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Dozens injured in Hong Kong ferry boat crash
“……….The boat struck an unknown object near Sunshine Island around 1:20 a.m., a government spokeswoman said. About an hour and a half later, it returned to the Hong Kong-Macau Ferry Terminal, where emergency crews rushed injured victims to hospitals……
At least 85 people were injured — six seriously………”
Image Credit: NASA/JPL
Image Addition Date: 1999-04-15
Case Report and Literature Review of a Dissecting Thoracic Aneurysm in a
16-Year-Old Boy Presenting to the Emergency Department
Published online: 04 December 2013
Bharat Kothakota, Johnnie Ford
Journal of Emergency Medicine, The,
“……A 16-year-old boy with a benign past medical history presented to the Emergency Department (ED) with sudden onset of chest pain. His diagnostic workup led to a diagnosis of aortic dissection. It is noted that his D-dimer was significantly elevated.
It is important to consider aortic dissection as a possibility when assessing the sick adolescent patient. The D-dimer is quite useful as a rapid and inexpensive test in the evaluation and stratification of adolescent chest pain patients in the ED.”
NEW YORK (AP) — “As people lay badly bleeding in the smoke of the Boston Marathon bombings, rescuers immediately turned to a millennia-old medical device to save their lives — the tourniquet.
Using belts, shirts and other materials, they tied off bleeding limbs in fast-acting bids to prevent major blood loss, shock and death. Such fast work no doubt saved many lives, doctors at Boston area hospitals said.
So it’s interesting to note that if this had happened a decade ago, many emergency responders might have avoided the tourniquet. As recently as the early 2000s, the tourniquet was still enmeshed in a longstanding controversy about whether they were more trouble than they were worth…………………
However, some experts remain cautious. The Red Cross, for example, continues to worry that tourniquets may be used improperly or in situations when blood loss is not great enough to warrant their use…………”
“………Morphine delays clopidogrel resorption, decreases plasma levels of clopidogrel active metabolite, retards and diminishes its effects, which can lead to treatment failure in susceptible individuals.”
Clinical Trial Registration NCT01369186, EUDRA-CT#: 2010-023761-22
Vitamin D status and ill health: a systematic review
Prof Philippe Autier MD,Prof Mathieu Boniol PhD,Cécile Pizot MSc,Prof Patrick Mullie PhD
The Lancet Diabetes & Endocrinology – 6 December 2013
“Low serum concentrations of 25-hydroxyvitamin D (25[OH]D) have been associated with many non-skeletal disorders. However, whether low 25(OH)D is the cause or result of ill health is not known. We did a systematic search of prospective and intervention studies that assessed the effect of 25(OH)D concentrations on non-skeletal health outcomes in individuals aged 18 years or older. We identified 290 prospective cohort studies (279 on disease occurrence or mortality, and 11 on cancer characteristics or survival), and 172 randomised trials of major health outcomes and of physiological parameters related to disease risk or inflammatory status. Investigators of most prospective studies reported moderate to strong inverse associations between 25(OH)D concentrations and cardiovascular diseases, serum lipid concentrations, inflammation, glucose metabolism disorders, weight gain, infectious diseases, multiple sclerosis, mood disorders, declining cognitive function, impaired physical functioning, and all-cause mortality. High 25(OH)D concentrations were not associated with a lower risk of cancer, except colorectal cancer.
Results from intervention studies did not show an effect of vitamin D supplementation on disease occurrence, including colorectal cancer. In 34 intervention studies including 2805 individuals with mean 25(OH)D concentration lower than 50 nmol/L at baseline supplementation with 50 μg per day or more did not show better results. Supplementation in elderly people (mainly women) with 20 μg vitamin D per day seemed to slightly reduce all-cause mortality. The discrepancy between observational and intervention studies suggests that low 25(OH)D is a marker of ill health. Inflammatory processes involved in disease occurrence and clinical course would reduce 25(OH)D, which would explain why low vitamin D status is reported in a wide range of disorders. In elderly people, restoration of vitamin D deficits due to ageing and lifestyle changes induced by ill health could explain why low-dose supplementation leads to slight gains in survival.”
Science 6 December 2013:
Vol. 342 no. 6163 pp. 1230-1235
Preferential Recognition of Avian-Like Receptors in Human Influenza A H7N9 Viruses
Rui Xu, et al
“The 2013 outbreak of avian-origin H7N9 influenza in eastern China has raised concerns about its ability to transmit in the human population. The hemagglutinin glycoprotein of most human H7N9 viruses carries Leu226, a residue linked to adaptation of H2N2 and H3N2 pandemic viruses to human receptors. However, glycan array analysis of the H7 hemagglutinin reveals negligible binding to humanlike α2-6–linked receptors and strong preference for a subset of avian-like α2-3–linked glycans recognized by all avian H7 viruses. Crystal structures of H7N9 hemagglutinin and six hemagglutinin-glycan complexes have elucidated the structural basis for preferential recognition of avian-like receptors.
These findings suggest that the current human H7N9 viruses are poorly adapted for efficient human-to-human transmission.”
All data are preliminary and may change as more reports are received.
During week 47 (November 17-23, 2013), influenza activity increased slightly in the United States.
A description of surveillance methods is available at: http://www.cdc.gov/flu/weekly/overview.htm
During week 47, 5.8% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.6% for week 47.
No influenza-associated pediatric deaths were reported to CDC during week 47. A total of two influenza-associated pediatric deaths for the 2013-2014 season have been reported.
Additional data can be found at http://gis.cdc.gov/GRASP/Fluview/PedFluDeath.html.
The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and the Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Additional FluSurv-NET data can be found at:http://gis.cdc.gov/GRASP/Fluview/FluHospRates.html and http://gis.cdc.gov/grasp/fluview/FluHospChars.html.
Nationwide during week 47, 1.7% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.0%. (ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and cough and/or sore throat.)
Region specific data is available at http://gis.cdc.gov/grasp/fluview/fluportaldashboard.html.
Data collected in ILINet are used to produce a measure of ILI activity* by state. Activity levels are based on the percent of outpatient visits in a state due to ILI and are compared to the average percent of ILI visits that occur during weeks with little or no influenza virus circulation. Activity levels range from minimal, which would correspond to ILI activity from outpatient clinics being below the average, to high, which would correspond to ILI activity from outpatient clinics being much higher than average.
During week 47, the following ILI activity levels were experienced:
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