scholarly journals Lightning Safety for Florida Agriculture Workers

EDIS ◽  
2018 ◽  
Vol 2018 (5) ◽  
Author(s):  
Shawn T. Steed ◽  
Alicia J. Whidden
Keyword(s):  
Common Occurrence ◽  
Good Working ◽  
Life Threatening ◽  
The U.S ◽  
Lightning Safety

Lightning is a common occurrence in the Sunshine State. In fact, Florida is known as the lightning capital of the U.S. and ranks number one in lightning-caused deaths. As Floridians, we have grown accustomed to living with lightning and are possibly complacent about the destructive force that surrounds us. Lightning causes about $5 billion worth of damage and kills an average of 50 people in the U.S. each year. Although lightning kills only about 10% of people struck, many victims can suffer from physical and mental complications for the rest of their lives. In agriculture especially, as employers and employees we need to have a good working knowledge of lightning, its effects, and how to protect ourselves and others from this potentially life-threatening hazard.

scholarly journals Gluteal artery injuries including pseudoaneurysm associated with powered bone marrow biopsies

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Aditi P. Singh ◽  
Gopichand Pendurti ◽  
Shashi Singh ◽  
Alexander Shestopalov ◽  
Thomas Pacello ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Minimal Risk ◽  
Safe Procedure ◽  
Bone Marrow Biopsies ◽  
Fundamental Component ◽  
Current Review ◽  
Life Threatening ◽  
Therapeutic Measures ◽  
Life Threatening Complication ◽  
The U.S

The bone marrow procedure (BMP) is a frequently performed procedure, with over 700,000 recorded in the U.S. annually. It is a fundamental component in the evaluation and management of both malignant and benign hematologic conditions. Adult patients are generally assured that the BMP is a safe procedure with minimal risk, albeit briefly painful. Traditionally performed using a manual Jamshidi needle, the procedure is increasingly being performed using powered bone marrow kits, which have shown consistently good results. In the current review we describe three cases of gluteal artery injuries following the powered driver procedure, one of which resulted in the formation of a pseudoaneurysm requiring radiology-guided intervention. We highlight the need for both hematologists and patients to be aware of this potentially life threatening complication as well as how to recognize it clinically and institute timely diagnostic and therapeutic measures.

Evaluation of Orphan Products by the U.S. Food and Drug Administration

1992 ◽  
Vol 8 (4) ◽  
pp. 647-657 ◽  
Author(s):  
Marlene E. Haffner ◽  
John V. Kelsey
Keyword(s):  
Drug Administration ◽  
Rare Diseases ◽  
Food And Drug Administration ◽  
Orphan Drugs ◽  
Marketing Approval ◽  
Drug Products ◽  
Governmental Agencies ◽  
Number Of Patients ◽  
Life Threatening ◽  
The U.S

AbstractOrphan drug products generally are used in treating or preventing rare diseases. The small number of patients available for study may create special problems in the evaluation of these products. This paper examines some of the special problems that are associated with the design and implementation of studies to evaluate the safety and efficacy of orphan drugs. The U.S. Food and Drug Administration (FDA) has not established special criteria for evaluating orphan drugs per se, but the FDA has been flexible in evaluating drug products that present special problems, especially when these products are for treatment of serious of life-threatening illnesses. The FDA and other U.S. governmental agencies also have taken steps to promote the development and availability of drugs for rare diseases, including making these products available to patients who are in need, even before the drugs have full FDA marketing approval.

Conduct Unbecoming

2019 ◽  
pp. 187-197
Author(s):  
Andrew E. Stoner
Keyword(s):  
Persian Gulf ◽  
Active Duty ◽  
Persian Gulf War ◽  
Hiv Status ◽  
Life Threatening ◽  
History Of ◽  
Run Up ◽  
The Persian Gulf ◽  
Aids Diagnosis ◽  
The U.S

Shilts turns his attention to the struggle for gays and lesbians to remain in active duty for the U.S. military. Shilts highlights the struggles of Edward Modesto, Leonard Matlovich and Margarethe Cammermeyer (among others) amidst gay purges. Shilts examines efforts to repeal the gay ban in the run-up to the Persian Gulf War. Shilts traces the history of the ban military ban to include the heart-breaking story of Thomas Dooley. The issue of outing is explored with Shilts in opposition to more radical opinions that closeted persons (especially those in positions of power) should be outed. Writing process for “Conduct Unbecoming” is explored as Shilts battles life-threatening health episodes as his HIV status advances to an AIDS diagnosis.

scholarly journals Triglyceride Levels Greater Than 10,000 mg/dL in a 49-Year-Old Female without Evidence of Pancreatitis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Anika Toor ◽  
Amit Toor ◽  
Koroush Khalighi ◽  
Mahesh Krishnamurthy
Keyword(s):  
Clinical Practice ◽  
Literature Review ◽  
Rare Case ◽  
Common Occurrence ◽  
Severe Pancreatitis ◽  
Severe Hypertriglyceridemia ◽  
Life Threatening ◽  
Underlying Diseases ◽  
Total Triglyceride

We present a rare case of a 49-year-old female with very severe hypertriglyceridemia (HTG) having a total triglyceride (TG) count of > 10,000 mg/dL in the absence of pancreatitis. Based on literature review, this is one of the highest recorded TG counts in an adult without evidence of pancreatitis. HTG is a common occurrence in clinical practice, but rarely do numbers exceed 2000 mg/dl. It is crucial to evaluate and rapidly lower TG levels to prevent potentially life-threatening complications such as severe pancreatitis. Removal of potential predisposing medications, control of underlying diseases known to cause HTG, and maintenance therapies are essential to prevent reoccurrence.

Abstract 15024: Efficacy of Bretylium in Termination of Treatment Resistant Ventricular Tachycardia and Ventricular Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Janos Molnar ◽  
John C Somberg
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Fibrillation ◽  
Meta Analysis ◽  
Controlled Clinical Trial ◽  
Clinical Use ◽  
Second Line ◽  
Treatment Resistant ◽  
Life Threatening ◽  
Pharmacologic Therapies ◽  
The U.S

Bretylium is the only drug approved by the FDA specifically to terminate ventricular fibrillation (VF). It has also been approved to treat life threatening ventricular tachycardia (VT) as a second line agent. Due to shortage of drug substance, bretylium became unavailable for clinical use and has been dropped from ACLS guidelines in 2000. Recently, intravenous (IV) bretylium became available again in the U.S. This study evaluated the efficacy of bretylium IV in the termination of treatment resistant VT and VF. In 4 studies, a total of 85 patients with sustained VT and/or VF were administered IV bretylium 5 mg/kg: 23 patients had VT and 62 had VF. Resistant VT/VF was defined as VT or VF that could not be terminated by shock or other anti-arrhythmics or recurred before bretylium was administered. All patients received IV lidocaine; 71 received between 1 to 5 additional antiarrhythmics, and all patients with VF received DC shocks and failed all pharmacologic therapies prior to bretylium administration. Overall, 61 patients (72%) were successfully treated with IV bretylium and 31 survived to discharge from the hospital (36%). A meta-analysis of these studies indicates that the weighted conversion rate across the studies was 70% (see figure). The only study that compared IV bretylium and amiodarone did not find superiority of amiodarone in the suppression of hemodynamically destabilizing VT or VF. In patients with resistant VT or VF bretylium is reported to be effective in acute termination of the VT or VF that otherwise was not responsive to shock or other anti-arrhythmic drugs. These results suggest that bretylium should be employed in the pharmacotherapy of VT and VF when DC shock or other anti-arrhythmic drugs fail. The studies this report is based on are small studies and thus there is a need for a large controlled clinical trial to provide a better understanding of bretyliums effectiveness and if a higher than 30 mg/kg dose of bretylium would be more effective.

scholarly journals Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms

2017 ◽  
Vol 97 (4) ◽  
pp. 1351-1402 ◽  
Author(s):  
Frank W. Booth ◽  
Christian K. Roberts ◽  
John P. Thyfault ◽  
Gregory N. Ruegsegger ◽  
Ryan G. Toedebusch
Keyword(s):  
Physical Inactivity ◽  
Twin Studies ◽  
Indirect Evidence ◽  
The United States ◽  
World Health ◽  
Organ Systems ◽  
Life Threatening ◽  
Health Organization ◽  
Care Costs ◽  
The U.S

This review proposes that physical inactivity could be considered a behavior selected by evolution for resting, and also selected to be reinforcing in life-threatening situations in which exercise would be dangerous. Underlying the notion are human twin studies and animal selective breeding studies, both of which provide indirect evidence for the existence of genes for physical inactivity. Approximately 86% of the 325 million in the United States (U.S.) population achieve less than the U.S. Government and World Health Organization guidelines for daily physical activity for health. Although underappreciated, physical inactivity is an actual contributing cause to at least 35 unhealthy conditions, including the majority of the 10 leading causes of death in the U.S. First, we introduce nine physical inactivity-related themes. Next, characteristics and models of physical inactivity are presented. Following next are individual examples of phenotypes, organ systems, and diseases that are impacted by physical inactivity, including behavior, central nervous system, cardiorespiratory fitness, metabolism, adipose tissue, skeletal muscle, bone, immunity, digestion, and cancer. Importantly, physical inactivity, itself, often plays an independent role as a direct cause of speeding the losses of cardiovascular and strength fitness, shortening of healthspan, and lowering of the age for the onset of the first chronic disease, which in turn decreases quality of life, increases health care costs, and accelerates mortality risk.

scholarly journals The FDA Oncology Center of Excellence and precision medicine

2017 ◽  
Vol 243 (3) ◽  
pp. 308-312 ◽  
Author(s):  
Kirsten B Goldberg ◽  
Gideon M Blumenthal ◽  
Amy E McKee ◽  
Richard Pazdur
Keyword(s):  
Drug Development ◽  
Precision Medicine ◽  
Targeted Therapies ◽  
Treatment Options ◽  
Regulatory Science ◽  
Cancer Drug ◽  
Center Of Excellence ◽  
Life Threatening ◽  
Oncology Center ◽  
The U.S

In January 2017, the U.S. Food and Drug Administration (FDA) formally established the Oncology Center of Excellence (OCE) to streamline the development of cancer therapies by uniting experts from FDA product centers to conduct expedited review of drugs, biologics, and devices. In May 2017, the FDA approved a cancer treatment based on a biomarker, without regard to the tumor’s site, by granting accelerated approval to pembrolizumab for patients with solid tumors that have the microsatellite instability-high or mismatch repair deficient biomarker. We describe here the OCE’s role in this first site-agnostic approval and OCE programs for further advancement of oncology-related regulatory science and policy. In addition, the FDA’s four expedited review programs that enable transformative therapies to reach patients with life-threatening malignancies earlier in the development process are key to the continued rapid development of safe and effective therapies for patients with few or no other treatment options. These changes at FDA are taking place in the context of recent progress in the understanding of the genetic and immunologic foundations of cancer, resulting in the development of targeted therapies and immunotherapies. The traditional system of phased clinical trials has evolved as early trials of breakthrough therapies use expansion cohorts in a process known as seamless drug development. Increasingly, FDA approvals of targeted therapies are likely to have contemporaneous approvals of companion diagnostics to identify patients whose cancers harbor actionable abnormalities. Impact statement This publication describes the U.S. Food and Drug Administration’s (FDA) first site-agnostic oncology drug approval, a landmark event in the history of cancer drug development. The role of the FDA’s newly established Oncology Center of Excellence (OCE) in this approval is described, as are several OCE programs to advance excellence in regulatory science in the era of precision medicine. Also provided is an overview of FDA’s expedited drug review programs, which are important to the continued acceleration of therapeutics development for patients with life-threatening diseases and few or no other treatment options.

scholarly journals Burn Injuries Related to E-Cigarettes Reported to Poison Control Centers in the United States, 2010-2019

2020 ◽  
Author(s):  
BAOGUANG WANG ◽  
Sherry T. Liu ◽  
Brian Rostron ◽  
Camille Hayslett
Keyword(s):  
United States ◽  
Health Care ◽  
Young Adults ◽  
The United States ◽  
Health Care Facilities ◽  
Burn Injuries ◽  
Poison Control ◽  
Poison Control Centers ◽  
Life Threatening ◽  
The U.S

Abstract Background: United States (U.S.) national data indicate that 2,035 individuals with burn injuries from e-cigarette explosions presented to U.S. hospital emergency departments (EDs) in 2015-2017. This national estimate is valuable for understanding the burden of burn injuries from e-cigarette explosions among individuals who presented to EDs. However, little is known about individuals who experienced e-cigarette-related burns but may not present to EDs or health care facilities.Findings: We analyzed data from the National Poison Data System (NPDS) to describe frequency and characteristics of e-cigarette-related burn cases in the U.S. in 2010-2019. NPDS contains information collected during telephone calls to poison control centers (PCCs) across the U.S., including e-cigarette-related burns and other unintended events. During 2010-2019, 19,306 exposure cases involving e-cigarettes were documented in NPDS. Of those, 69 were burn cases. The number of burn cases increased from one in 2011 to a peak of 26 in 2016, then decreased to three in 2019. The majority of the burn cases occurred among young adults aged 18-24 years (29.0%; n=20) and adults aged 25 years or older (43.5%; n=30); 14.4% occurred among individuals ≤ 17 years old. Of the 69 burn cases, 5.8% (n=4) were admitted to a hospital; 65.2% (n=45) were treated and released; 15.9 % (n=11) were not referred to a health care facility (HCF); 4.4% (n=3) refused referral or did not arrive at an HCF; and 8.7% (n=6) were lost to follow-up or left the HCF against medical advice. Nearly one-third (30.4%; n=21) of the cases had a minor effect (symptoms resolved quickly), 47.8% (n=33) had a moderate effect (symptoms were more pronounced and prolonged than in minor cases, but not life-threatening), and 2.9% (n=2) had a major effect (life-threatening symptoms).Conclusions: Approximately one-fifth of e-cigarette-related burn cases reported to PCCs were not referred to or did not arrive at an HCF. Some burn cases had serious medical outcomes. The burn cases mostly affected young adults and adults aged 25 years or older. The number of burn cases in NPDS represents a small portion of e-cigarette-related burn cases but it can serve as a complementary data source to traditional injury surveillance systems.

scholarly journals Rape and social death

2021 ◽  
pp. 146470012110129
Author(s):  
Bonnie Mann
Keyword(s):  
Law Enforcement ◽  
Sexual Assault ◽  
Tonic Immobility ◽  
Physical Violence ◽  
Fear Of Death ◽  
Social Death ◽  
Life Threatening ◽  
Physiological Explanation ◽  
The U.S

Rape that does not involve life-threatening physical violence, is committed by someone known to the victim, and is not reported to law enforcement (called, here, commonplace rape) raises two questions: “Why didn't she fight back or run away?” and “Why didn't she say anything at the time?” Recently, research on “tonic immobility,” based on animal predation studies, has provided a physiological explanation for experiences of immobilization during sexual assault. The juxtaposition of animal predation with commonplace sexual assault raises the question: How is it that a response reserved, in animals, for lethal, no-way-out scenarios is present in modes of violation where the victim does not report fear of death or extreme physical harm? Neither does this research help explain why women fail to report. This philosophical exploration of the meaning of tonic immobility in sexual assault helps to justify the juxtaposition of life-or-death scenarios with less-than-life-threatening violation, and sheds light on the reason for women's silence after sexual assault. Rape is accompanied by deep historical meanings that can be encapsulated in the notion of “social death,” associated in the U.S. with colonial conquest, enslavement, and impoverishment. The specter of social death haunts commonplace rape, producing life or death responses.

scholarly journals COVID-19 Susceptibility and Severity Risks in a Survey of Over 500,000 People

2020 ◽  
Author(s):  
Spencer C. Knight ◽  
Shannon R. McCurdy ◽  
Brooke Rhead ◽  
Marie V. Coignet ◽  
Danny S. Park ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Nasal Swab ◽  
Area Under The Curve ◽  
Epidemiological Data ◽  
Large Datasets ◽  
Risk Of Infection ◽  
Risk Models ◽  
Life Threatening ◽  
The U.S

AbstractThe growing toll of the COVID-19 pandemic has heightened the urgency of identifying individuals most at risk of infection and severe outcomes, underscoring the need to assess susceptibility and severity patterns in large datasets.1 The AncestryDNA COVID-19 Study collected self-reported survey data on symptoms, outcomes, risk factors, and exposures for over 563,000 adult individuals in the U.S., including over 4,700 COVID-19 cases as measured by a self-reported positive nasal swab test. We observed significant associations between several risk factors and COVID-19 susceptibility and severity outcomes. Many of the susceptibility associations were accounted for by differences in known exposures; a notable exception was elevated susceptibility odds for males after adjusting for known exposures and age. We also leveraged the dataset to build risk models to robustly predict individualized COVID-19 susceptibility (area under the curve [AUC]=0.84) and severity outcomes including hospitalization and life-threatening critical illness amongst COVID-19 cases (AUC=0.87 and 0.90, respectively). The results highlight the value of self-reported epidemiological data at scale to provide public health insights into the evolving COVID-19 pandemic.

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