canal temperature was measured, using an infrared tympanic thermometer. RESULTS: Measurements of body temperature at the 2 sites did not agree. Sensitivity and specificity of infrared thermometry in detecting fever, as determined by rectal thermometry, were 69.7 and 84.6%, respectively. Use of methods to predict rectal temperature from EECT did not improve the accuracy of infrared thermometry. Otitis externa significantly influenced EECT. CLINICAL IMPLICATIONS: Use of infrared thermometry as a replacement for rectal thermometry in assessing core body temperature in dogs was unsatisfactory. The 2 methods for measuring body temperature were not interchangeable in dogs.     

Modern electronic and chemical thermometers used in the axilla are inaccurate

Rectal and axillary temperatures were measured simultaneously in 83 children using three different thermometer devices providing 166 pairs of results. In the first series consisting of 22 febrile children (44 measurements) and 20 afebrile children (40 measurements), the rectal mercury measurement was compared to an axillary mercury and axillary Tempa-DOT thermometer. The axillary mercury had sensitivity of 14/22 (64%) and specificity of 20/20 (100%) while the Tempa-DOT had sensitivity of 15/22 (68%) and specificity of 19/20 (95%). In the second series comprising 21 febrile children (42 measurements) and 20 afebrile children (40 measurements) the axillary mercury had sensitivity of 11/21 (52%) and specificity of 20/20 (100%) while the electronic thermometer had sensitivity of 10/21 (48%) and specificity of 20/20 (100%). Regardless of the thermometer used, the axilla is a poor alternative to rectal measurements in the diagnosis of fever. CONCLUSION: Mercury-free thermometers, when used in the axilla are as poor alternatives to rectal measurements as mercury-in-glass thermometers.     

Thermometer use among Mexican immigrant mothers in California

A community-based household survey was utilized to assess the relationship between thermometer use, home treatment and utilization of health care services. Using a cross-sectional design, the study surveyed 688 low income Mexican origin mothers of children between the ages of 8 and 16 months in San Diego County. Mothers were asked how they determine that their child has fever and how often they use a thermometer. Nearly 40% of low income Mexican mothers interviewed in San Diego county never used a thermometer for determining childhood fever. Approximately two-thirds (64.7%) relied either primarily or exclusively on embodied methods such as visual observation or touch to determine fever in their child. A multivariate logistic regression analysis determined that low education and a separated or divorced marital status decreased the odds of thermometer use, whereas regular contact with the health care system doubled the likelihood of thermometer use. Mothers who relied on embodied methods were more likely to use over-the-counter medications than those who relied on thermometers; however, no significant differences were found between groups using other methods of home treatment. Fever determination modalities can be used to screen for lack of access to care and to provide for other health care needs in a culturally appropriate manner. While clinicians' expectations may include parental experience with temperature taking, current pediatric literature questions the need for home-based thermometer use. Possible alternatives to the traditional rectal thermometer might include digital thermometers and color coded thermometer strips.     

Supralingual temperatures compared to tympanic and rectal temperatures

OBJECTIVE: To evaluate the validity, reliability, sensitivity, and specificity of the PaciTemp supralingual digital pacifier thermometer as compared to the Thermoscan Instant tympanic and glass-mercury rectal thermometers. METHOD: Eighty-one children under the age of 2 years had temperatures taken sequentially at three body sites: supralingual, tympanic, and rectal. Corrections were calculated between the readings of the three types of thermometers. Percentage of agreement was done to examine sensitivity and specificity. RESULTS: Using the glass-mercury measurement as the standard, both the supralingual and tympanic measurements showed an overall specificity of 62.8% and sensitivity of 63.3%. Correlation between rectal and supralingual was 0.62, and correlation between rectal and tympanic was 0.71. CONCLUSIONS: The Paci-Temp provides temperature readings that are similar to the tympanic method as compared to the rectal method. Further research on at-home thermometers is needed.     

Agreement between rectal and tympanic membrane temperatures in marathon runners

STUDY OBJECTIVE: To determine the agreement between rectal temperature and infrared tympanic membrane temperatures in marathon runners presenting to a field hospital at the finish line. METHODS: The subjects of this prospective, blinded, controlled study were runners 18 years or older who were triaged to the acute care medical area at the finish line for suspected hypothermia, hyperthermia, dehydration, or altered mental status. Rectal and tympanic temperatures were measured simultaneously in all subjects for whom rectal temperature measurement had been deemed necessary and recorded on separate data cards. RESULTS: Of the 239 runners treated in the acute care medical area, 37 required rectal temperature measurement and were enrolled in the study. The mean rectal temperature was 38.45 degrees +/- 1.20 degrees C (range, 35.9 degrees to 41.5 degrees C). The mean tympanic membrane temperature was 37.81 degrees +/- 95 degrees C (range, 36.3 degrees to 40.4 degrees C). Pearson's correlation coefficient revealed a moderate correlation (r = .6902, P = .00023). The mean temperature difference between the two thermometers, mean rectal minus mean tympanic membrane, was .64 degrees C (95% confidence interval, .35 degrees to .93 degrees C). Sixty-Two percent of the tympanic membrane readings were within 1 degree C of their rectal counterparts. Agreement ranged from 1.16 degrees (+2 SD) to -2.95 degrees (-2 SD). The 95% confidence interval was 1.67 degrees to -2.95 degrees C. CONCLUSION: We were able to demonstrate only a moderate correlation between the two thermometer readings, with a wide spread between the limits of agreement. This spread could be clinically significant and therefore limits the usefulness of tympanic temperature in the marathon race setting. Because of the potentially large and clinically significant differences in rectal and tympanic temperatures and the limitations inherent in our study, we cannot endorse the use of tympanic temperature in the setting of a marathon event.     

Nursery outbreak of peritonitis with pneumoperitoneum probably caused by thermometer-induced rectal perforation

Between June 16 and October 9, 1974, 9 neonates at a small, community hospital were stricken with an unusual, serious illness manifested by peritonitis and pneumoperitoneum; 3 died. Although the illness was initially thought to be necrotizing entercolitis, clinical, laboratory, and epidemiologic evidence strongly suggested that it was instead the result of gastrointestinal perforation. in case-control studies employing 3 different conposure to a particular nurses' aide. Other studies including a comparison of expected and actual exposures of ill infants to nursery personnel further linked this nurses' aide to illness. Since rectal temperature-taking was the only procedure possibly predisposing to gastrointestinal perforation that was routinely practiced in the nursery, it was hypothesized that the illness might be the result of rectal perforations. In order that rectal temperature-taking technique could be observed, each nurse and nurses' aide on the OB-GYN service was asked to take part in a general practical examination of nursing skills on a life-like baby doll. The mean and median depths to which nursing personnel inserted the thermometer exceeded the maximum depth recommended to prevent perforation. The nurses' aide epidemiologically associated with illness inserted the thermometer to almost twice the maximum recommended depth-farther than all the personnel who worked primarily in the nursery. After this nurses' aide was removed from the nursery and axillary temperature-taking replaced rectal temperature-taking as the nursery routine, the outbreak ceased.     

A newborn's first bath: when?

OBJECTIVE: To determine the effects of early admission bathing on thermoregulation in newborns. DESIGN: Randomized, comparative study. SETTING: A regional hospital providing primary and secondary newborn care. PARTICIPANTS: One hundred healthy, full-term newborns. INTERVENTIONS: Newborns in the investigational group with a minimum rectal temperature of 36.5 degrees C. were bathed after the newborn admission assessment examination was completed (M = 61.15 minutes of age), whereas newborns in the control group were bathed at the standard of 4 hours of age (M = 252.12 minutes of age). MAIN OUTCOME MEASURE: Rectal temperatures were measured using a Diatek thermometer. Rectal temperatures were recorded during the newborn admission assessment examination, immediately before bathing, immediately after bathing, 1 hour after bathing, and 2 hours after bathing. RESULTS: No significant differences (p < .05) in rectal temperatures, were found between the groups during the admission assessment examination, before bathing, immediately after bathing, 1 hour after bathing, or 2 hours after bathing. No significant differences were found between the groups in type of delivery, time of birth, gestational age, birth weight, Apgar scores at 1 and 5 minutes, air temperature, apical heart rate, or respiratory rate. CONCLUSIONS: Healthy, full-term newborns whose rectal temperatures are greater than 36.5 degrees C can be bathed immediately after the admission assessment examination.     

钢筋热处理线的双色测温技术

分析了在钢筋热处理线的温度测量中，常规红外双色测温仪测量值跳动较大的原因，并据此对双色测温仪进行了改进。结果表明，改进后的双色测温仪在生产中的跳动明显减小。     

Congenital nystagmus image motion: influence on visual acuity at different luminances

This research study was undertaken to examine the relationship between pulmonary artery blood temperature (regarded as the 'gold standard' measurement for core body temperature), axilla temperature using the Tempa.DOT Ax chemical thermometer and tympanic membrane temperature using the Diatek 9000 InstaTemp thermometer. Sixty adult intensive care patients had their temperatures monitored. A single set of five simultaneous temperatures, i.e. left and right axilla, left and right tympanic membrane (TM), and pulmonary artery (PA) blood were recorded. The mean difference between left and right TM temperatures was 0.58 degree C, and although both were moderately well correlated with PA temperature (r = 0.63 and 0.78, respectively) the mean differences between the two sites were clinically significant (0.85 degree C and 0.94 degree C, respectively). The range of differences between the sites was significant. Plotting limits of agreement showed that both left and right TM temperatures may be up to 1.2 degrees C above or 1.3 degrees C below PA blood temperature: a clinically unacceptable range. In particular, large temperature differences were recorded when patients were lying with one side of their head to a pillow. Fan therapy directed to the head was not found to affect these differences significantly. The mean difference between left and right axilla temperatures was 0.36 degree C, and although both were modestly correlated with PA temperature (r = 0.48 and 0.53, respectively) the mean differences between the two sites were clinically significant (0.47 degree C and 0.50 degree C, respectively). The range of differences between the sites was particularly significant. Plotting limits of agreement showed that both left and right axilla temperatures may be up to 1.2 degrees C above or 1.6 degrees C below PA blood temperature: a clinically unacceptable range. Because the range of temperature differences found between PA blood and the other sites was so great, it is concluded that neither the chemical axilla thermometer nor the tympanic membrane thermometer used in this study are clinically reliable tools for adult intensive care patients.     

Are electronic thermometry techniques suitable alternatives to traditional mercury in glass thermometry techniques in the paediatric setting?

Three thermometers, mercury in glass, Becton-Dickinson digital and IVAC tympanic membrane thermometer, were compared. The study was designed to test the null hypothesis that there is no difference between the thermometer recordings, meaning that electronic thermometry is a suitable alternative to traditional mercury in glass thermometry. Children aged between 0 and 15 years old were entered into the study, n = 114. Standard procedures were used throughout the study to minimize the risk of errors in the data collection and technical errors were recorded. The data were analysed using graphical techniques described by Bland and Altman. The differences between the temperature recordings were plotted against their mean (the estimated true value), with the bias and limits of agreement (2 standard deviations from the mean) calculated for the mercury in glass/digital, mercury in glass/tympanic and digital/tympanic temperature recordings. The range of temperatures were 35.1 degrees C-38.5 degrees C, with a mean of 36.85 degrees C for the mercury in glass thermometer, 36.8 degrees C for the digital thermometer and 36.65 degrees C for the tympanic thermometer. The bias for each comparison was 0.36 degrees C, 0.21 degrees C and 0.17 degrees C and the limits of agreement were wide, -0.516 degrees C to 1.234 degrees C, -0.84 degrees C to 1.252 degrees C and -0.940C to 1.244 degrees C for the mercury in glass/digital, mercury in glass/tympanic and digital/ tympanic recordings respectively. A difference of 0.2 degrees C is usually accepted for clinical practice, therefore the null hypothesis was rejected.     

分布式光纤在铜电解测温中的应用实践

电解液温度影响槽电压、电解液导电率、电流效率、阴极铜表面质量等,是铜电解工艺控制的关键参数之一。传统的水银温度计或接触式测温仪依靠人工检测并记录每个电解槽电解液温度,工作量大、效率低,做不到实时在线监测。紫金铜业有限公司将分布式光纤测温技术首次应用于铜电解测温,可实现每个电解槽温度的在线监测、预警、报表、历史曲线记录等功能,并间接反映管道堵塞、槽子漏液、板换故障等问题。     

利用红外温度计实现回转窑温度在线检测的新方法

通过分析传统的回转窑温度测量方法,提出了一种新的在线测量方法。利用红外温度计测量回转窑内部温度,并与传统的测量方法对比,用实验及数据验证该方法的可行性,解决了用热电偶测量回转窑温度信号难取出的问题。测量结果准确、稳定,满足生产的要求。     

Forced-air warming versus routine thermal care and core temperature measurement sites

Hypothermia occurs commonly during the perioperative period and is preventable with proper warming measures and body temperature monitoring. Using a prospective, randomized study design, we compared forced-air warming (Warm Touch, Mallinckrodt Medical, Inc, St Louis, MO) (n = 15) with routine thermal care (n = 14) during the intraoperative and early postoperative periods. The results show that compared with routine thermal care, forced-air warming resulted in higher core temperatures both intraoperatively and postoperatively. The incidence of shivering was lower and thermal comfort scores were higher in the warming group. A secondary focus in this study was to assess the correlation between body temperatures measured at the urinary bladder, oral cavity, rectum, and tympanic membrane. The results indicated that the sites most highly correlated with tympanic temperature (listed in order of most to least correlated) were the bladder, rectum, and oral cavity. Assuming tympanic temperature is most representative of "core" temperature, oral measurements were likely to underestimate core temperature, whereas bladder and rectal temperatures overestimated core temperature. The relationship between body temperatures measured at commonly used monitoring sites must be recognized by nurses to account for the tendency to overestimate or underestimate core temperature. This knowledge can be applied in the management of patients in the operating room or PACU and specifically in the evaluation of PACU patients before discharge.     

Differences in immune responses induced by oral and rectal immunizations with Salmonella typhi Ty21a: evidence for compartmentalization within the common mucosal immune system in humans

Based on the concept of the common mucosal immune system, immunization at various inductive sites can induce an immune response at other, remote mucosal surfaces. The immune responses elicited through rectal and oral routes of antigen delivery were compared with respect to (i) measurement of antibody responses in serum and various external secretions of the vaccinees and (ii) characterization of the nature and homing potentials of circulating antibody-secreting cells (ASC). Specific ASC appeared in the circulation in 4 of 5 volunteers after oral and 9 of 11 volunteers after rectal immunization with Salmonella typhi Ty21a. The kinetics, magnitude, and immunoglobulin isotype distribution of the ASC responses were similar in the two groups. In both groups, almost all ASC (99 or 95% after oral or rectal immunization, respectively) expressed alpha4 beta7, the gut homing receptor (HR), whereas L-selectin, the peripheral lymph node HR, was expressed only on 22 or 38% of ASC, respectively. Oral immunization elicited a more pronounced immune response in saliva and vaginal secretion, while rectal immunization was more potent in inducing a response in nasal secretion, rectum, and tears. No major differences were found in the abilities of the two immunization routes to induce a response in serum or intestinal secretion. Thus, the rectal antigen delivery should be considered as an alternative to the oral immunization route. The different immune response profiles found in various secretions after oral versus rectal antigen administration provide evidence for a compartmentalization within the common mucosal immune system in humans.     

Failure of absorption of gabapentin after rectal administration

PURPOSE: We wished to determine the extent of absorption of gabapentin (GBP) after rectal administration to children on maintenance therapy. METHODS: Two children scheduled for extensive surgery received GBP rectally and orally. A pharmacokinetic profile was derived after each route of administration. RESULTS: Serum GBP levels after rectal administration decreased at a rate similar to their rate of decrease after oral administration. However, GBP concentrations were much lower after rectal administration; therefore, we concluded that the aqueous solution was poorly absorbed rectally. The GBP half-life (t1/2) for the 2 children after oral doses were 4.2 and 4.8 h. CONCLUSIONS: Rectal administration of GBP is not satisfactory when oral administration is interrupted. When oral GBP therapy is temporarily discontinued, clinicians should consider administration of alternative antiepileptic drugs (AEDs) that can be administered parenterally or rectally.