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March 31st, 2012 posted by Paul Rega, MD, FACEP March 31, 2012 @ 3:20 pm

French grab 17 after police shot dead the self-confessed killer of four Jews and three French paratroopers in Toulouse

NY Times

March 30, 2012
 
French Police Seize 17 in Raids After Killings in Toulouse
By and

PARIS — Eight days after the police shot dead the self-confessed killer of four Jews and three French paratroopers in Toulouse, the French police on Friday detained 17 people described as Islamic militants in that city and other parts of France.

The French president, Nicolas Sarkozy, said that the detentions were not directly related to the killings in Toulouse, where the gunman, Mohammed Merah, claimed membership in Al Qaeda and was killed by the police as he resisted arrest.

The raids appeared to have two purposes. The first was to “kick the ant pile,” as the French say — a preventive act to detain a variety of people and interrogate them, to try to ensure that there are no further plots under way and no copycat killings.



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 3:13 pm

Tofu suspected as source of botulism cases in Queens

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http://www.nydailynews.com/new-york/queens/tofu-suspected-giving-botulism-people-queens-article-1.1053799?localLinksEnabled=false

Tofu suspected of giving botulism to two people in Queens

By / NEW YORK DAILY NEWS

“Two people got botulism……after buying tofu at a store in Flushing.

The city Health Department said…..that it confirmed one case of the potent form of food poisoning, and suspected another case.

Both of the afflicted are Chinese-speaking Queens residents who recently bought fresh, unrefrigerated bulk tofu from Flushing market. The tofu was not made at the store, and its source is under investigation…….”



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 3:06 pm

FEMA: Daily Briefing, 3/31/2012

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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:14 am

Tsunami Lung

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UCSF:http://www.ucsf.edu/news/2012/03/11714/japan-earthquake-and-tsunami-one-year-later-lingering-impacts-and-lessons

A Japanese patient with tsunami lung: During the tsunami rescue effort on March 11, 2011, a 51-year-old policeman was engulfed and nearly drowned, and he had injuries over his entire body. He was hospitalized near the coast and received oxygen therapy, and then was transferred to Matsumura General Hospital due to worsening symptoms. His limbs were cold, and his nails were discolored. An X-ray detected lung inflammation and pulmonary edema. He was given antibiotics, and his symptoms became less severe. Then Matsumura General ran out of antibiotics, so the patient was transferred toanother hospital. After two months of inpatient care, he was discharged. Photo by Hiroshi Nimura



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:14 am

CDC: Cigarette Excise Taxes

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http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6112a1.htm?s_cid=mm6112a1_e

State Cigarette Excise Taxes — United States, 2010–2011

Weekly

March 30, 2012 / 61(12);201-204

Increasing the price of cigarettes reduces the demand for cigarettes, thereby reducing youth smoking initiation and cigarette consumption and decreasing the prevalence of cigarette use in the United States overall, particularly among youths and young adults (1,2). The most common way governments have increased the price of cigarettes is by increasing cigarette excise taxes (1,2), which currently are imposed by all states and the District of Columbia (1). To update data on state cigarette excise taxes in 2009 (3), CDC conducted a survey of changes in state cigarette excise taxes during 2010–2011. During that period, eight states increased their cigarette excise taxes, and one state decreased its tax; as a result, the mean state tax increased from $1.34 in 2009 to $1.46 in 2011. Previous evidence indicates that further increases in cigarette excise taxes would be expected to result in further reductions in demand for cigarettes, decreasing smoking and associated morbidity and mortality (1,2).

Cigarettes and other tobacco products are taxed by federal, state, and local governments in various ways, including through excise taxes, which typically are levied per pack of 20 cigarettes (1). Cigarette excise tax rates are set by legislation; excise taxes usually are collected before the point of sale from manufacturers, distributors, or wholesalers and often are denoted by a tax stamp.

State cigarette excise tax data for this report were obtained from CDC’s State Tobacco Activities Tracking and Evaluation (STATE) system database, which contains tobacco-related epidemiologic and economic data and information on state tobacco-related legislation (including the District of Columbia).* Data are collected quarterly from an online legal research database of state laws, analyzed, coded, and entered into the STATE system. The STATE system contains information on state laws regarding excise taxes for cigarettes in effect since the fourth quarter of 1995.

During 2010, cigarette excise tax increases took effect in six states (Hawaii, New Mexico, New York, South Carolina, Utah, and Washington). These increases ranged from $0.40 per pack in Hawaii to $1.60 per pack in New York; no state decreased its tax. For 2010, among the six states that increased their cigarette excise taxes, the mean state increase was $0.88 per pack. With its increase, New York became the only state with a cigarette excise tax exceeding $4.00 per pack. South Carolina, after increasing its cigarette excise tax for the first time since 1977 (from $0.07 to $0.57 per pack), no longer had the lowest state cigarette excise tax in the United States.

During 2011, cigarette excise tax increases took effect in three states (Connecticut, Hawaii, and Vermont).† These increases ranged from $0.20 per pack in Hawaii to $0.40 per pack in Connecticut. Hawaii was the only state to increase its tax in both 2010 and 2011. For 2011, among the three states that increased their cigarette excise taxes, the mean state increase was $0.33 per pack. One state (New Hampshire) decreased its cigarette tax by $0.10 per pack, the first time a state decreased its cigarette excise tax since 2004.

From 2009 to 2011, the national mean cigarette excise tax among all states increased from $1.34 per pack in 2009 to $1.44 in 2010 and $1.46 in 2011. In 2011, Missouri had the lowest state cigarette excise tax in the United States, at $0.17 per pack, and New York had the highest, at $4.35 per pack (Table). Among six major tobacco-growing states (Georgia, Kentucky, North Carolina, South Carolina, Tennessee, and Virginia), the mean state cigarette excise tax was $0.49 cents per pack in 2011, an increase from $0.40 per pack in 2009. For all other states, including the District of Columbia, the mean cigarette excise tax was $1.59 per pack in 2011, an increase from $1.46 in 2009.

In 2011, California, Missouri, and North Dakota remained the only states that had not increased their state cigarette excise taxes since 2000. Missouri and North Dakota have not raised their state cigarette excise taxes ($0.17 and $0.44 per pack, respectively) since 1993, and California has not raised its cigarette excise tax ($0.87 per pack) since 1998.

Reported by

Michael A. Tynan, Gabbi R. Promoff, MA, Allison MacNeil, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor: Michael A. Tynan, mtynan@cdc.gov, 770-488-5286.

Editorial Note

Because increasing the price of cigarettes is effective in reducing cigarette use and preventing initiation, the Surgeon General has concluded that increased cigarette taxes would lead to substantial long-term improvements in health (1). The effectiveness of cigarette excise tax increases in reducing smoking-related death and disease can be increased when combined with other evidence-based interventions of a comprehensive tobacco control program, including smoke-free policies and media campaigns (2).

State cigarette excise taxes in major tobacco-growing states and bordering southeastern states remain substantially lower than state cigarette excise taxes in the rest of the United States. The major tobacco-growing states typically have higher smoking rates and do not have strong tobacco control policies and interventions in place. For example, in addition to having lower excise taxes, no southern state has a comprehensive state smoke-free law that prohibits smoking in workplaces, restaurants, and bars (5).

In addition to reducing smoking rates, cigarette excise tax increases have been shown to increase state revenue despite consumption declines, increases in the number of smokers quitting, and any increase in smuggling or tax avoidance (2,6). During 1990–2000, all states that increased their cigarette excise tax by at least $0.10 per pack also increased cigarette tax revenue (6).

In 2011, state lawmakers in New Hampshire enacted a law decreasing the state’s cigarette excise tax by $0.10 per pack in an attempt to increase revenue by attracting cigarette customers from nearby states where cigarette excise taxes were higher (7,8). However, in the months following the tax decrease, revenues from the excise tax declined in the state (8,9). When compared with the previous fiscal year, New Hampshire’s cigarette excise tax revenue declined by $12.5 million from July 2011 through February 2012, and approximately $8.3 million of this loss was attributable to the excise tax decrease.§

Excise tax increases can provide a revenue source to fund and expand comprehensive state tobacco control programs. The Institute of Medicine recommends that all states dedicate revenue by statute to fund tobacco prevention programs at the state-specific levels recommended by CDC (2,4). However, only one state (South Carolina) that increased its tax in 2010 or 2011 dedicated any revenue from its increase for tobacco prevention, even though such a move has been shown to produce a strong return on investment. For example, when California increased its cigarette excise tax in 1988, approximately $0.05 per pack was dedicated to state tobacco control and prevention programs (2,10). During the first 15 years of the California tobacco control program, the state invested $1.8 billion in cigarette excise tax revenue in the program, resulting in $86 billion in health-care cost savings (10).

The findings in this report are subject to at least two limitations. First the STATE system tracks only state-level data and data from the District of Columbia and does not include information on local (i.e., county, city, or other jurisdiction) taxes. Although not included in this analysis, approximately 460 communities impose a local tax on cigarettes, including New York City ($1.50 per pack) and Chicago-Cook County ($2.68 per pack). Also, the federal government imposes an excise tax on cigarettes of $1.01 per pack. Second, this report does not include information on price per pack of cigarettes, which can vary considerably, even among states with similar excise taxes, in part because of differences in manufacturer, wholesaler, and retailer pricing and discounting practices.

A Healthy People 2020 objective (TU-17.1) calls for all states and the federal government to increase their cigarette excise taxes by at least $1.50 per pack. New York was the first state to achieve this objective, increasing its tax by $1.60 in 2010. If all states were to achieve the objective and dedicate a portion of cigarette excise tax revenue to fund comprehensive tobacco control programs at the state-specific levels recommended by CDC, previous evidence indicates that substantial decreases in smoking-attributable morbidity and health-care costs likely would occur (2,4,10).

Acknowledgments

Ryan Patrick, Blake Kline, The MayaTech Corporation, Silver Spring, Maryland.

References

  1. CDC. Reducing tobacco use: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, CDC; 2000. Available at http://www.cdc.gov/tobacco/data_statistics/sgr/2000/complete_report/index.htm. Accessed March 26, 2012.
  2. Institute of Medicine. Ending the tobacco problem: a blueprint for the nation. Washington, DC: The National Academies Press; 2007. Available at http://www.nap.edu/catalog.php?record_id=11795External Web Site Icon. Accessed March 26, 2012.
  3. CDC. State cigarette excise taxes—United States, 2009. MMWR 2010;59:385–8.
  4. CDC. Best practices for comprehensive tobacco control programs—2007. Atlanta, GA: US Department of Health and Human Services, CDC; 2007. Available at http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm. Accessed March 26, 2012.
  5. CDC. State smoke-free laws for worksites, restaurants, and bars—United States, 2000–2010. MMWR 2011;60:472–5.
  6. Farrelly MC, Nimsch CT, James J. State cigarette excise taxes: implications for revenue and tax evasion. Final report: prepared for Tobacco Technical Assistance Consortium. Research Triangle Park, NC: RTI International; 2003. Available at http://www.rti.org/pubs/8742_excise_taxes_fr_5-03.pdf Adobe PDF fileExternal Web Site Icon. Accessed March 26, 2012.
  7. The Associated Press. New Hampshire debates a reduced cigarette tax. New York, NY: The New York Times. March 19, 2011. Available at http://www.nytimes.com/2011/03/20/us/20budgets.htmlExternal Web Site Icon. Accessed March 26, 2012.
  8. Sanborn A. Tobacco price increase offsets N.H. tax cut. Portsmouth, NH: The Portsmouth Herald. July 24, 2011. Available at http://www.seacoastonline.com/apps/pbcs.dll/article?aid=%2f20110724%2fnews%2f107240318%2f-1%2fnewsmapExternal Web Site Icon. Accessed March 26, 2012.
  9. Landrigan K. 4 months in, cigarette tax cut no help. Nashua, NH: Nashua Telegraph. November 3, 2011. Available at http://www.nashuatelegraph.com/newsstatenewengland/938717-227/4-months-in-cigarette-tax-cut-no.htmlExternal Web Site Icon. Accessed March 26, 2012.
  10. Lightwood JM, Dinno A, Glantz SA. Effect of the California Tobacco Control Program on personal health care expenditures. PLoS Med 2008;5:e178.


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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:13 am

Human Salmonella Infections & Small Turtles

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http://www.cdc.gov/salmonella/small-turtles-03-12/index.html

Human Salmonella Infections Linked to Small Turtles

Posted March 30, 2012 02:30 PM ET

 



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:12 am

Circulating endothelial cells predictive of an MI

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http://www.latimes.com/health/la-he-heart-attack-warning-20120322,0,655419.story

LA Times

Researchers closer to a test to predict heart attacks

Using a blood sample to detect circulating endothelial cells that sloughed off damaged vessel walls could help save at-risk patients who had normal stress tests.

 

By Eryn Brown, Los Angeles TimesMarch 21, 2012, 5:29 p.m.
 

“……The new technique involves tracking a type of cell in the blood called a circulating endothelial cell.

Endothelial cells create a wrapper that lines the inside of blood vessels. When the vessel is damaged, endothelial cells break away and enter the bloodstream.

Healthy people have very few of these circulating cells. But a person with mild cholesterol buildup can develop a crack in an artery wall that disrupts the lining and sends them into the blood…….Knowing that the endothelial lining has been damaged before a blood clot grows might allow physicians to predict onset of a heart attack or stroke…….”



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:11 am

ASA & acute mountain sickness

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http://www.medicalnewstoday.com/articles/243152.php

Medical News Today, 3/20/12

“Stanford Hospital & Clinics and a clinical assistant professor at the Stanford University School of Medicine, has found that a widely available, over-the-counter (OTC) drug may help with altitude, or acute mountain sickness (C). Details of his research have been published this week in Annals of Emergency Medicine…….Lipman’s study took 86 men and women and used double-blind and placebos to look into the effects of Ibuprofen on altitude sickness…..In Lipman’s study the 58 men and 28 women traveled…..stayed overnight at 4,100 feet and took 400mg of ibuprofen. The next morning they went to 11,700 feet, took a second dose at 2pm and then hiked up to 12,570 feet, and took a third dose at 8pm, and spent the night on the mountain.

43% of those on the drug had symptoms of altitude sickness.

69% of those on the placebo had similar issues, showing the drug reduced the altitude sickness rate. Although a reduction in symptoms was not considered significant, overall, those on the placebo seemed to show slightly worse symptoms…..”



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:09 am

The Cardiac Cocktail

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http://www.ems1.com/cardiac-care/articles/1263253-Cardiac-cocktail-delivered-by-medics-may-save-lives/

AFP

CHICAGO — “Paramedics armed with a cheap, three-ingredient injection cocktail were able to reduce heart attack patients’ risk of dying by 50 percent, said a US study released on Tuesday.

When the shot was given early to patients with signs of a heart attack, the mixture of glucose, insulin and potassium, or GIK, showed remarkable success in preventing full cardiac arrest — when the heart stops beating — and even death……

The treatment did not prevent heart attacks from occurring, but cut the likelihood of cardiac arrest by 50 percent over patients who did not get the shot. The risk of immediate death also dropped by 50 percent……”



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March 31st, 2012 posted by Paul Rega, MD, FACEP @ 12:08 am

Week 12: The Flu in Europe

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http://www.euroflu.org/cgi-files/bulletin_v2.cgi

Current situation: week 12/2012

 



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