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PubMed1991

Behavioral aspects of temperature-taking.

Ear thermometry addresses two basic psychological aspects of fevers. The first one is obvious: the battle of the rectal temperature can be eliminated by ear thermometry. The second one addresses the overtreatment of tactile fevers. Tactile temperature taken by feeling the forehead occurs in 50% to 90% of homes. Half of warm foreheads occur in afebrile children who are warm because they're releasing heat generated by a recent activity or bath. If an actual temperature were measured, these children wouldn't be mislabeled as having fever and unnecessarily treated.

Age Factors↗
PubMed1993

Sternocleidomastoid muscle inhibition induced by trigeminal stimulation.

Among numerous reports of anatomical and functional coupling between the trigeminal and cervical systems is the demonstration that the sternocleidomastoid (SCM) muscles may become activated along with the masseter muscles during forceful abrupt biting maneuvers. Whether the co-activated SCM is also inhibited by stimuli that produce masseter inhibition is not known. This study evaluated the SCM for the presence of inhibition during mechanically-elicited (chin or forehead tap) and electrically-elicited (anterior maxillary gingiva stimulation) inhibition of the masseter muscle in ten healthy men. Surface EMG data were recorded bilaterally from the masseter and SCM muscles. The data for each muscle were converted to ratios of the pre-stimulus maximum voluntary contraction activity for each subject and averaged across subjects. Means of these percentages were determined at several defined pre- and post-stimulus intervals. The results indicate that masseter inhibition was clearly elicited by the electrical and both forms of mechanical stimulation. SCM co-inhibition could be evoked by electrical and chin tap stimulation but not by forehead tap. The responses to these stimuli varied among subjects, from trial to trial, and within subjects depending on the experimental condition. The fact that it was possible for this co-inhibition to be evoked is presented as further indication of the functional coupling of the trigeminal and cervical systems.

Adult↗
PubMed1988

Effect of continuously warmed irrigating solution during transurethral resection.

The effects of a continuously warmed irrigating solution on body temperature during transurethral resection of the prostate and of bladder tumours were studied in forty patients. Anaesthesia was spinal and deep body temperatures of the forehead and lower abdomen were measured, using a deep body thermometry system. Both forehead and lower abdominal deep body temperatures decreased significantly in the patients who underwent transurethral resection of the prostate with an irrigating solution at operating room temperature, but did not decrease in the patients who received a continuously warmed irrigating solution. The same results were obtained for the patients who underwent transurethral resection of bladder tumour. Our results indicate that a continuously warmed irrigating solution could prevent the fall in body temperature during transurethral resection, especially prostate resection, under spinal anaesthesia.

Aged↗
PubMed2005

Neuroradiologic findings in a young patient with characteristics of Sturge-Weber syndrome and Klippel-Trenaunay syndrome.

The patient presented here has extensive hemangiomata plana, especially on the right forehead, right upper eyelid, and right leg, as well as right leg hypertrophy and macrocephaly. Cerebral magnetic resonance imaging (MRI) showed abnormalities in only one occipital lobe consisting of focal cortical atrophy, leptomeningeal enhancement, and ipsilateral choroid plexus enlargement. Mental and motor development is normal, and he has no seizures. The parents are consanguineous. Leg hypertrophy associated with ipsilateral cutaneous vascular malformations is suggestive of Klippel-Trenaunay syndrome. The patient's central nervous system abnormalities on MRI and the hemangiomata plana on the ipsilateral upper eyelid and forehead point to Sturge-Weber syndrome. We conclude that the patient has an overlap syndrome between Klippel-Trenaunay syndrome and Sturge-Weber syndrome.

Child, Preschool↗
PubMed2005

Non-contact infrared thermometry temperature measurement for screening fever in children.

BACKGROUND: During the SARS epidemic, mass fever screening at border control points and public hospitals was done by measuring forehead temperature by non-contact infrared thermometry. However, its accuracy is not well documented. METHODS: We evaluated the agreement of non-contact infrared forehead temperature (NIFT) measurement by comparing NIFT readings with tympanic temperatures taken in children (1 mth to 18 yrs) admitted to the general paediatric wards of Kwong Wah Hospital, Hong Kong. RESULTS: A total of 567 patients were recruited and 1000 pairs of readings were obtained. The incidence of fever, defined as tympanic temperature (in rectal model) >38 degrees C (100.4 degrees F), was 12.3%. The mean difference between NIFT and tympanic temperature was 2.34 degrees C (4.21 degrees F) and the 95% limit of agreement between NIFT and tympanic temperature was 0.26-4.42 degrees C (0.47-7.96 degrees F). NIFT was significantly lower than tympanic temperature readings. The optimal cut-off point of NIFT derived from the receiver-operator characteristics curve for fever definition was 35.1 degrees C (95.2 degrees F). The sensitivity, specificity, positive predictive value and negative predictive value of this cut-off point for fever screening were 89.4%, 75.4%, 33.7% and 98.1%, respectively. CONCLUSIONS: NIFT measurement has a reasonable accuracy in detecting tympanic fever in children. However, one should be aware of the high false-positive rate of fever screening using NIFT.

Body Temperature↗
PubMed2006

Acoustic radiation from the head of echolocating harbor porpoises (Phocoena phocoena).

An experiment was conducted to investigate the sound pressure patterns on the melon of odontocetes by using four broadband hydrophones embedded in suction cups to measure echolocation signals on the surface of the forehead of two harbor porpoises (Phocoena phocoena). It has long been hypothesized that the special lipids found in the melon of odontocetes, and not in any other mammals, focus sounds produced in the nasal region that then propagate through the melon, producing a beam that is directional in both the horizontal and vertical planes. The results of our measurements supported the melon-focusing hypothesis, with the maximum click amplitude, representing the axis of the echolocation beam, located approximately 5.6-6.1 cm from the edge of the animal's upper lip along the midline of the melon. The focusing is not sharp but is sufficient to produce a transmission beam of about 16 degrees. Click amplitude dropped off rapidly at locations away from the location of site of maximum amplitude. Based on comparisons of forehead anatomy from similar sized porpoises, the beam axis coincided with a pathway extending from the phonic lips through the axis of the low-density/low sound velocity lipid core of the melon. The significant interaction between click number and hydrophone position suggests that the echolocation signals can take slightly different pathways through the melon, probably as a result of how the signals are launched by the production mechanism and the position of the acoustically reflective air sacs.

Acoustics↗
PubMed2002

The face that sank the Essex: potential function of the spermaceti organ in aggression.

'Forehead to forehead I meet thee, this third time, Moby Dick!' [Ahab (Melville, 1851)] Herman Melville's fictional portrayal of the sinking of the Pequod was inspired by instances in which large sperm whales sank whaling ships by ramming the ships with their heads. Observations of aggression in species of the four major clades of cetacean and the artiodactyl outgroup suggest that head-butting during male-male aggression is a basal behavior for cetaceans. We hypothesize that the ability of sperm whales to destroy stout wooden ships, 3-5 times their body mass, is a product of specialization for male-male aggression. Specifically, we suggest that the greatly enlarged and derived melon of sperm whales, the spermaceti organ, evolved as a battering ram to injure an opponent. To address this hypothesis, we examined the correlation between relative melon size and the level of sexual dimorphism in body size among cetaceans. We also modeled impacts between two equal-sized sperm whales to determine whether it is physically possible for the spermaceti organ to function as an effective battering ram. We found (i) that the evolution of relative melon size in cetaceans is positively correlated with the evolution of sexual dimorphism in body size and (ii) that the spermaceti organ of a charging sperm whale has enough momentum to seriously injure an opponent. These observations are consistent with the hypothesis that the spermaceti organ has evolved to be a weapon used in male-male aggression.

Aggression↗
PubMed1997

Radiation exposure during standard and complex interventional procedures.

Radiation doses given during standard and complex interventional procedures were compared. Screening times, dose-area products, and radiologists' forehead and finger doses were recorded during 28 standard percutaneous drainages and 10 complex drainages (eight combined procedures and two failed procedures). The median screening times (8.75 min) and finger doses (84 microGy) during standard drainages were less than those during complex drainages (20.5 min, p = 0.0005 and 163 microGy, p = 0.0003). Dose-area products and forehead doses were also lower, but not significantly. Previously published series on radiation measurements lack data on complex procedures. This may bias the results, since combined and failed interventions, which are common, are associated with higher radiation exposure than are standard procedures.

Humans↗
PubMed2001

Positional preference: prevalence in infants and follow-up after two years.

OBJECTIVES: 1) To determine the prevalence of positional preference in the general population of infants up to the age of 6 months; 2) to gather information on possible risk factors; 3) to determine the percentage of children with positional preference undergoing diagnostic evaluation and/or treatment; and 4) to assess the overall outcome of positional preference in infants and toddlers, with currently used diagnostic and treatment practices. SETTING: Infant health care centers in The Netherlands. METHODS: Seven thousand six hundred nine infants below the age of 6 months were screened for positional preference (cases: n = 623). Anamnestic data and physical signs of asymmetry of the range of motion and the shape of the head were recorded. These data were also registered of an immediate next child visiting the infant health care center with the same sex and about the same age but without positional preference (controls: n = 554). In a first follow-up study, 6 to 8 months after the original study, 468 of the 623 children with positional preference were reexamined for asymmetry of the range of motion and the shape of the head. In a second follow-up study, 24 to 32 months after the original study, 129 of 259 children who still had shown signs of asymmetry in the first follow-up study were again reexamined. RESULTS: The prevalence of positional preference was 8.2% and was highest in children below 16 weeks of age. The boy:girl ratio was 3:2. Firstborns, premature children, and children with breech position at the time of delivery proved to have a higher risk for positional preference. The supine sleeping position of the child and a strong preference in offering the feeding always from the right or the left side were positively correlated with positional preference. In the first follow-up study, 12% still showed restricted active range of motion, 8% restricted passive range of motion, 47% asymmetric flattening of the occiput, and 23% of the forehead. Thirty-two percent of the children with positional preference had been referred for diagnostical/therapeutical intervention. In the second follow-up study, active range of motion was restricted in 6%, passive rotation in 2%, 45% had an asymmetric flattening of the occiput, and 21% of the forehead. CONCLUSION: Positional preference is frequently observed (8.2%) in The Netherlands. It leads to referral, additional diagnostics and, if necessary, treatment of almost 1 of every 3 affected children. Extrapolated to the original population in 1995, 2.4% of all children would still have a restricted range of motion and/or flattening of the skull at the age of 2 to 3 years. The high prevalence of positional preference in infancy, the persistency of accompanying signs, the large number of children referred for further diagnostic and/or treatment, and the resulting high medical expenses strongly call for a primary preventive approach.positional preference, deformational plagiocephaly, asymmetry, infants, population-based study.

Case-Control Studies↗
PubMed2001

A clinical comparison of radiant warmer and incubator care for preterm infants from birth to 1800 grams.

OBJECTIVE: The objective of this study was to compare radiant warmer and incubator care for preterm infants from birth with respect to temperature control and weight gain. METHODS: Sixty preterm infants <33 weeks' gestation were randomized at birth to radiant warmer or incubator care. The initial goal was to maintain abdominal temperature at 36.8 degrees C in both groups and axillary temperature at 36.8 to 37.3 degrees C; air servocontrol was used for incubator infants. Infants in both groups received added humidity for 5 days if their weight was <1000 g and for 3 days if they weighed between 1000 and 1249 g. During a 3-hour period on days 1 to 7, recordings of abdominal, forehead, and foot temperatures were obtained. The percentage of the recording time during which the abdominal temperature was in the target range of between 36 degrees C and 37.5 degrees C was determined as an indicator of temperature control. Weight gain from birth to 1800 g was compared. Secondary outcomes included fluid balance and clinical events. RESULTS: There were 30 infants in each group; 48 were <1500 g (of whom 17 were <1000 g). There were no significant differences in birth weight, gestation, gender, or illness severity scores in the 2 groups. Significant differences in temperature control were noted on day 1. Although admission temperatures were similar, lower abdominal temperatures were noted in the first 2 hours of life in the incubator group (medians were 36.6 degrees C and 35.9 degrees C in the radiant warmer and incubator groups, respectively). Similarly, mean abdominal temperatures during the 3-hour recording on day 1 were lower in the incubator group, and infants in this group spent a significantly greater percentage of the recording time with temperatures outside the target range (17.3% compared with 0.88%). Other temperature recordings from the forehead and foot were not significantly different in the groups. Fluid intakes were higher for infants under radiant warmer on days 2, 3, and 4, and the difference amounted to a mean of 12.8 mL/kg/d. Maximum sodium levels in the first week were similar in the 2 groups. Mean weight gain was 17.4 g/kg/d for the radiant warmer group and 17.1 g/kg/d for the incubator group; days to regain birth weight and length of hospital stay were not significantly different. Greater numbers of infants in the radiant warmer group required phototherapy, and adverse events (which included death, necrotizing enterocolitis, chronic lung disease, grade 3 or 4 intraventricular hemorrhage, periventricular leukomalacia, or retinopathy requiring laser treatment) were less frequent in the radiant warmer group (1 infant compared with 8 in the incubator group; relative risk 0.1; 95% confidence intervals: 0.01-0.82). CONCLUSIONS: This study has shown differences in abdominal temperatures on day 1 and outcome, although the latter finding should be viewed with caution because of the sample size. The results indicate benefits for the initial use of the radiant warmer after birth. Although fluid requirements were higher in the radiant warmer group for days 2 through 4, the increased fluid volumes were given without apparent adverse effect.

Body Temperature↗
PubMed2006

Patterns of infantile hemangiomas: new clues to hemangioma pathogenesis and embryonic facial development.

OBJECTIVES: Large facial infantile hemangiomas have higher rates of complications than small localized hemangiomas, more often require treatment, and can be associated with neurological, ophthalmologic, and cardiac anomalies (PHACE syndrome). The anatomic patterns of these hemangiomas are often referred to as "segmental" despite a lack of precise anatomic definitions. Our study aims to define "segmental" hemangiomas based on clinically observed patterns. Our secondary goal is to relate the observed patterns to currently accepted developmental patterns to gain insight into hemangioma pathogenesis and craniofacial development. METHODS: Photographic data were extracted from a large cohort of patients with infantile hemangiomas. We mapped 294 hemangiomas and recorded common morphologic patterns. Anatomic descriptions of the most common patterns were described and compared with accepted concepts of craniofacial development. RESULTS: Four primary segments were identified (Seg1-Seg4). Seg2 and Seg3 correspond with the previously recognized maxillary and mandibular prominences. Seg1 and Seg4 differ from standard human embryology texts. The frontotemporal segment, Seg1, encompasses the lateral forehead, anterior temporal scalp, and lateral frontal scalp. The segment Seg4, encompassing the medial frontal scalp, nasal bridge, nasal tip, ala, and philtrum, is substantially narrower on the forehead than the previously described frontonasal prominence. CONCLUSIONS: The patterns provide new clues regarding facial development. The observed patterns resemble previously described facial developmental units on the lower face but are distinctly different on the upper face. The patterns suggest that neural crest derivatives may play a role in the development of facial hemangiomas. Finally, these patterns (Seg1-Seg4) help standardize the nomenclature of facial segmental hemangiomas to analyze more effectively hemangioma risks and behavior.

Face↗
PubMed1996

Physiological and psychological effects of head heating during rest and work.

The purpose of this study is to obtain some knowledge related to physiological and psychological effects of head heating by radiation on the vital body under varying conditions of the environmental temperature and physical activity. The study was proceeded with experiments 1 and 2 using 8 women, all in good health as subjects. In experiment 1, firstly the subject at rest was kept at an ambient temperature of 28 degrees C for 40 minutes. The, moving to a room kept at an ambient temperature of 18 degrees C or 28 degrees C, the state at rest was maintained with head heating at 3 radiant intensities (without radiation, 35 degrees C and 40 degrees C of globe temperature) for a further 40 minutes. In experiment 2, continued from the same procedure of experiment 1, work on the ergometer was performed for 30 minutes with head heating at 2 radiant intensities (without radiation and 35 degrees C of globe temperature). Items measured were tympanic temperature, skin temperatures, heart rate, and subjective sensations. The principal results obtained are as follows: 1) Tympanic temperature, forehead skin temperature and score of thermal sensation of head increased, while the others decreased at 18 degrees C. 2) Decrease of scores was inhibited by head heating in finger skin temperature, toe skin temperature and heart rate. 3) When radiant intensities at 35 degrees C and 40 degrees C were compared, statistical significant difference was noted in forehead skin temperature only, the difference of radiant conditions gives a little effect to the vital body. 4) Effects brought by head heating during rest decreased owing to the addition of work.

Adult↗
PubMed2025

Symptoms of Allodynia and Pain Thresholds Amongst Those with Acute Post-Traumatic Headache Attributed to Mild Traumatic Brain Injury: A Prospective, Longitudinal Study.

BACKGROUND: Post-traumatic headache (PTH) is a common acute and persistent symptom following mild traumatic brain injury (mTBI). Symptoms of cutaneous allodynia and presence of nociceptive sensitization might be associated with acute PTH and its persistence. The objectives of this study were to compare allodynia symptoms and cutaneous heat pain thresholds amongst males and females with acute PTH to healthy controls (HC) and determine if pain thresholds and allodynia symptoms are associated with PTH outcomes. METHODS: This prospective longitudinal study enrolled 139 adults with acute PTH attributed to mTBI as defined by the International Classification of Headache Disorders and 95 HC. All PTH participants completed a baseline research visit near PTH onset and a follow-up visit three to four months later. All PTH participants and a subset of HC completed the Allodynia Symptom Checklist (ASC-12) at each research visit. A different subset of the participants underwent quantitative sensory testing (QST) during baseline, 4-week, and 16-week research visits to quantify cutaneous heat pain thresholds at the forehead and forearms. Data from daily headache diaries were used to determine longitudinal PTH improvement versus non-improvement at three months. ASC-12 score and pain threshold comparisons were made between PTH and HC groups, PTH improved versus non-improved cohorts, and between PTH males and females. RESULTS: Participants with PTH had an average age of 42.6 years and 64.0% were female. HC had an average age of 40.0 years and 65.3% were female. At the first visit, PTH participant ASC-12 scores averaged 3.6 versus 0.1 amongst HC, p < 0.001. 44.8% of PTH participants had headache improvement at 3 months. ASC-12 scores were higher in the PTH non-improved versus improved group at baseline (4.0 versus 2.4, p = 0.038) and 3-month follow-up (3.4 versus 1.9, p = 0.012). ASC-12 scores were higher in females than males at baseline (4.7 versus 1.6, p < 0.001) and 3-months (3.9 versus 1.2, p < 0.001). Cutaneous heat pain thresholds at the forehead and forearm did not differ between any group. CONCLUSIONS: PTH attributed to mTBI is associated with symptoms of cutaneous allodynia. Greater allodynia symptoms are present in females with PTH compared to males and may be associated with PTH non-improvement.

allodynia↗
PubMed1996

The influence of work loads on regional differences in sweating rates.

The influence of work loads (20, 40 and 60% VO2max) on regional differences in sweating rates was investigated in six healthy male students. The ratios of local sweating rate (msw) on the chest and back to estimated total sweating rate (mean msw of four sites examined x body surface area) at 20% work load were significantly greater than those on the forearm and forehead, whereas the ratio on the forehead at 60% work load was greater than at the other sites. The ratios on the forearm at 40 and 60% work loads were significantly greater than at 20% work load. The regional differences in sweating rates change with the increase in work load as seen by the greater variation in the ratios of msw on each site at 20% work load compared with 40 and 60% work loads. The results indicate that redistribution of this sweat activity to whole body or head with the rise in work load induces favorable conditions for evaporation and controlling brain temperature.

Adult↗
PubMed2001

Trauma sites and clinical features associated with acute hyperextension spinal cord injury without bone damage--relationship between trauma site and severity.

To elucidate whether a relationship exists between the site of trauma and severity of acute hyperextension spinal cord injury without bone damage, we examined the clinical features of 25 male and 10 female patients aged 13 to 88 years. None of the patients had vertebral damage such as fracture and dislocation. The site of impact was classified as the buccal, forehead, or mandibular region. The neurological findings were assessed according to Frankel's classification at admission and at follow up after 3 months or more to assess outcome. Eleven patients suffered trauma in the buccal region, one patient in Frankel's grade B, three in grade C, and seven in grade D at admission. All 11 of these patients showed an improvement of one grade or more to an outcome of C in one patient, D in one, and E in nine. Trauma occurred at the forehead region in 18 patients, four in grade B, 10 in grade C, and four in grade D. Improvement was seen at follow up by one grade or more to C in one patient, D in 10, and E in seven. Trauma occurred at the mandibular region in six patients, four in grade B and two in grade C. Four of these patients showed improvement of one grade or more to grade B in one, grade C in four, and grade E in one. Overall, seven patients had poor outcomes, five of whom suffered trauma to the mandibular region, indicating that impact to the mandibular region tends to have an unfavorable clinical outcome. Our findings indicate that the site of trauma greatly influences the severity of hyperextension spinal cord injury.

Adolescent↗
PubMed2004

Isolated recurrence of granulocytic sarcoma manifesting as extra- and intracranial masses--case report.

A 30-year-old female presented with a rare case of isolated recurrence of granulocytic sarcoma manifesting as extra- and intracranial masses 16 months after successful treatment of acute myeloblastic leukemia (M-2). She presented with a swelling located on her forehead that had appeared just after hitting her forehead, and never diminished in size. The mass was elastic hard and not freely mobile. Computed tomography and magnetic resonance imaging demonstrated enhanced masses in the right frontal extra- and intracranial region with no bone destruction. There was no evidence of relapse in the bone marrow. Needle aspiration biopsy of the subscalpal mass was performed. Fluorescence in situ hybridization revealed AML1/MTG8 fusion gene associated with t(8; 21). Two courses of systemic chemotherapy with high-dose cytarabine and total neural axis irradiation resulted in complete remission.

Adult↗
PubMed1990

Lack of cutaneous hyperemia in response to insulin-induced hypoglycemia in IDDM.

Cutaneous blood flow was measured with the laser Doppler technique and by recording cutaneous O2 tension on the forearm and forehead in nine young adult patients with insulin-dependent diabetes mellitus (IDDM) and nine sex- and age-matched healthy control subjects after induction of hypoglycemia. In the healthy subjects, cutaneous blood flow measured with the laser Doppler technique was increased by 120 +/- 26% in the forehead (P less than 0.01) and 196 +/- 50% in the forearm (P less than 0.01) at the glucose nadir (blood glucose 1.8 +/- 0.2 mM) compared with basal blood flow. In contrast, in diabetic patients, cutaneous blood flow was unchanged. The corresponding changes, at the glucose nadir, with cutaneous O2 tension recordings were 286 +/- 131% (P less than 0.05) in control subjects and -22 +/- 15% (NS) in diabetic patients. An impairment of sympathetic nervous function, not detectable by simple cardiovascular tests, could be responsible for the lack of cutaneous hyperemia and sweating and could contribute to unawareness of hypoglycemia in diabetic patients.

Adult↗
PubMed1983

Comparison of auditory and visual feedback for EMG training.

27 undergraduate students participated in an experiment on EMG biofeedback. Three groups were employed (visual feedback, audio biofeedback, and control) to determine which group learned to reduce frontalis muscle tension more quickly. All subjects were trained during a 30-min. period for five days. The time consisted of a 10-min. baseline and a 20-min. biofeedback session. Over a 5-day period relaxation in the forehead due to biofeedback improved significantly. More training time yielded an increased relaxation in this area, and most learning occurred during the first two days. The significant interaction of training and time illustrated that the two biofeedback groups produced a more pronounced relaxation in the forehead muscle than did the control group. No significant difference was found between the two biofeedback groups.

Adolescent↗