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Fever And Its Role As Physilogical Necessity And As Disease
Does Fever Have Any Value To The Body? Oh yes, it definitely
has! Evolution has ‘invented’ fever as a means of bodily reaction
directed against the cause of the disease. A raised body temperature
stimulates the defense mechanisms of the organism, especially the
synthesis of interferons and the function of certain leukocytous
functions.On the other hand, fever is a burden or maybe even a threat
to the body. Even if the body temperature is only moderately increased,
children may suffer febrile convulsion.If body temperature exeeds
105,8 °F (41°C), infants and children may develop cerebral oedema
or circulatory shock due to the lability of the water- and electrolyte
metabolism.
Normal Body Temperature
A person's deep tissue temperature varies within a range of 1°F
(0,6°C) throughout the day. If external temperature does not reach
a value beyond 55°F (12,7°C) and 130°F (54,4°C), this will not affect
the normal core temperature which is, orally measured, within the
range of 97°F (36°C) and 98,6°F (37,5°C) as long as low humidity
permits perspiration to work in the regulatory mechanism. Measured
rectally, the temperature is approximately 1°F higher.The skin temperature
is much more influenced by the surroundings than the core temperature.
Body Heat Generation
Heat production within the body is closely depending of the metabolic
rate of the body and therefor of the following factors:
Within each single active body cell, metabolic processes take place,
most of which being chemical reactions, many of them releasing heat
as a side effect. These processes are necessary to maintain the
living processes of the whole body. We speak of the basal rate of
metabolism of the sum of the body cells. In addition to this, extra
rate of metabolism may be caused by muscle activity, by the effect
of epinephrine, norepinephrine, and some other hormones and also
by increased chemical activity in the cells.» Did You know
that body heat is mainly generated in the liver, the brain, the
heart, and in, during exercise, the skeletal muscles?
Regulation Of Body Temperature
The body owns a regulatory system that keeps body temperature within
a close range. The centers of this system are located in the hypothalamus.Temperature
sensors are found in the preoptic and anterior hypothalamic nuclei.
More sensors are contained in the skin and in a few deep tissues
in the body.The temperature is regulated by a nervous feedback mechanism.
The signals from the sensors are evaluated in the posterior hypothalamus.If
the body temperature is too high, the body's reaction will be vasodilatation,
sweating and decrease in heat production as responses.If the body
temperature is too low, the body's reaction will be skin vasoconstriction,
piloerection and an increase of heat production.The temperature
then will swing close to a 'set-point' of the hypothalamic temperature
controller.In diseased condition, exogenous (e.g. bacterial toxins)
or endogenous pyrogens may cause the 'set-point' to be raised, which
next will stimulate the body's regulatory system to raise the body
heat. A substance called interleukin-1 has to be mentioned in this
context, since it is released in killer lymphocytes and acts as
an endogenous pyrogen like the tumour necrosis factor, interleukin-6,
and interferon.Causes Of Fever Groups of diseases commonly being
associated with fever are infectious diseases, maligne diseases,
and autoimmune diseases (e.g. collagenosis, rheumatic diseases,
granulomatosis, vasculitids), metabolic diseases, allergic reactions,
inherited or acquired immmune deficiency, or various other maladies,
such as thrombosis, pulmonary embolism, phlogistic enteropathies,
drug-induced fever, disintegration of tissues, itravasal haemolysis,
Münchhausen-Syndrome (traumatophilia).The different types of fever
are Febris continua: most commonly it is a high temperatured fever of > 39°C
without much change of the value from the morning until the evening.
Febris remittens: there
is a considerable variation in body temperature (up to 2°C) from
the morning until the evening. Febris
intermittens: There is an
extreme variation in body temperature (> 2°C) during the day.
Febris recurrens: Periodic
episodes of fever (as F. continua, F. remittens, or F. intermittens)
separated from each other by intervals without fever.
Febris undulans: Continued fever with alternating slow rises and slow falls
of temperature.
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