Sierra Acai Company
Sierra Acai Company
Open 7 Days a Week
MonaVie Independent Distributor
Distributor Training
Shop Online
Enroll Now
Buy Wholesale and maintain an Active status for 2 months and we will refund your $39 Distributor Fee
Friends
Buy Wholesale and maintain an Active status for 2 months and we will refund your $39 Distributor Fee
07-SEPTEMBER-2008 03:17:44 - Fever This article is about the medical condition. For other uses, see Fever disambiguation. Symptom/Sign: Fever Classifications and external resources An analog medical thermometer showing the temperature of 38.7 °C ICD-10 R50. ICD-9 780.6 DiseasesDB 18924 eMedicine med/785 MeSH D005334 Fever also known as pyrexia, from the Greek pyretos meaning fire, or a febrile response, from the Latin word febris, meaning fever, and archaically known as ague is a frequent medical sign that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1-2 °C. Fever differs from hyperthermia. Hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation, or both. Carl Wunderlich discovered that fever is not a disease but a symptom of disease. The elevation in thermoregulatory set-point means that the previous normal body temperature is considered hypothermic, and effector mechanisms kick in. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point. A fever is one of the body's mechanisms to try to neutralize the perceived threat inside the body, be it bacterial or viral. Contents 1 Measurement and normal variation 2 Mechanism 2.1 Pyrogens 2.1.1 Endogenous 2.1.2 Exogenous 2.2 PGE2 release 2.3 Hypothalamus response 3 Types 4 Causes 5 Usefulness of fever 6 Treatment 7 Fever in domestic animals 8 Diseases called fever 8.1 in humans 8.2 in animals 9 References 10 Further reading 11 External links Measurement and normal variation Normally, a fever is when body temperature is at or over 38 °C 100.4°F. Normally, a fever is when body temperature is at or over 38 °C 100.4°F. When a patient has or is suspected of having a fever, that person's body temperature is measured using a thermometer. At a first glance, fever is present if: Temperature in the anus rectum/rectal or in the ear otic is at or over 38.0°C 100.4°F Temperature in the mouth oral is at or over 37.5 °C 99.5 °F Temperature under the arm axillary is at or over 37.2 °C 99.0 °F The common oral measurement of normal human body temperature is 36.8±0.7 °C 98.2±1.3 °F. This means that any oral temperature between 36.1 and 37.5 °C 96.9 and 99.5 °F is likely to be normal. However, there are many variations in normal body temperature, and this needs to be considered when measuring for fever. The values given are for an otherwise healthy, non-fasting adult, dressed comfortably, indoors, in a room that is kept at a normal room temperature 22.7 to 24.4°C or 73 to 76 °F , during the morning, but not shortly after arising from sleep. Furthermore, for oral temperatures, the subject must not have eaten, drunk, or smoked anything in at least the previous fifteen to twenty minutes. Body temperature normally fluctuates over the day, with the lowest levels around 4 a.m. and the highest around 6 p.m. 1 assuming the subject follow the prevalent pattern, i.e, sleeping at nighttime and staying awake during daytime. Therefore, an oral temperature of 37.2 °C 99.0 °F would strictly be a fever in the morning, but not in the afternoon. An oral body temperature reading up to 37.5 °C 99.5 °F in the early/late afternoon or early/late evening also wouldn't be a fever. Normal body temperature may differ as much as 1.0 °F between individuals or from day to day. In women, temperature differs at various points in the menstrual cycle, and this can be used for family planning although temperature is only one of the variables. Temperature is increased after eating, and psychological factors also influence body temperature. There are different locations where temperature can be measured, and these differ in temperature variability. Tympanic membrane thermometers measure radiant heat energy from the tympanic membrane infrared. These may be very convenient, but may also show more variability. Children develop higher temperatures with activities like playing, but this is not fever because their set-point is normal. Elderly patients may have a decreased ability to generate body heat during a fever, so even a low-grade fever can have serious underlying causes in geriatrics. Mechanism Temperature is regulated in the hypothalamus, in response to prostaglandin E2 PGE2. PGE2 release, in turn, comes from a trigger, a pyrogen. The hypothalamus generates a response back to the rest of the body, making it increase the temperature set-point. Hyperthermia: Characterized on the left. Normal body temperature thermoregulatory set-point is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be conceptualized as an increase above the thermoregulatory set-point.Hypothermia: Characterized in the center: Normal body temperature is shown in green, while the hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set-point.Fever: Characterized on the right: Normal body temperature is shown in green. It reads New Normal because the thermoregulatory set-point has risen. This has caused what was the normal body temperature in blue to be considered hypothermic. Hyperthermia: Characterized on the left. Normal body temperature thermoregulatory set-point is shown in green, while the hyperthermic temperature is shown in red. As can be seen, hyperthermia can be conceptualized as an increase above the thermoregulatory set-point. Hypothermia: Characterized in the center: Normal body temperature is shown in green, while the hypothermic temperature is shown in blue. As can be seen, hypothermia can be conceptualized as a decrease below the thermoregulatory set-point. Fever: Characterized on the right: Normal body temperature is shown in green. It reads New Normal because the thermoregulatory set-point has risen. This has caused what was the normal body temperature in blue to be considered hypothermic. Pyrogens A pyrogen is a substance that induces fever. These can be either internal endogenous or external exogenous. The bacterial substance lipopolysaccharide LPS is an example of an exogenous pyrogen. Because exposure to exogenous pyrogens can cause a dangerous reaction, the FDA has set limits on the amount of permissible endotoxin in drugs. Depyrogenation may be achieved through filtration, distillation, chromatography, or inactivation. Endogenous The cytokines such as interleukin 1 are a part of the innate immune system, produced by phagocytic cells, and cause the increase in the thermoregulatory set-point in the hypothalamus. Other examples of endogenous pyrogens are interleukin 6 IL-6, and tumor necrosis factor-alpha. These cytokine factors are released into general circulation where they migrate to the circumventricular organs of the brain, where the blood-brain barrier is reduced. The cytokine factors bind with endothelial receptors on vessel walls, or interact with local microglial cells. When these cytokine factors bind, they activate the arachidonic acid pathway. Exogenous One model for the mechanism of fever caused by exogenous pyrogens includes LPS, which is a cell wall component of gram-negative bacteria. An immunological protein called lipopolysaccharide-binding protein LBP binds to LPS. The LBP-LPS complex then binds to the CD14 receptor of a nearby macrophage. This binding results in the synthesis and release of various endogenous cytokine factors, such as interleukin 1 IL-1, interleukin 6 IL-6, and the tumor necrosis factor-alpha. In other words, exogenous factors cause release of endogenous factors, which, in turn, activate the arachidonic acid pathway. PGE2 release PGE2 release comes from the arachidonic acid pathway. This pathway as it relates to fever, is mediated by the enzymes phospholipase A2 PLA2, cyclooxygenase-2 COX-2, and prostaglandin E2 synthase. These enzymes ultimately mediate the synthesis and release of PGE2. PGE2 is the ultimate mediator of the febrile response. The set-point temperature of the body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the preoptic area POA through the prostaglandin E receptor 3 EP3. EP3-expressing neurons in the POA innervate the dorsomedial hypothalamus DMH, the rostral raphe pallidus nucleus in the medulla oblongata rRPa and the paraventricular nucleus of the hypothalamus PVN. Fever signals sent to the DMH and rRPa lead to stimulation of the sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface. It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving pituitary gland and various endocrine organs. Hypothalamus response The brain ultimately orchestrates heat effector mechanisms via the autonomic nervous system. These may be: Increased heat production by increased muscle tone, shivering and hormones like epinephrine. Prevention of heat loss, such as vasoconstriction. The autonomic nervous system may also activate brown adipose tissue to produce heat non-exercise-associated thermogenesis, also known as non-shivering thermogenesis, but this seems mostly important for babies. Increased heart rate and vasoconstriction contribute to increased blood pressure in fever. Types According to one common rule of thumb, fever is generally classified for convenience as: Fever classification Grade °C °F low grade 38-39 100.4-102.2 moderate 39-40 102.2-104.0 high-grade 40-42 104.0-107.6 hyperpyrexia 42 107.6 The last is a medical emergency because it approaches the upper limit compatible with human life. Most of the time, fever types can not be used to find the underlying cause. However, there are specific fever patterns that may occasionally hint the diagnosis: Pel-Ebstein fever: A specific kind of fever associated with Hodgkin's lymphoma, being high for one week and low for the next week and so on. However, there is some debate as to whether this pattern truly exists.2 Continuous fever: Temperature remains above normal throughout the day and does not fluctuate more than 1°C in 24 hours, e.g. lobar pneumonia, typhoid, urinary tract infection, brucellosis, or typhus. Typhoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau. Intermittent fever: Elevated temperature is present only for some hours of the day and becomes normal for remaining hours, e.g. malaria, kala-azar, pyaemia, or septicemia. In malaria, there may be a fever with a periodicity of 24 hours quotidian, 48 hours tertian fever, or 72 hours quartan fever, indicating Plasmodium malariae. These patterns may be less clear in travelers. Remittent fever: Temperature remains above normal throughout the day and fluctuates more than 1°C in 24 hours, e.g. infective endocarditis. A neutropenic fever, also called febrile neutropenia, is a fever in the absence of normal immune system function. Because of the lack of infection-fighting neutrophils, a bacterial infection can spread rapidly and this fever is therefore usually considered a medical emergency. This kind of fever is more commonly seen in people receiving immune-suppressing chemotherapy than in apparently healthy people. Febricula3 is a mild fever of short duration, of indefinite origin, and without any distinctive pathology. Causes Fever is a common symptom of many medical conditions: Infectious disease, e.g. influenza, common cold, HIV, malaria, infectious mononucleosis, or gastroenteritis Various skin inflammations, e.g. boils, pimples, acne, or abscess Immunological diseases, e.g. lupus erythematosus, sarcoidosis, inflammatory bowel diseases Tissue destruction, which can occur in hemolysis, surgery, infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc. Drug fever directly caused by the drug, e.g. lamictal, progesterone, or chemotherapeutics causing tumor necrosis as an adverse reaction to drugs, e.g. antibiotics or sulfa drugs. after drug discontinuation, e.g. heroin or fentanyl withdrawal Cancers, most commonly renal cancer and leukemia and lymphomas Metabolic disorders, e.g. gout or porphyria Thrombo-embolic processes, e.g. pulmonary embolism or deep venous thrombosis Persistent fever which cannot be explained after repeated routine clinical inquiries, is called fever of unknown origin. Usefulness of fever Give me a fever, and I can cure any illness. -- Hippocrates ca. 400 BC There are arguments for and against the usefulness of fever, and the issue is controversial.45 There are studies using warm-blooded vertebrates6 and humans7 in vivo, with some suggesting that they recover more rapidly from infections or critical illness due to fever. Theoretically, fever can aid in host defense.4 There are certainly some important immunological reactions that are sped up by temperature, and some pathogens with strict temperature preferences could be hindered.8 The overall conclusion seems to be that both aggressive treatment of fever7 and too little fever control4 can be detrimental. This depends on the clinical situation, so careful assessment is needed. Fevers may be useful to some extent since they allow the body to reach high temperatures, causing an unbearable environment for some pathogens. White blood cells also rapidly proliferate due to the suitable environment and can also help fight off the harmful pathogens and microbes that invaded the body. Research9 has demonstrated that fever has several important functions in the healing process: increased mobility of leukocytes enhanced leukocytes phagocytosis endotoxin effects decreased increased proliferation of T Cells10 enhanced activity of interferon 10 Treatment This section does not cite any references or sources. March 2008 Fever should not necessarily be treated. Fever is an important signal that there's something wrong in the body, and it can be used to govern medical treatment and gauge its effectiveness. Moreover, not all fevers are of infectious origin. Even when treatment is not indicated, however, febrile patients are generally advised to keep themselves adequately hydrated, as the dehydration produced by a mild fever can be more dangerous than the fever itself. Water is generally used for this purpose, but there is always a small risk of hyponatremia if the patient drinks too much water. For this reason, some patients drink sports drinks or electrolyte-replacing products designed specifically for this purpose. Most people take medication against fever because the symptoms cause discomfort. Fever increases heart rate and metabolism, thus potentially putting an additional strain on elderly patients, patients with heart disease, etc. This may even cause delirium. Therefore, potential benefits must be weighed against risks in these patients. In any case, fever must be brought under control in instances when fever escalates to hyperpyrexia and tissue damage is imminent. Treatment of fever is normally done by lowering the set-point, but facilitating heat loss may also be effective. The former is accomplished with antipyretics such as ibuprofen or acetominophen aspirin can be given to adults, but can cause Reye's Syndrome in children. Heat removal is generally by wet cloth or pads, usually applied to the forehead,11 but also through bathing the body in tepid water. This is particularly important for babies, where drugs should be avoided. However, using water that is too cold can induce vasoconstriction, and reduce effective heat loss. Heat loss may also be accomplished by heat conduction, convection, radiation, or evaporation sweating, perspiration, or a combination of these. Fever in domestic animals Fever is also an important feature for the diagnosis of disease in domestic animals. The body temperature of animals, which is always taken rectally, is different from one species to another. For example, a horse is said to have a fever at 38.5°C, while a cow is said to have a fever at 39.6°C. In species that allow the body to have a wide range of normal temperatures, such as camels, it is sometimes difficult to determine a febrile stage. Diseases called fever As fever is a prominent symptom of many diseases, in man and animals, it will often appear in the common appellation of diseases. in humans Ebola fever Puerperal fever Yellow fever in animals East Coast fever an African disease of cattle Malignant catarrhal fever a world-wide disease of cattle Milk fever a metabolic illness of cattle with hypothermia Rift valley fever an African disease of sheep References ^ Body Temperature ^ Hilson, A.J.W. DiNubile, M.J. 1995-07-06, Correspondence, New England Journal of Medicine 333: 66-67, doi:10.1056/NEJM199507063330118, PMID 7777006, http://content.nejm.org/cgi/content/short/333/1/66. Retrieved on 18 March 2008 . They cite Richard Asher's lecture Making Sense Lancet, 1959, 2, 359 ^ Febricula, definition from Biology-Online.org, consulted June 7, 2006 http://www.biology-online.org/dictionary/Febricula ^ a b c Schaffner A. Fever-useful or noxious symptom that should be treated? Ther Umsch 2006; 63: 185-8. PMID 16613288 ^ Soszynski D. The pathogenesis and the adaptive value of fever. Postepy Hig Med Dosw 2003; 57: 531-54. PMID 14737969 ^ Su, F.; Nguyen, N.D.; Wang, Z.; Cai, Y.; Rogiers, P.; Vincent, J.L. Fever control in septic shock: beneficial or harmful? Shock 2005; 23: 516-20. PMID 15897803 ^ a b Schulman, C.I.; Namias, N.; Doherty, J., et al. The effect of antipyretic therapy upon outcomes in critically ill patients: a randomized, prospective study. Surg Infect Larchmt 2005; 6:369-75. PMID 16433601 ^ Fischler, M.P.; Reinhart, W.H. Fever: friend or enemy? Schweiz Med Wochenschr 1997; 127: 864-70. PMID 9289813 ^ Craven, R and Hirnle, C. 2006. Fundamentals of nursing: Human health and function. Fourth ion. p. 1044 ^ a b Lewis, SM, Heitkemper, MM, and Dirksen, SR. 2007. Medical-surgical nursing: Assessment and management of clinical problems. sixth ion. p. 212 ^ Craven ,R and Hirnle,C. 2006. Fundamentals of nursing:Human health and function. Forth ion.. Antipyretics 11 7-8: 1044. PMID 15636181. Further reading Rhoades, R. and Pflanzer, R. Human physiology, third ion, chapter 27 Regulation of body temperature, p. 820 Clinical focus: pathogenesis of fever. ISBN 0-03-005159-2 Kasper, D.L.; Braunwald, E.; Fauci, A.S.; Hauser, S.L.; Longo, D.L.; Jameson, J.L. Harrison's Principles of Internal Medicine. New York: McGraw-Hill, 2005. ISBN 0-07-139140-1. External links What to do if your child has a fever from Seattle Children's Hospital Fever and Taking Your Child's Temperature US National Institute of Health factsheet BUPA factsheet v d e Symptoms and signs: general R50-R69, 780-789 Fever Hyperpyrexia - Fever of unknown origin Pain Headache - Chronic pain Malaise/Fatigue Asthenia - Debility Fainting/syncope Vasovagal syncope - Carotid sinus syncope - Heat syncope Ingestion food and fluid intake Anorexia, Polydipsia, Polyphagia - Cachexia - Xerostomia Anorexia/Weight loss Hemodynamic Shock: Cardiogenic - Hypovolemic - Distributive Septic, Neurogenic Edema: Peripheral edema - Anasarca Hyperaemia: Functional - Reactive Lymphadenopathy Underdevelopment Delayed milestone - Failure to thrive - Short stature Idiopathic Other Seizure Febrile seizure Hyperhidrosis Sleep hyperhidrosis Clubbing - Tenderness Retrieved from http://en..org/wiki/Fever Categories: SymptomsHidden categories: Articles lacking sources from March 2008 | All articles lacking sources Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية বাংলা БългарÑ?ки Català Česky Dansk Deutsch Ελληνικά Español Esperanto Euskara Français हिनà¥?दी Ido Bahasa Indonesia Italiano עברית Latina Lingála Magyar മലയാളം Bahasa Melayu Nederlands नेपाल à¤à¤¾à¤·à¤¾ 日本語 ‪Norsk bokmÃ¥l‬ ‪Norsk nynorsk‬ پښتو Polski Português Runa Simi РуÑ?Ñ?кий Sicilianu සිංහල Simple English SlovenÄ?ina SlovenÅ¡Ä?ina Suomi Svenska தமிழà¯? తెలà±?à°—à±? УкраїнÑ?ька Vèneto Walon ייִדיש ä¸æ–‡ This page was last modified on 26 August 2008, at 03:38
39 Reasons to Drink Acai Juice Every Day
What is MonaVie - Watch the 8-minute video
Discovering MonaVie Video
The Power of You Video
Effects of MonaVie Active on Antioxidant Capacity in Humans
Log into your Wholesale MonaVie Account
So many of us do not eat a balanced diet, get enough sleep, have too much stress, or are impacted with toxins and pollutants. Drinking 2 ounces of MonaVie twice a day will help your body detoxify as well as build your immune system. Its the smartest thing you can do for yourself, so start today. Buying MonaVie through our company guarantees you support 7 days a week and, if you would like to share MonaVie with your family and friends we will guide you from start to finish.
1. Click on Enroll Now (30 - 55% off retail price)
2. Pay $39 for your Wholesale ID number.
3. NO minimum order required.
4. MonaVie is delivered to your door in 3 to 5 days.