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March 21st, 2012 posted by Paul Rega, MD, FACEP March 21, 2012 @ 4:26 am

(Audio) Tornadoes trample US Heartland, 3/21/1932

This was recorded 3/21/2011.

Super Outbreak – March 21, 1932


“This is regarded as the worst tornado day on record in modern Alabama history. A series of tornadoes swept across the state and before the afternoon was over, 268 persons died and 1,874 were injured. In Shelby County, Columbiana was hardest hit, with 15 killed, as the storm struck at dusk. Damage was almost beyond estimate”

This article taken from Shelby County Reporter
Columbiana, Alabama
September 7, 1972.

“At Lawley, Alabama, an automobile was picked up by the tornado and carried at least 50 feet.”

This article taken from The Tuscaloosa News
Tuscaloosa, Alabama
February 25, 1968.

“The Northport Tornado struck around 4 pm CST. Ninety eight homes were destroyed and hundreds of other homes and buildings were damaged. The twister caused at least 2,000 persons to be temporarily homeless. The Northport-Tuscaloosa area was almost like a city hit by a bomb. Druid City Hospital was not equipped to handle such a disaster so the University of Alabama gym was converted into a temporary hospital. Most of the fatalities and injuries were from the Northport area. The tornado leveled the Tuscaloosa Country Club but did not hit downtown Tuscaloosa. National Guardsmem were called out to prevent looting. A tent city was constructed to provide quarters for some of the people without places to stay. An extra edition of the Tuscaloosa News was printed at 7 pm.”

This article taken from The Tuscaloosa News
Tuscaloosa, Alabama
February 25, 1968.

“The Homewood Plantation in Hale County, 4 miles north of Faunsdale, is an empty roofless shell of its former self. Twelve people were killed on the plantation and at least 18 were injured. A dozen tenant cabins were blown completely away, the large dairy barn was flattened and the grove was left a tangle of broken trees and limbs. In an old tree stump, a horse collar, a dead pig and a 3 year old baby were found jammed together. Several people were found several hundred yards away after the storm. An iron pot sailed through the air nearly a half mile. The estate of Richard Harris a quarter mile away was swept clean but none were killed there.”

This article taken from an unknown newspaper.

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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 4:22 am

Mexican Earthquake: Hundreds of houses down, some injuries, no deaths


Hundreds of houses damaged after strong earthquake hits Mexico

By the CNN Wire Staff
updated 2:03 AM EDT, Wed March 21, 2012
The latest:
  • Interior minister: 11 people are injured nationwide
  • At least 500 homes are damaged in Guerrero state, the governor says
  • At epicenter: “There are many cracked ceilings, many houses that collapsed”

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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 4:18 am

Have they caught the Toulouse monster?


French police in standoff with suspect in Toulouse shootings

From Diana Magnay and Marilia Brocchetto, CNN
updated 5:04 AM EDT, Wed March 21, 2012

Toulouse, France (CNN) — “About 300 police officers surrounded a house in the south of France on Wednesday, trying to coax a man whom authorities called a self-styled al Qaeda jihadist to surrender after a series of shootings that left seven people dead.

Soon after special operations police mounted their raid in Toulouse at 3:30 a.m. (10:30 p.m. ET Tuesday), shots rang out from inside, wounding two officers……The 24-year-old suspect is accused of killing seven people in the last 10 days: a rabbi and three children at a Jewish school on Monday, and three soldiers of north African origin who had recently returned from Afghanistan in two earlier incidents.

Interior Minister Gueant said the suspect is a French national of Algerian origin who spent considerable time in Afghanistan and Pakistan…….”

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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:58 am

OSHA-Chemical Hazards Manual



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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:52 am



Asian leaf ‘kratom’ making presence felt in US emergency rooms

By Kari Huus,

“When a patient showed up in a West Coast emergency room early this month suffering withdrawal from something he called “kratom,” the psychiatrist on duty was forced to scramble for information. But when the doctor looked it up, she found that the opiate-like leaf from Southeast Asia is well known in the worlds of alternative medicine and the drug culture.

What the doctor, who asked not to be named for patient confidentiality reasons, found in an Internet search were Web pages set up by dozens of companies selling kratom leaf and touting it as a way to combat fatigue, pain and depression — even as an antidote to heroin addiction.But in addition to its possible medicinal uses, kratom is beginning to show up in U.S. emergency rooms, with doctors saying they are dealing with people sick from taking it — especially teens who try it to get high.

“Every month somebody is trying to get a new ‘safe high’,” said Frank LoVecchio, medical director of the Banner Good Samaritan Poison and Drug Information Center in Phoenix, Ariz. “(Kratom) is definitely not safe.”……..The leaf, which is indigenous to Southeast Asia, has been around for thousands of years, and proponents argue that it is safe and effective for many maladies, while having fewer side effects and being less addictive than pharmaceutical alternatives, such as oxycodone. In small doses, they say, kratom provides an energy boost — the plant is in the coffee family — and in larger doses it creates a mellow, sedating effect, acting on the opioid receptors……….

Although there have been no fatalities from kratom, “The known risks and dangers of Kratom overdoses include hallucinations, delusions, listlessness, tremors, aggression, constipation and nausea,” the site said.

The emergency room psychiatrist said the patient who recently came in reported using kratom several times a day, every day, “because he discovered that if he stopped it he started getting withdrawal.” The doctor said the man’s symptoms appeared “identical to heroin withdrawal.”

Upon arrival, the patient was suffering “severe depression and anxiety and emerging opiate withdrawal symptoms,” including chills, aching muscles and gooseflesh, the psychiatrist said. The patient was treated to ease withdrawal symptoms and then hospitalized, according to the doctor…….”


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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:46 am

DEA on Kratom


KRATOM (Mitragyna speciosa korth)

(Street Names: Thang, Kakuam, Thom, Ketum, Biak)

December 2010


Kratom, (Mitragyna speciosa korth), is a tropical tree indigenous to Thailand, Malaysia, Myanmar and other areas of South East Asia. Kratom is in the same family as the coffee tree (Rubiaceae). The tree reaches heights of 50 feet with a spread of over 15 feet.

Kratom has been used by natives of Thailand and other regions of Southeast Asia as an herbal drug for decades. Traditionally, kratom was mostly used as a stimulant by Thai and Malaysian laborers and farmers to overcome the burdens of hard work. They chewed the leaves to make them work harder and provide energy and relief from muscle strains. Kratom was also used in Southeast Asia and by Thai natives to substitute for opium when opium is not available. It has also been used to manage opioid withdrawal symptoms by chronic opioid users.

In 1943, the Thai government passed the Kratom Act 2486 that made planting of the tree illegal. In 1979, the Thai government enacted the Narcotics Act B.E. 2522, placing kratom along with marijuana in Category V of a five category classification of narcotics. Kratom remains a popular drug in Thailand. As of December 2006, kratom is the third most popular drug within southern Thailand, after methamphetamine and marijuana. It has been reported that young Thai militants drink a “4×100” kratom formula to make them “more bold and fearless and easy to control.” The two “4×100” kratom formulas are described as a mixture of a boiled kratom leaves and mosquito coils and cola or a mixture of boiled cough syrup, kratom leaves and cola served with ice. In this report it was also mentioned use of that the “4×100” formula was gaining popularity among Muslim youngsters in several districts of Yala (Southern Thailand) and was available in local coffee and tea shops.

Kratom is promoted as a legal psychoactive product on numerous websites in the U.S. On those websites, topics range from vendors listings, preparation of tea and recommended doses, to alleged medicinal uses, and user reports of drug experiences.

Licit Uses:

There is no legitimate medical use for kratom in the U.S.

Chemistry and Pharmacology:

Over 25 alkaloids have been isolated from kratom; mitragynine is the primary active alkaloid in the plant.

Pharmacology studies show that mitragynine has opioid-like activity in animals. It inhibits electrically stimulated ileum and vas deferens smooth muscle contraction. Through actions on centrally located opioid receptor, it inhibits gastric secretion and reduces pain response.

Kratom has been described as producing both stimulant and sedative effects. At low doses, it produces stimulant effects, with users reporting increased alertness, physical energy, talkativeness and sociable behavior. At high doses, opiate effects are produced, in addition to sedative and euphoric effects. Effects occur within 5 to 10 minutes after ingestion and last for 2 to 5 hours. Acute side effects include nausea, itching, sweating, dry mouth, constipation, increased urination, and loss of appetite.

Kratom consumption can lead to addiction. In a study of Thai kratom addicts, it was observed that some addicts chewed kratom daily for 3 to 30 years (mean of 18.6 years). Long-term use of kratom produced anorexia, weight loss, insomnia, skin darkening, dry mouth, frequent urination, and constipation. A withdrawal syndrome was observed, consisting of symptoms of hostility, aggression, emotional lability, wet nose, achy muscles and bones, and jerky movement of the limbs. Furthermore, several cases of kratom psychosis were observed, where kratom addicts exhibited psychotic symptoms that included hallucinations, delusion and confusion.

Illicit Uses:

Information on the illicit use of kratom in the U.S. is anecdotal. Based on information posted on the Internet, kratom is mainly being abused orally as a tea. Chewing kratom leaves is another method of consumption. Doses in the range of 2 to 10 grams are recommended to achieve the desired effects. Users report that the dominant effects are similar to those of psychostimulant drugs.

Other countries are reporting emerging new trends in the use of kratom. In the United Kingdom, kratom is promoted as an “herbal speedball.” In Malaysia, kratom (known as ketum) juice preparations are illegally available.

User Population:

Information on user population in the U.S. is very limited. Kratom abuse is not monitored by any national drug abuse surveys.

Illicit Distribution:

Kratom is widely available on the Internet. There are numerous vendors within and outside of the U.S. selling kratom. Forms of kratom available through the Internet, includes leaves (whole or crushed), powder, extract, encapsulated powder and extract resin “pies” (40g pellets made from reduced extract). Seeds and whole trees are also available from some vendors through the Internet, suggesting the possibility of domestic cultivation.

Control Status:

Kratom is not controlled under the Controlled Substances Act.

Comments and additional information are welcomed by the Drug and Chemical Evaluation Section; Fax 202-353-1263, telephone 202-307-7183, or Email

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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:43 am

The Cinnamon Challenge


By Katye Martens, USA TODAY

“Just a spoon full of cinnamon could land your kid in the hospital.

It’s happened at least once in the past few weeks as teens inspired by viral videos — and egged on by friends online — have taken what’s called “the cinnamon challenge.”

The idea: Try to swallow a heaping helping of the spice, within a minute, with no water. The usual result: A coughing, gagging fit that produces clouds of cinnamon dust and leaves some people choking and gasping for air. Some end up vomiting. And it can get worse: Dejah Reed, a freshman at Huron High School in Ann Arbor, Mich., spent four days in the hospital with an infection and a collapsed right lung after trying it. Several other cases of kids sickened by the stunt were reported to a Michigan poison control center…….The problem… that the cinnamon can block airways and get into lungs, causing irritation and inflammation…….”


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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:38 am

Michigan ambulances to cross boundaries for cardiac arrests


By Ken Kolker

ROCKFORD, Mich. — “Kent County’s three ambulance companies have agreed to major changes in how they respond to cardiac arrests after a Target 8 investigation raised questions about the handling of a recent call.

In the past, the three ambulance companies — Rockford Ambulance, Life EMS, and AMR — dispatched their own units to calls in their designated territories.

Now, in apparent cardiac arrest cases, they have agreed to call each other first, to see if an ambulance from another company is closer.

They are sending that closest ambulance, even if it means crossing territorial lines……

Linda Oosdyke called 911 from her home, about a mile from the Rockford Fire Department. But, because she lives 200 feet into Plainfield Township, Kent County dispatchers sent firefighters from the Plainfield station six miles away.

A three-minute response turned into 10 minutes. Her 72-year-old husband, Tom Oosdyke, died….”

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March 21st, 2012 posted by Paul Rega, MD, FACEP @ 3:31 am

Canada: Salmonella Outbreak now stands at 37……..


Number of salmonella cases keeps rising

Outbreak now stands at 37, public health says
By David Reevely, Ottawa CitizenMarch 20, 2012

“……Starting last week, the department began analysing samples of ground beef and a handful of other foods from a particular Lunch Lady kitchen on Boyd Avenue, with the contamination thought to have come in meat lasagna and beef tacos.

The results of lab tests needed to confirm the suspicion are still outstanding…..”

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