Friday, June 3, 2022

The Page of the Day: About fever (Fièvre)

 

Par Dr Jacques  Hyacinthe

This term was echoed for the first time around the late 14th century as”feaver” meaning fever or temperature of the body higher than normal. But it stemmed from the old French” fievre” by way of Latin “febris,” related to” fevore”(to warm, to heat).


Generally speaking, a fever stands for an elevation of body temperature above normal, which for most people has not been well-defined since it is usually lower in the morning and higher in the evening. Normally, the body temperature varies between 97.5 degrees Fahrenheit to 99.5 with an average of 96.7 degrees Fahrenheit. Nonetheless, on a clinical basis, the Center for Disease Control (CDC) estimates someone to have a fever when their temperature goes above 100.4 degrees Fahrenheit or 38 degrees Celsius.

  In terms of etiology, fever is part of the overall response from the immune system and can be physiological stress at times, namely during strenuous exercises or ovulation which is not of great concern in adults. However, a fever is usually caused by an infection, particularly in infants and children. Other causes of fever involve a host of noninfectious processes such as lesions of the central nervous system, certain inflammation, and release of materials from the body’s immune system in leukemia, vasculitis, granulomatous diseases, etc.

  Most adults and especially children may feel uncomfortable with a fever, but it may accompany shivering, headache, and in some rare cases confusion and delirium. Otherwise, a fever usually goes away in a few days with hydration and some over-the-counter medications that may help relieve discomfort. A word of caution, avoid giving aspirin to children because it may cause, among others, a rare but serious condition called Reye’s syndrome which is characterized by vomiting and personality changes, namely irritability, combativeness, and confusion.

 

Needless to say, call your Physicians or any other qualified health care professionals for anything that approximates this syndrome or any persistent fever.

 Today's funny English word is Frolic(play and move about cheerfully and energetically).

  I wish you a sumptuous day, for the record.


Français

Le mot d'aujourd'hui est fièvre

  Ce terme a été repris pour la première fois vers la fin du 14ème siècle sous le nom de "feaver" signifiant fièvre ou température du corps supérieure à la normale.  Mais il est issu de l'ancien français "fievre" en passant par le latin "febris", lié à "fevore" (réchauffer, chauffer).

 

 De manière générale, une fièvre correspond à une élévation de la température corporelle au-dessus de la normale, qui pour la plupart des gens n'a pas été bien définie puisqu'elle est généralement plus basse le matin et plus élevée le soir.  Normalement, la température corporelle varie entre 97,5 degrés Fahrenheit et 99,5 degrés Fahrenheit avec une moyenne de 96,7 degrés Fahrenheit.  Néanmoins, sur une base clinique, le Center for Disease Control (CDC) estime qu'une personne a de la fièvre lorsque sa température dépasse 100,4 degrés Fahrenheit ou 38 degrés Celsius.

 

 En termes d'étiologie, la fièvre fait partie de la réponse globale du système immunitaire et peut parfois être un stress physiologique, notamment lors d'exercices intenses ou de l'ovulation, ce qui n'est pas très préoccupant chez les adultes.  Cependant, la fièvre est généralement causée par une infection, en particulier chez les nourrissons et les enfants.  D'autres causes de fièvre impliquent une foule de processus non infectieux tels que des lésions du système nerveux central, certaines inflammations et la libération de matériaux du système immunitaire de l'organisme dans la leucémie, la vascularite, les maladies granulomateuses, etc.

  La plupart des adultes et en particulier les enfants peuvent se sentir mal à l'aise avec de la fièvre, mais elle peut s'accompagner de frissons, de maux de tête et, dans de rares cas, de confusion et de délire.  Sinon, la fièvre disparaît généralement en quelques jours avec une hydratation et certains médicaments en vente libre qui peuvent aider à soulager l'inconfort.  Attention, évitez de donner de l'aspirine aux enfants car elle peut provoquer, entre autres, une affection rare mais grave appelée syndrome de Reye qui se caractérise par des vomissements et des changements de personnalité, à savoir irritabilité, combativité et confusion.  Inutile de dire, appelez vos médecins ou tout autre professionnel de la santé qualifié pour tout ce qui se rapproche de ce syndrome ou de toute fièvre persistante.

  Le mot anglais drôle d'aujourd'hui est Frolic (jouer et bouger joyeusement et énergiquement).

  Je vous souhaite une somptueuse journée, pour mémoire.

 

Kreyòl

 Pawòl jodi a se de lafyèv

   Tèm sa a te premye itilize nan fen 14yèm syèk la kòm "feaver" sa vle di lafyèv oswa pi wo pase tanperati nòmal kò a.  Men, li soti nan ansyen franse "fievre" atravè Latin "febris", ki gen rapò ak "fevore" (chofe, chofe).

   Anjeneral pale, yon lafyèv se yon ogmantasyon nan tanperati kò pi wo pase nòmal, ki pou pifò moun pa te byen defini paske li anjeneral pi ba nan maten an ak pi wo nan aswè a.  Nòmalman, tanperati kò a varye ant 97.5 degre Fahrenheit ak 99.5 degre Fahrenheit ak yon mwayèn de 96.7 degre Fahrenheit.  Men, sou yon baz klinik, Sant pou Kontwòl Maladi (CDC) konsidere yon moun gen yon lafyèv lè tanperati yo depase 100.4 degre Fahrenheit oswa 38 degre Sèlsiyis.

   An tèm de etyoloji, lafyèv se yon pati nan repons sistèm iminitè a an jeneral epi pafwa ka yon estrès fizyolojik, espesyalman pandan fè egzèsis difisil oswa ovilasyon, ki pa nan gwo enkyetid nan granmoun.  Sepandan, lafyèv anjeneral koze pa yon enfeksyon, espesyalman nan tibebe ak timoun.  Lòt kòz lafyèv enplike nan yon pakèt pwosesis ki pa enfektye tankou domaj nan sistèm nève santral la, sèten enflamasyon, ak liberasyon an nan materyèl nan sistèm iminitè kò a nan lesemi, vaskulit, maladi granulomatoz, elatriye.

   Pifò granmoun ak espesyalman timoun yo ka santi yo alèz ak yon lafyèv, men li ka akonpaye pa frison, tèt fè mal ak, nan ka ki ra, konfizyon ak delir.  Sinon, lafyèv la anjeneral ale nan kèk jou ak idratasyon ak sèten medikaman san preskripsyon ki ka ede fasilite malèz la.  Fè atansyon, evite bay timoun aspirin paske sa ka lakòz, pami lòt bagay, yon kondisyon ki ra men grav ki rele sendwòm Reye ki karakterize pa vomisman ak chanjman pèsonalite, sètadi chimerik, konbativite ak konfizyon.  Evidamman di, rele doktè ou oswa lòt pwofesyonèl sante ki kalifye pou nenpòt bagay ki toupre sendwòm sa a oswa nenpòt lafyèv ki pèsistan.

   Mo anglè komik jodi a se Frolic (pou jwe ak deplase ak kè kontan ak enèjik).

   Mwen swete w yon bon jounen, pou memwa.

 


News/Nouvelles:

Les 5 choses à savoir de la semaine:

Check this out on Chirbit 

 (Reuters) - Use of Pfizer Inc's COVID-19 antiviral Paxlovid spiked last week, but some doctors are reconsidering the pills for lower-risk patients after a U.S. public health agency warned that symptoms can recur after people complete a course of the drug, and that they should then isolate a second time.

 More quarantine time "is not a crowd-pleaser," Dr. Sandra Kemmerly, an infectious disease specialist at Ochsner Health in New Orleans, told Reuters. "For those people who really aren't at risk ... I would recommend that they not take it."

 Use of Pfizer's Paxlovid, authorized to treat newly infected, at-risk people in order to prevent severe illness, has soared as infections have risen. More than 162,000 courses were dispensed last week - compared with an average of 33,000 a week since the drug was launched late last year, according to government data. Biden administration officials have pushed for wide use of Paxlovid, which the government purchased and provides free.

But higher use has also come with more reports from people who say their symptoms eased with Paxlovid only to return a few days after finishing a five-day regimen of the pills.

  Last Tuesday, the Centers for Disease Control and Prevention, citing case reports and concerns that relapsed patients could spread the virus, issued its advisory that Paxlovid users should isolate for a second five day period if symptoms rebound.

 "I am shying away from giving it to people who are very low- risk, and are not terribly ill, particularly people who are vaccinated and boosted," said Dr. Bruce Farber, chief of public health and epidemiology for Northwell Health. He said he is still recommending Paxlovid for people who have significant health conditions or are over age 75.

 

Pfizer, in an email, said it is monitoring the data, but believes the return of detectable virus is uncommon and not uniquely associated with its drug. "We have not seen any resistance emerge to date in patients treated with Paxlovid," a spokesperson said.

 Paxlovid's emergency authorization stipulates that it should be used only for newly infected people with risk factors, but doctors said many others have sought out a prescription.

 "We get a lot of requests - maybe somebody is traveling and they want to take it just in case," said Dr. Tara Vijayan, infectious disease specialist at UCLA Health in Los Angeles. "We are not offering it as a just-in-case."

The CDC also said it is unclear whether cases of rebound symptoms have anything to do with Paxlovid, or are simply part of the natural trajectory of COVID-19. The agency did not flag any specific concerns about health effects.

 "COVID historically has had this sort of stuttering course - people will feel better one day and then feel worse the next day, but I can say we haven't seen these rebound symptoms with other COVID treatments," said Vijayan, referring to therapies such as monoclonal antibodies.

 "The patients that do get a rebound, it's usually very mild," said Dr. Earl Strum, medical director of employee health at Keck Medicine of USC in Los Angeles.

Some question how much Paxlovid is helping given the high number of people vaccinated or previously infected with COVID-19. The drug was authorized in December after a study in unvaccinated, high-risk COVID patients with conditions like diabetes showed an 88% reduction in hospitalization or death.

At the time, the Delta variant was prevalent, but it has since been displaced by the more transmissible Omicron.

 "There's so much more baseline immunity around. There's still a lot of infections, but they're not nearly as severe," Northwell's Farber said.

He estimated the rate of Paxlovid-related COVID rebounds at around 10% - higher than the 3-4% rate cited by Pfizer in its trials of the drug.

 Jason Gallagher, an infectious diseases expert at Temple University's School of Pharmacy, said the rebounds do not detract from the drug's utility. "It prevents you from going to the hospital ... if you become symptomatic after you stop taking it, that stinks, but the overall drug was a success," he said.

 

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