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March 1st, 2012 posted by Paul Rega, MD, FACEP March 1, 2012 @ 10:32 pm

Short-Range Weather Forecast from NOAA

http://www.hpc.ncep.noaa.gov/discussions/pmdspd.html

SHORT RANGE FORECAST DISCUSSION
NWS HYDROMETEOROLOGICAL PREDICTION CENTER CAMP SPRINGS MD
319 PM EST THU MAR 1 2012

VALID 00Z FRI MAR 2 2012 – 00Z SUN MAR 4 2012

…BAD WEATHER EXPECTED FROM THE DEEP SOUTH TO THE OHIO VALLEY
WITH SEVERE STORMS DEVELOPING ON FRIDAY…

…UNSETTLED CONDITIONS CONTINUE OVER PARTS OF THE PACIFIC
NORTHWEST THROUGH THE END OF THE WEEK…

THE MAIN WEATHER STORY FOR THE END OF THE WEEK WILL BE A POTENT
STORM SYSTEM THAT IS FORECAST TO AFFECT MUCH OF THE EASTERN HALF
OF THE COUNTRY.  A STRONG SHORTWAVE ALOFT OVER THE ROCKIES WILL
MOVE OUT OVER THE CENTRAL PLAINS AND PROVIDE THE LIFT NEEDED TO
GENERATE A SURFACE LOW.  WARM AND HUMID SOUTHERLY FLOW AHEAD OF
THIS LOW SHALL BRING A WARM FRONT THROUGH THE MID SOUTH AND INTO
THE OHIO VALLEY BY FRIDAY AFTERNOON…WHICH WILL CREATE
INSTABILITY AND WIND SHEAR.  THE ATMOSPHERE AHEAD OF THE COLD
FRONT WILL BE CONDUCIVE TO THE DEVELOPMENT OF STRONG TO SEVERE
THUNDERSTORMS IN THE WARM SECTOR…ALONG WITH MODERATE TO HEAVY
RAINFALL. 

THIS SAME STORM SYSTEM IS EXPECTED TO REACH THE EAST COAST BY
SATURDAY…WITH WIDESPREAD SHOWERS AND STORMS EXPECTED FROM
NORTHERN FLORIDA TO SOUTHERN NEW ENGLAND.  A BRIEF PERIOD OF
RELATIVELY WARM AND MODERATELY HUMID CONDITIONS AHEAD OF THE COLD
FRONT WILL BE FOLLOWED BY A RETURN TO DRY AND SEASONAL CONDITIONS
BY SUNDAY FOR MOST AREAS.  A BAND OF SNOW IS LIKELY NORTHWEST OF
THE MAIN LOW CENTER…EXTENDING FROM THE UPPER GREAT LAKES TO
SOUTHERN QUEBEC.  MOST OF THE STEADY AND ACCUMULATING SNOW WILL
LIKELY STAY NORTH OF THE CANADIAN BORDER WITH THIS EVENT.

OVER THE PACIFIC NORTHWEST AND INTERMOUNTAIN WEST…A FRONTAL
SYSTEM IS EXPECTED TO BRING PERIODS OF COASTAL RAIN FRIDAY INTO
SATURDAY OVER THE PACIFIC NORTHWEST…ALONG WITH MOUNTAIN SNOW.
THIS EVENT IS EXPECTED TO BE LIGHTER THAN RECENT STORMS IN THE
AREA.  OVER THE INTERMOUNTAIN WEST…POCKETS OF MID AND UPPER
LEVEL ENERGY WILL PROVIDE ENOUGH ASCENT FOR SCATTERED MOUNTAIN
SNOW SHOWERS.

FORECASTER HAMRICK



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 4:11 am

Where is 8 inches of snow predicted?

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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 4:06 am

NOAA: Short-Term Forecast

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http://www.hpc.ncep.noaa.gov/discussions/pmdspd.html

SHORT RANGE FORECAST DISCUSSION
NWS HYDROMETEOROLOGICAL PREDICTION CENTER CAMP SPRINGS MD
359 AM EST THU MAR 01 2012

VALID 12Z THU MAR 01 2012 – 12Z SAT MAR 03 2012

…WINTER STORM OVER THE NORTHEAST WILL DEPART INTO THE ATLANTIC
ON FRIDAY AS A NEW STORM FORMS IN THE CENTER OF THE COUNTRY AND
QUICKLY INTENSIFIES…

…MOUNTAIN SNOW IN THE ROCKIES IS EXPECTED TO GRADUALLY TAPER OFF
DURING THE NEXT COUPLE OF DAYS….

A LOW PRESSURE SYSTEM NEAR THE GREAT LAKES IS EXPECTED TO WEAKEN
WHILE MOVING EASTWARD TOWARDS NEW ENGLAND TODAY.  A NEW LOW
PRESSURE CENTER IS EXPECTED TO FORM IN THE GULF OF MAINE AND
BECOME THE DOMINANT SYSTEM TONIGHT.  THIS WILL RESULT IN A PERIOD
OF WINTRY PRECIPITATION MOVING ACROSS NEW ENGLAND TODAY…AND
SHOULD DEPART THE AREA OVERNIGHT TONIGHT. FREEZING RAIN INITIALLY
IN UPSTATE NEW YORK SHOULD CHANGE OVER TO SNOW BEFORE ENDING
TONIGHT.

BEHIND THIS SYSTEM…ANOTHER LOW PRESSURE SYSTEM IS TAKING SHAPE
IN THE CENTRAL PLAINS. THIS LOW IS EXPECTED TO STEADILY INTENSIFY
AS IT TRACKS ACROSS THE CENTRAL PLAINS INTO THE OHIO VALLEY ON
FRIDAY…REACHING THE GREAT LAKES AND INTO SOUTHERN ONTARIO CANADA
BY SATURDAY MORNING.  INITIALLY…THERE IS VERY LITTLE MOISTURE TO
WORK WITH IN THIS SYSTEM AS LITTLE OR NO PRECIPITATION IS FORECAST
IN THE CENTRAL PLAINS TODAY. BY FRIDAY…THUNDERSTORMS ARE
EXPECTED TO DEVELOP AHEAD OF A DRY LINE AND A COLD FRONT IN THE
LOWER MISSISSIPPI VALLEY…ESPECIALLY IN THE AFTERNOON AND EARLY
EVENING HOURS.  BY FRIDAY NIGHT…THE CENTER OF THE DEEPENING LOW
SHOULD BE MOVING ACROSS THE OHIO VALLEY.  ENOUGH COLD AIR NORTH OF
THE LOW SHOULD SUPPORT A PERIOD OF SNOW IN THE NORTHERN PART OF
LOWER MICHIGAN FRIDAY EVENING.

OVER THE INTERMOUNTAIN WEST…A BROAD UPPER-LEVEL TROUGH IS
SUPPORTING SCATTERED AREAS OF SNOW BEHIND A SURFACE COLD FRONT
ACROSS THE NORTHERN AND CENTRAL ROCKIES. AS THE UPPER TROUGH MOVES
INTO THE PLAINS ON FRIDAY…HIGH PRESSURE WILL BUILD INTO THE
REGION AND SNOW IS EXPECTED TO GRADUALLY TAPER OFF. ELSEWHERE…A
WEAKENING FRONTAL SYSTEM IS EXPECTED TO BRING A PERIOD OF COASTAL
RAIN FRIDAY INTO FRIDAY NIGHT OVER THE PACIFIC NORTHWEST.

KONG



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 3:49 am

CDC on Raw (Unpasteurized) Milk

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http://www.cdc.gov/features/rawmilk/’

Trying to decide about raw milk?

Photo: Pouring a glass of milk.Developing a healthy lifestyle is a process with many decisions and steps. One step you might be thinking about is adding raw milk to your diet. Raw milk is milk that has not been pasteurized to kill harmful germs. Germs include bacteria, viruses, and parasites. It’s important to understand the risks of drinking raw milk, especially because you may be hearing claims about the supposed “benefits” of raw milk.

Raw milk contains bacteria, and some of them can be harmful. So, if you’re thinking about consuming raw milk because you believe that it is a good source of beneficial bacteria, you need to know that it isn’t and you may instead get sick from the harmful bacteria. If you think that certain types of bacteria may be beneficial to your health, consider getting them from foods that don’t involve such a high risk. For example, so-called probiotic bacteria are sometimes added to pasteurized fermented foods, such as yogurt and kefir.

Milk and products made from milk need minimal processing, called pasteurization, which can be done by heating the milk briefly (for example, heating it to 161°F for about 20 seconds). When milk is pasteurized, some bacteria remain in it, but the disease-causing ones are killed. Harmful germs usually don’t change the look, taste, or smell of milk, so only when milk has been pasteurized can you be confident that these germs are not present. To ensure that milk is safe, processors rapidly cool it after pasteurization, practice sanitary handling, and store milk in clean, closed containers at 45°F or below.

Remember, you can’t look at, smell, or taste a bottle of raw milk and tell if it’s safe to drink. Make the best decision for the health of your family. If you want to keep milk in your family’s diet, protect them by not giving them raw milk. Even healthy adults can get sick from drinking raw milk. If you’re thinking about drinking raw milk because you believe it has health benefits, consider other options.

Who is at greatest risk of getting sick from drinking raw milk?

Photo: Father and son with a glass of milk.The risk of getting sick from drinking raw milk is greater for infants and young children, the elderly, pregnant women, and people with weakened immune systems, such as people with cancer, an organ transplant, or HIV/AIDS, than it is for healthy school-aged children and adults. But, it is important to remember that healthy people of any age can get very sick or even die if they drink raw milk contaminated with harmful germs.

What are the risks associated with drinking raw milk?

Raw milk can carry harmful bacteria and other germs that can make you very sick or kill you. While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all.

Getting sick from raw milk can mean many days of diarrhea, stomach cramping, and vomiting. Less commonly, it can mean kidney failure, paralysis, chronic disorders, and even death.

Many people who chose raw milk thinking they would improve their health instead found themselves (or their loved ones) sick in a hospital for several weeks fighting for their lives from infections caused by germs in raw milk. For example, a person can develop severe or even life-threatening diseases, such as Guillain-Barré syndrome, which can cause paralysis, and hemolytic uremic syndrome, which can result in kidney failure and stroke.

Aren’t raw or natural foods better than processed foods?

Many people believe that foods with no or minimal processing are better for their health. Many people also believe that small, local farms are better sources of healthy food. However, some types of processing are needed to protect health. For example, consumers process raw meat, poultry, and fish for safety by cooking. Similarly, when milk is pasteurized, it is heated just long enough to kill disease-causing germs. Most nutrients remain after milk is pasteurized. There are many local, small farms that offer pasteurized organic milk and cheese products.

I’ve heard that many organic and raw milk producers are creating sanitary and humane conditions for raising animals and producing “safe” raw milk and raw milk products (like cheeses and yogurts). Does this help reduce milk contamination?

Adherence to good hygienic practices during milking can reduce, but not eliminate, the risk of milk contamination. The dairy farm environment is a reservoir for illness-causing germs. No matter what precautions farmers take, and even if their raw milk tests come back negative, they cannot guarantee that their milk, or the products made from their milk, are free of harmful germs.

How does milk get contaminated?

Photo: Bottles of milk.Milk contamination may occur from:

Pasteurization is the only way to kill many of the bacteria in milk that can make people very sick.

Information about raw milk-related outbreaks

States that allow the legal sale of raw milk for human consumption have more raw milk-related outbreaks of illness than states that do not allow raw milk to be sold legally.

Among dairy product-associated outbreaks reported to CDC between 1973 and 2009 in which the investigators reported whether the product was pasteurized or raw, 82% were due to raw milk or cheese. From 1998 through 2009, 93 outbreaks due to consumption of raw milk or raw milk products were reported to CDC. These resulted in 1,837 illnesses, 195 hospitalizations, and 2 deaths. Most of these illnesses were caused by Escherichia coli, Campylobacter, or Salmonella. It is important to note that a substantial proportion of the raw milk-associated disease burden falls on children; among the 93 raw dairy product outbreaks from 1998 to 2009, 79% involved at least one person younger than 20 years old.

A study released by CDC in February 2012 examined the number of dairy outbreaks in the United States during a 13‐year period. Between 1993 and 2006, 60% (73/121) of dairy-related outbreaks reported to CDC were linked to raw milk products. Three‐quarters of these outbreaks occurred in states where the sale of raw milk was legal at the time. Experts also found that those sickened in raw milk outbreaks were 13 times more likely to be hospitalized than those who got ill from pasteurized milk during an outbreak.

As a consumer, you can take steps when grocery shopping and at home with all of your dairy products to minimize the risk of getting sick:

  1. Only consume pasteurized milk and milk products. Look for the word “pasteurized” on the dairy labels. If in doubt, don’t buy it!
  2. Keep pasteurized dairy products refrigerated at 40 degrees Fahrenheit or below at home and dispose of any expired products to reduce the risk of illness.
  3. If you consume soft, fresh, un-aged cheeses like queso fresco, make sure they are made from pasteurized milk. Aged cheeses made from raw milk are generally okay to eat because germs usually die off during the aging process. However, outbreaks associated with these cheeses have been identified.

Reported outbreaks represent the tip of the iceberg. For every outbreak and every illness reported, many others occur, and most illnesses are not part of recognized outbreaks. Protect yourself and your loved ones. Avoid raw milk, it’s just not worth the risk.

 


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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 3:39 am

Yesterday’s tornadoes: “It’s surreal. Nothing I’ve ever seen before. It’s something you’d see on a movie. Complete devastation.”

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http://www.nytimes.com/2012/03/01/us/storm-system-crushes-midwestern-towns.html?_r=1&nl=todaysheadlines&emc=tha23

February 29, 2012
 
Storms Cross the Midwest and South, Crushing Towns
By and

HARRISBURG, Ill. — “A powerful storm system tore through parts of the Midwest and South on Wednesday, killing at least 12 people, leaving pockets of devastation across several states and marking the acceleration of another deadly tornado season.

Tornadoes and powerful winds tore off roofs, downed power lines, tossed mobile homes and injured more than 150 people from Kansas to Kentucky, according to the National Weather Service….”



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 3:33 am

Hypnotics & the threefold increased hazards of death

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Source reference:
Kripke DF, et al “Hypnotics’ association with mortality or cancer: A matched cohort study” .  BMJ Open 2012; 2: e000850.

“……A prescription for 0.4 to 18 doses per year was associated with a mortality hazard ratio of 3.60 compared with patients who had no prescriptions for hypnotics.  The hazard jumped to 5.32 for patients prescribed more than 132 doses a year, investigators reported online in BMJ Open……”

http://bmjopen.bmj.com/content/2/1/e000850.full

Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality.



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 3:29 am

Heat-related deaths among football players

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http://www.medicalnewstoday.com/releases/242236.php

Morning Temperatures Thought To Play A Role In The Tripling Of Deaths Among Football Players

“Heat-related deaths among football players across the country tripled to nearly three per year between 1994 and 2009 after averaging about one per year the previous 15 years, according to an analysis of weather conditions and high school and college sports data conducted by University of Georgia researchers. ….More than half of the players fell ill on days when practice ended before noon. The majority of the deaths occurred in August, when most high school and college football coaches ramp up preseason training……..Linemen, who tend to have a higher body mass index than other players, seem especially susceptible to hyperthermia. In Grundstein’s sample, 86 percent of those who died were linemen. The increase in deaths also could be explained by an overall increase in weight and BMI in the past 15 years. …….”



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 3:01 am

Namibia, Cassava, & Cyanide

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http://www.newera.com.na/articles/43026/Cassava-lunch-turns-deadly

New Era, 3/1/12

22 Feb 2012 – Story by Helvy Shaanika

OSHAKATI – “One child has died while three others are recovering after eating what is suspected to be poisonous cassava roots. Three adults were discharged from the Outapi State Hospital after also eating the roots.

Cassava is often used to make a tropical delicacy in the form of a flour. However, if it is not properly washed or cooked, its roots contain a toxin called cyanide that is fatal to humans, even in small doses…..”



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 2:56 am

Q Fever in the Netherlands

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http://www.dutchnews.nl/news/archives/2012/02/qfever_death_toll_reached_at_l.php

DutchNews.nl

2/29/12

“The number of people killed by Q-fever, a flu-like illness which mainly infects sheep and goats, was at least 24………

The outbreak of Q-fever began in 2007 and led to the slaughter of some 40,000 goats in an effort to get the spread under control. Some 4,000 humans became ill……”



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March 1st, 2012 posted by Paul Rega, MD, FACEP @ 2:53 am

Pertussis in Canada

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http://www.world-first.co.uk/home/travel-insurance/medical-problems/canadian-whooping-cough-warning$44160.aspx

Canadian whooping cough warning

28 February 2012 09:09

“Canadian health officials have issued a warning over whooping cough as the disease continues to sweep through parts of British Columbia.

There have been more than 140 suspected or confirmed cases of the illness since early December, according to the Fraser Health Authority…..”



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