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Objective: To determine the best approach for the evaluation of fever, detected by infrared thermal scanning, at an international airport. Methods: Arriving passengers with fever were divided into three groups: community evaluation by a GP, with or without cost compensation, or evaluation at the airport by a health practitioner. Uptake of offered evaluations was measured, diagnoses were recorded, and region-specific rates of fever measured. Observations were made on practical aspects of thermal screening. Results: Over a six-month period, 181,759 passengers were screened for fever at the Cairns international airport, Queensland, Australia. Fever was identified in 118 (0.06%) of the arriving passengers and 76 were enrolled in the study. Only 19 of these passengers (25%) voluntarily underwent further evaluation. No differences were observed in the three approaches. Conclusions: Public health surveillance of febrile passengers arriving at an international airport should not rely on voluntary passenger participation for the detection of imported contagious diseases. Key words: fever, surveillance, infrared rays, travel, patient participation. Aust NZ J Public Health. 2010; 34:5-10 doi: 10.1111/j.1753-6405.2010.00466.x

The Arrhenius and thermal isoeffective dose (TID) models are the two most commonly used models for predicting hyperthermic injury. The TID model is essentially derived from the Arrhenius model, but due to a variety of assumptions and simplifications now leads to different predictions, particularly at temperatures higher than 50[degrees]C. In the present study, the two models are compared and their appropriateness tested for predicting hyperthermic injury in both the traditional hyperthermia (usually, 43-50[degrees]C) and thermal surgery (or thermal therapy/thermal ablation, usually, >50[degrees]C) regime. The kinetic parameters of thermal injury in both models were obtained from the literature (or literature data), tabulated, and analyzed for various prostate and kidney systems. It was found that the kinetic parameters vary widely, and were particularly dependent on the cell or tissue type, injury assay used, and the time when the injury assessment was performed. In order to compare the capability of the two models for thermal injury prediction, thermal thresholds .for complete killing (i.e., 99% cell or tissue injury) were predicted using the models in two important urologic systems, viz., the benign prostatic hyperplasia tissue and the normal porcine kidney tissue. The predictions of the two models matched well at temperatures below 50[degrees]C. At higher temperatures, however, the thermal thresholds predicted using the TID model with a constant R value of 0.5, the value commonly used in the traditional hyperthermia literature, are much lower than those predicted using the Arrhenius model. This suggests that traditional use of the TID model (i.e., R =0.5) is inappropriate for predicting hyperthermic injury in the thermal surgery regime (>50[degrees]C). Finally, the time-temperature relation ships for complete killing (i.e., 99% injury) were calculated and analyzed using the Arrhenius model for the various prostate and kidney systems. [DOI: 10.1115/1.3128671 ]

This paper presents a complete thermal analysis of a novel conformal surface thermometer design with directional sensitivity for real-time temperature monitoring during hyperthermia treatments of large superficial cancer. The thermal monitoring sheet (TMS) discussed in this paper consists of a 2-D array of fiberoptic sensors embedded between two layers of flexible, low-loss, and thermally conductive printed circuit board (PCB) film. Heat transfer across all interfaces from the tissue surface through multiple layers of insulating dielectrics surrounding the small buried temperature sensor and into an adjacent temperature-regulated water coupling bolus was studied using 3-D thermal simulation software. Theoretical analyses were carried out to identify the most effective differential TMS probe configuration possible with commercially available flexible PCB materials and to compare their thermal responses with omnidirectional probes commonly used in clinical hyperthermia. A TMS sensor design that employs 0.0508-mm Kapton MTB and 0.2032-mm Kapton HN flexible polyimide films is proposed for tissue surface thermometry with low influence from the adjacent waterbolus. Comparison of the thermal simulations with clinical probes indicates the new differential TMS probe design to outperform in terms of both transient response and steady-state accuracy in selectively reading the tissue surface temperature, while decreasing the overall thermal barrier of the probe between the coupling waterbolus and tissue surface. Index Terms--Heat transfer, hyperthermia, noninvasive thermometry, surface thermal modeling, temperature distribution measurement, thermal monitoring sheet.

A 39-year-old woman presented to our institution with a 4-month history of weight loss, nausea, malaise, and daily fever (temperature, 38.3[degrees]C-39.5[degrees]C). Her medical history was remarkable for type 2 diabetes [...]

A case study of a 55-year-old male physician suffering from heavy night sweats and fever is presented. The patient also had persistent cough due to esophageal reflux.

A case study of a 40-year old man with persistent fever, night sweats, anorexia, and weight loss is presented. Magnetic resonance imaging (MRI) of the liver on the day after admission showed a non-enhancing thrombus in the main portal vein that extended into both the right and left intrahepatic branches.

Objective. Previous studies of febrile children who were 3 to 36 months of age and had clinically recognizable viral syndromes have shown low rates of concurrent bacteremia. We sought to determine the prevalence of serious bacterial infections (SBIs) among children with influenza A, a viral syndrome that can be established definitively by specific tests. Methods. We performed a retrospective cross-sectional study of patients who were 0 to 36 months of age and presented with fever to the emergency department (ED) over 4 consecutive influenza seasons. Chest radiographs and urine and cerebrospinal fluid cultures also were reviewed. Results. Of 705 included patients, 163 (23%) were influenza positive (IP) and 542 (77%) were influenza negative (IN). Only 1 IP patient was bacteremic (0.6%) versus 23 of the 542 IN control subjects (4.2%). Two (1.8%) of 110 IP cases had urinary tract infections versus 38 (9.9%) of the 382 IN control subjects. Thirteen (25.4%) of 51 IP patients had radiographic evidence of pneumonia versus 99 (41.9%) of 236 IN control subjects. There were no cases of meningitis in 41 cerebrospinal fluid samples obtained from IP patients versus 4 (2.2%) cases of culture-positive meningitis in 179 IN control subjects. A total of 16 (9.8%) SBIs were identified in the IP cases versus 153 (28.2%) in the IN control subjects. Conclusions. Febrile children with influenza A had a lower prevalence of bacteremia, urinary tract infections, consolidative pneumonia, or any SBI compared with those without influenza A infection in this study. Pediatrics 2005;115:710-718; influenza A, fever, serious bacterial infections, recognizable viral syndrome, testable viral syndrome., ABBREVIATIONS. Hib, Haemophilus influenzae type b; OB, occult pneumococcal bacteremia; ED, emergency department; SBI, serious bacterial infection; UTI, urinary tract infection; RAT, rapid antigen testing; TCH, Texas Children's Hospital; CSF, [...]

A bone marrow (BM) aspiration and biopsy is often believed to be a needed diagnotic procedure in the work-up of patients with fever of unknown origin (FUO) is discussed. The majority of BN biopsies in this series revealed diagnostic features of infections.

Byline: F. Tabak (1), A. Mert (2), A. D. Celik (2), R. Ozaras (2), M. R. Altiparmak (3), R. Ozturk (2), Y. Aktuglu (2) Abstract: Abstract. Background: The etiology of fever of unknown origin (FUO) includes primarily infectious, collagen-vascular and neoplastic diseases. The distribution of the disorders causing FUO may differ according to the geographic area and the socioeconomical status of the country. Moreover, the developments in radiographic and microbiologic methods have changed the spectrum of diseases causing FUO. Materials and Methods: We reviewed 117 cases that fulfilled the criteria of FUO followed in our department during the period 1984 to 2001. Results: The etiology of FUO was infectious diseases in 34% of the patients, collagen-vascular diseases in 23%, neoplasms in 19% and miscellaneous diseases in 10%. In 14% of the cases the etiology could not be found. The three leading diseases were tuberculosis (24%), lymphomas (19%) and adult-onset Still's disease (11%). Tuberculosis was found to be a more common cause of FUO than reported in studies in developed countries. Invasive procedures helped to establish the diagnosis in 50 out of 92 patients (43%). As a final diagnostic procedure, laparotomy aided the establishment of a diagnosis in 15 out of 20 patients (75%). Conclusion: Although the relative rate of infectious disease as etiologic category is less commonly encountered, infectious disease, especially tuberculosis, remains a common cause of FUO. Although several diseases may lead to FUO, lymphomas, adult-onset Still's disease and particularly tuberculosis should be considered in the differential diagnosis of a patient admitted with FUO. Author Affiliation: (1) Yaliboyu cad. Koruluk. Mehpare Basaran sok. No: 15/1, Beylerbeyi, 81210, Istanbul, Turkey (2) Dept. of Clinical Bacteriology and Infectious Diseases, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey (3) Dept. of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey Article History: Registration Date: 01/01/2003 Received Date: 25/02/2002 Accepted Date: 08/04/2003

Byline: A. Bouchama (1), M.M. Hammami (1), E. Al Shail (2), E. DeVol (3) Keywords: Heatstroke Interleukin-10 Hyperthermia Heat stress Monocytes LPS Abstract: Objective: To determine whether hyperthermia activates an anti-inflammatory response. Design: A prospective study. Setting: Heatstroke Center, Makkah, and King Faisal Specialist Hospital, Riyadh, Saudi Arabia. Patients: Twenty-five heatstroke patients pre-cooling (rectal temperature 42.4+-0.8 degC) (group 1) and 13 normothermic heat-stressed subjects were studied (group 2). Twelve of the 25 heatstroke patients were also studied post-cooling (group 3). Mononuclear cells from six healthy blood donors resting at 24 degC were used for in vitro study. Interventions: Mononuclear cells were cultured at a concentration of 1x10.sup.6/ml without and with lipopolysaccharide (LPS) added at concentration of 10, 100, and 1000 ng/ml. The cells were incubated for 24 h at 37, 39, 41, and 43 degC. ELISA was used to measure IL-10 in the supernatant and plasma from heatstroke and heat-stressed subjects. Results: All patients in group 1, 40% of group 2, and 37% of group 3, showed elevation of IL-10 (1289+-2519, 248+-393, and 172+-226 pg/ml, respectively) compared with normal control levels, ( Author Affiliation: (1) Department of Medicine, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh 11211, Saudi Arabia (2) Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (3) Department of Biomedical Statistics and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia Article History: Received Date: 04/01/2000 Accepted Date: 03/08/2000 Article note: Final revision received: 30 June 2000 Electronic Publication