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February 8th, 2012 posted by Paul Rega, MD, FACEP February 8, 2012 @ 6:16 am

Judiciary Road Map in the event of a Pandemic

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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 6:00 am

Where the snow might get 4 inches high today……….

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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:58 am

NOAA: Today’s Weather Map

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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:43 am

Assad’s forces allegedly targeting healthcare in Homs

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http://edition.cnn.com/2012/02/07/world/meast/syria-unrest/index.html

‘……..Among the targets on Tuesday was a Red Cross ambulance……. The soldiers have taken up residence in the lone hospital in the southwest Homs neighborhood of Baba Amr…… “They hit the operation room while doctors are doing operations; they kicked the doctors out of the hospital and all of the nurses out of the hospital and left all of the people in there.”

Civilian casualties who seek treatment there won’t find it……’



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:37 am

2.1 million smallpox shots led to 115 contact vaccinia cases

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Contact transmission of vaccinia virus from smallpox vaccinees in the United States, 2003–2011:
 

Ellen R. Wertheimer, Denise S. Olive, John F. Brundage, Leslie L. Clark

 http://www.sciencedirect.com/science/article/pii/S0264410X11019736

 

Abstract

Since 2002, approximately 40,000 US civilians and 2.1 million military personnel have been vaccinated against smallpox. The vaccine contains live vaccinia virus that can be transferred through physical contact. This report summarizes numbers, rates, and characteristics of contact vaccinia cases that presented between December 2002 and March 2011. Cases were identified from reports in adverse event reporting systems and peer-reviewed literature. One hundred fifteen cases of vaccinia transmission through contact were identified (5.4 per 100,000 vaccinees); 52 reports (45%) noted laboratory confirmation. Three-quarters of vaccinees, but fewer than 8% of contact vaccinia cases, were described as military members. Most cases were household or intimate contacts (n = 86, 75%) or wrestling partners (n = 18, 16%) of vaccinees. Nearly all cases manifested mild, local skin reactions; of 14 hospitalized cases, one was life-threatening. Vaccinia transmission from vaccinees is relatively infrequent. Continued attention to both vaccinee education and screening for contraindications to vaccination is appropriate.

Highlights

► We identified secondary and tertiary contact vaccinia cases that presented between December 2002 and March 2011. ► Cases were described in civilian or military adverse event reporting systems or peer-reviewed literature. ► One hundred fifteen cases of vaccinia transmission through contact were identified (5.4 per 100,000 vaccinees). ► Most cases were female household members or intimate contacts (n = 70, 60%) or wrestling partners (n = 18, 16%) of recent vaccinees. ► Contact vaccinia infections are infrequent and preventable through patient education and screening for contraindications to vaccination.



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:32 am

overweight women who smoke & have babies

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Women who are both overweight and smoke during pregnancy are at an increased
risk for having a child with a heart defect, suggest results of a study
published in Heart.
http://www.medwire-news.md/438/97274/Pediatrics_News/Overweight_mothers_who_smoke_while_pregnant_put_children_at_risk_for_heart_defects_.html



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:31 am

Economy Class Syndrome: Fact or Fancy?

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http://www.medicalnewstoday.com/articles/241296.php

Is Economy Class Air Travel Linked To Blood Clot Risk? Apparently Not

MNT

“Economy Class Syndrome” is a myth, your risk of developing a blood clot during a long-distance economy trip by plane is not higher than in first class, researchers report in an article published in Chest. The American College of Chest Physicians (ACCP) has issued new evidence-based guidelines which address some of the risk factors linked to DVT……. – it says that there is no compelling evidence linking economy class air travel to the development of DVT……The authors stress that the chances of developing DVT/PE (deep vein thrombosis, pulmonary embolism) during long-distance flights very small in the majority of cases. …..”



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:28 am

Heroin, tobacco, cocaine, tanning booths……SALT!

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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm61e0207a1.htm?s_cid=mm61e0207a1_e

Vital Signs: Food Categories Contributing the Most to Sodium Consumption — United States, 2007–2008

Early Release

February 7, 2012 / 61(Early Release);1-7

Abstract

Background: Most of the U.S. population consumes sodium in excess of daily guidelines (<2,300 mg overall and 1,500 mg for specific populations). Excessive sodium consumption raises blood pressure, which is a major risk factor for heart disease and stroke, the nation’s first and fourth leading causes of death. Identifying food categories contributing the most to daily sodium consumption can help reduction.

Methods: Population proportions of sodium consumption from specific food categories and sources were estimated among 7,227 participants aged ≥2 years in the What We Eat in America, National Health and Nutrition Examination Survey, 2007–2008.

Results: Mean daily sodium consumption was 3,266 mg, excluding salt added at the table. Forty-four percent of sodium consumed came from 10 food categories: bread and rolls, cold cuts/cured meats, pizza, poultry, soups, sandwiches, cheese, pasta mixed dishes, meat mixed dishes, and savory snacks. For most of these categories, >70% of the sodium consumed came from foods obtained at a store. For pizza and poultry, respectively, 51% and 27% of sodium consumed came from foods obtained at fast food/pizza restaurants. Mean sodium consumption per calorie consumed was significantly greater for foods and beverages obtained from fast food/pizza or other restaurants versus stores.

Implications for Public Health Practice: Average sodium consumption is too high, reinforcing the importance of implementing strategies to reduce U.S. sodium intake. Nationwide, food manufacturers and restaurants can strive to reduce excess sodium added to foods before purchase. States and localities can implement policies to reduce sodium in foods served in institutional settings (e.g., schools, child care settings, and government cafeterias). Clinicians can counsel most patients to check food labels and select foods lower in sodium.



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 5:25 am

therapeutic hypothermia & cardiogenic shock

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Stegman BM, Newby LK, Hochman JS, Ohman EM. Post-myocardial infarction cardiogenic shock is a systemic illness in need of systemic treatment. Is therapeutic hypothermia one possibility? J Am Coll Cardiol 2012; 59:644-647.

“……..Cardiogenic shock in the MI setting was usually fatal until the advent of acute reperfusion therapy with balloon angioplasty, but even today with modern PCI and intra-aortic balloon pumping, mortality is about 50%, note the viewpoint’s authors, led by Dr Brian M Stegman (Duke University Medical Center, Durham, NC). They describe a range of pathophysiologic processes involved in cardiogenic shock that could potentially be lessened or blocked by therapeutic hypothermia, possibly improving outcomes. They include ischemia and reperfusion injury, systemic inflammation, and vascular dysfunction…..”

http://www.theheart.org/article/1352015.do



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February 8th, 2012 posted by Paul Rega, MD, FACEP @ 4:58 am

Fed advisors: How to vaccinate healthcare workers without using Gestapo tactics……

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http://www.cidrap.umn.edu/cidrap/content/influenza/general/news/feb0712worker.html

Federal advisors propose steps to boost health worker flu vaccination

Lisa Schnirring * Staff Writer

Feb 7, 2012 (CIDRAP News) – “Federal vaccine advisors today unveiled proposed voluntary recommendations for increasing flu vaccination in healthcare workers, sparking strong reactions from employee groups who object to language that stops just short of urging mandatory vaccination……”



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