Nuova registrazione 18

2:22

S… Speaker 1 (Nuova registrazione 18)

of what I'm going to speak of. We are a general pathologist in immunology and it's quite a crowded course. The starter is Per Andrea, I don't know if there is some nature with him, then it's me, then De Andrea, then he will provide Marta.

4:04

S… Speaker 1 (Nuova registrazione 18)

This is the pathophysiology model. It's split in four submodels. And the one is taking care of some topics. And then you add all... Did you finish with the lacone? Yes. And then you will start with Muntoni, which mainly focuses on atherosclerosis, diabetes, and then...

4:36

S… Speaker 1 (Nuova registrazione 18)

before you start to write down everything you will see during the lecture you will have on the learning platform you don't know because you have just started but this afternoon before the weekend I will upload my lectures and the next time I will upload in advance all my lectures

5:00

S… Speaker 1 (Nuova registrazione 18)

the lectures and you don't need to write down what I say, but you just can follow it and then you have to just delete what you think is left. So this is my habit to give the lectures in advance so you can easily follow. And then this is the way where I am. I'm a block A, just one of the blocks of campus. These are my contacts. And please, whenever you will send me a mail, you will understand.

5:32

S… Speaker 1 (Nuova registrazione 18)

Fiorellino amoroso, girasole, and things like that. Write down Luigi.azzori at studenti.unica.

6:45

S… Speaker 1 (Nuova registrazione 18)

passed before, because if I ask to be, there is the risk that when you go to my exam on the third year, which is laboratory medicine, I'm speaking about the time, which is just translated into the, you are not ready to attend laboratory medicine. You don't need to have general pathology passed, a physiology passed, but you understand that if you don't know physiology, it's tough to understand.

7:25

S… Speaker 1 (Nuova registrazione 18)

I will focus on this. Thermoregulation, we start with thermoregulation, physiopathology. Then we'll talk about respiratory failure and main causes of non-inflammatory epidermis and ultradicodactional, which basically means why sometimes the hormones are functioning too much or are not functioning. So I've heard from people what was on the program, on the webpage.

8:11

S… Speaker 1 (Nuova registrazione 18)

To the best of my knowledge, you should have a test written, it's not compulsive, as far as I know, on several molecular genetic and general pathology, one on oncology and one on pathophysiology. But I know, if I'm not known, by Cadeo, that you already mixed blood and general pathology. So, I don't know, if someone will have to be very anxious for one quick test on pathophysiology.

8:41

S… Speaker 2 (Nuova registrazione 18)

I will provide my multiple choice equation, otherwise, also because the test is not going to affect the Afghanistan, so I don't know. We have different for different exams, like Professor Lacombe's exam is different, like your exam is different. Do we like that, or it's just in general? Just to make clear, I'm the one who is pretending the rules to be respected. On the other side, it's like he is the same.

9:23

S… Speaker 1 (Nuova registrazione 18)

The exam, via exam, needs two teachers or two professors sitting in front of you. We have seven. But if I will be there and, let's say, you know, Manda and Kobani are there, we can question you and you will pass the exam. You don't have to expect all seven professors in front of you. Only two. These two, they can...

10:00

S… Speaker 2 (Nuova registrazione 18)

because the exam is one exam, and you don't have to pass all individual speakers. So, depending on, in June, maybe four of us are going to be there. In July, three different, but it's not a program, you know, we'll try to talk.

10:23

S… Speaker 2 (Nuova registrazione 18)

And so don't think, oh, I will have to pass all seven professors. I guess that you will never see all seven in front of you. Maybe four, five, it can be sometimes eight. This is why, but this is not my area. I do the first exam, I have written multiple choice test, which is not compulsory. And then all the rest of my exam.

10:55

S… Speaker 1 (Nuova registrazione 18)

But the first is a real multiple choice test with 100 questions, and then this is coming. I'm not the owner of this course, so I'm just a guest. So, the question is, I'm very famous general pathologist, and at the end of the day, you will get a senior. We do symbology with us, and then pathology is the... That is the only... They call me that.

11:45

S… Speaker 2 (Nuova registrazione 18)

Officially, I cannot say this is correct, but if you agree and you're going to do that, just do it, and then they merge. What is important is that the exam is always one exam, because you cannot register immunology, and then after one month, you must register the rest. What you will get is the final score if the immunology, because it is complicated,

12:28

S… Speaker 2 (Nuova registrazione 18)

immunology will say, no, if you don't give immunology separately, you cannot give the rest. You can sit and pass immunology and general patology. You know that you need to. These are the textbooks I suggest. Apart from the logins, I found very easy to use if you have some basic knowledge of Italian. Also, Pontiere Russofrati, General Patology, which is a book you can find in the library.

13:38

S… Speaker 2 (Nuova registrazione 18)

I just opened this general physiopathology just to see how it will look like in the case of medicine. I will do my best so you can find lectures and supplementary materials of the learning.

14:43

S… Speaker 2 (Nuova registrazione 18)

I know who is registering and when you are having access.

14:52

S… Speaker 1 (Nuova registrazione 18)

If I put lectures, and after one or two lectures, I see that only China are using the lectures.

15:01

S… Speaker 2 (Nuova registrazione 18)

I ask that you register and then you have access and then you download the library. If you don't leave them, then I will download them. Sorry, Professor. I think a lot of people will do it. We will not right away download it, but later when we need it for study. So I think it's in general good if you would upload it anyways. Also when we get the beginning, not a lot of people will download it.

15:28

S… Speaker 1 (Nuova registrazione 18)

Because like not all of us can all the time like... Just a quick question. Who is fine with physiology? Who passed already physiology? Okay, most of you just... But there are other elements also like... Yeah, but you can just go type the word and there it is. No, but one trick. It's great for me. If you have a physiology, for me, it means you already passed anatomy. You already passed chemistry.

15:58

S… Speaker 1 (Nuova registrazione 18)

It's difficult for me to understand. How do you know? We speak about temperature control. You speak about liver function and then you don't know of the fatty acids. No, no, no. They are perpendicular, I think it's called.

16:22

S… Speaker 1 (Nuova registrazione 18)

But like for example, me, I have to first do like Anatomy 2, like of the third semester. And so right now I'm studying Anatomy 2 and I'm not studying pathology. But it doesn't mean that I'm not, will use the slides for studying in two, three weeks. No, no, I'm not saying two, three weeks. But since I have lessons every week, if I, during the weekend, I'll have three weeks. We have like representatives. What I do...

18:38

S… Speaker 1 (Nuova registrazione 18)

With you, it's even easier because we have a lecture and then we'll see after one week. I try to recap some of the most important things of the previous lecture. What you have to do now is to go with your obite on Socrates. Do you know Socrates? Yes. Go to Socrates. I complete L, A, Z, or I. That's all it? No.

19:31

S… Speaker 1 (Nuova registrazione 18)

If you go to talk at the Lazzoni, I will start with five questions. They are not very, very general questions. Some are general, but some they need to have some knowledge of control of temperature. I expect that now most of the answers are going to be wrong.

20:35

S… Speaker 2 (Nuova registrazione 18)

I'm sorry, what is the wrong name?

21:01

S… Speaker 4 (Nuova registrazione 18)

I know that it starts with the exography, but everybody is arguing.

21:47

S… Speaker 3 (Nuova registrazione 18)

You don't need to have your name on.

22:05

S… Speaker 1 (Nuova registrazione 18)

I know that you don't have the knowledge for being corrected with this answer, but try to get one thing. Today is just the first day, I'm going to be just late, but please don't be 75 taking the code and then only 25, which means that if I go and change it, some of you are not here, but are somewhere else.

23:08

S… Speaker 1 (Nuova registrazione 18)

Today you can also discuss, because I know that is something I'm going to learn. At least one, for sure, you must correctly answer, because it's physiology.

24:01

S… Speaker 5 (Nuova registrazione 18)

Thank you.

24:18

S… Speaker 2 (Nuova registrazione 18)

Which lab? Which lab?

25:24

S… Speaker 1 (Nuova registrazione 18)

Thank you.

25:28

S… Speaker 1 (Nuova registrazione 18)

Thank you.

25:39

S… Speaker 1 (Nuova registrazione 18)

Thank you.

26:12

S… Speaker 2 (Nuova registrazione 18)

you can see so one was four correct out of five so it means it's possible

27:14

S… Speaker 1 (Nuova registrazione 18)

Thank you. Thank you. Thank you.

27:47

S… Speaker 1 (Nuova registrazione 18)

I guess the shape is a pain for everything. Otherwise, why do you do this? Let's start now. I thought it was. So, this is what we'll do next time. Once we finish the filter, we have maybe 15 minutes of these questions. We are going to do this. What I will do now is that we are going to start.

28:55

S… Speaker 2 (Nuova registrazione 18)

And then at the end, we are going back to these questions, and I am sure that J3 is not going to be allowed.

29:36

S… Speaker 1 (Nuova registrazione 18)

They say that in which situation we don't have with the Saruman agreement.

30:27

S… Speaker 2 (Nuova registrazione 18)

Thank you.

30:36

S… Speaker 1 (Nuova registrazione 18)

This guy is considered to be the father of the modern man, William Hoster. During a speech, he was saying that we have, as humanity, three great enemies. Fever, famine, war, and of teens, it was at the end of the, the talk was 1806, I think. He was saying that of teens degraded, in fact, the most terrible is fever. At that time, it was a patient increasing body.

31:28

S… Speaker 1 (Nuova registrazione 18)

Also, if you have a decometer, you just check the heart rate, then you can see, okay, I'm sitting, I'm reading 90 per minute, if something is not normal, because I'm 70, right? The temperature is agitated by degrees, and generally, let's see the answer. Some of you will keep on guard asking what is the answer. Now, we can take one example, but then you will understand why. This is a case of a person with

32:19

S… Speaker 1 (Nuova registrazione 18)

Fever with high temperature, and the question is which of the following substances is the most likely mediator for the fever observed in this patient. By the way, in some cases, some of the questions are from the book of, the textbook, and then there is, if you study from the Robbins in that day, the answer is, if you go to the value book of Robbins.

33:10

S… Speaker 1 (Nuova registrazione 18)

You will have also the discussion why it's not A, it's not B, it's not C, it's not E, but the reticolism. Tumor matrix factor introduced. These are molecules which can activate and you set up a regulatory center. It also puts through all of these mechanisms, except one, which is the mechanism which is not regulating the right-hand question is C. Thermogenesis, if you have done...

34:16

S… Speaker 1 (Nuova registrazione 18)

A channel which is more steeply than ATPases or... Yes, but the question is region, if you choose one of them. If it's dark or the second, you're still supposed one of them. Excuse me, could we briefly go back to the previous question? Okay. Just a... Because if we say ATPases, which is the normal cycle...

35:07

S… Speaker 1 (Nuova registrazione 18)

In this case the question is how do you produce mostly of the energy in our organism? Exothermic, metabolic process.

35:33

S… Speaker 2 (Nuova registrazione 18)

Exothermic is not because it means that you produce a high increase in temperature because you sink on the sun and then the sun is like some other type. They can increase the temperature of the exothermic reaction. So it's not like exothermic. Endothermic metabolic process, it means many things but doesn't mean a specific matter.

36:33

S… Speaker 2 (Nuova registrazione 18)

I generally don't create questions because I want to skip discussion. I know this, I know that, which can be correct. So I take from Robbins or from Pontier, which are two.

36:48

S… Speaker 1 (Nuova registrazione 18)

And then I translate, if I need to translate, in the case of the roadies I need to translate. I just cut and paste the question of the author in the question. We can discuss it, of course. Select more specific. Because the endotermin of the volume process can be at the same time as ATP. Yeah, but it's not of 10 new machines, the most important of the endotermin process. ATP is probably the main point.

37:22

S… Speaker 2 (Nuova registrazione 18)

But you have passed a very much test. When you have a multiple choice test, generally, every single word, question and the alternative answer, it means something. If you say something, let me say, female of 60 years of age, probably female in 60 years of age has something to do with the right answer. Otherwise, you are not so specific. You are just very, very female.

37:52

S… Speaker 2 (Nuova registrazione 18)

the age was not relevant. But if you put the age, maybe the age is telling that this pathological condition is maybe more relevant for a female, is more relevant for one particular time of the life. So, if you write properly the question, every single word, it does some kind of procedure. The mainly process, which is, and so there I think it is important, but it's not generally, which is mainly appropriate. We can discuss, of course. This is for the

38:27

S… Speaker 2 (Nuova registrazione 18)

test for the middle schools in Italy this year they called the so called semestre aperto or semestre filtro they in order to say oh it's not just put across and then you get the answer they want to ask this question they call a completamente you have to fill the answer so it was an open question and then just one word for the right it was

38:55

S… Speaker 2 (Nuova registrazione 18)

nightmare, because there was not only one answer, but maybe five, six, seven correct answers. So, the people correcting the test were thinking, oh, maybe it's not just A, but maybe it's also B, but can be also C, and so, because I think that next semester, we are going to move nationwide the question that we need to fill in, because then it's discussion, but it's just this right answer, maybe not. So,

39:26

S… Speaker 2 (Nuova registrazione 18)

the discussion you just right corrected that if you know this heat stroke you are seeking to get the heating temperature for sure in this case you don't have a neothermogenesis so the right answer was heat stroke at rest is the except one because

40:00

S… Speaker 1 (Nuova registrazione 18)

Okay, this is the malignant hyperthermia, hyperdirexia, and fever. Then this is J3 new, as you know, for this malignant hyperthermia. It's a specific condition, which is associated with the use of some drug when you're preparing for anesthesia. And then there is a gallofunction mutation in the calcium channels, which is not so common.

40:46

S… Speaker 1 (Nuova registrazione 18)

you can die if you don't tap very close to the patient one specific drug and these things I was introduced to Dr. Rauss now this story of Dr. Rauss there is a person with malignant hipertermia and they were looking for the drug which is dantrolide which is if you have you save the patient if you don't tap the patient will die so it's composed of this drug because you can stop

41:17

S… Speaker 1 (Nuova registrazione 18)

What you get, basically, you will be going to see this in detail. You get the calcium in the cell, so you get controlled conduction. If you contract the muscle, you get an increase in temperature, and typically the temperature can be 41, 42, 40, there you don't die. So it's, you lose the control of the calcium, and then you get dandruff and another. If you have not all 100%, that is the heat production in the special.

42:07

S… Speaker 1 (Nuova registrazione 18)

the difference is very important that when we speak about the increase in temperature you can say hyperthermia but hyperthermia can be increase of temperature because you have one condition which is associated with the change of the set point controlling the temperature in the botanum and in this case you can speak about fever or hyperthermia with fever

42:38

S… Speaker 1 (Nuova registrazione 18)

And it's completely different if you have hyperthermia without fever or hyperthermia without changes in the set point of table time. Very simple example. If you run a marathon, you can be, not every marathon you are to run a marathon. Once you finish the marathon, your temperature is not for sure 37 degrees. If you have a training, you can have also 39 or even more. But if everything you are training, you increase.

43:12

S… Speaker 1 (Nuova registrazione 18)

the temperature. Use so much heat that even if you cool down, you drink, so you can spray and do the thing, and then the temperature will increase. In this case, the set point is still 47, but the temperature is increasing because you are producing more heat than you cannot use.

43:36

S… Speaker 1 (Nuova registrazione 18)

It's very important to differentiate the cause of highly fever because if the fever is increased by, let's say, you have already seen basic mechanisms and you started, I can manage with inflammation. One of the typical, you know, there is also fever. And if you have fever because it is an inflammatory process,

44:11

S… Speaker 1 (Nuova registrazione 18)

Then you can get rid of the fever, giving something which is less simple, stopping the inflammation. So you take a aspirin, and then you get rid of it. If you run a marathon, you are not properly trained, you can take five grams of aspirin. The fever is not done with the fever. How do you take it? I mean, it doesn't cool. You take bath in the ice. You just cool down, and then if it's something which is...

44:57

S… Speaker 2 (Nuova registrazione 18)

player or other

45:10

S… Speaker 1 (Nuova registrazione 18)

So, to understand the difference between fever or hyperthermia, which have the negative consequences. On the other side, you must assume that it's between one side or the other side. You can go on one side. In this case, when you're speaking about temperature, you will get fever or hyperthermia. You can also get ice. It's much less common.

45:44

S… Speaker 1 (Nuova registrazione 18)

still important in terms of thermorepulation between these subjects. Where shall we put the lines? And why? Okay, this is the big difference. This is what we have known. They keep the temperature, or we keep the temperature constant. If the temperature is constant, it can change, but not so much. But these animals, reptiles, amphibians, fishes, they change the temperature.

46:44

S… Speaker 1 (Nuova registrazione 18)

depending on the environment. And what is important to know is they don't have a fever, but if they want to get rid of some inflammatory process or some infection, they try to move where the temperatures are. Because they get very fit and it's also easier for them to get rid of what they're inducing. So we need to focus on keeping a reason why some general practitioner or just attending someone.

47:47

S… Speaker 1 (Nuova registrazione 18)

I have eye fever and I don't know what to do. And if you go to the hospital, of course, don't, I expect, you don't learn by that 29-36%. If you want to say that, then you don't say it's wrong. But I prefer that you say around one-third, 30%, more or less. I will never ask you, this is also meant to medical. I don't pretend that you know exactly.

48:21

S… Speaker 1 (Nuova registrazione 18)

76.3. Of course, if I ask you now how many blood cells we have and you must orient it on millions per cubic millimetre. If you start to say 100,000 per millimetre, then something is wrong. But if you say 4, 5 millimetres per centimetres per cent, it's fine. But if you say

49:27

S… Speaker 2 (Nuova registrazione 18)

So it's very, very common.

49:30

S… Speaker 1 (Nuova registrazione 18)

In some cases, depending on the clinic, you will see even more patients with increasing temperature, especially if you have intensive care focused on neurological conditions. Why in a neurological clinic with intensive care you have more? Because probably trauma or pathological condition.

50:00

S… Speaker 1 (Nuova registrazione 18)

of the brain will affect the problems and this will affect brain-wise in the neurological cases per unit you have even more people with the brain. And maintaining the temperature, we are so used, we feel, we realize and we realize something that is wrong. This kind of balance, it's not a big debate, it's the right normal temperature, let's say between 36 and 37 degrees.

50:53

S… Speaker 1 (Nuova registrazione 18)

And this is affected quite a lot by the room temperature, the physical activity, and it is not. So, if you observe some slight change in the temperature, you should say, what is the temperature in the room? Maybe it's just too hot, there is no... Or maybe 2 p.m. in the summertime without properly hydration. Generally, the temperature is detected in...

51:51

S… Speaker 1 (Nuova registrazione 18)

The temperature can be slightly different, which are slightly higher or slightly lower. The most common place to measure a difference compared to the axillary temperature.

52:51

S… Speaker 1 (Nuova registrazione 18)

on the axillary temperature, on the subliminal temperature, it doesn't reflect, it's not exactly the same. I don't know if someone is taking the rectum, but if you want to be 100% sure of closest to the 100% sure, that is the closest temperature. I'm just telling you that one is more close to the real one, the other one are indicative, of course. What is very important in general, if you start with one approach,

53:21

S… Speaker 1 (Nuova registrazione 18)

and you want to compare what is the temperature in the morning, what is in the afternoon, what is the next day, you keep the same approach. It's not that you measure it randomly and then you say, oh, yeah. Keep in mind that the temperature can change over time. This is during the day. But it's just this object. You have three of these objects. You have different levels in the morning.

53:59

S… Speaker 1 (Nuova registrazione 18)

In the moment, there is also the whisper cycle that is also changing the temperature during the cycle, which is something to keep in mind, but more changes can be associated with this. Still considering what can be.

54:24

S… Speaker 1 (Nuova registrazione 18)

Physiological, just to speak about physiological variations of the temperature after eating, depending on how much we eat, we more increase the temperature, because the digestion is what we're making from thermogenesis, then we have changes that kind of have changes in the frequency, or changes we've seen, and age, it's very clear evidence that the age is at the temperature, for instance.

54:56

S… Speaker 2 (Nuova registrazione 18)

If you have the same affection, you are...

55:00

S… Speaker 1 (Nuova registrazione 18)

Seven to five, eight years old, or you are 10, 15 years old, you can have the same pathological condition, but maybe in the advanced age, total fever, you have very high fever in the teenager. Because with the age, we lose some of this mechanological negative for which we have control of the temperature and then the induction of the fever.

55:24

S… Speaker 1 (Nuova registrazione 18)

And then, of course, quite a lot of physical activity is still a physiological factor which is affecting the temperature can increase a few degrees if you are not trained and putting together more than half million values as it was possible to identify this very important factor affecting the normal temperature, the age, the sex, the weight.

56:23

S… Speaker 1 (Nuova registrazione 18)

And if you look at all the population, the lowest value, for instance, were in underweight, still without person. In this case, it was a 20-year-old woman, late in the end. She had the normal patient, not hospitalized, and the final value was

57:27

S… Speaker 1 (Nuova registrazione 18)

normal, temperature around 36.6. Another important conclusion of this paper is that in the last decade, so in the last century, the temperature was a little bit decreasing. This is explained because probably we have better control of inflammation, especially inflammation induced by infection because of the antibiotics.

58:02

S… Speaker 1 (Nuova registrazione 18)

There is an improvement in dental care. And all these things together can explain why the temperature is decreasing slowly, but is decreasing in the last decade. So when we speak about what is normal temperature, the normal temperature is centered in the hypothalamus, which is being changed by some molecules which are released during the inflammatory process, especially the pyrogenic cytokines.

58:47

S… Speaker 1 (Nuova registrazione 18)

You notice you try to measure the boiler for the temperature you have at home and just change the temperature you want to have 36, 38, 39 degrees. This is what is doing this set point. When things are normal, the set point is at 37. But when you are exposed to some molecules, maybe from the process, and from the process can be also generated by

59:19

S… Speaker 1 (Nuova registrazione 18)

by inflammation, by trauma, macrosis, they release some molecules which are then releasing some molecules that you have seen in the technology world like cytokines. Some of them, not all cytokines. Some cytokines are able to induce changes in the membrane to the center and this is inducing the heat. When you get high temperature because of the marathon,

59:51

S… Speaker 2 (Nuova registrazione 18)

This center is not touching. It's not changing. So it's still at 37 degrees. But why then get up?

1:00:03

S… Speaker 2 (Nuova registrazione 18)

Because we are producing too much heating and we are not losing heating. This is the problem.

1:00:27

S… Speaker 1 (Nuova registrazione 18)

and which works to modify interaction and loss as a function of temperature so in order to keep 37 this is but then once you set a different level of the temperature then you must if it's going high then you need to miss the temperature therefore mainly in this region we produce but if it won't

1:01:12

S… Speaker 1 (Nuova registrazione 18)

We need to lose a lot of heat, and then what you do is buzz and dilate, sweat, and all this heat. So this is why we anticipate it. Why, when you are getting rid of the fever, you uncover, you remove the blanket, and then you lose a lot of water.

1:01:38

S… Speaker 1 (Nuova registrazione 18)

Because this is the mechanism to speed up the process of going back from 39 to 37. Opposite. When the fever is starting, what you do? You cover yourself, you start to shake, because you need to produce energy to move from 37 to 39. So, these are the mechanisms we use. It's not just thermogenesis. You put a blanket when you have a fever. It's one behavioral component that is...

1:02:08

S… Speaker 1 (Nuova registrazione 18)

increasing the temperature is bringing up the temperature. But if you don't put a blanket, the temperature will reach 39 degrees, but it will need water. And thermogenesis and heat loss are important. And we need to produce all the time heating, because...

1:02:41

S… Speaker 1 (Nuova registrazione 18)

It's also normal that we live, first of all there are no fishes or reptiles, that we can have 37 degrees living in one 37 degrees of environment. But we live in an environment which can be 24 degrees, 26 degrees, 37. It means that we are producing it all the time, otherwise we don't have 37 degrees. So we need to have a lot of reaction, metabolic reaction.

1:03:11

S… Speaker 1 (Nuova registrazione 18)

transforming molecules to keep this basal level of 36 to 72. And of course, if we start to run throughout physical things, the temperature can be even higher. So it's always this to keep in mind. And some organ like liver, air,

1:03:38

S… Speaker 1 (Nuova registrazione 18)

muscle and they can always constitute for this. This is why sometimes the front temperature or the piece of temperature. There are these mechanisms that we have seen or you have seen in physics. Conduction, convection, radiation, evaporation, respirations in cities.

1:04:06

S… Speaker 1 (Nuova registrazione 18)

which is sometimes I need some Latin words because I check and also in MSD, which is a kind of Bible for medicine from the states, they still use Latin words. So I think I'm not right with these Latin words, but just having respirations. It's when you lose small amounts of water from the skin. We don't realize it, but you're still...

1:04:35

S… Speaker 1 (Nuova registrazione 18)

cooling down and keeping temperature and of course we increase this and also not so much IOTO it's more for some other animals we can also control the temperature by food too cold or too warm it is also affecting danger

1:05:04

S… Speaker 2 (Nuova registrazione 18)

So these are things you need to keep in mind, because one question was speaking about the difference in the national convention of radiation and elaboration. But these are things that you're seeing. And these cartoons up there, they show which are the difference. Integral cartoons is very similar. In one, you have physical contact where you can change.

1:05:28

S… Speaker 2 (Nuova registrazione 18)

the heat. In one case you don't have contact but you have a movement of particles with different temperatures that are affecting your sensors like with heating. And then radiation, you just take thermal energy with random radiated waves and then there is no physical temperature but you can scale it. If you are under the sun it means the temperature and then it moves.

1:06:00

S… Speaker 2 (Nuova registrazione 18)

Then there's evaporation, which is the transition of water from liquid to gas. It's a chemical reaction which is taking a lot of energy and then this is why with evaporation of water we use temperature. This is quite important if you want to increase the temperature. Of course, to have a good evaporation, we need to have a low humidity because humidity is stopping evaporation and by stopping evaporation

1:06:29

S… Speaker 1 (Nuova registrazione 18)

because of the abnormality we don't want to decrease the temperature. This is why a high temperature and high humidity is very difficult to decrease the temperature. The respiratory insensibility that was mentioned, isn't that also just a reparation just happening in the mucous membranes? Yeah. Why do we count it as like a separate category? On the previous slide mentioned there's like this thing.

1:07:08

S… Speaker 2 (Nuova registrazione 18)

You know, this one, if you put into your esophagus or trachea hot or cold air or food, this is going overall affect the general temperature of the body. So it's just, this is something which is, of course, warm in it, which is not the end, but it's ingested. This is going to be...

1:07:40

S… Speaker 2 (Nuova registrazione 18)

included in one of these categories. Of course, we have a contest and then if you drink in cold water, cold water will lower. Drink will be part of the mechanism of increasing the temperature. In some animals, for instance in the dogs, this mechanism is affecting much more. Except we don't behave like dogs, we don't have this mechanism of inhalation, for instance, the animals they use.

1:08:48

S… Speaker 1 (Nuova registrazione 18)

What again is the exact difference between the respirations?

1:09:21

S… Speaker 2 (Nuova registrazione 18)

I'm quite democratic. Do you want to have a break or do you want to finish 10, 15 years advance? Majority. Majority? Can you stay? Okay, so generally you ask for 15 years advance when it's this slot because there is...

1:10:07

S… Speaker 2 (Nuova registrazione 18)

And just to understand how this balance is important, is that if someone was calculating, but just take this as one suggestion, I mean, just in general, if you run a marathon, and then you keep all the energy you are producing, you will increase 22 degrees in an hour of intensive time.

1:10:38

S… Speaker 2 (Nuova registrazione 18)

And if you're sometimes in some kind of marathon, half-marathon or intensive run, you know that you need to drink a lot, because you use a lot of water, and then you sweat a lot. So if you're not trained, it means you can really end up exhausted and with heat stroke. But if you're trained even for marathon, you can keep this patient's seizure, not hyperterial.

1:11:29

S… Speaker 2 (Nuova registrazione 18)

You can have a mechanism with shivering or non-shivering. The first one, non-shivering, is mediated by sympathetic nervous system and activation. So we need to produce energy. With shiver, what we do is we increase and produce this way. One very important mechanism is controlling the temperature to pre-design.

1:12:09

S… Speaker 2 (Nuova registrazione 18)

and it's the peripheral thermal constriction of vasopostriction. This is the temperature, you have the vasopostriction. So, by reducing the diameter of the vessel, you less energy and this is increasing the temperature. If you want to decrease the temperature, the vasopostriction, you have energy and the temperature. Of course, radiation and conduction and compression are quite important.

1:12:47

S… Speaker 1 (Nuova registrazione 18)

There is also one important thing that the causal control is mediated by the sympathetic zone. On the other hand, there is an important mechanism which is mediated by cholinergic fibers which are controlling the sweat, acting on the glands and activating the evaporation. This is also one of the reasons that we can identify that some drugs

1:13:17

S… Speaker 1 (Nuova registrazione 18)

which are affecting the co-energy process, can affect the sweating and can, for instance, the degree of the temperature we need. Also important that this wave is sometimes not so fast, I mean, maybe the buzz operation, water constriction, sweating, and then we try to speed up the process with some human behavior. For instance,

1:13:51

S… Speaker 1 (Nuova registrazione 18)

If you are outside, it is too cold. If you don't have enough blankets, blankets, blankets to go, we go inside. By going inside, we prevent to go in one uncomfortable situation or at least we don't lose the control of the temperature.

1:14:13

S… Speaker 1 (Nuova registrazione 18)

As a consequence of the discomfort that we have if the temperature is moving to high or too low, this is quite typical of human beings. And when we don't apply these strategies, we can have some pathological conditions. For instance, hypothermia is very common in people living outside.

1:14:41

S… Speaker 1 (Nuova registrazione 18)

which are very good, homeless, they don't have a place where to go to sleep, at the same time they drink to alcohol, alcohol is vasodonated, so you put drinks together, vasodonation, temperature is decreased, and then you are outside in the wintertime, sleeping, and then to go to sleep.

1:15:00

S… Speaker 1 (Nuova registrazione 18)

So I present one hypothermic condition, then I have a problem that we see at the heart level and so on. So in the human being, the idea is also very important. First of all, it's very simple. We can hypothesize that, not hypothesize, we can describe it like this. We want to change that.

1:15:52

S… Speaker 2 (Nuova registrazione 18)

If you want to cool the temperature otherwise it's too high

1:16:01

S… Speaker 1 (Nuova registrazione 18)

So, when you want to move from the fever, 39 to 37, when you are running the marathon and you don't want to have 38, 39 degrees, you vaso dilate and you are sweating. These mechanisms are very, very good. The evolution of some hormones, something you have seen maybe in biochemism, in previous courses, they are very good on...

1:16:39

S… Speaker 1 (Nuova registrazione 18)

inducing release of energy. Once you have a high level of thyroid hormones, you have a condition called thyroid osteoporosis, which is characterized, apart from typical signs, by a high level of temperature, which can be very, very high and is dependent on the thyroid hormones. Adrenaline also can stimulate the release of glycogen in the pathosides, and this can then produce fatty acid.

1:17:09

S… Speaker 1 (Nuova registrazione 18)

in and then oxidation of these molecules the fatty acids producing it and also glucocorticoid they have stimulated lupinogenesis which is then used for producing energy so these thyroid hormones adrenaline and glucocorticoid which are hormones you can say can have an important role in thermogenesis of course

1:17:35

S… Speaker 1 (Nuova registrazione 18)

thermogenesis induces by these molecules. We need then to have a solid factor on the gene activation, etiolase, control of the phosphorylation, and then activation of protonesis, lipolysis. These are technical mechanisms which are to explain why we increase the temperature. This is the same. When we are shivers, don't forget that we have also another symptom.

1:18:14

S… Speaker 1 (Nuova registrazione 18)

medically we say the reaction in italian we say in english we say goosebumps you all know this what it means this is a typical science of temperature compared to what is the temperature the set point is standing i want to have 38 39 degrees if you are 37 now you must speed up the progress

1:18:42

S… Speaker 1 (Nuova registrazione 18)

of using energy, and all these things that we see, all techniques of these molecules are important to increase the temperature. Of course, these are, in terms of energy, almost without any cost. You just assume a small surface in order to expose your body to the minimal amount of skin and external.

1:19:08

S… Speaker 1 (Nuova registrazione 18)

temperature, so you don't lose temperature. You move the proper place, so you cover yourself. But then you activate all of this in the mechanism, like the dilated production, to pass the donation, pass the concentration. If you go to the epithelium, then you have different neurons.

1:19:47

S… Speaker 1 (Nuova registrazione 18)

to make the story simple because this is not neuroanatomy is not neurophysiology there are molecules of cells which can create a signal of the temperature outside

1:20:00

S… Speaker 2 (Nuova registrazione 18)

And then they adjust the signal to produce or not more energy. Unfortunately, some of the slides are in Italian because in spite of the fact that I use some software for translating video and song, in some cases, quite complicated than that. I hope that you can understand. Sometimes I can say this. When I do the Italian course,

1:20:30

S… Speaker 1 (Nuova registrazione 18)

Some of the slides I use there in English. And I tell them, you have to know a little bit of English at least to understand the slides. New slides in Italian course. So slides is in Italian. I apologize and I pretend that you try to understand what it is. But it's that message. When you go to the hypothalamus, you have different cell populations. These neurons are affected by some ascenias, mediated by mainly...

1:21:03

S… Speaker 2 (Nuova registrazione 18)

They produce energy and the temperature. Of course, this is seen as a protaglandin mediator as a consequence from cytokines that we have mentioned before, like the energy in the one, which are after that. But then, for producing or keeping energy and the temperature. We are producing this.

1:22:00

S… Speaker 2 (Nuova registrazione 18)

later when we speak about event. This mechanism, which is the mechanical, physiological mechanism of cooling the temperature, is telling that when you have 37, you produce and you lose cost and demand throughout 37 degrees. When you have external temperature, which is lower than 37, of course, what you need to do is produce some energy, otherwise the temperature goes down.

1:22:30

S… Speaker 2 (Nuova registrazione 18)

But if the temperature is too high, what you do is you lose the temperature, otherwise the temperature is high. So you want to keep it only 37. In fever, it's the same process. You have a similar slide from the continue book, just telling you in the central part 39, but the mechanism you have when you have 39 are the same. That is, if the temperature is low, you need to increase the temperature, activating the mechanism for that reading provision.

1:23:01

S… Speaker 2 (Nuova registrazione 18)

39 so you start to have an activation of the thermogenesis but during the resolution of the process when 39 needs to go back to 37 then you start to lose energy and don't produce energy anymore the central part is exactly the same when you have a fever or when you have a normal control of temperature of course i'm speaking about one situation where

1:23:33

S… Speaker 2 (Nuova registrazione 18)

You are normal, you get fever, and then you go back to a normal condition. If you are normal, you get fever, and you don't recover, of course you don't get the last phase, which is when you go back to dental. Now, pathophysiology. Pathophysiology, we divide our thermoregulation in when the temperature is high and when the temperature is low, having as a reference around 37 degrees.

1:24:13

S… Speaker 1 (Nuova registrazione 18)

Hyperthermia or hyperthermia? Hyperthermia can be without fever and I like, I think it's very personal, sometimes people have different classification. One thing, my main research is about biomarkets and we deal with a lot of, in that and in that. And I love classification. But at the same time, classification are not something.

1:24:40

S… Speaker 1 (Nuova registrazione 18)

Real, in nature. Classification is something that we use to simplify things and to communicate better some idea or some understanding things. AI is working on classification and data and other things. One classification for me in this case is you have...

1:25:00

S… Speaker 1 (Nuova registrazione 18)

temperature which is without influence at the hippocallumus and then you have the fever which is high temperature, hypothermia, hyperthermia but with one change in the termoregulatory center in the temperature so you can say hyperthermia and for me it means there is no fever or you say fever which means there is hyperthermia with

1:25:32

S… Speaker 1 (Nuova registrazione 18)

and then there is hypothermia in this case it's not so if it's cold or if you are resting we keep the temperature or if we want to go higher we have a fever if the temperature is too high

1:26:11

S… Speaker 1 (Nuova registrazione 18)

and we are exercising, then we need to lose temperature, energy, and then there is thermo-discretion, we decrease the basal metabolism, and then if this is physiological, if it is too much, the hypothermic area.

1:26:40

S… Speaker 1 (Nuova registrazione 18)

What is a perturbation? It's the elevation of body temperature due to pathological levels. We know that 37, assuming 36.6, whatever is it, is the normal. If we go higher, we have a non-pathological condition, and then we divide these two situations. If this is persistent, this equilibrium, the result can be endogenous, which is hormone-mediated,

1:27:11

S… Speaker 1 (Nuova registrazione 18)

can be also external, in this case, dry temperature. And we don't have enough thermal dispersion, the temperature is. External factors are not important in the fever. Fever is something to keep in mind just for the dysregulation of the soil. Hypothermia as such.

1:27:41

S… Speaker 1 (Nuova registrazione 18)

There is an increase in body temperature as a result of excessive heat production by the organ or by some problem in the dispersion we have. Because when you are resting, but also resting if you rest on the sun for too long, it will increase the temperature. So it's not associated to one too much energy production. Of course, what is a very bad condition can be if you work in the mine.

1:28:10

S… Speaker 1 (Nuova registrazione 18)

you work a lot, you spend a lot of time by doing physical activity, but at the same time, in the mines, you have high humidity, poor ventilation. At these two conditions, intensive physical activity, high humidity, and poor ventilation will increase easily the temperature, but no effect on the temperature.

1:28:41

S… Speaker 1 (Nuova registrazione 18)

Fever, this is the most important difference. The increasing temperature depends on alteration of the level of the thermoevatory center. And this alteration, produced by biogenic cytokines, will reduce the rearrangement at a level higher of the reference temperature. It's like you are with boiler or thermo.

1:29:28

S… Speaker 2 (Nuova registrazione 18)

It's just a matter of classification. If you say that hypothermia is without involvement of the hypothermia center, I would say no.

1:29:41

S… Speaker 1 (Nuova registrazione 18)

It can be the opposite, that hyperthermia can start without alteration of the hypothalamus center, but some cases of hyperthermia, for example during the big stroke, have increased permeability of the intestine.

1:30:00

S… Speaker 1 (Nuova registrazione 18)

This will induce a leakage of bacteria in the blood circulation. And then this can, as a consequence of each stroke, you can have bacteria, which are then induced in also fever. Or, in some specific cases that we'll see later, you can have a pathological condition, which is, for instance, one brain injury, bleeding, and some problem which is...

1:30:29

S… Speaker 1 (Nuova registrazione 18)

then inducing damage also to the hypo-paranus and the hypo-paranus once brought this damage can also change the control of the temperature and can convey from one pathological condition that was just inducing increasing temperature can also be associated with one change of the...

1:30:54

S… Speaker 1 (Nuova registrazione 18)

thermostat of the hypothalamus but in this case it's not one change which can be adjusted because if you damage the hypothalamus this kind of permanent damage which is modifying the temperature control temperature control can also induce persistent fever of course it's a serious problem when you damage the hypothalamus

1:31:20

S… Speaker 2 (Nuova registrazione 18)

at the level of the level of the center, because that can be more of the system, which is increasing, increasing, increasing, increasing, and then what we need. But, Jerry, it is a hyperthernia as such. Of course, what can I specify? Hyperthernia without fever, or hyperthernia with fever? And then it's fever. In one case, it's fever, but...

1:31:46

S… Speaker 1 (Nuova registrazione 18)

I accept and I speak in terms of hyperteria, I forget the risk of fever. If I say fever, I know that there is one increasing temperature mediated by this cycle. It's very important that we spend the time trying to understand why the true condition are very, very important.

1:32:14

S… Speaker 1 (Nuova registrazione 18)

It's not just for the exam. Whatever we study is just for the exam. Whatever we study, it's not for the exam, for the test, but it's for what are you going to do with this knowledge. Because depending on if you specify correctly, fever or hypertension, you have a completely different approach. In one case, what you have to do is calling down the patient.

1:32:42

S… Speaker 1 (Nuova registrazione 18)

Different way, but you have to cool down the patient. Then it's just an offer to take the patient out of the sun and put in a cool room and then wait and leave the coffee. In the other case, you need to act with antipyletic drugs which are able to bring back the after the hypodermic set point to the normal body.

1:33:10

S… Speaker 2 (Nuova registrazione 18)

If you are not able to discriminate conditions, then you have no problem. Because that, because it's high temperature without the density, okay, let's see. What can you do, sir? Sorry, 10 to 1. Can we stop here? I can just address it, sir. Okay. This is a weekend. I'll just put the floor. So, because we're planning, sir.

Nuova registrazione 18

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