Influence of the Vaginal Microbiota on Toxic Shock Syndrome Toxin 1 Production by Staphylococcus aureus

OpenAIRE

MacPhee, Roderick A.; Miller, Wayne L.; Gloor, Gregory B.; McCormick, John K.; Hammond, Jo-Anne; Burton, Jeremy P.; Reid, Gregor

2013-01-01

Menstrual toxic shock syndrome (TSS) is a serious illness that afflicts women of premenopausal age worldwide and arises from vaginal infection by Staphylococcus aureus and concurrent production of toxic shock syndrome toxin-1 (TSST-1). Studies have illustrated the capacity of lactobacilli to reduce S. aureus virulence, including the capacity to suppress TSST-1. We hypothesized that an aberrant microbiota characteristic of pathogenic bacteria would induce the increased production of TSST-1 and...

Streptococcal toxic shock syndrome caused by Streptococcus suis serotype 2.

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Jiaqi Tang

2006-05-01

Full Text Available BACKGROUND: Streptococcus suis serotype 2 (S. suis 2, SS2 is a major zoonotic pathogen that causes only sporadic cases of meningitis and sepsis in humans. Most if not all cases of Streptococcal toxic shock syndrome (STSS that have been well-documented to date were associated with the non-SS2 group A streptococcus (GAS. However, a recent large-scale outbreak of SS2 in Sichuan Province, China, appeared to be caused by more invasive deep-tissue infection with STSS, characterized by acute high fever, vascular collapse, hypotension, shock, and multiple organ failure. METHODS AND FINDINGS: We investigated this outbreak of SS2 infections in both human and pigs, which took place from July to August, 2005, through clinical observation and laboratory experiments. Clinical and pathological characterization of the human patients revealed the hallmarks of typical STSS, which to date had only been associated with GAS infection. Retrospectively, we found that this outbreak was very similar to an earlier outbreak in Jiangsu Province, China, in 1998. We isolated and analyzed 37 bacterial strains from human specimens and eight from pig specimens of the recent outbreak, as well as three human isolates and two pig isolates from the 1998 outbreak we had kept in our laboratory. The bacterial isolates were examined using light microscopy observation, pig infection experiments, multiplex-PCR assay, as well as restriction fragment length polymorphisms (RFLP and multiple sequence alignment analyses. Multiple lines of evidence confirmed that highly virulent strains of SS2 were the causative agents of both outbreaks. CONCLUSIONS: We report, to our knowledge for the first time, two outbreaks of STSS caused by SS2, a non-GAS streptococcus. The 2005 outbreak was associated with 38 deaths out of 204 documented human cases; the 1998 outbreak with 14 deaths out of 25 reported human cases. Most of the fatal cases were characterized by STSS; some of them by meningitis or severe

Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations.

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Ing-Kit Lee

Full Text Available BACKGROUND: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF is important in alerting clinicians of severe dengue and improving management. METHODS AND FINDINGS: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI bleeding was found in 4 patients, dengue shock syndrome (DSS alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization, hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3% and bacteremia (25% were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20,000/µL, and 50% of the patients with pre-fatal prothrombin time (PT prolongation experienced massive GI bleeding. CONCLUSIONS: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding

Possible central nervous system oxygen toxicity seizures among US recreational air or enriched air nitrox open circuit diving fatalities 2004-2013.

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Buzzacott, P; Denoble, P J

2017-01-01

The first diver certification programme for recreational 'enriched air nitrox' (EAN) diving was released in 1985. Concerns were expressed that many EAN divers might suffer central nervous system (CNS) oxygen toxicity seizures and drown. US fatalities on open-circuit scuba occurring between 2004-2013, where the breathing gas was either air or EAN, were identified. Causes of death and preceding circumstances were examined by a medical examiner experienced in diving autopsies. Case notes were searched for witnessed seizures at elevated partial pressures of oxygen. The dataset comprised 344 air divers (86%) and 55 divers breathing EAN (14%). EAN divers' fatal dives were deeper than air divers' (28 msw vs 18 msw, p < 0.0001). Despite this, of the 249 cases where a cause of death was established, only three EAN divers were considered to have possibly died following CNS oxygen toxicity seizures at depth (ppO2 132, 142 and 193 kPa). The analysis of recreational diving fatalities in the US over 10 years found just one death likely from CNS oxygen toxicity among EAN divers. A further two possible, although unlikely, cases were also found. Fears of commonplace CNS oxygen toxicity seizures while EAN diving have not apparently been realized.

Individual and combined effects of organic, toxic, and hydraulic shocks on sequencing batch reactor in treating petroleum refinery wastewater

Energy Technology Data Exchange (ETDEWEB)

Mizzouri, Nashwan Sh., E-mail: nashwan_mizzouri@yahoo.com [Department of Civil Engineering, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur (Malaysia); Department of Civil Engineering, University of Duhok, Kurdistan (Iraq); Shaaban, Md Ghazaly [Department of Civil Engineering, University of Malaya, Lembah Pantai, 50603 Kuala Lumpur (Malaysia)

2013-04-15

Highlights: ► This research focuses on the combined impact of shock loads on the PRWW treatment. ► System failure resulted when combined shock of organic and hydraulic was applied. ► Recovery was achieved by replacing glucose with PRWW and OLR was decreased to half. ► Worst COD removals were 68.9, and 57.8% for organic, and combined shocks. -- Abstract: This study analyzes the effects of toxic, hydraulic, and organic shocks on the performance of a lab-scale sequencing batch reactor (SBR) with a capacity of 5 L. Petroleum refinery wastewater (PRWW) was treated with an organic loading rate (OLR) of approximately 0.3 kg chemical oxygen demand (COD)/kg MLSS d at 12.8 h hydraulic retention time (HRT). A considerable variation in the COD was observed for organic, toxic, hydraulic, and combined shocks, and the worst values observed were 68.9, 77.1, 70.2, and 57.8%, respectively. Improved control of toxic shock loads of 10 and 20 mg/L of chromium (VI) was identified. The system was adversely affected by the organic shock when a shock load thrice the normal value was used, and this behavior was repeated when the hydraulic shock was 4.8 h HRT. The empirical recovery period was greater than the theoretical period because of the inhibitory effects of phenols, sulfides, high oil, and grease in the PRWW. The system recovery rates from the shocks were in the following order: toxic, organic, hydraulic, and combined shocks. System failure occurred when the combined shocks of organic and hydraulic were applied. The system was resumed by replacing the PRWW with glucose, and the OLR was reduced to half its initial value.

Fatal toxic epidermal necrolysis associated with minoxidil.

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Karaoui, Lamis R; Chahine-Chakhtoura, Corinne

2009-04-01

Minoxidil is a direct-acting peripheral vasodilator for the treatment of symptomatic hypertension, or refractory hypertension associated with target organ damage, that is not manageable with a diuretic and two other antihypertensive drugs. The most frequent adverse events associated with minoxidil include hypertrichosis and cardiovascular events related to its powerful antihypertensive effect, and less frequently, rashes, bullous eruptions, and Stevens-Johnson syndrome (SJS). Evidence suggests that SJS and toxic epidermal necrolysis (TEN) are variants of a single disease with common causes and mechanisms, but differing severities. Epidermal detachment is mild in SJS, moderate in overlap SJS-TEN, and severe (> 30% of body surface area) in TEN. We describe a case of minoxidil-associated SJS that evolved into fatal TEN. A 69-year-old African-American woman with a history of chronic kidney disease was admitted to the hospital for a cerebrovascular accident and uncontrolled hypertension. On hospital day 12, oral minoxidil was added to her drug regimen. On day 23, she developed a maculopapular rash on her face that gradually diffused to her chest and back. Vesicles and papular lesions extended to her extremities and mucosal membranes; results of a skin biopsy revealed SJS. A positive Nikolsky's sign (blisters spread on application of pressure) was detected. On days 27-31, diffuse bullae developed with rash exacerbation. Skin detachment exceeded 30% and was consistent with TEN. The patient died on day 39. An evaluation of the causality and time course suggested that minoxidil was the most likely culpable drug, with a Naranjo adverse drug reaction probability scale score indicating that the likelihood of the association was possible (score of 3). The mechanism of this reaction has not been well elucidated. It may be related to an impaired clearance of the minoxidil metabolite, or an immune stimulation resulting in apoptosis and epidermis destruction. To our knowledge, this

[Fatal toxic leukoencephalopathy associated with consumption of pasta base of cocaine: Report of three cases].

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Cartier R, Luis; González L, Daniela; Harán D, Jorge

2015-11-01

The prevalence of drug-associated toxic encephalopathy is unknown, but it is an uncommon condition. Toxic leukoencephalopathy was described associated with heroin consumption, it has been less commonly described with the use of cocaine and there are no reports of its association with consumption pasta base of cocaine (PBC). We report two females aged 31 years and a male aged 19 years, consumers of PBC who developed a fatal toxic leukoencephalopathy. They initiated their disease with severe and persistent headache, sequential focal neurologic deficits and a progressive impairment of consciousness that culminated with their death. Laboratory parameters such as blood count, cerebrospinal fluid analyses or infectious biological indices were normal. MRI showed multifocal lesions in brain white matter of both hemispheres confirming the leukoencephalopathy. There was no response to the use of methylprednisolone.

Immunomodulatory pretreatment with Kalanchoe pinnata extract and its quercitrin flavonoid effectively protects mice against fatal anaphylactic shock.

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Cruz, E A; Da-Silva, S A G; Muzitano, M F; Silva, P M R; Costa, S S; Rossi-Bergmann, B

2008-12-10

Previously, we reported the immunosuppressive action of the aqueous extract of Kalanchoe pinnata (Kp) in mice. In the present study, we report on the protective effect of Kp in fatal anaphylactic shock, likewise a Th2-driven immunopathology, and the identification of its active component. Mice daily treated with oral Kp during hypersensitization with ovalbumin were all protected against death when challenged with the allergen, as compared with the 100% mortality in the untreated group. A single intraperitoneal dose 3 h prior to challenge was partially effective. Oral protection was accompanied by a reduced production of OVA-specific IgE antibodies, reduced eosinophilia, and impaired production of the IL-5, IL-10 and TNF-alpha cytokines. In vitro, Kp prevented antigen-induced mast cell degranulation and histamine release. Oral treatment with the quercitrin flavonoid isolated from Kp prevented fatal anaphylaxis in 75% of the animals. These findings indicate that oral treatment with Kp effectively downmodulates pro-anaphylactic inducing immune responses. Protection achieved with quercitrin, although not maximal, suggests that this flavonoid is a critical component of Kp extract against this extreme allergic reaction.

Emergence of Streptococcus pyogenes emm102 causing toxic shock syndrome in Southern Taiwan during 2005-2012.

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Jiun-Nong Lin

Full Text Available BACKGROUND: Streptococcal toxic shock syndrome (STSS is an uncommon but life-threatening disease caused by Streptococcus pyogenes. METHODS: To understand the clinical and molecular characteristics of STSS, we analyzed clinical data and explored the emm types, superantigen genes, and pulsed-field gel electrophoresis of causative S. pyogenes isolates obtained between 2005 and 2012. RESULTS: In total, 53 patients with STSS were included in this study. The median age of the patients was 57 years (range: 9-83 years, and 81.1% were male. The most prevalent underlying disease was diabetes mellitus (45.3%. Skin and soft-tissue infection accounted for 86.8% of STSS. The overall mortality rate was 32.1%. Underlying diseases had no statistical impact on mortality. A total of 19 different emm types were identified. The most prevalent emm type was emm102 (18.9%, followed by emm11 (17%, emm1 (11.3%, emm87 (9.4%, and emm89 (7.5%. There was no statistically significant association between emm type and a fatal outcome. Among the superantigen genes, speB was the most frequently detected one (92.5%, followed by smeZ (90.6%, speG (81.1%, speC (39.6%, and speF (39.6%. The majority of emm102 strains were found to have speB, speC, speG, and smeZ. The presence of speG was negatively associated with a fatal outcome (P = 0.045. CONCLUSIONS: Our surveillance revealed the emergence of uncommon emm types, particularly emm102, causing STSS in southern Taiwan. Characterization of clinical, epidemiological, and molecular characteristics of STSS will improve our understanding of this life-threatening disease.

The functional range of heat shock proteins to combat environmental toxicity

International Nuclear Information System (INIS)

Mahmood, K.; Mahmood, Q.; Pervez, A.; Nasreen, S.

2012-01-01

Almost all the organisms possess a system to cope with the harsh physiochemical factors of environment. Such a system is based on a group of stress genes, which show rapid responses in form of stress proteins, especially heat shock proteins, when cells are confronted with insult. Heat shock proteins are now known to express in response to variety of toxic and stress conditions including diseases. As a molecular chaperone, against cytotoxicity, these ensure the functional ability of cells by repairing the denatured proteins, cellular structures like cytoskeleton and centrosomes and processes dealing with protein synthesis are stabilized or repaired during a second stress in stress tolerant cells and organisms. In unstressed cells these play an imperative role in the synthesis and transport of normal proteins. Their role in certain diseases reveals their potential application in medical field. Certain Hsp are helpful in coping carcinogenicity caused environmental pollutants and have been suggested to have anti-apoptotic, anti stress and anti-allergic function. Their expression is tissue and species specific with respect to type, intensity and duration of a toxicant. These are developmentally regulated and help in process of differentiation and thus their abnormal regulation impairs the normal development. However, their role as bio marker in risk assessment of environmental pollution warrants further research. Due to broad functional range, therefore, present review is embracing the functional aspects of smaller and Hsp 70 families expressing in animals under toxic conditions. (author)

Small heat shock proteins protect against α-synuclein-induced toxicity and aggregation

International Nuclear Information System (INIS)

Outeiro, Tiago Fleming; Klucken, Jochen; Strathearn, Katherine E.; Liu Fang; Nguyen, Paul; Rochet, Jean-Christophe; Hyman, Bradley T.; McLean, Pamela J.

2006-01-01

Protein misfolding and inclusion formation are common events in neurodegenerative diseases, such as Parkinson's disease (PD), Alzheimer's disease (AD) or Huntington's disease (HD). α-Synuclein (aSyn) is the main protein component of inclusions called Lewy bodies (LB) which are pathognomic of PD, Dementia with Lewy bodies (DLB), and other diseases collectively known as LB diseases. Heat shock proteins (HSPs) are one class of the cellular quality control system that mediate protein folding, remodeling, and even disaggregation. Here, we investigated the role of the small heat shock proteins Hsp27 and αB-crystallin, in LB diseases. We demonstrate, via quantitative PCR, that Hsp27 messenger RNA levels are ∼2-3-fold higher in DLB cases compared to control. We also show a corresponding increase in Hsp27 protein levels. Furthermore, we found that Hsp27 reduces aSyn-induced toxicity by ∼80% in a culture model while αB-crystallin reduces toxicity by ∼20%. In addition, intracellular inclusions were immunopositive for endogenous Hsp27, and overexpression of this protein reduced aSyn aggregation in a cell culture model

Diversity of Dominant Bacterial Taxa in Activated Sludge Promotes Functional Resistance following Toxic Shock Loading

KAUST Repository

Saikaly, Pascal; Oerther, Daniel B. Barton

2010-01-01

and functional resistance. In this system, activated sludge bacterial communities with higher biodiversity are functionally more resistant to disturbance caused by toxic shock loading. © 2010 Springer Science+Business Media, LLC.

Left ventricular calcification following postpartum toxic shock syndrome

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Stella C Pak

2018-01-01

Full Text Available Toxic shock syndrome (TSS is a rare but lethal clinical event that can occur during the postpartum period. Early recognition and intervention is critical to improve patient outcomes. This is a case of TSS complicated by cardiac arrest and left ventricular calcification. This is a case report of streptococcal TSS in a 29-year-old female in the postpartum period who presented with fever, abdominal distension, and a purpuric rash. Her hospital course was characterized by multiple organ failure, including respiratory distress syndrome, liver failure, renal failure, and coagulopathy. She was found to have acute compartment syndrome, which resulted in a below-the-knee amputation. She deteriorated further after experiencing cardiac arrest and the development of hypoxic-ischemic encephalopathy with hemorrhagic transformation. A computed tomography scan of the chest revealed evidence of dystrophic myocardial calcification in the left ventricle. She improved clinically but remained ventilator dependent upon discharge to an extended acute care facility. Sepsis-induced cardiomyopathy can result in myocardial calcification. As dystrophic calcification can significantly affect cardiac function, clinicians should rule out cardiac calcification in patients who have had severe septic shock.

Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan.

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Sada, Ryuichi; Fukuda, Saori; Ishimaru, Hiroyasu

2017-01-01

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis due to a cleft narrowing associated with vulvar lichen sclerosus. Both patients were admitted to our hospital with septic shock and severe acute kidney injury and subsequently recovered with appropriate antibiotic treatment. In our review of the literature, 8 cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus were reported in Japan. In these 8 cases, the main portals of entry were the skin and respiratory tract; however, the portal of entry of Community-acquired methicillin-resistant Staphylococcus aureus from a vaginal lesion has not been reported in Japan previously.

Fatal toxic leukoencephalopathy secondary to overdose of a new psychoactive designer drug 2C-E ("Europa").

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Sacks, Justin; Ray, M Jordan; Williams, Sue; Opatowsky, Michael J

2012-10-01

We present a case of a fatal toxic leukoencephalopathy following ingestion of a new psychoactive designer drug known as 2C-E or "Europa." Recreational drugs, particularly hallucinogenic substances, appear to be growing in popularity, with increasing amounts of information available via the Internet to entice potential users. In addition, some newer "designer" psychoactive substances are available for purchase online without adverse legal consequences, therefore adding to their popularity. We describe magnetic resonance imaging (MRI) findings to include selective diffuse toxic injury of the cerebral white matter with sparing of the cortex and most of the deep gray nuclei. To our knowledge, this is the first reported description of cerebral findings on MRI that are likely related to a lethal ingestion of 2C-E.

Near fatal 5-FU gut toxicity post surgery--remarkable effect of high-dose sucralfate.

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Toh, James Wei Tatt; Morris, David; Chen, Zhuoran; Chen, Cindy

2015-06-01

The objective of this review article and case report was to investigate the effectiveness of high-dose sucralfate on severe life-threatening 5-fluorouracil (5-FU) gut toxicity, with reference to, but not limited to dihydropyrimidine dehydrogenase (DPD) deficiency. A search was conducted on PubMed from 1950 to July 2013 for original studies on 5-FU gut toxicity and sucralfate. Studies were limited to human trials and English language and all articles included in this study were assessed with the application of predetermined selection criteria. Each article was then reviewed independently by two reviewers. A case report from our own centre was included in this review. From 33 results, 6 manuscripts were identified including 4 randomized controlled trial. One trial evaluated the use of sucralfate to alleviate stomatitis in patients with 5-FU-based chemotherapy. The other three trials evaluated the role of sucralfate in radiation toxicity. There was one case report which showed gastroscopy confirmed normalization of severe dysplastic erosive gastroduodenitis attributed to hepatic arterial infusion of 5-FU following a 2-month course of sucralfate and cimetidine and one case series showing clinical and sigmoidoscopically demonstrated improvement in ulcerative colitis in majority of patients receiving sucralfate enemas. There was no current literature specifically focussed on the role of sucralfate in 5-FU gut toxicity. Our case report describes the clinical course and successful treatment with sucralfate of a patient with Pseudomyxoma peritonei (PMP) who experienced 5-FU gut toxicity resulting in life-threatening bleeding due to presumed DPD deficiency post intraperitoneal 5-FU administration. This review article showed a lack of literature concerning the use of sucralfate in 5-FU gut toxicity. In our patient's case, sucralfate had a crucial role in the management of near fatal 5-FU gut toxicity, and further evaluation is required.

Fatal toxic leukoencephalopathy secondary to overdose of a new psychoactive designer drug 2C-E (“Europa”)

OpenAIRE

Sacks, Justin; Ray, M. Jordan; Williams, Sue; Opatowsky, Michael J.

2012-01-01

We present a case of a fatal toxic leukoencephalopathy following ingestion of a new psychoactive designer drug known as 2C-E or “Europa.” Recreational drugs, particularly hallucinogenic substances, appear to be growing in popularity, with increasing amounts of information available via the Internet to entice potential users. In addition, some newer “designer” psychoactive substances are available for purchase online without adverse legal consequences, therefore adding to their popularity. We ...

IL-2 regulates SEB induced toxic shock syndrome in BALB/c mice.

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Aslam Ali Khan

2009-12-01

Full Text Available Toxic Shock Syndrome (TSS is characterized by fever, rash, hypotension, constitutional symptoms, and multi-organ involvement and is caused by Staphylococcus aureus enterotoxins such as Staphylococcal Enterotoxin B (SEB. SEB binds to the MHC-IIalpha chain and is recognized by the TCRbeta chain of the Vbeta8 TCR(+ T cells. The binding of SEB to Vbeta chain results in rapid activation of T cells and production of inflammatory cytokines, such as Interleukin-2 (IL-2, Interferon-gamma and Tumor Necrosis Factor-alpha which mediate TSS. Although IL2 was originally identified as the T cell growth factor and was proposed to contribute to T cell differentiation, its role in TSS remains unexplored.Mice were injected with D-Gal (25 mg/mouse. One hour after D-Galactosamine (D-Gal injection each mouse was injected with SEB (20 microg/mouse. Mice were then observed for 72 hrs and death was recorded at different times. We tested Interleukin-12, IFNgamma, and IL-2 deficient mice (IL-2(-/-, but only the IL-2 deficient mice were resistant to SEB induced toxic shock syndrome. More importantly reconstitution of IL-2 in IL-2 deficient mice restored the shock. Interestingly, SEB induced IL-2 production from T cells was dependent on p38MAPK activation in macrophages as inhibition of it in macrophages significantly inhibited IL-2 production from T cells.This study shows the importance of IL -2 in TSS which has not been previously explored and it also shows that regulating macrophages function can regulate T cells and TSS.

Toxic shock syndrome following inguinal hernia repair: a rare condition

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Rohit Prasad Yadav

2014-01-01

Full Text Available A 25-year-old man developed fulminant multisystem failure 28 hours after elective repair of an inguinal hernia. Toxic shock syndrome (TSS was diagnosed. The patient recovered fully with supportive care in ICU, antibiotics, and IV human immunoglobin . To the best of our knowledge, only one case of TSS following inguinal hernia repair have ever been previously published. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 57-59 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9689

Fatal poisonings in Oslo: a one-year observational study.

Science.gov (United States)

Bjornaas, Mari A; Teige, Brita; Hovda, Knut E; Ekeberg, Oivind; Heyerdahl, Fridtjof; Jacobsen, Dag

2010-06-06

Acute poisonings are common and are treated at different levels of the health care system. Since most fatal poisonings occur outside hospital, these must be included when studying characteristics of such deaths. The pattern of toxic agents differs between fatal and non-fatal poisonings. By including all poisoning episodes, cause-fatality rates can be calculated. Fatal and non-fatal acute poisonings in subjects aged > or =16 years in Oslo (428 198 inhabitants) were included consecutively in an observational multi-centre study including the ambulance services, the Oslo Emergency Ward (outpatient clinic), and hospitals, as well as medico-legal autopsies from 1st April 2003 to 31st March 2004. Characteristics of fatal poisonings were examined, and a comparison of toxic agents was made between fatal and non-fatal acute poisoning. In Oslo, during the one-year period studied, 103 subjects aged > or =16 years died of acute poisoning. The annual mortality rate was 24 per 100 000. The male-female ratio was 2:1, and the mean age was 44 years (range 19-86 years). In 92 cases (89%), death occurred outside hospital. The main toxic agents were opiates or opioids (65% of cases), followed by ethanol (9%), tricyclic anti-depressants (TCAs) (4%), benzodiazepines (4%), and zopiclone (4%). Seventy-one (69%) were evaluated as accidental deaths and 32 (31%) as suicides. In 70% of all cases, and in 34% of suicides, the deceased was classified as drug or alcohol dependent. When compared with the 2981 non-fatal acute poisonings registered during the study period, the case fatality rate was 3% (95% C.I., 0.03-0.04). Methanol, TCAs, and antihistamines had the highest case fatality rates; 33% (95% C.I., 0.008-0.91), 14% (95% C.I., 0.04-0.33), and 10% (95% C.I., 0.02-0.27), respectively. Three per cent of all acute poisonings were fatal, and nine out of ten deaths by acute poisonings occurred outside hospital. Two-thirds were evaluated as accidental deaths. Although case fatality rates were

Diversity of Dominant Bacterial Taxa in Activated Sludge Promotes Functional Resistance following Toxic Shock Loading

KAUST Repository

Saikaly, Pascal

2010-12-14

Examining the relationship between biodiversity and functional stability (resistance and resilience) of activated sludge bacterial communities following disturbance is an important first step towards developing strategies for the design of robust biological wastewater treatment systems. This study investigates the relationship between functional resistance and biodiversity of dominant bacterial taxa by subjecting activated sludge samples, with different levels of biodiversity, to toxic shock loading with cupric sulfate (Cu[II]), 3,5-dichlorophenol (3,5-DCP), or 4-nitrophenol (4-NP). Respirometric batch experiments were performed to determine the functional resistance of activated sludge bacterial community to the three toxicants. Functional resistance was estimated as the 30 min IC50 or the concentration of toxicant that results in a 50% reduction in oxygen utilization rate compared to a referential state represented by a control receiving no toxicant. Biodiversity of dominant bacterial taxa was assessed using polymerase chain reaction-terminal restriction fragment length polymorphism (PCR-T-RFLP) targeting the 16S ribosomal RNA (16S rRNA) gene. Statistical analysis of 30 min IC50 values and PCR-T-RFLP data showed a significant positive correlation (P<0.05) between functional resistance and microbial diversity for each of the three toxicants tested. To our knowledge, this is the first study showing a positive correlation between biodiversity of dominant bacterial taxa in activated sludge and functional resistance. In this system, activated sludge bacterial communities with higher biodiversity are functionally more resistant to disturbance caused by toxic shock loading. © 2010 Springer Science+Business Media, LLC.

Toxic shock syndrome due to community-acquired methicillin-resistant Staphylococcus aureus infection: Two case reports and a literature review in Japan

OpenAIRE

Sada, Ryuichi; Fukuda, Saori; Ishimaru, Hiroyasu

2017-01-01

Community-acquired methicillin-resistant Staphylococcus aureus has been spreading worldwide, including in Japan. However, few cases of toxic shock syndrome caused by Community-acquired methicillin-resistant Staphylococcus aureus have been reported in Japan. We report 2 cases, in middle-aged women, of toxic shock syndrome due to Community-acquired methicillin-resistant Staphylococcus aureus via a vaginal portal of entry. The first patient had used a tampon and the second patient had vaginitis ...

Fatal invasive aspergillosis: a rare co-infection with an unexpected image presentation in a patient with dengue shock syndrome.

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Wang, Hui-Ching; Chang, Ko; Lu, Po-Liang; Tsai, Kun-Bow; Chen, Huang-Chi

2017-03-01

Pulmonary infiltration and pleural effusion caused by permeability syndrome are the hallmark of pulmonary manifestation of dengue cases. We report a 95-year-old chronic obstructive pulmonary disease case having dengue shock syndrome. Chest X-ray examination revealed diffuse lung infiltration. However, bilateral pneumotoceles were unexpectedly found in computed tomography (CT) images. Dengue virus type 2 infection was confirmed by virus culture, serology and reverse transcriptase-polymerase chain reaction. Profound shock with bilateral lung infiltration developed rapidly in 2 days with supportive care and empirical ampicillin/ sulbactam. Bronchoscopy revealed a whitish plaque over bilateral upper bronchi. Biopsy via bronchoscopy revealed moulds with vascular invasion. Culture of bronchial alveolar lavage yielded Aspergillus flavus. The patient died despite amphotericin B treatment, which was started since finding the whitish plaque with bronchoscopy examination. Besides to considering capillary leakage syndrome, our case report and literature review alert clinicians that CT and bronchoscopy may help to identify the true pathogen though all cases with concurrent dengue and Aspergillus infections had fatal outcomes. © 2015 John Wiley & Sons Ltd.

Fatal Candidemia in a Patient with Acute Lymphoblastic Leukemia

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2018-02-16

Profoosionaf 7 ,0 Fatal Candidemia in a Patient with Acute Lymphoblastic Leukemia Brittany Lenz, MD, Arturo Dominguez, MD, Adnan Mir, MD, PhD Objectives...with pre-B cell acute lymphoblastic leukemia was admitted for presumed septic shock secondary to an unknown infectious etiology. The patient was...NOTES 14. ABSTRACT Fatal Candidcn1ia in a Patient \\\\ith Acute Lympboblastic Leukemia Brittany Lenz. MD. Arturo Dominguez.. MD. Adnan J’vlir. MD, PhD

Necrotizing fasciitis with toxic shock syndrome in 5 month old baby: A case report

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Abbas Al-Ramzi

2017-12-01

Full Text Available Necrotizing fasciitis is considered to be a severe form of soft-tissue infection that is accompanied with rapidly progressive necrosis to the subcutaneous tissue layer and the superficial fascia. It is also characterized by early development of systemic toxicity. The invasive Streptococcus pyogenes is the most often encountered species as a cause of this disease. The delay in diagnosing is common as the differentiation of the evolving necrotizing fasciitis from cellulitis can be very difficult. Treatments include rapid radical debridement and administration of appropriate antibiotics. However, even with proper treatment, the mortality rate is considered to be high. We reported a 5-month-old girls with fatal necrotizing fasciitis associated with toxic shock–like syndrome due to Streptococcal infection.

Optic atrophy, necrotizing anterior scleritis and keratitis presenting in association with Streptococcal Toxic Shock Syndrome: a case report

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Papageorgiou Konstantinos I

2008-02-01

Full Text Available Abstract Introduction We report a case of optic atrophy, necrotizing anterior scleritis and keratitis presenting in a patient with Streptococcal Toxic Shock Syndrome. Case presentation A 43-year-old woman developed streptococcal toxic shock syndrome secondary to septic arthritis of her right ankle. Streptococcus pyogenes (b-haemolyticus Group A was isolated from blood cultures and joint aspirate. She was referred for ophthalmology review as her right eye became injected and the pupil had become unresponsive to light whilst she was in the Intensive Therapy Unit (ITU. The iris appeared atrophic and was mid-dilated with no direct or consensual response to light. Three zones of sub-epithelial opacification where noted in the cornea. There where extensive posterior synechiae. Indirect ophthalmoscopy showed a pale right disc. The vision was reduced to hand movements (HM. A diagnosis of optic atrophy was made secondary to post-streptococcal uveitis. She subsequently developed a necrotizing anterior scleritis. Conclusion This case illustrates a previously unreported association of optic atrophy, necrotizing anterior scleritis and keratitis in a patient with post-streptococcal uveitis. This patient had developed Streptococcal Toxic Shock Syndrome secondary to septic arthritis. We recommend increased awareness of the potential risks of these patients developing severe ocular involvement.

Clostridium sordellii as a Cause of Fatal Septic Shock in a Child with Hemolytic Uremic Syndrome

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Rebekah Beyers

2014-01-01

Full Text Available Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC database infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS. The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU for initiation of peritoneal dialysis (PD. Due to increased edema and intolerance of PD, he was transitioned to hemodialysis through a femoral vascular catheter. He subsequently developed severe septic shock with persistent leukocytosis and hypotension, resulting in subsequent death. Stool culture confirmed Shiga toxin producing Escherichia coli 0157:H7. A blood culture was positively identified for Clostridium sordellii. Clostridium sordelli is rarely reported in children; to our knowledge this is the first case described in a pediatric patient with HUS.

Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiae subspecies equisimilis in breast cancer-related lymphedema: a case report.

Science.gov (United States)

Sumazaki, Makoto; Saito, Fumi; Ogata, Hideaki; Yoshida, Miho; Kubota, Yorichika; Magoshi, Syunsuke; Kaneko, Hironori

2017-07-14

Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease.

Fulminant Necrotizing Fasciitis and Toxic Shock Syndrome Caused by Streptococcus agalactiae

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Emin UYSAL

2018-03-01

Full Text Available Necrotizing fasciitis is a rare and life-threatening soft tissue infection that spreads rapidly and involves the skin, subcutaneous tissue, fascia, and muscle layer. The treatment is possible by initiating appropriate antibiotherapy for the clinically suspected cause and by performing surgical intervention quickly and aggressively. However, it should be known that necrotizing fasciitis is a disease that is difficult to manage despite all interventions, effective treatment protocols, and patient care. This article presents the case of a 60-year-old patient with diabetes mellitus who died of toxic shock syndrome with fulminant necrotizing fasciitis caused by Streptococcus agalactiae.

[A postpartum woman with toxic shock syndrome: group A streptococcal infection, a much feared postpartum complication.

NARCIS (Netherlands)

Abbink, K.; Kortekaas, J.C.; Buise, M.P.; Dokter, J.; Kuppens, S.M.; Hasaart, T.H.M.

2016-01-01

BACKGROUND: The development of toxic shock syndrome (TSS) after an invasive group A streptococcal (GAS) infection in the postpartum period is a much feared complication. The mortality rate of TSS with necrotizing fasciitis is 30 to 50%. CASE DESCRIPTION: We present the case of a woman with atypical

Glovebox-contained forty-millimeter gun system for the study of one-dimensional shock waves in toxic materials

International Nuclear Information System (INIS)

Honodel, C.A.

1975-01-01

A new gun system is being constructed at the Lawrence Livermore Laboratory for studies of the behavior of toxic materials under shock-loaded conditions. Due to the extreme toxicity of some materials, such as plutonium, the entire gun system must be enclosed in gloveboxes. Some of the experimental requirements that affected the design of the system, various diagnostic techniques that will be employed with the system, and some details of the final design that is presently under assembly are presented

FATAL GROUP A STREPTOCOCCAL TOXIC SHOCK-LIKE SYNDROME IN A CHILD WITH VARICELLA: REPORT OF THE FIRST WELL DOCUMENTED CASE WITH DETECTION OF THE GENETIC SEQUENCES THAT CODE FOR EXOTOXINS SPE A AND B, IN SÃO PAULO, BRAZIL

Directory of Open Access Journals (Sweden)

SZTAJNBOK Jaques

1999-01-01

Full Text Available A previously healthy seven-year-old boy was admitted to the intensive care unit because of toxaemia associated with varicella. He rapidly developed shock and multisystem organ failure associated with the appearance of a deep-seated soft tissue infection and, despite aggressive treatment, died on hospital day 4. An M-non-typable, spe A and spe B positive Group A Streptococcus was cultured from a deep soft tissue aspirate. The criteria for defining Streptococcal toxic shock-like syndrome were fulfilled. The authors discuss the clinical and pathophysiological aspects of this disease as well as some unusual clinical findings related to this case.

Fatal anaphylactoid reaction following ioversol administration

NARCIS (Netherlands)

Jansman, Frank G. A.; Kieft, Hans; Harting, Johannes W.

2007-01-01

We report a fatal intravenous ioversol administration in a 60-year old male patient. Although the introduction of new low-osmolar non-ionogenic contrast media with a more favourable efficacy-toxicity balance has diminished the side-effects significantly, everyone involved in radiodiagnostic

An Alternative Approach to Combination Vaccines: Intradermal Administration of Isolated Components for Control of Anthrax, Botulism, Plague and Staphylococcal Toxic Shock

National Research Council Canada - National Science Library

Morefield, Garry L; Tammariello, Ralph F; Purcell, Bret K; Worsham, Patricia L; Chapman, Jennifer; Smith, Leonard A; Alarcon, Jason B; Mikszta, John A; Ulrich, Robert G

2008-01-01

... incompatible vaccine mixtures. Intradermally administered arrays of vaccines for protection from anthrax, botulism, plague, and staphylococcal toxic shock were biocompatible in vivo, retained potent antibody responses...

Enhancing Signal Output and Avoiding BOD/Toxicity Combined Shock Interference by Operating a Microbial Fuel Cell Sensor with an Optimized Background Concentration of Organic Matter

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Yong Jiang

2016-08-01

Full Text Available In the monitoring of pollutants in an aquatic environment, it is important to preserve water quality safety. Among the available analysis methods, the microbial fuel cell (MFC sensor has recently been used as a sustainable and on-line electrochemical microbial biosensor for biochemical oxygen demand (BOD and toxicity, respectively. However, the effect of the background organic matter concentration on toxicity monitoring when using an MFC sensor is not clear and there is no effective strategy available to avoid the signal interference by the combined shock of BOD and toxicity. Thus, the signal interference by the combined shock of BOD and toxicity was systematically studied in this experiment. The background organic matter concentration was optimized in this study and it should be fixed at a high level of oversaturation for maximizing the signal output when the current change (ΔI is selected to correlate with the concentration of a toxic agent. When the inhibition ratio (IR is selected, on the other hand, it should be fixed as low as possible near the detection limit for maximizing the signal output. At least two MFC sensors operated with high and low organic matter concentrations and a response chart generated from pre-experiment data were both required to make qualitative distinctions of the four types of combined shock caused by a sudden change in BOD and toxicity.

Pathological findings in 2 cases of fatal 25I-NBOMe toxicity.

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Walterscheid, Jeffrey P; Phillips, Garrett T; Lopez, Ana E; Gonsoulin, Morna L; Chen, Hsin-Hung; Sanchez, Luis A

2014-03-01

The research compound 25I-NBOMe, also known as CIMBI-5 or INBMeO, was created in academic laboratories as a potent serotonin 2A receptor agonist. Because of its high affinity and ambiguous legal status, recreational drug enthusiasts have used this compound as a powerful alternative to other hallucinogenic drugs such as lysergic acid diethylamide. We report 2 deaths after 25I-NBOMe ingestion by decedents who attended separate "rave" parties. The first case involved a 21-year-old male who admitted taking "acid" to his friend. A sudden violent rage caused him to flail about, and he subsequently became unresponsive. The postmortem examination revealed numerous external injuries that were consistent with physical aggression. The second case involved a 15-year-old female who was socializing outside a rave party, became ill, and rapidly deteriorated as her friend transported her to the hospital. The postmortem assessment was similar to the first case in that external contusions featured prominently. Comprehensive toxicology screens in both cases revealed only evidence of marijuana use. A deeper analysis using time-of-flight mass spectrometry revealed the presence of 25I-NBOMe, which was further confirmed by tandem-mass spectrometry. The behavior and injuries in these cases reveal a consistent pattern preceding fatal 25I-NBOMe toxicity.

Second Fatal Case of Infective Endocarditis caused by Gemella bergeriae

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Aijan Ukudeeva

2017-03-01

Full Text Available Our case illustrates a fatal course of infection with Gemella bergeriae endocarditis that was complicated by cardiogenic shock due to perforation of the mitral valve with severe mitral regurgitation, extension of infection into the myocardium adjacent to the mitral valve, and coronary sinus thrombosis.

Influence of the vaginal microbiota on toxic shock syndrome toxin 1 production by Staphylococcus aureus.

Science.gov (United States)

MacPhee, Roderick A; Miller, Wayne L; Gloor, Gregory B; McCormick, John K; Hammond, Jo-Anne; Burton, Jeremy P; Reid, Gregor

2013-03-01

Menstrual toxic shock syndrome (TSS) is a serious illness that afflicts women of premenopausal age worldwide and arises from vaginal infection by Staphylococcus aureus and concurrent production of toxic shock syndrome toxin-1 (TSST-1). Studies have illustrated the capacity of lactobacilli to reduce S. aureus virulence, including the capacity to suppress TSST-1. We hypothesized that an aberrant microbiota characteristic of pathogenic bacteria would induce the increased production of TSST-1 and that this might represent a risk factor for the development of TSS. A S. aureus TSST-1 reporter strain was grown in the presence of vaginal swab contents collected from women with a clinically healthy vaginal status, women with an intermediate status, and those diagnosed with bacterial vaginosis (BV). Bacterial supernatant challenge assays were also performed to test the effects of aerobic vaginitis (AV)-associated pathogens toward TSST-1 production. While clinical samples from healthy and BV women suppressed toxin production, in vitro studies demonstrated that Streptococcus agalactiae and Enterococcus spp. significantly induced TSST-1 production, while some Lactobacillus spp. suppressed it. The findings suggest that women colonized by S. aureus and with AV, but not BV, may be more susceptible to menstrual TSS and would most benefit from prophylactic treatment.

[Toxic-shock syndrome. Three cases (author's transl)].

Science.gov (United States)

Rapin, M; D'Enfert, J; Cabane, J

1981-06-13

Several cases of toxic shock syndrome (T.S.S) have been recently reported from the U.S.A. Clinical features of this new syndrome include fever, desquamative scarlatiniform rash, hypotension and involvement of central nervous system, liver, kidney and muscles. More than 90% of cases are women with staphylococcic vaginitis using tampons during menstruations. A toxin produced by staphylococcus aureus is thought to be the causative agent, because the germ has been isolated in local (vaginal, pharyngeal, subcutaneous or other sites) but not systemic (blood, cerebrospinal fluid) cultures. The mortality rate is 3-10%, and relapse can occur. We report the first three french cases of T.S.S.: a 17 year old girl with typical tampon-associated vaginitis, a 36 year old woman with a postoperative peritonitis and a 20 year old man with a popliteal abscess. Staphylococcus aureus of type I or IV was identified at the site of infection in all cases, but never in blood cultures. These three patients recovered with antistaphylococcic antibiotics and supportive therapy, but local treatment of infections seems to have been of utmost importance. These cases suggest that T.S.S. can occur with several staphylococcus serotypes and confirm that this syndrome is not always associated with tampons and vaginitis.

A fatal case of thallium toxicity: challenges in management.

Science.gov (United States)

Riyaz, R; Pandalai, S L; Schwartz, M; Kazzi, Z N

2013-03-01

Thallium is a highly toxic compound and is occasionally involved in intentional overdoses or criminal poisonings. Accidental poisonings also occur, but are increasingly rare owing to restricted use and availability of thallium. We report a fatal suicidal ingestion of thallium sulfate rodenticide in which multi-dose activated charcoal (MDAC) and Prussian Blue (PB) were both used without changing the outcome. A 36 year old man ingested an unknown amount of thallium sulfate grains from an old rodenticide bottle. He presented to an emergency department (ED) 45 minutes later with abdominal pain and vomiting. On examination he was agitated with a blood pressure of 141/60 mmHg and a heart rate of 146 beats per minute (bpm). He received MDAC during his initial ED management and was started on PB 18 hours post arrival; he was intubated on the following day for airway protection. The patient continued to be tachycardic and hypertensive and subsequently developed renal failure. On hospital day three, the patient developed hypotension that did not respond to fluids. The patient required vasopressors and was transferred to a tertiary care center to undergo continuous renal replacement therapy (CRRT). The patient died shortly after his transfer. His last blood thallium concentration was 5369 mcg/L, a spot urine thallium >2000 mcg/L, and a 24- hour urine thallium was >2000 mcg/L. Though extremely rare, thallium intoxication can be lethal despite early administration of MDAC and use of Prussian blue therapy. Rapid initiation of hemodialysis can be considered in cases of severe thallium poisoning, to remove additional thallium, to correct acid-base disturbance, or to improve renal function.

Fatal acute pulmonary injury associated with everolimus.

Science.gov (United States)

Depuydt, Pieter; Nollet, Joke; Benoit, Dominique; Praet, Marleen; Caes, Frank

2012-03-01

To report a case of fatal alveolar hemorrhage associated with the use of everolimus in a patient who underwent a solid organ transplant. In a 71-year-old cardiac transplant patient, cyclosporine was replaced with everolimus because of worsening renal function. Over the following weeks, the patient developed nonproductive cough and increasing dyspnea. His condition deteriorated to acute respiratory failure with hemoptysis, requiring hospital admission. Bilateral patchy alveolar infiltrates were apparent on chest X-ray and computed tomography. Cardiac failure was ruled out and empiric antimicrobial therapy was initiated. Additional extensive workup could not document opportunistic infection. Everolimus was discontinued and high-dose corticosteroid therapy was initiated. Despite this, the patient required invasive mechanical ventilation and died because of refractory massive hemoptysis. Autopsy revealed diffuse alveolar hemorrhage. Everolimus is a mammalian target of rapamycin inhibitor approved for use as an immunosuppressant and antineoplastic agent. Its main advantage over calcineurin inhibitors (tacrolimus and cyclosporine) is a distinct safety profile. Although it has become clear that everolimus induces pulmonary toxicity more frequently than initially thought, most published cases thus far represented mild and reversible disease, and none was fatal. Here, we report a case of pulmonary toxicity developing over weeks following the introduction of everolimus, in which a fatal outcome could not be prevented by drug withdrawal and corticosteroid treatment. The association of everolimus and this syndrome was probable according to the Naranjo probability scale. This case indicates that with the increasing use of everolimus, clinicians should be aware of the rare, but life-threatening manifestation of pulmonary toxicity.

A review of drug therapy for sporadic fatal insomnia.

Science.gov (United States)

Tabaee Damavandi, Pardis; Dove, Martin T; Pickersgill, Richard W

2017-09-03

Sporadic fatal insomnia (sFI) is a rapid progressive neurodegenerative disease characterised by gradual to perpetual insomnia, followed by dysautonomia, coma and death. 1 The cause of sFI was recently mapped to a mutation in a protein, the prion, found in the human brain. It is the unfolding of the prion that leads to the generation of toxic oligomers that destroy brain tissue and function. Recent studies have confirmed that a methionine mutation at codon 129 of the human Prion is characteristic of sFI. Current treatment slows down the progression of the disease, but no cure has been found, yet. We used Molecular Docking and Molecular Dynamics simulation methods, to study the toxic Fatal-Insomnia-prion conformations at local unfolding. The idea was to determine these sites and to stabilise these regions against unfolding and miss-folding, using a small ligand, based on a phenothiazine "moiety". As a result we here discuss current fatal insomnia therapy and present seven novel possible compounds for in vitro and in vivo screening.

Fatal attraction: adaptations to prey on native frogs imperil snakes after invasion of toxic toads.

Science.gov (United States)

Hagman, Mattias; Phillips, Benjamin L; Shine, Richard

2009-08-07

Adaptations that enhance fitness in one situation can become liabilities if circumstances change. In tropical Australia, native snake species are vulnerable to the invasion of toxic cane toads. Death adders (Acanthophis praelongus) are ambush foragers that (i) attract vertebrate prey by caudal luring and (ii) handle anuran prey by killing the frog then waiting until the frog's chemical defences degrade before ingesting it. These tactics render death adders vulnerable to toxic cane toads (Bufo marinus), because toads elicit caudal luring more effectively than do native frogs, and are more readily attracted to the lure. Moreover, the strategy of delaying ingestion of a toad after the strike does not prevent fatal poisoning, because toad toxins (unlike those of native frogs) do not degrade shortly after the prey dies. In our laboratory and field trials, half of the death adders died after ingesting a toad, showing that the specialized predatory behaviours death adders use to capture and process prey render them vulnerable to this novel prey type. The toads' strong response to caudal luring also renders them less fit than native anurans (which largely ignored the lure): all toads bitten by adders died. Together, these results illustrate the dissonance in behavioural adaptations that can arise following the arrival of invasive species, and reveal the strong selection that occurs when mutually naive species first interact.

Fatal Candida septic shock during systemic chemotherapy in lung cancer patient receiving corticosteroid replacement therapy for hypopituitarism. A case report

International Nuclear Information System (INIS)

Morichika, Daisuke; Sato-Hisamoto, Akiko; Hotta, Katsuyuki

2014-01-01

Invasive candidiasis has increased as nosocomial infection recently in cancer patients who receive systemic chemotherapy, and the timely risk assessment for developing such specific infection is crucial. Especially in those concomitantly with hypopituitarism, febrile neutropenia with candidiasis can cause severe stress and lead potentially to sudden fatal outcome when the temporal steroid coverage for the adrenal insufficiency is not fully administered. We report a 72-year-old male case diagnosed as non-small-cell lung cancer, Stage 3A. He had received a steroid replacement therapy for the prior history of hypophysectomy due to pituitary adenoma with hydrocortisone of 3.3 mg/day, equivalent to prednisolone of 0.8 mg/day. This very small dosage of steroid was hardly supposed to weaken his immune system, but rather potentially led to an inappropriate supplementation of his adrenal function, assuming that the serum sodium and chlorine levels decreased. On Day 6 of second cycle of chemotherapy with carboplatin and paclitaxel, he developed sudden febrile neutropenia, septic shock and ileus, leading to death. After his death, the venous blood culture on Day 7 detected Candida albicans. Autopsy findings showed a massive necrotizing enterocolitis with extensive Candida invasion into submucous tissue. In conclusion, this case may suggest that (1) immediate initiation of antifungal therapy soon after the careful risk assessment of Candida infection and (2) adequate administration of both basal steroid replacement therapy and temporal steroid coverage for febrile neutropenia might have improved his fatal outcome. (author)

Analyzing temozolomide medication errors: potentially fatal.

Science.gov (United States)

Letarte, Nathalie; Gabay, Michael P; Bressler, Linda R; Long, Katie E; Stachnik, Joan M; Villano, J Lee

2014-10-01

The EORTC-NCIC regimen for glioblastoma requires different dosing of temozolomide (TMZ) during radiation and maintenance therapy. This complexity is exacerbated by the availability of multiple TMZ capsule strengths. TMZ is an alkylating agent and the major toxicity of this class is dose-related myelosuppression. Inadvertent overdose can be fatal. The websites of the Institute for Safe Medication Practices (ISMP), and the Food and Drug Administration (FDA) MedWatch database were reviewed. We searched the MedWatch database for adverse events associated with TMZ and obtained all reports including hematologic toxicity submitted from 1st November 1997 to 30th May 2012. The ISMP describes errors with TMZ resulting from the positioning of information on the label of the commercial product. The strength and quantity of capsules on the label were in close proximity to each other, and this has been changed by the manufacturer. MedWatch identified 45 medication errors. Patient errors were the most common, accounting for 21 or 47% of errors, followed by dispensing errors, which accounted for 13 or 29%. Seven reports or 16% were errors in the prescribing of TMZ. Reported outcomes ranged from reversible hematological adverse events (13%), to hospitalization for other adverse events (13%) or death (18%). Four error reports lacked detail and could not be categorized. Although the FDA issued a warning in 2003 regarding fatal medication errors and the product label warns of overdosing, errors in TMZ dosing occur for various reasons and involve both healthcare professionals and patients. Overdosing errors can be fatal.

A glimpse of streptococcal toxic shock syndrome from comparative genomics of S. suis 2 Chinese isolates

DEFF Research Database (Denmark)

Chen, Chen; Tang, Jiaqi; Dong, Wei

2007-01-01

shock syndrome (STSS), which was originally associated with Streptococcus pyogenes (GAS) in Streptococci. However, the molecular mechanisms underlying STSS are poorly understood. METHODS AND FINDINGS: To elucidate the genetic determinants of STSS caused by SS2, whole genome sequencing of 3 different......BACKGROUND: Streptococcus suis serotype 2 (SS2) is an important zoonotic pathogen, causing more than 200 cases of severe human infection worldwide, with the hallmarks of meningitis, septicemia, arthritis, etc. Very recently, SS2 has been recognized as an etiological agent for streptococcal toxic...

Toxic Shock Syndrome Toxin-1-Mediated Toxicity Inhibited by Neutralizing Antibodies Late in the Course of Continual in Vivo and in Vitro Exposure

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Norbert Stich

2014-05-01

Full Text Available Toxic shock syndrome (TSS results from the host’s overwhelming inflammatory response and cytokine storm mainly due to superantigens (SAgs. There is no effective specific therapy. Application of immunoglobulins has been shown to improve the outcome of the disease and to neutralize SAgs both in vivo and in vitro. However, in most experiments that have been performed, antiserum was either pre-incubated with SAg, or both were applied simultaneously. To mirror more closely the clinical situation, we applied a multiple dose (over five days lethal challenge in a rabbit model. Treatment with toxic shock syndrome toxin 1 (TSST-1 neutralizing antibody was fully protective, even when administered late in the course of the challenge. Kinetic studies on the effect of superantigen toxins are scarce. We performed in vitro kinetic studies by neutralizing the toxin with antibodies at well-defined time points. T-cell activation was determined by assessing T-cell proliferation (3H-thymidine incorporation, determination of IL-2 release in the cell supernatant (ELISA, and IL-2 gene activation (real-time PCR (RT-PCR. Here we show that T-cell activation occurs continuously. The application of TSST-1 neutralizing antiserum reduced IL-2 and TNFα release into the cell supernatant, even if added at later time points. Interference with the prolonged stimulation of proinflammatory cytokines is likely to be in vivo relevant, as postexposure treatment protected rabbits against the multiple dose lethal SAg challenge. Our results shed new light on the treatment of TSS by specific antibodies even at late stages of exposure.

Septic arthritis and subsequent fatal septic shock caused by Vibrio vulnificus infection

DEFF Research Database (Denmark)

Emamifar, Amir; Asmussen Andreasen, Rikke; Andersen, Nanna Skaarup

2015-01-01

Vibrio vulnificus is a rare but potential fatal bacterium that can cause severe infections. Wound infections, primary sepsis and gastroenteritis are the most common clinical features. Septic arthritis caused by V. vulnificus is an atypical presentation that has been reported in only two case...

Monoclonal antibodies protect from Staphylococcal Enterotoxin K (SEK) induced toxic shock and sepsis by USA300 Staphylococcus aureus.

Science.gov (United States)

Aguilar, Jorge L; Varshney, Avanish K; Pechuan, Ximo; Dutta, Kaushik; Nosanchuk, Joshua D; Fries, Bettina C

2017-08-18

Staphylococcus aureus is a leading infectious cause of life-threatening disease in humans, yet there is currently no vaccine to combat this bacterium. The pathogenesis of S. aureus is mediated by a diverse array of protein toxins including a large family of secreted pyrogenic superantigens. Neutralization of superantigens, including SEB and TSST-1, has proven to be protective in several animal models of toxic shock and sepsis. We demonstrate, for the first time, that a far more prevalent staphylococcal superantigen, SEK, can also induce lethal shock in mice. Additionally, we describe monoclonal antibodies (mAbs) that inhibit SEK-induced mitogenicity as well as protect against SEK-induced lethality, and enhance survival from S. aureus septicemia in murine models. MAb-4G3 (IgG2b), mAb-5G2 (IgG1), and mAb-9H2 (IgG1), all inhibit SEK-induced proliferation and cytokine production of human immune cells. We then demonstrate that passive immunization with a combination of mAb-4G3 and mAb-5G4, 2 mAbs that do not compete for epitope(s) on SEK, significantly enhance survival in a murine model of SEK-induced toxic shock (p = 0.006). In the setting of sepsis, passive immunization with this combination of mAbs also significantly enhances survival in mice after challenge with CA-MRSA strain USA300 (p = 0.03). Furthermore, septic mice that received mAb treatment in conjunction with vancomycin exhibit less morbidity than mice treated with vancomycin alone. Taken together, these findings suggest that the contribution of SEK to S. aureus pathogenesis may be greater than previously appreciated, and that adjunctive therapy with passive immunotherapy against SEs may be beneficial.

Review of fatal and severe cases of box jellyfish envenomation in Thailand.

Science.gov (United States)

Thaikruea, Lakkana; Siriariyaporn, Potjaman; Wutthanarungsan, Rochana; Smithsuwan, Punnarai

2015-03-01

The study aimed to describe severe and fatal cases of box jellyfish stings in Thailand. Medical records were reviewed and patients, relatives, health staffs, and witnesses were interviewed. The pictures of suspected box jellyfish were sent via e-mail to experts in the toxic jellyfish network for further identification. There were at least 8 cases of box jellyfish envenomation, with 4 fatal and 4 near-fatal cases. There were an equal number of male and female patients from 4 to 26 years of age. In each case, there was immediate severe pain followed by systemic reactions. Immediately after exposure to the sting, 7 victims collapsed experiencing severe pain at the tentacle marks, respiratory failure, and cardiac arrest. All patients had tentacle marks on their bodies. In none of the fatal cases was vinegar applied to the tentacle marks as first aid, but 3 out of the 4 near-fatal cases were treated with a vinegar application. © 2012 APJPH.

A Case of Mushroom Poisoning with Russula subnigricans: Development of Rhabdomyolysis, Acute Kidney Injury, Cardiogenic Shock, and Death.

Science.gov (United States)

Cho, Jong Tae; Han, Jin Hyung

2016-07-01

Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis.

Distribution and optical purity of methamphetamine found in toxic concentration in a civil aviation accident pilot fatality.

Science.gov (United States)

Chaturvedi, Arvind K; Cardona, Patrick S; Soper, John W; Canfield, Dennis V

2004-07-01

Toxicological evaluation of postmortem samples collected from a pilot involved in a unique fatal civil aircraft accident is described in this paper. A one-occupant airplane was substantially damaged upon colliding with terrain in poor visibility. Remains of the pilot were found outside the aircraft. Pathological examination revealed multiple blunt force injuries and vascular congestion. The fluorescence polarization immunoassay disclosed 8.0 microg/mL amphetamines in urine. Gas chromatographic/mass spectrometric analyses determined the presence of methamphetamine (1.13 microg/mL in blood and 59.2 microg/mL in urine) and amphetamine (0.022 microg/mL in blood and 1.50 microg/mL in urine). Methamphetamine was distributed throughout the body, including the brain. The amount of methamphetamine in gastric contents was 575-fold higher than that of amphetamine. The (+)- and (-)-forms of methamphetamine were present in equal proportions in gastric contents. The methamphetamine concentration found in blood was in the range sufficient to produce toxic effects, causing performance impairment.

Spatial distribution of cavitation-shock-pressure around a jet-flow gate-valve

International Nuclear Information System (INIS)

Oba, Risaburo; Takayama, Kazuyoshi; Ito, Yukio; Miyakura, Hideto; Nozaki, Satoru; Ishige, Tadashi; Sonoda, Shuji; Sakamoto, Kenji.

1987-01-01

To make clear the mechanism of cavitation erosion, the spatial distribution of cavitation shock pressures were quantitatively measured by a pressure sensitive sheet in the 1/10 scale model of a jet-flow gate-valve, for various valve-openings and cavitation numbers. The dynamic pressure response of the sheet was corrected by the shock wave generated from detonation explosives. It is made clear that the erosive shock pressures are distributed in a limited part of the whole cavitation region, and the safety region without the fatal cavitation erosion is defined. (author)

Cardiogenic shock following blunt chest trauma

Directory of Open Access Journals (Sweden)

Rodríguez-González Fayna

2010-01-01

Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

Is LSD toxic?

Science.gov (United States)

Nichols, David E; Grob, Charles S

2018-03-01

LSD (lysergic acid diethylamide) was discovered almost 75 years ago, and has been the object of episodic controversy since then. While initially explored as an adjunctive psychiatric treatment, its recreational use by the general public has persisted and on occasion has been associated with adverse outcomes, particularly when the drug is taken under suboptimal conditions. LSD's potential to cause psychological disturbance (bad trips) has been long understood, and has rarely been associated with accidental deaths and suicide. From a physiological perspective, however, LSD is known to be non-toxic and medically safe when taken at standard dosages (50-200μg). The scientific literature, along with recent media reports, have unfortunately implicated "LSD toxicity" in five cases of sudden death. On close examination, however, two of these fatalities were associated with ingestion of massive overdoses, two were evidently in individuals with psychological agitation after taking standard doses of LSD who were then placed in maximal physical restraint positions (hogtied) by police, following which they suffered fatal cardiovascular collapse, and one case of extreme hyperthermia leading to death that was likely caused by a drug substituted for LSD with strong effects on central nervous system temperature regulation (e.g. 25i-NBOMe). Given the renewed interest in the therapeutic potential of LSD and other psychedelic drugs, it is important that an accurate understanding be established of the true causes of such fatalities that had been erroneously attributed to LSD toxicity, including massive overdoses, excessive physical restraints, and psychoactive drugs other than LSD. Copyright © 2018 Elsevier B.V. All rights reserved.

[Group A streptococcus-induced toxic shock syndrome in pregnancy: a case report of cesarean section].

Science.gov (United States)

Yamada, Kumiko; Fukuda, Taeko; Kimura, Maiko; Hagiya, Keiichi; Danmura, Masato; Nakayama, Shin; Ogura, Tsuyoshi; Tanaka, Makoto

2012-12-01

Group A streptococcus (GAS)-induced toxic shock syndrome (TSS) in pregnancy is rare, but its clinical course is fulminant. The mortality rates of mother and fetus are reported to be 58 and 66%, respectively. We report a case of GAS-TSS after cesarean section. A 38-year-old pregnant woman of 38 weeks gestation was admitted to our hospital because of vomiting, fever of 39 degrees C, and continuous abdominal pain with scanty genital bleeding. She had complained of sore throat several days before. One hour after admission, external fetal monitoring revealed periodic pulse deceleration to 90 x beats min(-1). The emergent cesarean section was performed under general anesthesia. Approximately 8 hours after the cesarean section, she developed coma, shock and respiratory insufficiency requiring intubation. Streptococcus pyogens were isolated from her blood sample and the patient met criteria for GAS-TSS. She was treated with antibiotics (penicillin and clindamycin), antithrombin III, recomodulin, catecholamins, and continuous hemodialysis with filtration of toxins. Although the patient recovered and was discharged on 63rd day, the infant died on postpartum day 4. Early recognition and intensive treatment for GAS is recommended in a late stage pregnancy with an episode of sore throat, vomiting, high fever, strong labor pain, and DIC signs.

Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: a postmortem case report

International Nuclear Information System (INIS)

Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Saito, Haruo; Igari, Yui; Funayama, Masato

2013-01-01

Gallbladder injuries are extremely rare in blunt trauma, with a reported incidence of <2%. We report an autopsy case of fatal hemorrhagic shock due to intra-abdominal bleeding resulting from complete avulsion of the gallbladder associated with liver cirrhosis. Multiplanar images derived from multislice computed tomography (MSCT) performed as part of pre-autopsy screening showed complete avulsion of the gallbladder without any other associated intra-abdominal injuries, facilitating forensic autopsy planning. In this report, we discuss the role of MSCT in cases of fatal intra-abdominal bleeding caused by avulsion of the gallbladder and discuss the mechanism of this injury

Heat shock protein 90 in neurodegenerative diseases

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Rodina Anna

2010-06-01

Full Text Available Abstract Hsp90 is a molecular chaperone with important roles in regulating pathogenic transformation. In addition to its well-characterized functions in malignancy, recent evidence from several laboratories suggests a role for Hsp90 in maintaining the functional stability of neuronal proteins of aberrant capacity, whether mutated or over-activated, allowing and sustaining the accumulation of toxic aggregates. In addition, Hsp90 regulates the activity of the transcription factor heat shock factor-1 (HSF-1, the master regulator of the heat shock response, mechanism that cells use for protection when exposed to conditions of stress. These biological functions therefore propose Hsp90 inhibition as a dual therapeutic modality in neurodegenerative diseases. First, by suppressing aberrant neuronal activity, Hsp90 inhibitors may ameliorate protein aggregation and its associated toxicity. Second, by activation of HSF-1 and the subsequent induction of heat shock proteins, such as Hsp70, Hsp90 inhibitors may redirect neuronal aggregate formation, and protect against protein toxicity. This mini-review will summarize our current knowledge on Hsp90 in neurodegeneration and will focus on the potential beneficial application of Hsp90 inhibitors in neurodegenerative diseases.

[Septic shock in a patient with the Fournièr gangrene with fatal outcome].

Science.gov (United States)

Zonca, P; Mrázek, T; Matusek, A; Hajek, M; Stiglerová, S; Jurytko, A; Kucera, C; Nieslanik, M

2009-07-01

The authors present a case of a patient with developed Fournièr gangrene and septic shock. Fournièr gangrene belongs to the group of local non-specific infection of soft tissues (NSTI). Its incidence is relatively low, but the infection is extraordinary aggressive with a possible lethal end. 39 years old patient with 4 days history of Fournier gangrene's development was admitted in irreversible septic shock. The initial APACHE II score was 36. The delay in treatment was an important factor in the further course of illness with lethal end. Above the mentioned 39 years old patient died because of septic shock. The hemorrhagic cystitis was the original source of infection with further development of Fournièr gangrene according to the pathological record. We often come across all different kinds of stages of sepsis from the MODS to the septic shock for patients with Fournièr gangrene. Causal treatment should be started early. The local surgical excision and wide broad antibiotic administrations are basic treatments in the context of other treatment modalities according to the current patient's needs. The adjuvant hyperbaric oxygen treatment takes place in patients with Fournièr gangrene as well and is beneficial. The following factor even worsens the illness prognosis: delay in diagnostic, higher age, anorectal origin of infection, the amount of organ with dysfunction or failure, diabetes mellitus and significant immunodeficiency.

Clinical and Molecular Epidemiology of Staphylococcal Toxic Shock Syndrome in the United Kingdom

Science.gov (United States)

Sharma, Hema; Smith, Debra; Turner, Claire E.; Game, Laurence; Pichon, Bruno; Hope, Russell; Hill, Robert; Kearns, Angela

2018-01-01

Staphylococcal toxic shock syndrome (TSS) was originally described in menstruating women and linked to TSS toxin 1 (TSST-1)–producing Staphylococcus aureus. Using UK national surveillance data, we ascertained clinical, molecular and superantigenic characteristics of TSS cases. Average annual TSS incidence was 0.07/100,000 population. Patients with nonmenstrual TSS were younger than those with menstrual TSS but had the same mortality rate. Children <16 years of age accounted for 39% of TSS cases, most caused by burns and skin and soft tissue infections. Nonmenstrual TSS is now more common than menstrual TSS in the UK, although both types are strongly associated with the tst+ clonal complex (CC) 30 methicillin-sensitive S. aureus lineage, which accounted for 49.4% of all TSS and produced more TSST-1 and superantigen bioactivity than did tst+ CC30 methicillin-resistant S. aureus strains. Better understanding of this MSSA lineage and infections in children could focus interventions to prevent TSS in the future. PMID:29350159

Barcoding heat shock proteins to human diseases : looking beyond the heat shock response

NARCIS (Netherlands)

Kakkar, Vaishali; Meister-Broekema, Melanie; Minoia, Melania; Carra, Serena; Kampinga, Harm H.

There are numerous human diseases that are associated with protein misfolding and the formation of toxic protein aggregates. Activating the heat shock response (HSR) - and thus generally restoring the disturbed protein homeostasis associated with such diseases - has often been suggested as a

Reliability assessment of competing risks with generalized mixed shock models

International Nuclear Information System (INIS)

Rafiee, Koosha; Feng, Qianmei; Coit, David W.

2017-01-01

This paper investigates reliability modeling for systems subject to dependent competing risks considering the impact from a new generalized mixed shock model. Two dependent competing risks are soft failure due to a degradation process, and hard failure due to random shocks. The shock process contains fatal shocks that can cause hard failure instantaneously, and nonfatal shocks that impact the system in three different ways: 1) damaging the unit by immediately increasing the degradation level, 2) speeding up the deterioration by accelerating the degradation rate, and 3) weakening the unit strength by reducing the hard failure threshold. While the first impact from nonfatal shocks comes from each individual shock, the other two impacts are realized when the condition for a new generalized mixed shock model is satisfied. Unlike most existing mixed shock models that consider a combination of two shock patterns, our new generalized mixed shock model includes three classic shock patterns. According to the proposed generalized mixed shock model, the degradation rate and the hard failure threshold can simultaneously shift multiple times, whenever the condition for one of these three shock patterns is satisfied. An example using micro-electro-mechanical systems devices illustrates the effectiveness of the proposed approach with sensitivity analysis. - Highlights: • A rich reliability model for systems subject to dependent failures is proposed. • The degradation rate and the hard failure threshold can shift simultaneously. • The shift is triggered by a new generalized mixed shock model. • The shift can occur multiple times under the generalized mixed shock model.

Successful Treatment of Necrotizing Fasciitis and Streptococcal Toxic Shock Syndrome with the Addition of Linezolid

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Hana Rac

2017-01-01

Full Text Available Necrotizing fasciitis is a deep-seated subcutaneous tissue infection that is commonly associated with streptococcal toxic shock syndrome (TSS. Surgical debridement plus penicillin and clindamycin are the current standard of care. We report a case of necrotizing fasciitis and streptococcal TSS where linezolid was added after a failure to improve with standard therapy. Briefly after isolation of Streptococcus pyogenes from tissue cultures, the patient underwent two surgical debridement procedures and was changed to standard of care therapy. While the patient was hemodynamically stable, the patient’s wounds, leukocytosis, and thrombocytopenia all progressively worsened. After initiation of linezolid, the patient slowly improved clinically. The present report is the first to highlight the role of linezolid in streptococcal necrotizing fasciitis and TSS not improving with standard therapy.

Staphylococcal superantigens; toxic shock syndrome toxin-1 and enterotoxins in pediatric otitis media effusion: a brief report

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Noorbakhsh S

2013-03-01

Full Text Available Background: Staphylococcal superantigens (SAg's may have some role in otitis media with effusion (OME. The aim of this study was the search of staphylococcal SAg's in middle ear effusion of children with OME.  Methods: This cross sectional-analytic study was done in ENT & pediatric wards upon 64 children with otitis media with effusion (OME between 1-15 years, (mean age=7.42+4 years of Rasoul Akram University Hospital, Tehran, Iran in 2009-2011. Fifty six percent (36 of cases were male, 43.8% (28 were female. Staphylococcal SAg's; Toxic Shock Syndrome Toxin-1 (TSST-1, Staphylococcal enterotoxin A, B, C, D (Enzyme immune assay, AB Cam, USA were detected in middle ear effusion samples after conventional culture.Results: None type of SAg's found in 39% of OME cases, enterotoxin B found in: 22%; enterotoxin A: 17%, enterotoxin C: 15.6%, enterotoxin D: 12.5%, Toxic Shock Syndrome Toxin-1 (TSST-1: 7.8% Mean age of cases with positive TSST-1, enterotoxin A, B, C, and D was: 1, 5, 8.6, 9.6 and 9.6 years respectively. Positive TSST had no agreement with positive enterotoxin A and C but had weak agreement with type B and D. Mean age of cases with positive TSST was one years which had significant difference with (7.9 years in cases with negative TSST test (P<0.0001.Conclusion: At least one or more type of staphylococcal toxins had found in middle ear effusion of 70% of OME cases with negative culture for Staphylococcus aureus. Even in culture negative cases, staphylococcal toxins might have some immunologic role in middle ear effusion forming. Finding the SAg's (at least one type are important for treatment of immunosuppressive or corticosteroid in cases with resistant OME.

Regulation of lead toxicity by heat shock protein 90 (daf-21) is affected by temperature in Caenorhabditis elegans.

Science.gov (United States)

Wang, Yunbiao; Xu, Songbai; Liu, Jing; Zhang, Yanhui; Guo, Tai L

2014-06-01

In the nematode Caenorhabditis elegans, stress resistance can be regulated by dauer formation (daf) genes. In the present study, regulation of heavy metal lead (Pb) toxicity by the 90-kDa heat shock proteins (Hsp90; daf-21) was investigated in both wild-type C. elegans and daf-21/Hsp90 mutants by focusing on the effects of varied temperatures below (15°C) or above (25 and 30°C) the presumptive optimum growth temperature (20°C). More acute toxicity of Pb, indicated by the 24-h median lethal concentrations (LC50), was observed in wild-type adults than in the daf-21 mutant adults at 15, 20 and 25°C; however, the daf-21 mutant adults showed more sensitivity at 30°C. Enhanced Pb sensitivity (e.g., decrease LC50) in both types of C. elegans was observed with both increased and decreased temperatures when compared to that at 20°C. Additional examined endpoints included time course of toxicity at LC50s, pharyngeal pumping, reproduction, life span, and Hsp90 expression. Collective results showed that temperatures both above and below 20°C exacerbated Pb toxicity, and that the protein level of daf-21/Hsp90 was one of the most sensitive indicators of Pb toxicity in wild-type C. elegans, while pharyngeal pumping was more Pb sensitive in daf-21 mutants. Therefore, the expression of daf-21/Hsp90 has apparent utility for the prediction and assessment of Pb-induced toxicity in nematodes. Further, the stress responses related to Hsp90 expression in C. elegans may have considerable potential as sensitive biomarkers for the monitoring of environmental Pb contamination. Copyright © 2014 Elsevier Inc. All rights reserved.

ELABELA Improves Cardio-Renal Outcome in Fatal Experimental Septic Shock.

Science.gov (United States)

Coquerel, David; Chagnon, Frédéric; Sainsily, Xavier; Dumont, Lauralyne; Murza, Alexandre; Côté, Jérôme; Dumaine, Robert; Sarret, Philippe; Marsault, Éric; Salvail, Dany; Auger-Messier, Mannix; Lesur, Olivier

2017-11-01

Apelin-13 was recently proposed as an alternative to the recommended β-adrenergic drugs for supporting endotoxin-induced myocardial dysfunction. Since Apelin-13 signals through its receptor (Apelin peptide jejunum) to exert singular inotropic/vasotropic actions and to optimize body fluid balance, this candidate pathway might benefit septic shock management. Whether the newly discovered ELABELA (ELA), a second endogenous ligand of the Apelin peptide jejunum receptor highly expressed in the kidney, further improves cardio-renal impairment remains unknown. Interventional study in a rat model of septic shock (128 adult males) to assess the effects of ELA and Apelin-13 on vascular and cardio-renal function. Experiments were performed in a tertiary care University-based research institute. Polymicrobial sepsis-induced cardiac dysfunction was produced by cecal ligation puncture to assess hemodynamic efficacy, cardioprotection, and biomechanics under acute or continuous infusions of the apelinergic agonists ELA or Apelin-13 (39 and 15 µg/kg/hr, respectively) versus normal saline. Apelinergic agonists improved 72-hour survival after sepsis induction, with ELA providing the best clinical outcome after 24 hours. Apelinergic agonist infusion counteracted cecal ligation puncture-induced myocardial dysfunction by improving left ventricular pressure-volume relationship. ELA-treated cecal ligation puncture rats were the only group to 1) display a significant improvement in left ventricular filling as shown by increased E-wave velocity and left ventricular end-diastolic volume, 2) exhibit a higher plasma volume, and 3) limit kidney injury and free-water clearance. These beneficial renal effects were superior to Apelin-13, likely because full-length ELA enabled a distinctive regulation of pituitary vasopressin release. Activation of the apelinergic system by exogenous ELA or Apelin-13 infusion improves cardiovascular function and survival after cecal ligation puncture

Hydrogen sulfide toxicity in a thermal spring: a fatal outcome.

Science.gov (United States)

Daldal, Hale; Beder, Bayram; Serin, Simay; Sungurtekin, Hulya

2010-08-01

Hydrogen sulfide (H(2)S) is a toxic gas with the smells of "rotten egg"; its toxic effects are due to the blocking of cellular respiratory enzymes leading to cell anoxia and cell damage. We report two cases with acute H(2)S intoxication caused by inhalation of H(2)S evaporated from the water of a thermal spring. Two victims were found in a hotel room were they could take a thermal bath. A 26-year-old male was found unconscious; he was resuscitated, received supportive treatment and survived. A 25-year-old female was found dead. Autopsy showed diffuse edema and pulmonary congestion. Toxicological blood analysis of the female revealed the following concentrations: 0.68 mg/L sulfide and 0.21 mmol/L thiosulfate. The urine thiosulfate concentration was normal. Forensic investigation established that the thermal water was coming from the hotel's own illegal well. The hotel was closed. This report highlights the danger of H(2)S toxicity not only for reservoir and sewer cleaners, but also for individuals bathing in thermal springs.

Fatal Necrotizing Fasciitis following Episiotomy

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Faris Almarzouqi

2015-01-01

Full Text Available Introduction. Necrotizing fasciitis is an uncommon condition in general practice but one that provokes serious morbidity. It is characterized by widespread fascial necrosis with relative sparing of skin and underlying muscle. Herein, we report a fatal case of necrotizing fasciitis in a young healthy woman after episiotomy. Case Report. A 17-year-old primigravida underwent a vaginal delivery with mediolateral episiotomy. Necrotizing fasciitis was diagnosed on the 5th postpartum day, when the patient was referred to our tertiary care medical center. Surgical debridement was initiated together with antibiotics and followed by hyperbaric oxygen therapy. The patient died due to septic shock after 16 hours from the referral. Conclusion. Delay of diagnosis and consequently the surgical debridement were most likely the reasons for maternal death. In puerperal period, a physician must consider necrotizing fasciitis as a possible diagnosis in any local sings of infection especially when accompanied by fever and/or tenderness. Early diagnosis is the key for low mortality and morbidity.

[Fatal alveolar haemorrhage following a "bang" of cannabis].

Science.gov (United States)

Grassin, F; André, M; Rallec, B; Combes, E; Vinsonneau, U; Paleiron, N

2011-09-01

The new methods of cannabis consumption (home made water pipe or "bang") may be responsible for fatal respiratory complications. We present a case, with fatal outcome, of a man of 19 years with no previous history other than an addiction to cannabis using "bang". He was admitted to intensive care with acute dyspnoea. A CT scan showed bilateral, diffuse alveolar shadowing. He was anaemic with an Hb of 9.3g/l. Bronchoalveolar lavage revealed massive alveolar haemorrhage. Investigations for infection and immunological disorder were negative and toxicology was negative except for cannabis. Antibiotic treatment was given and favourable progress allowed early discharge. Death occurred 15 days later due to alveolar haemorrhage following a further "bang" of cannabis. Autopsy showed toxic alveolar haemorrhage. The probable mechanism is pulmonary damage due to acid anhydrides released by the incomplete combustion of cannabis in contact with plastic. These acids have a double effect on the lungs: a direct toxicity with severe inflammation of the mucosa leading to alveolar haemorrhage and subsequently the acid anhydrides may lead to the syndrome of intra-alveolar haemorrhage and anaemia described in occupational lung diseases by Herbert in Oxford in 1979. It manifests itself by haemoptysis and intravascular haemolysis. We draw attention to the extremely serious potential consequences of new methods of using cannabis, particularly the use of "bang" in homemade plastic materials. Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.

[The morphofunctional changes in the rat lung tissue during simulation of acute fatal poisoning with household gas].

Science.gov (United States)

Kalinina, E Iu; Iagmurov, O D

2014-01-01

The methods of light microscopy, immunohistochemistry, and electron microscopy were employed to study the morphofunctional changes in epithelium of bronchial and respiratory segments of the rat lungs used as models of acute fatal poisoning with household gas. It was shown that this toxic effect induces the pathological process involving all the elements of the epithelial layer in the bronchial and respiratory segments of the lungs of experimental animals. At the ultrastructural level, mitochondria and endoplasmic reticulum structures are affected, with the death of epithelial cells leading to the damage of the aerohematic barrier. The toxic effect of the gaseous mixture on the membranes causes the destruction of various elements of the epithelial layer. The results of this study help to understand the mechanisms of death in the case of acute fatal poisoning with household gas.

Accidental Phosphine Gas Poisoning with Fatal Myocardial Dysfunction in Two Families

International Nuclear Information System (INIS)

Akhtar, S.; Rehman, A.; Haque, A.; Bano, S.

2015-01-01

Aluminum phosphide is commonly used as a rodenticide and insecticide and is one of the most fatal poisons. The active ingredient is Phosphine gas which inhibits cytochrome oxidase and cellular oxygen utilization. The clinical symptoms are due to multiorgan involvement including cardiac toxicity which is the most common cause of mortality. Severity of clinical manifestations depends upon the amount of the gas to which a person is exposed. There is no specific antidote available. High index of suspicion and early aggressive treatment is the key to success. We report 2 cases of aluminum phosphide toxicity in 2 families due to incidental exposure after fumigation. (author)

Human recombinant protein C for severe sepsis and septic shock in adult and paediatric patients

DEFF Research Database (Denmark)

Martí-Carvajal, Arturo J; Solà, Ivan; Gluud, Christian

2012-01-01

Sepsis is a common and frequently fatal condition. Human recombinant activated protein C (APC) has been introduced to reduce the high risk of death associated with severe sepsis or septic shock. This systematic review is an update of a Cochrane review originally published in 2007....

Paraquat: A fatal poison

Directory of Open Access Journals (Sweden)

J Shashibhushan

2015-01-01

Full Text Available Paraquat (1, 1′-dimethyl-4, 4′-dipyridylium is a bipyridilium herbicide used widely in our country and is a highly toxic compound. This compound is very notorious to cause rapid development of renal, liver, and respiratory failure with very high mortality due to lack of specific antidote and dearth of high-quality evidence-based treatment. Respiratory system involvement is the most common cause of death in these people. We hereby report a fatal case of a 30-year-old male with a history of paraquat consumption. The patient developed oliguric renal failure, deterioration of liver function, and acute respiratory distress syndrome over next few days. Different treatment modalities were tried to manage patient′s condition. In this case, none of the strategies worked well, and death ensued due to multi-organ dysfunction syndrome.

Fatal Fentanyl: One Pill Can Kill.

Science.gov (United States)

Sutter, Mark E; Gerona, Roy R; Davis, M Thais; Roche, Bailey M; Colby, Daniel K; Chenoweth, James A; Adams, Axel J; Owen, Kelly P; Ford, Jonathan B; Black, Hugh B; Albertson, Timothy E

2017-01-01

The current national opioid epidemic is a public health emergency. We have identified an outbreak of exaggerated opioid toxicity caused by fentanyl adulterated tablets purchased on the street as hydrocodone/acetaminophen. Over an 8-day period in late March 2016, a total of 18 patients presented to our institution with exaggerated opioid toxicity. The patients provided a similar history: ingesting their "normal dose" of hydrocodone/acetaminophen tablets but with more pronounced symptoms. Toxicology testing and analysis was performed on serum, urine, and surrendered pills. One of the 18 patients died in hospital. Five patients underwent cardiopulmonary resuscitation, one required extracorporeal life support, three required intubation, and two received bag-valve-mask ventilation. One patient had recurrence of toxicity after 8 hours after naloxone discontinuation. Seventeen of 18 patients required boluses of naloxone, and four required prolonged naloxone infusions (26-39 hours). All 18 patients tested positive for fentanyl in the serum. Quantitative assays conducted in 13 of the sera revealed fentanyl concentrations of 7.9 to 162 ng/mL (mean = 52.9 ng/mL). Pill analysis revealed fentanyl amounts of 600-6,900 μg/pill. The pills are virtually indistinguishable from authentic hydrocodone/acetaminophen tablets and are similar in weight. To date, our county has reported 56 cases of fentanyl opioid toxicity, with 15 fatalities. In our institution, the outbreak has stressed the capabilities and resources of the emergency department and intensive care units. A serious outbreak of exaggerated opioid toxicity caused by fentanyl-adulterated tablets purchased on the street as hydrocodone/acetaminophen is under way in California. These patients required higher dosing and prolonged infusions of naloxone. Additionally, observation periods off naloxone were extended due to delayed, recurrent toxicity. The outbreak has serious ramifications for public health and safety, law

Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

Energy Technology Data Exchange (ETDEWEB)

Wu, Cheng Hsien; Huang, Chen Chin; Wang, Li Jen; Wong, Yon Cheng; Wang, Chao Jan; Lo, Wang Chak; Lin, Being Chuan; Wan, Yung Liang; Haueh, Chuen [Chang Gung Memorial Hospital, Chang Gung University, Taoyuan (China)

2012-06-15

Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

Value of CT in the Discrimination of Fatal from Non-Fatal Stercoral Colitis

International Nuclear Information System (INIS)

Wu, Cheng Hsien; Huang, Chen Chin; Wang, Li Jen; Wong, Yon Cheng; Wang, Chao Jan; Lo, Wang Chak; Lin, Being Chuan; Wan, Yung Liang; Haueh, Chuen

2012-01-01

Clinical presentation and physical signs may be unreliable in the diagnosis of stercoral colitis (SC). This study evaluates the value of computed tomography (CT) in distinguishing fatal from non-fatal SC. Ten patients diagnosed as SC were obtained from inter-specialist conferences. Additional 13 patients with suspected SC were identified via the Radiology Information System (RIS). These patients were divided into two groups; fatal and non-fatal SCs. Their CT images are reviewed by two board-certified radiologists blinded to the clinical data and radiographic reports. SC occurred in older patients and displayed no gender predisposition. There was significant correlation between fatal SC and CT findings of dense mucosa (p 0.017), perfusion defects (p = 0.026), ascites (p = 0.023), or abnormal gas (p = 0.033). The sensitivity, specificity, and accuracy of dense mucosa were 71%, 86%, and 81%, respectively. These figures were 75%, 79%, and 77% for perfusion defects; 75%, 80%, and 78% for ascites; and 50%, 93%, and 78% for abnormal gas, respectively. Each CT sign of mucosal sloughing and pericolonic abscess displayed high specificity of 100% and 93% for diagnosing fatal SC, respectively. However, this did not reach statistical significance in diagnosing fatal SC. CT appears to be valuable in discriminating fatal from non-fatal SC.

Potassium permanganate poisoning--a rare cause of fatal self poisoning.

OpenAIRE

Ong, K L; Tan, T H; Cheung, W L

1997-01-01

Attempted suicide by self poisoning is common because of the ready availability of drugs, whether prescribed or bought over the counter. In some cases, the ingestion of seemingly innocuous household products or chemicals can result in death. Potassium permanganate is an example. Poisoning with potassium permanganate can be fatal when a significant amount is ingested, as shown by a patient who suffered both the corrosive and systemic toxic effects of this chemical.

States with low non-fatal injury rates have high fatality rates and vice-versa.

Science.gov (United States)

Mendeloff, John; Burns, Rachel

2013-05-01

State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken. Copyright © 2012 Wiley Periodicals, Inc.

[Fatal flecainide intoxication in a 17-year-old girl].

Science.gov (United States)

Dokter, M; Talarico, G; Armbrust, S; Below, E; Bockholdt, B

2018-05-01

A 17-year-old girl was found vomiting and somnolent at home and was taken to a hospital. The girl initially presented with ventricular tachycardia with broad QRS complexes which was very difficult to control. During the course a subsequent cardiogenic shock developed and despite exhaustion of all therapeutic options the fatal outcome could not be averted. The medicolegal autopsy revealed no evidence of any form of violence but the signs of medical treatment. Furthermore, no pathology of internal organs was detected. The toxicological analyses revealed a lethal intoxication with flecainide as the cause of death. The investigations of the police indicated that the girl took flecainide in suicidal intention.

Megacólon tóxico fatal por cytomegalovirus em paciente com retocolite ulcerativa idiopática: relato de caso e revisão de literatura Fatal toxic megacolon due to cytomegalovirosis in a patient with ulcerative colitis: case report and review

Directory of Open Access Journals (Sweden)

Sérgio Ossamu IOSHII

2002-04-01

Full Text Available Racional - O megacólon tóxico é complicação grave e pouco freqüente na retocolite ulcerativa idiopática. Ocorre, geralmente, em pacientes cuja doença ativa é resistente ao tratamento clínico e, em algumas situações, o fator desencadeante é desconhecido. A infecção pelo cytomelogalovirus em seres humanos em geral é evento subclínico; entretanto, em pacientes imunocomprometidos a primoinfecção ou mesmo a reativação de infecção latente pode ter amplas repercussões clínicas, uma das quais o desencadeamento de megacólon tóxico. Objetivo - Descrever um caso de megacólon tóxico fatal por cytomegalovirose em paciente com retocolite ulcerativa idiopática. Paciente - Masculino, 38 anos, com clínica de diarréia e perda ponderal cuja investigação mostrou tratar-se de retocolite ulcerativa idiopática e para a qual foi instituída terapêutica imunossupressora vigorosa. Resultados - Evoluiu com quadro clínico de megacólon tóxico, sendo submetido a colectomia total. Complicações clínicas culminaram no óbito pós-operatório e o estudo anatomopatológico do cólon revelou doença ativa, associada a ulcerações confluentes na base das quais foram observadas células com alterações características da cytomegalovirose. Conclusão - A cytomegalovirose deve ser considerada como um dos agentes causadores de megacólon tóxico em retocolite ulcerativa.Background - The toxic megacolon is a rare and severe complication of ulcerative colitis. In general it complicates patients with active colitis that are resistant to clinical treatment and, in some cases, the developing factor is unknown. Cytomegalovirus infection in humans in general is a subclinical condition. However, in patients with immunodeficiency the primary infection or the reactivation of latent infection could have enormous clinical effects. One of these effects is the toxic megacolon. Aim - To report a case of fatal toxic megacólon due to cytomegalovirosis in a

Glycerol monolaurate and dodecylglycerol effects on Staphylococcus aureus and toxic shock syndrome toxin-1 in vitro and in vivo.

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Ying-Chi Lin

2009-10-01

Full Text Available Glycerol monolaurate (GML, a 12 carbon fatty acid monoester, inhibits Staphylococcus aureus growth and exotoxin production, but is degraded by S. aureus lipase. Therefore, dodecylglycerol (DDG, a 12 carbon fatty acid monoether, was compared in vitro and in vivo to GML for its effects on S. aureus growth, exotoxin production, and stability.Antimicrobial effects of GML and DDG (0 to 500 microg/ml on 54 clinical isolates of S. aureus, including pulsed-field gel electrophoresis (PFGE types USA200, USA300, and USA400, were determined in vitro. A rabbit Wiffle ball infection model assessed GML and DDG (1 mg/ml instilled into the Wiffle ball every other day effects on S. aureus (MN8 growth (inoculum 3x10(8 CFU/ml, toxic shock syndrome toxin-1 (TSST-1 production, tumor necrosis factor-alpha (TNF-alpha concentrations and mortality over 7 days. DDG (50 and 100 microg/ml inhibited S. aureus growth in vitro more effectively than GML (p<0.01 and was stable to lipase degradation. Unlike GML, DDG inhibition of TSST-1 was dependent on S. aureus growth. GML-treated (4 of 5; 80% and DDG-treated rabbits (2 of 5; 40% survived after 7 days. Control rabbits (5 of 5; 100% succumbed by day 4. GML suppressed TNF-alpha at the infection site on day 7; however, DDG did not (<10 ng/ml versus 80 ng/ml, respectively.These data suggest that DDG was stable to S. aureus lipase and inhibited S. aureus growth at lower concentrations than GML in vitro. However, in vivo GML was more effective than DDG by reducing mortality, and suppressing TNF-alpha, S. aureus growth and exotoxin production, which may reduce toxic shock syndrome. GML is proposed as a more effective anti-staphylococcal topical anti-infective candidate than DDG, despite its potential degradation by S. aureus lipase.

Pleural empyema and streptococcal toxic shock syndrome due to Streptococcus pyogenes in a healthy Spanish traveler in Japan

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Tetsuya Sakai

2017-01-01

Full Text Available Group A Streptococcus (GAS, Streptococcus pyogenes causes invasive infections including streptococcal toxic shock syndrome (STSS and local infections. To our knowledge, this is the first report of a case of an invasive GAS infection with pneumonia and pleural empyema (PE followed by STSS (disseminated intravascular coagulation [DIC] and acute renal insufficiency in a healthy male adult. He received combined supportive therapies of PE drainage, anti-DIC agent, hemodialysis, and antimicrobials and eventually made a clinical recovery. GAS isolated from PE was found to have emm1/speA genes, suggestive of a pathogenic strain. Clinicians should be aware of the possibility of this disease entity (pneumonia, PE, and STSS in healthy male adults as well as children and adult women.

Islamic fatalism

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Helmer Ringgren

1967-02-01

Full Text Available The author sketches the historical background, then the teaching of the Koran, and finally, the development of the typical Islamic fatalism. The fatalism of Islam has to be viewed against the background of the ideas of pre-Islamic Arabia. Unfortunately, there is no other evidence from this epoch that a few poems on a very restricted range of topics which have been able to survive Islamic censure. The conventional and stereotyped character of these poems makes it difficult to decide to what extent they reflect commonly accepted views or the ideas of a certain group. In any case, they present a picture of the pagan Arab which is extremely idealized and formed after a rigid pattern. Historically speaking, Islamic 'fatalism' is the result of a combination of pre-Islamic fatalism and Muhammad's belief in God's omnipotence. From another point of view it is an interpretation of destiny that expresses man's feeling of total dependence, not on an impersonal power or universal order, but on an omnipotent God.

Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study

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Lin Hung-Jung

2008-01-01

Full Text Available Abstract Background Poisoning is a significant public health problem worldwide and is one of the most common reasons for visiting emergency departments (EDs, but factors that help to predict overall poisoning-related fatality have rarely been elucidated. Using 1512 subjects from a hospital-based study, we sought to describe the demographic and clinical characteristics of poisoning patients and to identify predictors for poisoning-related fatality. Methods Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality. Results A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%, and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%, followed by pesticides (14.5%. Of the 1512 patients, 63 fatalities (4.2% occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%. The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure. Conclusion In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.

Estimating cost ratio distribution between fatal and non-fatal road accidents in Malaysia

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Hamdan, Nurhidayah; Daud, Noorizam

2014-07-01

Road traffic crashes are a global major problem, and should be treated as a shared responsibility. In Malaysia, road accident tragedies kill 6,917 people and injure or disable 17,522 people in year 2012, and government spent about RM9.3 billion in 2009 which cost the nation approximately 1 to 2 percent loss of gross domestic product (GDP) reported annually. The current cost ratio for fatal and non-fatal accident used by Ministry of Works Malaysia simply based on arbitrary value of 6:4 or equivalent 1.5:1 depends on the fact that there are six factors involved in the calculation accident cost for fatal accident while four factors for non-fatal accident. The simple indication used by the authority to calculate the cost ratio is doubted since there is lack of mathematical and conceptual evidence to explain how this ratio is determined. The main aim of this study is to determine the new accident cost ratio for fatal and non-fatal accident in Malaysia based on quantitative statistical approach. The cost ratio distributions will be estimated based on Weibull distribution. Due to the unavailability of official accident cost data, insurance claim data both for fatal and non-fatal accident have been used as proxy information for the actual accident cost. There are two types of parameter estimates used in this study, which are maximum likelihood (MLE) and robust estimation. The findings of this study reveal that accident cost ratio for fatal and non-fatal claim when using MLE is 1.33, while, for robust estimates, the cost ratio is slightly higher which is 1.51. This study will help the authority to determine a more accurate cost ratio between fatal and non-fatal accident as compared to the official ratio set by the government, since cost ratio is an important element to be used as a weightage in modeling road accident related data. Therefore, this study provides some guidance tips to revise the insurance claim set by the Malaysia road authority, hence the appropriate method

Viridans streptococcal shock syndrome during bone marrow transplantation.

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Martino, R; Manteiga, R; Sánchez, I; Brunet, S; Sureda, A; Badell, I; Argilés, B; Subirá, M; Bordes, R; Domingo-Albós, A

1995-01-01

Of 320 patients receiving a marrow transplant at the Hospital de Sant Pau between 1986 and 1992, 12% developed viridans streptococcal bacteremia during severe neutropenia. Five of these patients (13%) developed a rapidly progressive fatal shock syndrome characterized by bilateral pulmonary infiltrates, acute respiratory failure (ARDS) and septic shock early in the transplantation course (6 or 7 days posttransplantation). All patients were transplanted for acute leukemia in remission, and 2 received an allogeneic and 3 an autologous transplant. Four of these subjects were younger than 15 years of age and all had received cyclophosphamide and total body irradiation as conditioning regimen for marrow transplantation. All 5 patients died, and postmortem examinations revealed diffuse pulmonary lesions characteristic of the ARDS. These observations contribute to defining the clinical and pathologic characteristics of this serious complication of intensive anticancer treatment.

Kombucha--toxicity alert.

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The Kombucha mushroom, also known as Manchurian mushroom, is a mail-order product touted to lower blood pressure and raise T-cell counts. No controlled trials have been conducted to test these claims. Aspergillus, a mold that may grow on the Kombucha mushroom, attacks the brain and may be fatal to persons with weakened immune systems. Reported toxicity reactions have included stomach problems and yeast infections. Taking Kombucha in combination with other drugs may affect the drugs potency.

Evaluation of poly-drug use in methadone-related fatalities using segmental hair analysis.

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Nielsen, Marie Katrine Klose; Johansen, Sys Stybe; Linnet, Kristian

2015-03-01

In Denmark, fatal poisoning among drug addicts is often related to methadone. The primary mechanism contributing to fatal methadone overdose is respiratory depression. Concurrent use of other central nervous system (CNS) depressants is suggested to heighten the potential for fatal methadone toxicity. Reduced tolerance due to a short-time abstinence period is also proposed to determine a risk for fatal overdose. The primary aims of this study were to investigate if concurrent use of CNS depressants or reduced tolerance were significant risk factors in methadone-related fatalities using segmental hair analysis. The study included 99 methadone-related fatalities collected in Denmark from 2008 to 2011, where both blood and hair were available. The cases were divided into three subgroups based on the cause of death; methadone poisoning (N=64), poly-drug poisoning (N=28) or methadone poisoning combined with fatal diseases (N=7). No significant differences between methadone concentrations in the subgroups were obtained in both blood and hair. The methadone blood concentrations were highly variable (0.015-5.3, median: 0.52mg/kg) and mainly within the concentration range detected in living methadone users. In hair, methadone was detected in 97 fatalities with concentrations ranging from 0.061 to 211ng/mg (median: 11ng/mg). In the remaining two cases, methadone was detected in blood but absent in hair specimens, suggesting that these two subjects were methadone-naive users. Extensive poly-drug use was observed in all three subgroups, both recently and within the last months prior to death. Especially, concurrent use of multiple benzodiazepines was prevalent among the deceased followed by the abuse of morphine, codeine, amphetamine, cannabis, cocaine and ethanol. By including quantitative segmental hair analysis, additional information on poly-drug use was obtained. Especially, 6-acetylmorphine was detected more frequently in hair specimens, indicating that regular abuse of

Beware the yellow slimming pill: fatal 2,4-dinitrophenol overdose.

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Holborow, Alexander; Purnell, Richard M; Wong, Jenny Frederina

2016-04-04

An industrial chemical, 2,4-dinitrophenol (DNP), has found use as a weight loss drug. It is extremely toxic in overdose and has a narrow therapeutic window with significant interindividual variability in metabolism. The rise in internet-based sales and distribution of this drug has seen an increased incidence of both accidental and intentional overdose presenting to emergency departments across the UK. No antidote currently exists and overdose is often fatal despite management based on current recommendations. We report a case of intentional overdose of DNP in a young man and discuss the current treatment guidelines. The case highlights the need for an increased awareness among frontline medical staff of the effects of DNP poisoning and questions the need for a more aggressive approach in the management of acute toxicity. 2016 BMJ Publishing Group Ltd.

Hypovolemic Shock and Hemoperitoneum from Spontaneous Avulsion of a Large Pedunculated Uterine Leiomyoma.

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Mizrahi, Daniel J; Kaushik, Chhavi; Adamo, Robert

2017-03-01

Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus. Following fluid resuscitation, the patient underwent emergent myomectomy and ligation of the right uterine artery and was discharged home in good condition.

Chlorfenapyr-induced toxic leukoencephalopathy with radiologic reversibility: A case report and literature review

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Baek, Byung Hyun; Kim, Seul Kee; Yoon, Woong; Heo, Tae Wook; Lee, Yun Young [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Kang, Heonung Keun [Dept. of Radiology, Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

2016-04-15

Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.

[Fatal occupational accidents in Lombardy].

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Pianosi, G

1995-01-01

All fatal occupational accidents compensated in Lombardy from 1984 to 1989 were analyzed (1259 cases): significant differences between geographical distribution of fatal occupational accidents and workers were observed. Males accounted for about 95% of fatalities; an excess of cases was shown in both young and elderly workers. Death was the consequence of injuries involving most frequently the head, thorax and spinal cord. An excess of fatalities was observed in agriculture and, at a lower level, in manufacturing industries; small enterprises were involved in approximately 25% of fatalities occurring in the manufacturing industries and services. Employers were the victims of fatal accidents in 50% of cases in agriculture and in 70% of cases in craft industries. Construction, agriculture and transport accounted for about 50% of all fatalities. About 50% of fatal occupational accidents were related to vehicle use: the victim was the driver in the majority of cases, sometimes the victim was run over by a vehicle or fell from a vehicle. The results agree with some previous observations (e.g.: sex and age distribution; construction, agriculture and transport as working activities at high accident risk); but some original observations have emerged, in particular about the frequency of employers as victims and the role of vehicles in the genesis of fatal occupational accidents. If further studies confirm these latter observations, important developments could follow in preventive action design and implementation.

Estimation of fatality and injury risk by means of in-depth fatal accident investigation data.

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Yannis, George; Papadimitriou, Eleonora; Dupont, Emmanuelle; Martensen, Heike

2010-10-01

In this article the factors affecting fatality and injury risk of road users involved in fatal accidents are analyzed by means of in-depth accident investigation data, with emphasis on parameters not extensively explored in previous research. A fatal accident investigation (FAI) database is used, which includes intermediate-level in-depth data for a harmonized representative sample of 1300 fatal accidents in 7 European countries. The FAI database offers improved potential for analysis, because it includes information on a number of variables that are seldom available, complete, or accurately recorded in road accident databases. However, the fact that only fatal accidents are examined requires for methodological adjustments, namely, the correction for two types of effects on a road user's baseline risk: "accident size" effects, and "relative vulnerability" effects. Fatality and injury risk can be then modeled through multilevel logistic regression models, which account for the hierarchical dependences of the road accident process. The results show that the baseline fatality risk of road users involved in fatal accidents decreases with accident size and increases with the vulnerability of the road user. On the contrary, accident size increases nonfatal injury risk of road users involved in fatal accidents. Other significant effects on fatality and injury risk in fatal accidents include road user age, vehicle type, speed limit, the chain of accident events, vehicle maneuver, and safety equipment. In particular, the presence and use of safety equipment such as seat belt, antilock braking system (ABS), and electronic stability program (ESP) are protection factors for car occupants, especially for those seated at the front seats. Although ABS and ESP systems are typically associated with positive effects on accident occurrence, the results of this research revealed significant related effects on accident severity as well. Moreover, accident consequences are more severe

Clinical Features of Fatal Asthma

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Chiung-Zuei Chen

2006-05-01

Full Text Available To characterize the clinical features of fatal asthma, we retrospectively analyzed the clinical characteristics of patients who died of an acute asthma attack in our hospital during a 15-year period from 1989 to 2003. Twelve patients had fatal asthma during this period, including eight who were dead on arrival in the emergency room (ER and three who died within 1 hour of admission to the ER. Patients were categorized into three groups according to the clinical presentations during the fatal attack: (1 rapid (< 3 hours decompensation in four patients; (2 gradual development of respiratory failure over several days in two patients; and (3 acute deterioration after unstable asthma lasting several days in six patients. All patients in groups 1 and 2 had reported previous near-fatal attacks. The proportion of young patients was highest in group 3, with half of them (3/6 younger than 35 years of age. Only one patient in group 3 had had a previous near-fatal attack. Five of the seven patients, with previous near-fatal attacks, had a pattern of decompensation during their fatal attack that was similar to their previous attacks. In conclusion, nearly all patients with fatal asthma in this study died outside of the hospital or within 1 hour after admission to the ER. Patients had patterns of decompensation during the fatal attack that were similar to those of their previous attacks. Early detection of warning signs, early admission to the ER, adequate treatment, and extremely close observation of patients, especially within 1 hour after ER arrival, may prevent or decrease the incidence of fatal asthmatic attack.

Fatal Brazilian spotless fever caused by Rickettsia rickettsii in a dark-skinned patient

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Alexsandra Rodrigues de Mendonça Favacho

2011-06-01

Full Text Available Brazilian spotted fever (BSF is the most important and frequent rickettsial disease in Brazil. A fatal case of BSF is reported in a 32-year-old black man, who died of irreversible shock after five days of fever, severe headache and abdominal pain with no rash. Spleen, kidney and heart samples collected at autopsy were positive for Rickettsia rickettsii by PCR and sequencing. The authors emphasize the need for a high index of diagnostic suspicion for spotted fever in black patients. Absence of a skin rash should not dissuade clinicians from considering the possibility of BSF and initiating empirical therapy.

Global earthquake fatalities and population

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Holzer, Thomas L.; Savage, James C.

2013-01-01

Modern global earthquake fatalities can be separated into two components: (1) fatalities from an approximately constant annual background rate that is independent of world population growth and (2) fatalities caused by earthquakes with large human death tolls, the frequency of which is dependent on world population. Earthquakes with death tolls greater than 100,000 (and 50,000) have increased with world population and obey a nonstationary Poisson distribution with rate proportional to population. We predict that the number of earthquakes with death tolls greater than 100,000 (50,000) will increase in the 21st century to 8.7±3.3 (20.5±4.3) from 4 (7) observed in the 20th century if world population reaches 10.1 billion in 2100. Combining fatalities caused by the background rate with fatalities caused by catastrophic earthquakes (>100,000 fatalities) indicates global fatalities in the 21st century will be 2.57±0.64 million if the average post-1900 death toll for catastrophic earthquakes (193,000) is assumed.

Anticipating Early Fatality: Friends', Schoolmates' and Individual Perceptions of Fatality on Adolescent Risk Behaviors

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Soller, Brian; Williams, Kristi

2015-01-01

Past research indicates that anticipating adverse outcomes, such as early death (fatalism), is associated positively with adolescents' likelihood of engaging in risky behaviors. Health researchers and criminologists have argued that fatalism influences present risk taking in part by informing individuals' motivation for delaying gratification for the promise of future benefits. While past findings highlight the association between the anticipation of early death and a number of developmental outcomes, no known research has assessed the impact of location in a context characterized by high perceptions of fatality. Using data from Add Health and a sample of 9,584 adolescents (51 % female and 71 % white) nested in 113 schools, our study builds upon prior research by examining the association between friends', school mates', and individual perceptions of early fatality and adolescent risk behaviors. We test whether friends' anticipation of being killed prior to age 21 or location in a school where a high proportion of the student body subscribes to attitudes of high fatality, is associated with risky behaviors. Results indicate that friends' fatalism is positively associated with engaging in violent delinquency, non-violent delinquency, and drug use after controlling for individual covariates and prior individual risk-taking. Although friends' delinquency accounts for much of the effect of friends' fatalism on violence, none of the potential intervening variables fully explain the effect of friends' fatalism on youth involvement in nonviolent delinquency and drug use. Our results underscore the importance of friendship contextual effects in shaping adolescent risk-taking behavior and the very serious consequences perceptions of fatality have for adolescents' involvement in delinquency and drug use. PMID:23828725

Expression of Hsp27 and Hsp70 and vacuolization in the pituitary glands in cases of fatal hypothermia.

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Doberentz, Elke; Markwerth, Philipp; Wagner, Rebecca; Madea, Burkhard

2017-09-01

Hypothermia causes systemic cellular stress. The pituitary gland is an endocrine gland and plays an important role in thermoregulation. When the core body temperature drops, the pituitary gland is activated by stimulation of hypothalamic hormones. In this study, we investigated morphological alterations of the pituitary gland in cases of fatal hypothermia. Several morphological alterations of the anterior lobe of the pituitary gland, such as hemorrhage, vacuolization, and hyperemia, have been previously described in fatal hypothermia. However, the diagnostic value of these findings is controversial. We compared 11 cases of fatal hypothermia with 10 cases lacking antemortem hypothermic influences. In the presence of thermal cellular stress, the expression of heat shock proteins increases to protect cellular structures. Therefore, we immunohistochemically analyzed Hsp27 and Hsp70. Hsp27 expression was detected in 27.3% of the cases of fatal hypothermia and in 10.0% of the control cases, whereas Hsp70 expression was not detected in any case. Additionally, Sudan staining was performed to quantify fatty degeneration. A positive reaction was found in 45.5% of the study group and in 10.0% of the control group. This indicates that fatty degeneration might be a valuable marker when other macroscopic signs of hypothermia are absent.

Dataset on psychosocial risk factors in cases of fatal and near-fatal physical child abuse

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Mary Clyde Pierce

2017-10-01

Full Text Available This article presents the psychosocial risk factors identified in the cases of 20 children less than four years of age who were victims of fatal or near-fatal physical abuse during a 12 month period in the Commonwealth of Kentucky. These data are related to the article “History, injury, and psychosocial risk factor commonalities among cases of fatal and near-fatal physical child abuse” (Pierce et al., 2017 [1].

Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

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Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

2006-12-15

A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

The effect of C1-esterase inhibitor in definite and suspected streptococcal toxic shock syndrome. Report of seven patients.

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Fronhoffs, S; Luyken, J; Steuer, K; Hansis, M; Vetter, H; Walger, P

2000-10-01

To evaluate the effect of adjunctive C1-esterase inhibitor substitution therapy on clinical characteristics and outcome of patients with streptococcal toxic shock syndrome (TSS). Observational. Medizinische Poliklinik, University of Bonn, Germany. Seven patients with direct or indirect evidence of streptococcal TSS. In addition to conventional and supportive therapy, all patients received 2-3 single doses of C1-esterase inhibitor totaling 6,000-10,000 U within the first 24 h after admission. All patients developed fulminant septic shock, multiorgan failure and/or capillary leak syndrome and necrotizing fasciitis within 10-72 h following the onset of first symptoms. Between 1 and 4 days following administration of C1-esterase inhibitor, a marked shift of fluid from extravascular to intravascular compartments took place in all but one patient, accompanied by a transient intra-alveolar lung edema and rapidly decreasing need for adrenergic agents. Six of seven patients survived. These clinical observations in a small series of patients and the favorable outcome point towards a positive effect of early and high-dose administration of C1-esterase inhibitor as adjunctive therapy in streptococcal TSS. The possible mechanism involved may be the attenuation of capillary leak syndrome (CLS) via early inactivation of complement and contact systems. Controlled studies are needed to establish an improvement of the survival rates of patients with streptococcal TSS following administration of C1-esterase inhibitor.

Pathological features of glutaminase toxicity.

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Baskerville, A.; Hambleton, P.; Benbough, J. E.

1980-01-01

In an investigation of the toxicity of the anti-tumour enzyme glutaminase Rhesus monkeys, marmosets, rabbits and mice were given various doses of chemically modified glutaminase parenterally. The enzyme induced diarrhoea and dysentery and at all but the lowest doses caused illness which was fatal within 10 days. Pathological lesions produced were hepatic lipidosis and glycogen accumulation, and, in the primates, acute necrotizing colitis. Images Fig. 1 Fig. 2 PMID:6775661

Literature analysis of Acanthopanax anaphylactic shock in China

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Qian Zhan

2015-10-01

Full Text Available The aims of this study are to investigate the occurrence characteristics of Acanthopanax (刺五加 cì wǔ jiā anaphylactic shock and to provide objective evidence for the rational use of the medicine. Fifty-seven cases of Acanthopanax anaphylactic shock were collected from several professional databases in China. The statistical data of the patients were analyzed with Visual FoxPro 6.0 and Office Excel 2003 by Microsoft (Redmond, WA, USA. The male:female incidence ratio was 0.5:1. Fifty-six (98.25% patients were older than 30 years. Thirty-nine (68.42% patients had an unknown allergy history. Nine (15.79% patients used Acanthopanax for unlabeled indications. In most (98.25 % patients, Acanthopanax was used in the form of dosage injection. Anaphylactic shock occurred within 30 minutes after treatment in 52 (94.54% patients, and all episodes occurred during the infusion process. In two (3.51% patients, the episode occurred when they used Acanthopanax for the second time. In one (1.75% patient, the episode occurred during the third time of use. The clinical symptoms of anaphylactic shock are diversified, but all patients presented with cardiovascular and respiratory system symptoms. Acanthopanax injections that led to anaphylactic shock were produced exclusively by four manufacturers. Four (7.02% patients died and 49 (85.96% patients were cured, but the status of four patients is unknown. Because an Acanthopanax injection may cause anaphylactic shock and can be fatal in severe cases, physicians and patients must pay close attention to using it rationally. Clinicians should carefully consult the allergic constitution of their patients, strictly follow the guidelines of the drug, use Acanthopanax in the oral dosage form as much as possible, and strengthen therapeutic monitoring.

Femme fatale

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Francisco Javier Tardío Gastón

2011-12-01

Full Text Available Our history is full of myths and topics. Therefore the image of femme fatale is frequent in the works of all periods and places. The author of this article first analyzes how the history and literature consistently showed and defined these women, and then presents examples that come from ancient Greece. The art is powered by their power of seduction and the article explains how this femme fatale appeared in literature and film. The article concludes with a brief overview of various arguments concerning women and feminism, present in the literary criticism.

Work-related fatal motor vehicle traffic crashes: Matching of 2010 data from the Census of Fatal Occupational Injuries and the Fatality Analysis Reporting System.

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Byler, Christen; Kesy, Laura; Richardson, Scott; Pratt, Stephanie G; Rodríguez-Acosta, Rosa L

2016-07-01

Motor vehicle traffic crashes (MVTCs) remain the leading cause of work-related fatal injuries in the United States, with crashes on public roadways accounting for 25% of all work-related deaths in 2012. In the United States, the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) provides accurate counts of fatal work injuries based on confirmation of work relationship from multiple sources, while the National Highway Traffic Safety Administration (NHTSA) Fatality Analysis Reporting System (FARS) provides detailed data on fatal MVTCs based on police reports. Characterization of fatal work-related MVTCs is currently limited by data sources that lack either data on potential risk factors (CFOI) or work-relatedness confirmation and employment characteristics (FARS). BLS and the National Institute for Occupational Safety and Health (NIOSH) collaborated to analyze a merged data file created by BLS using CFOI and FARS data. A matching algorithm was created to link 2010 data from CFOI and FARS using date of incident and other case characteristics, allowing for flexibility in variables to address coding discrepancies. Using the matching algorithm, 953 of the 1044 CFOI "Highway" cases (91%) for 2010 were successfully linked to FARS. Further analysis revealed systematic differences between cases identified as work-related by both systems and by CFOI alone. Among cases identified as work-related by CFOI alone, the fatally-injured worker was considerably more likely to have been employed outside the transportation and warehousing industry or transportation-related occupations, and to have been the occupant of a vehicle other than a heavy truck. This study is the first step of a collaboration between BLS, NHTSA, and NIOSH to improve the completeness and quality of data on fatal work-related MVTCs. It has demonstrated the feasibility and value of matching data on fatal work-related traffic crashes from CFOI and FARS. The results will lead to

Giant Cell Myocarditis: Not Always a Presentation of Cardiogenic Shock

Directory of Open Access Journals (Sweden)

Rose Tompkins

2015-01-01

Full Text Available Giant cell myocarditis is a rare and often fatal disease. The most obvious presentation often described in the literature is one of rapid hemodynamic deterioration due to cardiogenic shock necessitating urgent consideration of mechanical circulatory support and heart transplantation. We present the case of a 60-year-old man whose initial presentation was consistent with myopericarditis but who went on to develop a rapid decline in left ventricular systolic function without overt hemodynamic compromise or dramatic symptomatology. Giant cell myocarditis was confirmed via endomyocardial biopsy. Combined immunosuppression with corticosteroids and calcineurin inhibitor resulted in resolution of symptoms and sustained recovery of left ventricular function one year later. Our case highlights that giant cell myocarditis does not always present with cardiogenic shock and should be considered in the evaluation of new onset cardiomyopathy of uncertain etiology as a timely diagnosis has distinct clinical implications on management and prognosis.

Extended investigation on road fatality in Brunei.

Science.gov (United States)

Yusof, N B; Hoque, M A; Steele, M C; Yong, S Y

2018-06-08

Road fatality is one of the leading causes of death in Brunei with 79 deaths in 1993, the highest ever recorded. The Brunei government has been trying to reduce this by implementing new traffic measures and successfully reduced fatalities to 24 fatalities in 2014. Yearly road fatality has been fluctuating, but there has been a declining tendency overall. The aim of this study is to investigate road fatality in Brunei by extending the research. We developed a multiple regression model and carried out an analysis on road fatality in Brunei. Our analysis indicates that the road fatality appears to rise depending on the increase in the number of young drivers between 15 to 24 years and the number of unemployed people. Comparisons of Brunei road fatality rate per 10,000 vehicles are made with some other countries and we conclude that Brunei has approximately the same rate as Australia in 2014.

[Fatal toxic respiratory epitheliolysis. Subacute tracheo-bronchial desquamation in Stevens-Johnson syndrome].

Science.gov (United States)

Martin, L; Hazouard, E; Michalak-Provost, S; Maurage, C; Machet, L

2001-09-01

Acute bronchial mucosal sloughing related to Toxic Epidermal Necrolysis (Lyell syndrome) is widely reported in literature. On the contrary severe respiratory involvement is rare in post-infectious or toxic Epitheliolysis (Stevens-Johnson syndrome). There is no well-known predictive sign of bronchial epithelium involvement. An 18-year-old patient was admitted for Stevens-Johnson syndrome related to sulfasalazine (salazosulfapyridine). There were no respiratory signs. An acute respiratory failure occurred 36 hours after from admission due to an obstructive and desquamative necrosis of the tracheobronchial epithelium. We purpose that a fiberoptic laryngoscopy should be performed even in non-dyspneic patients suffering from Stevens-Johnson syndrome if hypersecretion is present. Fiberoptic bronchoscopy can be helpful in these cases.

Non-fatal self-poisoning in Sri Lanka: associated triggers and motivations.

Science.gov (United States)

Rajapakse, Thilini; Griffiths, Kathleen Margaret; Christensen, Helen; Cotton, Sue

2015-11-24

Attempted or non-fatal self-poisoning is common in Sri Lanka. To date, most preventive strategies have focused on limitation of access to toxic pesticides, which has reduced the rates of fatal self-poisoning. However the ongoing phenomenon of non-fatal self-poisoning indicates the need for exploration of alternate preventive strategies. Self-poisoning in Sri Lanka has been described as impulsive, with little premeditation, but the motivations associated with this act have not been studied in depth. This research describes the triggers and motivations associated with non-fatal self-poisoning in Sri Lanka. It is anticipated that the findings would help guide future preventive strategies. Two studies were carried out, at Teaching Hospital Peradeniya, Sri Lanka, each using a different methodology - Study 1 consisted of qualitative semi-structured interviews, and Study 2 was a cross sectional survey. Both studies were conducted among those who had recently attempted self-poisoning, and explored associated triggers and motivations associated with the act of self-poisoning. There was no overlap between participants of the two studies. A total of 24 persons participated in the semi-structured interviews (Study 1), and 921 took part in the cross-sectional survey (Study 2). Interpersonal conflict was the most common trigger prior to the act of non-fatal self-poisoning. A mixture of motivations was associated with the act of self-poisoning, including intent to die, to escape, and difficulty tolerating distress associated with interpersonal conflict. Development of interpersonal skills and interpersonal problem solving skills, particularly in adolescents and young people, emerges as a key primary preventive strategy. Further, there is value in exploring and helping people to develop more adaptive strategies to cope with emotional distress associated with interpersonal conflict. While distress tolerance and interpersonal skill training strategies used in the West may be

Clostridum sordelli-infektion udgået fra ovariecyste

DEFF Research Database (Denmark)

Bjerregaard, Jens Holst; Bülow, Charlotte; Buskov, Laura Katrine

2012-01-01

Clostridium sordellii is a Gram-positive bacterium which can cause a serious toxic shock syndrome with a mortality of up to 69%. C. sordellii is a part of the normal vaginal flora in up to 10% of all women. This case describes a fatal case of a healthy 49 year-old woman with a C. sordellii...

Characterization of Staphylococcus aureus isolates from patients with toxic shock syndrome, using polyethylene infection chambers in rabbits.

Science.gov (United States)

Scott, D F; Kling, J M; Kirkland, J J; Best, G K

1983-01-01

Isolates of Staphylococcus aureus from patients with toxic shock syndrome (TSS) were compared with non-TSS strains of S. aureus with respect to their virulence in rabbits. When the organisms were injected into subcutaneous chambers (perforated polyethylene golf balls) to assess virulence, a rapid mortality was observed with TSS but not with non-TSS strains. Of 16 TSS strains, 11 caused lethal infections in 33 rabbits tested, and none of the 5 control strains caused mortality in 10 rabbits. This evidence of enhanced virulence associated with TSS strains did not appear to be associated with the size of the inoculum. In addition, strains which produced lethal infections appeared to do so despite a reduction in the size of the original inoculum during the first 24 h. All of the TSS strains and none of the non-TSS strains elaborated extracellular protein(s) with a neutral pI when grown in a dialyzed beef heart medium. No other physiological difference was noted between the TSS and non-TSS strains.

Markedly Elevated Carbamazepine-10,11-epoxide/Carbamazepine Ratio in a Fatal Carbamazepine Ingestion

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Jason L. Russell

2015-01-01

Full Text Available Carbamazepine is a widely used anticonvulsant. Its metabolite, carbamazepine-10,11-epoxide, has been found to display similar anticonvulsant and neurotoxic properties. While the ratio of parent to metabolite concentration varies significantly, at therapeutic doses the epoxide concentration is generally about 20% of the parent. We report a case of fatal carbamazepine overdose in which the epoxide metabolite concentration was found to be 450% higher than the parent compound, suggesting a potential role for metabolite quantification in severe toxicity.

Recombinant heat shock protein 27 (HSP27/HSPB1) protects against cadmium-induced oxidative stress and toxicity in human cervical cancer cells.

Science.gov (United States)

Alvarez-Olmedo, Daiana G; Biaggio, Veronica S; Koumbadinga, Geremy A; Gómez, Nidia N; Shi, Chunhua; Ciocca, Daniel R; Batulan, Zarah; Fanelli, Mariel A; O'Brien, Edward R

2017-05-01

Cadmium (Cd) is a carcinogen with several well-described toxicological effects in humans, but its molecular mechanisms are still not fully understood. Overexpression of heat shock protein 27 (HSP27/HSPB1)-a multifunctional protein chaperone-has been shown to protect cells from oxidative damage and apoptosis triggered by Cd exposure. The aims of this work were to investigate the potential use of extracellular recombinant HSP27 to prevent/counteract Cd-induced cellular toxicity and to evaluate if peroxynitrite was involved in the development of Cd-induced toxicity. Here, we report that the harmful effects of Cd correlated with changes in oxidative stress markers: upregulation of reactive oxygen species, reduction in nitric oxide (NO) bioavailability, increment in lipid peroxidation, peroxynitrite (PN), and protein nitration; intracellular HSP27 was reduced. Treatments with Cd (100 μM) for 24 h or with the peroxynitrite donor, SIN-1, decreased HSP27 levels (~50%), suggesting that PN formation is responsible for the reduction of HSP27. Pre-treatments of the cells either with Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME) (a pharmacological inhibitor of NO synthase) or with recombinant HSP27 (rHSP27) attenuated the disruption of the cellular metabolism induced by Cd, increasing in a 55 and 52%, respectively, the cell viability measured by CCK-8. Cd induced necrotic cell death pathways, although apoptosis was also activated; pre-treatment with L-NAME or rHSP27 mitigated cell death. Our findings show for the first time a direct relationship between Cd-induced toxicity and PN production and a role for rHSP27 as a potential therapeutic agent that may counteract Cd toxicity.

Alcohol intake in relation to non-fatal and fatal coronary heart disease and stroke

DEFF Research Database (Denmark)

Ricci, Cristian; Wood, Angela; Muller, David

2018-01-01

OBJECTIVE: To investigate the association between alcohol consumption (at baseline and over lifetime) and non-fatal and fatal coronary heart disease (CHD) and stroke. DESIGN: Multicentre case-cohort study. SETTING: A study of cardiovascular disease (CVD) determinants within the European Prospecti...

Fatal Cobalt Toxicity after a Non-Metal-on-Metal Total Hip Arthroplasty

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Rinne M. Peters

2017-01-01

Full Text Available This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA. After diagnosing a fractured ceramic liner, the hip prosthesis was revised into a metal-on-polyethylene bearing. At one year postoperatively, X-rays and MARS-MRI showed a fixed reversed hybrid THA, with periarticular densities, flattening of the femoral head component, and a pattern of periarticular metal wear debris and pseudotumor formation. Before revision could take place, the patient was admitted with the clinical picture of systemic cobalt toxicity, supported by excessively high serum cobalt and chromium levels, and ultimately died. At autopsy dilated cardiomyopathy as cause of death was hypothesized. A third body wear reaction between ceramic remnants and the metal femoral head very likely led to excessive metal wear, which contributed systemic cobalt toxicity leading to neurotoxicity and heart failure. This case emphasizes that fractured ceramic-on-ceramic bearings should be revised to ceramic-on-ceramic or ceramic-on-polyethylene bearings, but not to metal-on-polyethylene bearings. We aim to increase awareness among orthopedic surgeons for clinical clues for systemic cobalt intoxication, even when there is no metal-on-metal bearing surface.

Drugs taken in fatal and non-fatal self-poisoning : A study in South London

NARCIS (Netherlands)

Neeleman, J; Wessely, S

This study compared the number and type of substances taken in deliberate self-poisoning with fatal (n=127) and non-fatal (n=521) outcome. The aims were (i) to describe substances typically involved in self-poisoning in England and Wales, (ii) to examine the role of drug 'cocktails' and (iii) to

Highly plastic genome of Microcystis aeruginosa PCC 7806, a ubiquitous toxic freshwater cyanobacterium

NARCIS (Netherlands)

Frangeul, L.; Quillardet, P.; Castets, A.M.; Humbert, J.F.; Matthijs, H.C.P.; Cortez, D.; Tolonen, A.; Zhang, C.C.; Gribaldo, S.; Kehr, J.C.; Zilliges, Y.; Ziemert, N.; Becker, S.; Talla, E.; Latifi, A.; Billault, A.; Lepelletier, A.; Dittmann, E.; Bouchier, C.; Tandeau de Marsac, N.

2008-01-01

Background The colonial cyanobacterium Microcystis proliferates in a wide range of freshwater ecosystems and is exposed to changing environmental factors during its life cycle. Microcystis blooms are often toxic, potentially fatal to animals and humans, and may cause environmental problems. There

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning—Implications for Prevention and Public Education

Science.gov (United States)

Chan, Thomas Y. K.

2016-01-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g., Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. PMID:26787145

Characteristic Features and Contributory Factors in Fatal Ciguatera Fish Poisoning--Implications for Prevention and Public Education.

Science.gov (United States)

Chan, Thomas Y K

2016-04-01

In this review, the main objective was to describe the characteristic features of fatal ciguatera fish poisoning and identify contributory factors, with a view to promote prevention and public education. Ciguatera-related deaths, although rare, have been reported from the Pacific, Caribbean, and Indian Ocean regions. The clinical features were generally dominated by convulsions and coma, with various focal neurological signs. Several contributory factors could be identified, including consumption of ciguatoxin (CTX)-rich fish parts (viscera and head) in larger amounts, the most ciguatoxic fish species (e.g.,Gymnothorax flavimarginatus) and reef fish collected after storms and individuals' susceptibility. Mass ciguatera fish poisoning with mortalities also occurred when G. flavimarginatus and other ciguatoxic fish species were shared in gatherings and parties. The characteristic features of fatal ciguatera fish poisoning must be recognized early. The public should be repeatedly reminded to avoid eating the most ciguatoxic fish species and the CTX-rich parts of reef fish. To prevent mass poisoning in gatherings and parties, the most ciguatoxic fish species and potentially toxic fish species must be avoided. Particularly after hits by disastrous storms, it is important to monitor the toxicity of reef fish and the incidence rates of ciguatera. © The American Society of Tropical Medicine and Hygiene.

Albendazole Induced Recurrent Acute Toxic Hepatitis: A Case Report.

Science.gov (United States)

Bilgic, Yilmaz; Yilmaz, Cengiz; Cagin, Yasir Furkan; Atayan, Yahya; Karadag, Nese; Harputluoglu, Murat Muhsin Muhip

2017-01-01

Drug induced acute toxic hepatitis can be idiosyncratic. Albendazole, a widely used broad spectrum antiparasitic drug is generally accepted as a safe drug. It may cause asymptomatic transient liver enzyme abnormalities but acute toxic hepatitis is very rare. Case Report : Herein, we present the case of 47 year old woman with recurrent acute toxic hepatitis after a single intake of albendazole in 2010 and 2014. The patient was presented with symptoms and findings of anorexia, vomiting and jaundice. For diagnosis, other acute hepatitis etiologies were excluded. Roussel Uclaf Causality Assessment Method (RUCAM) score was calculated and found to be 10, which meant highly probable drug hepatotoxicity. Within 2 months, all pathological findings came to normal. There are a few reported cases of albendazole induced toxic hepatitis, but at adults, there is no known recurrent acute toxic hepatitis due to albendazole at this certainty according to RUCAM score. Physicians should be aware of this rare and potentially fatal adverse effect of albendazole. © Acta Gastro-Enterologica Belgica.

Toksisk shock syndrom. Et tilfoelde hos et barn med forbroending

DEFF Research Database (Denmark)

Glazowski, M J; Ostergaard, G Z; Arpi, M

1992-01-01

A case of the toxic shock syndrome (TSS) in a burnt (scalded) child is presented. TSS is a condition most frequently associated with menstruating women using tampons. In recent years, however, increased knowledge of the syndrome has led to an increase in the number of reported cases associated...

[Biochemical diagnostics of fatal opium intoxication].

Science.gov (United States)

Papyshev, I P; Astashkina, O G; Tuchik, E S; Nikolaev, B S; Cherniaev, A L

2013-01-01

Biochemical diagnostics of fatal opium intoxication remains a topical problem in forensic medical science and practice. We investigated materials obtained in the course of forensic medical expertise of the cases of fatal opium intoxication. The study revealed significant differences between myoglobin levels in blood, urine, myocardium, and skeletal muscles. The proposed approach to biochemical diagnostics of fatal opium intoxication enhances the accuracy and the level of evidence of expert conclusions.

Fatal Lemierre’s syndrome as a complication of chronic otitis media with cholesteatoma

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Tashneem Harris

2016-12-01

Full Text Available Background. Lemierre’s syndrome is septic thrombophlebitis of the internal jugular vein, initiated by an infection of the head and neck region. This septic thrombophlebitis gives rise to septic microemboli that can disseminate throughout the body to form septic infarctions and abscesses, with the most frequent site being pulmonary. Methods. We discuss the case of a 14-year-old male with Lemierre’s syndrome as a complication of chronic middle ear infection. Results. The patient developed septic shock and microemboli, and subsequently died. Conclusion. This case report illustrates that untreated chronic middle ear infection can lead to potentially fatal complications such as Lemierre’s syndrome, and emphasises the importance of timeous treatment of chronic middle ear pathology.

The state of the residential fire fatality problem in Sweden: Epidemiology, risk factors, and event typologies.

Science.gov (United States)

Jonsson, Anders; Bonander, Carl; Nilson, Finn; Huss, Fredrik

2017-09-01

Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events. Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering. Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45-64years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%). Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required. Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire

Fatal occupational injuries in Taiwan, 1994-2005.

Science.gov (United States)

Ho, Shu-Chen; Wang, Li-Yu; Ho, Chi-Kung; Yang, Chun-Yuh

2010-04-01

This study examines the trends in rates of fatal occupational injuries in Taiwan by demographic group and occupation for 1994-2005. Data on deaths due to injuries at work from 1994 through 2005 were obtained from the Department of Health which is responsible for the death registration system in Taiwan. Employment data, which were used as the denominators of fatality rates in this study, were retrieved from the Directorate-General of Budget and Accounting Statistics 'Employment and Earnings' database. A Poisson regression model was used to examine the trends in rates of fatal occupational injuries in various occupations while controlling for demographic characteristics. Overall fatal occupational injury rates declined during the study period among all demographic groups and occupations. Adjusted annual changes in rates of fatal injuries ranged from a decrease of 13.6% a year in machine operators/related workers to a decrease of 35.9% in clerks. The annual decrement was faster for males than for females and for older workers compared to young workers. Despite declining rates, the number of fatal occupational injuries in Taiwan remains significant because of the growing work force. Future research should focus on the disparities in fatal injury trends.

Highway Safety: Trends in Highway Fatalities 1975-1987

Science.gov (United States)

1990-03-01

pattern of fatalities as the overall trend. This pattern applies to many of the general fatality statis- tics we present, and, in all cases, it serves as a...Fatalities 1975-87 Appemfx IV Vehicle-Related Statistics Figure IV.17: Vehicle Fatalities by Direction of Principal Impacto NNNumber of PddUlsils lwam 0 1975

Choque cardiogênico por dissulfiram Shockcardiogénico por disulfiram Cardiogenic shock caused by disulfiram

Directory of Open Access Journals (Sweden)

Ana Jerónimo

2009-03-01

Full Text Available A intoxicação medicamentosa por dissulfiram é uma situação rara, mas, que pode se apresentar com manifestações cardiovasculares graves e potencialmente fatais, como choque cardiogênico. É apresentado o caso de uma paciente com choque refratário, após intoxicação voluntária por dissulfiram. A avaliação clínica e bioquímica, junto à avaliação ecocardiográfica e à monitorização invasiva, confirmaram tratar-se de um choque cardiogênico associado a esse fármaco. São discutidos os mecanismos de ação conhecidos do dissulfiram e descritos os principais efeitos colaterais, especialmente os cardiovasculares, alertando para a importância da suspeição diagnóstica e da abordagem terapêutica imediata mais adequada nesse contexto.La intoxicación medicamentosa por disulfiram es una situación rara, aunque puede presentarse con manifestaciones cardiovasculares graves y potencialmente fatales, como el shock cardiogénico. Este relato presenta el caso de una paciente con shock refractario, tras intoxicación voluntaria por disulfiram. La evaluación clínica y bioquímica, junto a la evaluación ecocardiográfica y el monitoreo invasivo, confirmaron tratarse de un shock cardiogénico asociado a ese fármaco. A lo largo del presente relato se discuten los mecanismos de acción del disulfiram conocidos, así como se describen los principales efectos colaterales, específicamente los cardiovasculares. En este sentido, también se alerta para la importancia de la sospecha diagnóstica y del abordaje terapéutico inmediato más adecuado a este contexto.Drug intoxication with disulfiram is a rare condition that may lead to severe and potentially fatal cardiovascular manifestations such as cardiogenic shock. We report the case of a female patient with refractory shock after deliberate self-poisoning with disulfiram. Clinical, biochemical and echocardiographic assessment, as well as invasive monitoring confirmed cardiogenic shock

Fatal and non-fatal injury outcomes: results from a purposively sampled census of seven rural subdistricts in Bangladesh.

Science.gov (United States)

Alonge, Olakunle; Agrawal, Priyanka; Talab, Abu; Rahman, Qazi S; Rahman, Akm Fazlur; Arifeen, Shams El; Hyder, Adnan A

2017-08-01

90% of the global burden of injuries is borne by low-income and middle-income countries (LMICs). However, details of the injury burden in LMICs are less clear because of the scarcity of data and population-based studies. The Saving of Lives from Drowning project, implemented in rural Bangladesh, did a census on 1·2 million people to fill this gap. This Article describes the epidemiology of fatal and non-fatal injuries from the study. In this study, we used data from the baseline census conducted as part of the Saving of Lives from Drowning (SoLiD) project. The census was implemented in 51 unions from seven purposively sampled rural subdistricts of Bangladesh between June and November, 2013. Sociodemographic, injury mortality, and morbidity information were collected for the whole population in the study area. We analysed the data for descriptive measures of fatal and non-fatal injury outcomes. Age and gender distribution, socioeconomic characteristics, and injury characteristics such as external cause, intent, location, and body part affected were reported for all injury outcomes. The census covered a population of 1 169 593 from 270 387 households and 451 villages. The overall injury mortality rate was 38 deaths per 100 000 population per year, and 104 703 people sustained major non-fatal injuries over a 6-month recall period. Drowning was the leading external cause of injury death for all ages, and falls caused the most number of non-fatal injuries. Fatal injury rates were highest in children aged 1-4 years. Non-fatal injury rates were also highest in children aged 1-4 years and those aged 65 years and older. Males had more fatal and non-fatal injuries than females across all external causes except for burns. Suicide was the leading cause of injury deaths in individuals aged 15-24 years, and more than 50% of the suicides occurred in females. The home environment was the most common location for most injuries. The burden of fatal and non-fatal injuries

Barcoding heat shock proteins to human diseases: looking beyond the heat shock response.

Science.gov (United States)

Kakkar, Vaishali; Meister-Broekema, Melanie; Minoia, Melania; Carra, Serena; Kampinga, Harm H

2014-04-01

There are numerous human diseases that are associated with protein misfolding and the formation of toxic protein aggregates. Activating the heat shock response (HSR)--and thus generally restoring the disturbed protein homeostasis associated with such diseases--has often been suggested as a therapeutic strategy. However, most data on activating the HSR or its downstream targets in mouse models of diseases associated with aggregate formation have been rather disappointing. The human chaperonome consists of many more heat shock proteins (HSPs) that are not regulated by the HSR, however, and researchers are now focusing on these as potential therapeutic targets. In this Review, we summarize the existing literature on a set of aggregation diseases and propose that each of them can be characterized or 'barcoded' by a different set of HSPs that can rescue specific types of aggregation. Some of these 'non-canonical' HSPs have demonstrated effectiveness in vivo, in mouse models of protein-aggregation disease. Interestingly, several of these HSPs also cause diseases when mutated--so-called chaperonopathies--which are also discussed in this Review.

Neglecting safety precautions may lead to trenching fatalities.

Science.gov (United States)

Deatherage, J Harold; Furches, Lisa K; Radcliffe, Mike; Schriver, William R; Wagner, John P

2004-06-01

Trench collapses ranked as the seventh leading cause of the possible twenty-nine causes of OSHA-inspected fatal construction events during the period 1991-2001. This study aims to examine why these fatalities occurred. Forty-four case files from OSHA inspections of fatal trench collapses were reviewed. Improper protection of the excavation site where work was taking place was the leading fatality cause. Several organizational or physical conditions were present at many fatal sites; the most frequent was that no training had been provided for trenching. Presence of a competent, diligent person at the site would have prohibited most fatalities. The top cited violation was lack of protection, that is, benching, shoring, sloping, trench boxes, etc. (29 CFR 1926.652 (a) (1)). Copyright 2004 Wiley-Liss, Inc.

Age trajectories of stroke case fatality

DEFF Research Database (Denmark)

Olsen, Tom Skyhøj; Andersen, Zorana Jovanovic; Andersen, Klaus Kaae

2011-01-01

Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages....

Fatal work injuries involving natural disasters, 1992-2006.

Science.gov (United States)

Fayard, Gregory M

2009-12-01

Although a goal of disaster preparedness is to protect vulnerable populations from hazards, little research has explored the types of risks that workers face in their encounters with natural disasters. This study examines how workers are fatally injured in severe natural events. A classification structure was created that identified the physical component of the disaster that led to the death and the pursuit of the worker as it relates to the disaster. Data on natural disasters from the Census of Fatal Occupational Injuries for the years 1992 through 2006 were analyzed. A total of 307 natural disaster deaths to workers were identified in 1992-2006. Most fatal occupational injuries were related to wildfires (80 fatalities), hurricanes (72 fatalities), and floods (62 fatalities). Compared with fatal occupational injuries in general, natural disaster fatalities involved more workers who were white and more workers who were working for the government. Most wildfire fatalities stemmed directly from exposure to fire and gases and occurred to those engaged in firefighting, whereas hurricane fatalities tended to occur more independently of disaster-produced hazards and to workers engaged in cleanup and reconstruction. Those deaths related to the 2005 hurricanes occurred a median of 36.5 days after landfall of the associated storm. Nearly half of the flood deaths occurred to passengers in motor vehicles. Other disasters included tornadoes (33 fatalities), landslides (17), avalanches (16), ice storms (14), and blizzards (9). Despite an increasing social emphasis on disaster preparation and response, there has been little increase in expert knowledge about how people actually perish in these large-scale events. Using a 2-way classification structure, this study identifies areas of emphasis in preventing occupational deaths from various natural disasters.

Impact of the Regulators SigB, Rot, SarA and sarS on the Toxic Shock Tst Promoter and TSST-1 Expression in Staphylococcus aureus.

Directory of Open Access Journals (Sweden)

Diego O Andrey

Full Text Available Staphylococcus aureus is an important pathogen manifesting virulence through diverse disease forms, ranging from acute skin infections to life-threatening bacteremia or systemic toxic shock syndromes. In the latter case, the prototypical superantigen is TSST-1 (Toxic Shock Syndrome Toxin 1, encoded by tst(H, and carried on a mobile genetic element that is not present in all S. aureus strains. Transcriptional regulation of tst is only partially understood. In this study, we dissected the role of sarA, sarS (sarH1, RNAIII, rot, and the alternative stress sigma factor sigB (σB. By examining tst promoter regulation predominantly in the context of its native sequence within the SaPI1 pathogenicity island of strain RN4282, we discovered that σB emerged as a particularly important tst regulator. We did not detect a consensus σB site within the tst promoter, and thus the effect of σB is likely indirect. We found that σB strongly repressed the expression of the toxin via at least two distinct regulatory pathways dependent upon sarA and agr. Furthermore rot, a member of SarA family, was shown to repress tst expression when overexpressed, although its deletion had no consistent measurable effect. We could not find any detectable effect of sarS, either by deletion or overexpression, suggesting that this regulator plays a minimal role in TSST-1 expression except when combined with disruption of sarA. Collectively, our results extend our understanding of complex multifactorial regulation of tst, revealing several layers of negative regulation. In addition to environmental stimuli thought to impact TSST-1 production, these findings support a model whereby sporadic mutation in a few key negative regulators can profoundly affect and enhance TSST-1 expression.

Protection of biofilms against toxic shocks by the adsorption and desorption capacity of carriers in anaerobic fluidized bed reactors

Energy Technology Data Exchange (ETDEWEB)

Petrozzi, S. (Biological Reaction Engineering Group, Chemical Engineering Dept., ETH, Zurich (Switzerland)); Kut, O.M. (Biological Reaction Engineering Group, Chemical Engineering Dept., ETH, Zurich (Switzerland)); Dunn, I.J. (Biological Reaction Engineering Group, Chemical Engineering Dept., ETH, Zurich (Switzerland))

1993-05-01

The aim of this study was to select a support medium for an anaerobic biofilm fluidized bed reactor (AFBR) for waste water treatment. Six materials, shale, pumice, porous glass, quartz sand, activated carbon and anthracite were used as carriers for the biofilm. The reactors were operated in parallel for several months with vapour condensate from a sulfite cellulose process as feed. The criteria used for the evaluation were: (a) Reproducibility of the reactor performance, (b) performance of the different carriers under various loading rates, (c) stability against toxic shock loadings using 2,4,6-trichlorophenol (TCP) as toxicant, (d) recovery capacity after intoxication and starvation, (e) adsorption/desorption behavior of the carriers. A comparison between four runs showed good reproducibility of the steady state removal rates. The performance of the reactors and the stability of the degradation rates were tested for a range of loading conditions. Unbuffered, buffered and pH controlled conditions were compared. The pumice carrier was best with respect to the degradation rate achieved per carrier mass. The response of the reactors to massive TCP step loadings was tested. Loadings less than 1.5 kg TCP/m[sup 3]d resulted in initially normal gas production rates for all the systems, except the activated carbon, whose gas production was partially inhibited from the start. After increasing the load to 1.5 kg TCP/m[sup 3]d the gas production rates of all the other reactors fell abruptly to zero. Restarting after 2 months, all reactors showed methanogenic activity without requiring new inoculum. (orig.)

Incidence of paediatric fatal and non-fatal low speed vehicle run over events in Queensland, Australia: eleven year analysis

Science.gov (United States)

2014-01-01

Background The purpose of this study was to estimate the incidence of fatal and non-fatal Low Speed Vehicle Run Over (LSVRO) events among children aged 0–15 years in Queensland, Australia, at a population level. Methods Fatal and non-fatal LSVRO events that occurred in children resident in Queensland over eleven calendar years (1999-2009) were identified using ICD codes, text description, word searches and medical notes clarification, obtained from five health related data bases across the continuum of care (pre-hospital to fatality). Data were manually linked. Population data provided by the Australian Bureau of Statistics were used to calculate crude incidence rates for fatal and non-fatal LSVRO events. Results There were 1611 LSVROs between 1999–2009 (IR = 16.87/100,000/annum). Incidence of non-fatal events (IR = 16.60/100,000/annum) was 61.5 times higher than fatal events (IR = 0.27/100,000/annum). LSVRO events were more common in boys (IR = 20.97/100,000/annum) than girls (IR = 12.55/100,000/annum), and among younger children aged 0–4 years (IR = 21.45/100000/annum; 39% or all events) than older children (5–9 years: IR = 16.47/100,000/annum; 10–15 years IR = 13.59/100,000/annum). A total of 896 (56.8%) children were admitted to hospital for 24 hours of more following an LSVRO event (IR = 9.38/100,000/annum). Total LSVROs increased from 1999 (IR = 14.79/100,000) to 2009 (IR = 18.56/100,000), but not significantly. Over the 11 year period, there was a slight (non –significant) increase in fatalities (IR = 0.37-0.42/100,000/annum); a significant decrease in admissions (IR = 12.39–5.36/100,000/annum), and significant increase in non-admissions (IR = 2.02-12.77/100,000/annum). Trends over time differed by age, gender and severity. Conclusion This is the most comprehensive, population-based epidemiological study on fatal and non-fatal LSVRO events to date. Results from this study indicate

Work-related agricultural fatalities in Australia, 1982-1984.

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Erlich, S M; Driscoll, T R; Harrison, J E; Frommer, M S; Leigh, J

1993-06-01

Work-related agricultural fatalities were examined as part of a larger population-based study of all work-related fatalities in Australia in the period 1982-1984. A total of 257 farm-related fatalities were identified, of which 223 were deaths of persons in the employed civilian labor force (19.4 deaths per 100,000 persons per year) and 34 were deaths of children less than 15 years of age. The fatality incidence was higher among men, older age groups, and nonmanagers in general and in certain occupations in particular. Mobile mechanical equipment (particularly tractors) was the main fatal agent, roll-overs accounting for many of the fatalities. Better provision of information to agricultural workers, improvements in compliance to and enforcement of legislation, and changes in farming work practices are recommended to improve the safety of farms and farm work.

Geometrical shock dynamics for magnetohydrodynamic fast shocks

KAUST Repository

Mostert, W.; Pullin, D. I.; Samtaney, Ravi; Wheatley, V.

2016-01-01

We describe a formulation of two-dimensional geometrical shock dynamics (GSD) suitable for ideal magnetohydrodynamic (MHD) fast shocks under magnetic fields of general strength and orientation. The resulting area–Mach-number–shock-angle relation is then incorporated into a numerical method using pseudospectral differentiation. The MHD-GSD model is verified by comparison with results from nonlinear finite-volume solution of the complete ideal MHD equations applied to a shock implosion flow in the presence of an oblique and spatially varying magnetic field ahead of the shock. Results from application of the MHD-GSD equations to the stability of fast MHD shocks in two dimensions are presented. It is shown that the time to formation of triple points for both perturbed MHD and gas-dynamic shocks increases as (Formula presented.), where (Formula presented.) is a measure of the initial Mach-number perturbation. Symmetry breaking in the MHD case is demonstrated. In cylindrical converging geometry, in the presence of an azimuthal field produced by a line current, the MHD shock behaves in the mean as in Pullin et al. (Phys. Fluids, vol. 26, 2014, 097103), but suffers a greater relative pressure fluctuation along the shock than the gas-dynamic shock. © 2016 Cambridge University Press

Geometrical shock dynamics for magnetohydrodynamic fast shocks

KAUST Repository

Mostert, W.

2016-12-12

We describe a formulation of two-dimensional geometrical shock dynamics (GSD) suitable for ideal magnetohydrodynamic (MHD) fast shocks under magnetic fields of general strength and orientation. The resulting area–Mach-number–shock-angle relation is then incorporated into a numerical method using pseudospectral differentiation. The MHD-GSD model is verified by comparison with results from nonlinear finite-volume solution of the complete ideal MHD equations applied to a shock implosion flow in the presence of an oblique and spatially varying magnetic field ahead of the shock. Results from application of the MHD-GSD equations to the stability of fast MHD shocks in two dimensions are presented. It is shown that the time to formation of triple points for both perturbed MHD and gas-dynamic shocks increases as (Formula presented.), where (Formula presented.) is a measure of the initial Mach-number perturbation. Symmetry breaking in the MHD case is demonstrated. In cylindrical converging geometry, in the presence of an azimuthal field produced by a line current, the MHD shock behaves in the mean as in Pullin et al. (Phys. Fluids, vol. 26, 2014, 097103), but suffers a greater relative pressure fluctuation along the shock than the gas-dynamic shock. © 2016 Cambridge University Press

Fatal versus non-fatal heroin "overdose": blood morphine concentrations with fatal outcome in comparison to those of intoxicated drivers.

Science.gov (United States)

Meissner, Christoph; Recker, Sabine; Reiter, Arthur; Friedrich, Hans Juergen; Oehmichen, Manfred

2002-11-05

The study was performed to distinguish fatal from non-fatal blood concentrations of morphine. For this purpose, blood levels of free morphine and total morphine (free morphine plus morphine conjugates) in 207 cases of heroin-related deaths were compared to those in 27 drivers surviving opiate intoxication. The majority of both survivors and non-survivors were found to show a concomitant use of depressants including alcohol or stimulants. Blood morphine levels in both groups varied widely, with a large area of overlap between survivors (free morphine: 0-128 ng/ml, total morphine: 10-2,110 ng/ml) and non-survivors (free morphine: 0-2,800 ng/ml, total morphine: 33-5,000 ng/ml). Five (18.5%) survivors and 87 (42.0%) non-survivors exhibit intoxication only by morphine. In these cases, too, both groups overlapped (survivors-free morphine: 28-93 ng/ml, total morphine: 230-1,451 ng/ml; non-survivors-free morphine: 0-2,800 ng/ml, total morphine: 119-4,660 ng/ml). Although the blood levels of free or total morphine do not allow a reliable prediction of survival versus non-survival, the ratio of free/total morphine may be a criterion to distinguish lethal versus survived intoxication. The mean of the ratio of free to total morphine for all lethal cases (N=207) was 0.293, for those that survived (N=27) 0.135, in cases of intoxication only by morphine 0.250 (N=87) and 0.080 (N=5), respectively. Applying a cut-off of 0.12 for free/total morphine and performing ROC analyses, fatal outcome can be predicted in 80% of the cases correctly, whereas 16% of the survivors were classified as dead. Nevertheless, in this study, all cases with a blood concentration of 200 ng/ml and more of free morphine displayed a fatal outcome.

Free radical production by high energy shock waves--comparison with ionizing irradiation.

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Morgan, T R; Laudone, V P; Heston, W D; Zeitz, L; Fair, W R

1988-01-01

Fricke chemical dosimetry is used as an indirect measure of the free radical production of ionizing irradiation. We adapted the Fricke ferrous sulfate radiation dosimeter to examine the chemical effects of high energy shock waves. Significant free radical production was documented. The reaction was dose dependent, predictably increased by acoustic impedance, but curvilinear. A thousand shocks at 18 kilovolts induced the same free radical oxidation as 1100 rad cobalt-60 gamma ionizing irradiation, increasing to 2900 rad in the presence of an air-fluid zone of acoustic impedance. The biological effect of these free radicals was compared to that of cobalt-60 ionizing irradiation by measuring the affect on Chinese hamster cells by clonogenic assay. While cobalt-60 irradiation produced a marked decrease in clonogenic survivors, little effect was noted with high energy shock waves. This suggested that the chemical effects produced by shock waves were either absent or attenuated in the cells, or were inherently less toxic than those of ionizing irradiation.

Effects of black liquor shocks on activated sludge treatment of bleached kraft pulp mill wastewater.

Science.gov (United States)

Morales, Gabriela; Pesante, Silvana; Vidal, Gladys

2015-01-01

Kraft pulp mills use activated sludge systems to remove organic matter from effluents. Process streams may appear as toxic spills in treatment plant effluents, such as black liquor, which is toxic to microorganisms of the activated sludge. The present study evaluates the effects of black liquor shocks in activated sludge systems. Four black liquor shocks from 883 to 3,225 mg chemical oxygen demand-COD L(-1) were applied during 24 hours in a continuously operating lab-scale activated sludge system. Removal efficiencies of COD, color and specific compounds were determined. Moreover, specific oxygen uptake rate (SOUR), sludge volumetric index (SVI) and indicator microorganisms were evaluated. Results show that the addition of black liquor caused an increase in COD removal (76-67%) immediately post shock; followed two days later by a decrease (-19-50%). On the other hand, SOUR ranged between 0.152 and 0.336 mgO2 g(-1) volatile suspended solids-VSS• min(-1) during shocks, but the initial value was reestablished at hour 24. When the COD concentration of the shock was higher than 1,014 mg/L, the abundance of stalked ciliates and rotifers dropped. Finally, no changes in SVI were observed, with values remaining in the range 65.8-40.2 mL g(-1) total suspended solids-TSS during the entire operating process. Based on the results, the principal conclusion is that the activated sludge system with the biomass adapted to the kraft pulp effluent could resist a black liquor shock with 3,225 mgCOD L(-1) of concentration during 24 h, under this study's conditions.

Copper toxicity in housed lambs

Energy Technology Data Exchange (ETDEWEB)

Adamson, A H; Valks, D A; Appleton, M A; Shaw, W B

1969-09-27

Copper toxicity among 170 lambs artificially reared indoors at High Mowthorpe NAAS Experimental Husbandry Farm is reported. Although only three lambs were lost it is not unreasonable to suggest that the liver copper levels of the lambs which were slaughtered would have been high and losses could have been much heavier had there been any further copper supplementation. Even a copper level of 20 ppm in lamb concentrates given to lambs reared artificially indoors is dangerous, and intakes of much less than 38 mg per lamb per day can be fatal if given of a prolonged period. 5 references, 1 table.

Acute toxicity of ingested fluoride.

Science.gov (United States)

Whitford, Gary Milton

2011-01-01

This chapter discusses the characteristics and treatment of acute fluoride toxicity as well as the most common sources of overexposure, the doses that cause acute toxicity, and factors that can influence the clinical outcome. Cases of serious systemic toxicity and fatalities due to acute exposures are now rare, but overexposures causing toxic signs and symptoms are not. The clinical course of systemic toxicity from ingested fluoride begins with gastric signs and symptoms, and can develop with alarming rapidity. Treatment involves minimizing absorption by administering a solution containing calcium, monitoring and managing plasma calcium and potassium concentrations, acid-base status, and supporting vital functions. Approximately 30,000 calls to US poison control centers concerning acute exposures in children are made each year, most of which involve temporary gastrointestinal effects, but others require medical treatment. The most common sources of acute overexposures today are dental products - particularly dentifrices because of their relatively high fluoride concentrations, pleasant flavors, and their presence in non-secure locations in most homes. For example, ingestion of only 1.8 ounces of a standard fluoridated dentifrice (900-1,100 mg/kg) by a 10-kg child delivers enough fluoride to reach the 'probably toxic dose' (5 mg/kg body weight). Factors that may influence the clinical course of an overexposure include the chemical compound (e.g. NaF, MFP, etc.), the age and acid-base status of the individual, and the elapsed time between exposure and the initiation of treatment. While fluoride has well-established beneficial dental effects and cases of serious toxicity are now rare, the potential for toxicity requires that fluoride-containing materials be handled and stored with the respect they deserve. Copyright © 2011 S. Karger AG, Basel.

Subacute right ventricle perforation by pacemaker lead presenting with left hemothorax and shock.

Science.gov (United States)

Nichols, Julianne; Berger, Natalie; Joseph, Praveen; Datta, Debapriya

2015-01-01

Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT) of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

The global distribution of fatal pesticide self-poisoning: Systematic review

Directory of Open Access Journals (Sweden)

Eddleston Michael

2007-12-01

Full Text Available Abstract Background Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown. Methods We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007, papers cited in publications retrieved, the worldwide web (using Google and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning. Results We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907 deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37% of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267. The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm. Conclusion Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a the use of pesticides most toxic to humans was restricted, (b pesticides could be safely stored in rural communities, and (c the accessibility and quality of care for poisoning

Different features of Vδ2 T and NK cells in fatal and non-fatal human Ebola infections.

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Cimini, Eleonora; Viola, Domenico; Cabeza-Cabrerizo, Mar; Romanelli, Antonella; Tumino, Nicola; Sacchi, Alessandra; Bordoni, Veronica; Casetti, Rita; Turchi, Federica; Martini, Federico; Bore, Joseph A; Koundouno, Fara Raymond; Duraffour, Sophie; Michel, Janine; Holm, Tobias; Zekeng, Elsa Gayle; Cowley, Lauren; Garcia Dorival, Isabel; Doerrbecker, Juliane; Hetzelt, Nicole; Baum, Jonathan H J; Portmann, Jasmine; Wölfel, Roman; Gabriel, Martin; Miranda, Osvaldo; Díaz, Graciliano; Díaz, José E; Fleites, Yoel A; Piñeiro, Carlos A; Castro, Carlos M; Koivogui, Lamine; Magassouba, N'Faly; Diallo, Boubacar; Ruibal, Paula; Oestereich, Lisa; Wozniak, David M; Lüdtke, Anja; Becker-Ziaja, Beate; Capobianchi, Maria R; Ippolito, Giuseppe; Carroll, Miles W; Günther, Stephan; Di Caro, Antonino; Muñoz-Fontela, César; Agrati, Chiara

2017-05-01

Human Ebola infection is characterized by a paralysis of the immune system. A signature of αβ T cells in fatal Ebola infection has been recently proposed, while the involvement of innate immune cells in the protection/pathogenesis of Ebola infection is unknown. Aim of this study was to analyze γδ T and NK cells in patients from the Ebola outbreak of 2014-2015 occurred in West Africa, and to assess their association with the clinical outcome. Nineteen Ebola-infected patients were enrolled at the time of admission to the Ebola Treatment Centre in Guinea. Patients were divided in two groups on the basis of the clinical outcome. The analysis was performed by using multiparametric flow cytometry established by the European Mobile Laboratory in the field. A low frequency of Vδ2 T-cells was observed during Ebola infection, independently from the clinical outcome. Moreover, Vδ2 T-cells from Ebola patients massively expressed CD95 apoptotic marker, suggesting the involvement of apoptotic mechanisms in Vδ2 T-cell loss. Interestingly, Vδ2 T-cells from survivors expressed an effector phenotype and presented a lower expression of the CTLA-4 exhaustion marker than fatalities, suggesting a role of effector Vδ2 T-cells in the protection. Furthermore, patients with fatal Ebola infection were characterized by a lower NK cell frequency than patients with non fatal infection. In particular, both CD56bright and CD56dim NK frequency were very low both in fatal and non fatal infections, while a higher frequency of CD56neg NK cells was associated to non-fatal infections. Finally, NK activation and expression of NKp46 and CD158a were independent from clinical outcome. Altogether, the data suggest that both effector Vδ2 T-cells and NK cells may play a role in the complex network of protective response to EBOV infection. Further studies are required to characterize the protective effector functions of Vδ2 and NK cells.

Different features of Vδ2 T and NK cells in fatal and non-fatal human Ebola infections.

Directory of Open Access Journals (Sweden)

Eleonora Cimini

2017-05-01

Full Text Available Human Ebola infection is characterized by a paralysis of the immune system. A signature of αβ T cells in fatal Ebola infection has been recently proposed, while the involvement of innate immune cells in the protection/pathogenesis of Ebola infection is unknown. Aim of this study was to analyze γδ T and NK cells in patients from the Ebola outbreak of 2014-2015 occurred in West Africa, and to assess their association with the clinical outcome.Nineteen Ebola-infected patients were enrolled at the time of admission to the Ebola Treatment Centre in Guinea. Patients were divided in two groups on the basis of the clinical outcome. The analysis was performed by using multiparametric flow cytometry established by the European Mobile Laboratory in the field. A low frequency of Vδ2 T-cells was observed during Ebola infection, independently from the clinical outcome. Moreover, Vδ2 T-cells from Ebola patients massively expressed CD95 apoptotic marker, suggesting the involvement of apoptotic mechanisms in Vδ2 T-cell loss. Interestingly, Vδ2 T-cells from survivors expressed an effector phenotype and presented a lower expression of the CTLA-4 exhaustion marker than fatalities, suggesting a role of effector Vδ2 T-cells in the protection. Furthermore, patients with fatal Ebola infection were characterized by a lower NK cell frequency than patients with non fatal infection. In particular, both CD56bright and CD56dim NK frequency were very low both in fatal and non fatal infections, while a higher frequency of CD56neg NK cells was associated to non-fatal infections. Finally, NK activation and expression of NKp46 and CD158a were independent from clinical outcome.Altogether, the data suggest that both effector Vδ2 T-cells and NK cells may play a role in the complex network of protective response to EBOV infection. Further studies are required to characterize the protective effector functions of Vδ2 and NK cells.

Fatal crashes involving large numbers of vehicles and weather.

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Wang, Ying; Liang, Liming; Evans, Leonard

2017-12-01

Adverse weather has been recognized as a significant threat to traffic safety. However, relationships between fatal crashes involving large numbers of vehicles and weather are rarely studied according to the low occurrence of crashes involving large numbers of vehicles. By using all 1,513,792 fatal crashes in the Fatality Analysis Reporting System (FARS) data, 1975-2014, we successfully described these relationships. We found: (a) fatal crashes involving more than 35 vehicles are most likely to occur in snow or fog; (b) fatal crashes in rain are three times as likely to involve 10 or more vehicles as fatal crashes in good weather; (c) fatal crashes in snow [or fog] are 24 times [35 times] as likely to involve 10 or more vehicles as fatal crashes in good weather. If the example had used 20 vehicles, the risk ratios would be 6 for rain, 158 for snow, and 171 for fog. To reduce the risk of involvement in fatal crashes with large numbers of vehicles, drivers should slow down more than they currently do under adverse weather conditions. Driver deaths per fatal crash increase slowly with increasing numbers of involved vehicles when it is snowing or raining, but more steeply when clear or foggy. We conclude that in order to reduce risk of involvement in crashes involving large numbers of vehicles, drivers must reduce speed in fog, and in snow or rain, reduce speed by even more than they already do. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Physics of Collisionless Shocks Space Plasma Shock Waves

CERN Document Server

Balogh, André

2013-01-01

The present book provides a contemporary systematic treatment of shock waves in high-temperature collisionless plasmas as are encountered in near Earth space and in Astrophysics. It consists of two parts. Part I develops the complete theory of shocks in dilute hot plasmas under the assumption of absence of collisions among the charged particles when the interaction is mediated solely by the self-consistent electromagnetic fields. Such shocks are naturally magnetised implying that the magnetic field plays an important role in their evolution and dynamics. This part treats both subcritical shocks, which dissipate flow energy by generating anomalous resistance or viscosity, and supercritical shocks. The main emphasis is, however, on super-critical shocks where the anomalous dissipation is insufficient to retard the upstream flow. These shocks, depending on the direction of the upstream magnetic field, are distinguished as quasi-perpendicular and quasi-parallel shocks which exhibit different behaviours, reflecti...

Propensity of tampons and barrier contraceptives to amplify Staphylococcus aureusToxic shock syndrome toxin-I.

Science.gov (United States)

Tierno, P M; Hanna, B A

1994-01-01

Although the incidence of reported cases of toxic shock syndrome (TSS) has declined in recent years, the disease continues to occur in menstruating women using the newer, less-absorbent tampons or barrier contraceptives. Extant tampons and other vaginal devices were tested for the ability to induce TSS toxin-1 (TSST-1) by a TSS strain of Staphylococcus aureus MN8, a known high-toxin producer. Tested for the first time were 20 varieties of tampons, including 2 all-cotton brands newly introduced in the United States, a polyurethane contraceptive sponge, a latex diaphragm, and a polymer menstrual collection cup. All products were washed in sterile distilled water prior to use to reduce the effect of leachable chemicals. Duplicate experiments with unwashed products were also performed. Entire tampons and other test products were immersed in brain heart infusion broth plus yeast extract (BHIY) and inoculated with S. aureus MN8, a known TSST-1 producer. After incubation, the culture supernatants were assayed for TSST-1 by gel immunodiffusion. Except for all-cotton tampons, greater amounts of TSST-1 were detected in the supernatant fluid of washed tampons than detected in those which were not washed. While TSST-1 levels in unwashed non-cotton tampons ranged from 0.5 to 8 microg/ml, when these products were washed, TSST-1 levels increased to 2-32 microg/ml. In all-cotton tampons, whether washed or not, there was no detectable TSST-1. The propensity for all-cotton tampons not to amplify TSST-1 in vitro suggests they would lower the risk for tampon-associated TSS.

Using speeding detections and numbers of fatalities to estimate relative risk of a fatality for motorcyclists and car drivers.

Science.gov (United States)

Huggins, Richard

2013-10-01

Precise estimation of the relative risk of motorcyclists being involved in a fatal accident compared to car drivers is difficult. Simple estimates based on the proportions of licenced drivers or riders that are killed in a fatal accident are biased as they do not take into account the exposure to risk. However, exposure is difficult to quantify. Here we adapt the ideas behind the well known induced exposure methods and use available summary data on speeding detections and fatalities for motorcycle riders and car drivers to estimate the relative risk of a fatality for motorcyclists compared to car drivers under mild assumptions. The method is applied to data on motorcycle riders and car drivers in Victoria, Australia in 2010 and a small simulation study is conducted. Copyright © 2013 Elsevier Ltd. All rights reserved.

Electric gun: a new method for generating shock pressures in excess of 1 TPa

International Nuclear Information System (INIS)

Steinberg, D.; Chau, H.; Dittbenner, G.; Weingart, R.

1978-01-01

By combining the electrically-driven, flying-plate, high-explosive initiator with well-known gas-gun technology, a novel method of generating and measuring shock pressures greater than 1 TPa has been developed. Called the electric gun, this system is competitive with laser or nuclear-driven, shock-wave, equation-of-state experiments in the 1 to 5 TPa range. Compared to those other methods, it has the advantage of simplicity, high precision, and low cost. In addition, its small size and low total energy allow it to be easily contained for experiments with toxic materials

Coffee consumption and risk of fatal cancers.

Science.gov (United States)

Snowdon, D A; Phillips, R L

1984-01-01

In 1960, the coffee consumption habits and other lifestyle characteristics of 23,912 white Seventh-day Adventists were assessed by questionnaire. Between 1960 and 1980, deaths due to cancer were identified. There were positive associations between coffee consumption and fatal colon and bladder cancer. The group consuming two or more cups of coffee per day had an estimated relative risk (RR) of 1.7 for fatal colon cancer and 2.0 for fatal bladder cancer, compared to the group that consumed less than one cup per day (RR = 1.0). These positive associations were apparently not confounded by age, sex, cigarette smoking, or meat consumption habits. In this study, there were no significant or suggestive associations between coffee consumption and fatal pancreatic, breast, and ovarian cancer, or a combined group of all other cancer sites. PMID:6742274

Breaking Bad Delirium: Methamphetamine and Boric Acid Toxicity with Hallucinations and Pseudosepsis.

Science.gov (United States)

Johnson, Kayla; Stollings, Joanna L; Ely, E Wesley

2017-02-01

A 30-year-old patient presented with hallucinations and profound shock. He was initially misdiagnosed as having severe sepsis; once ingestions were considered, he was diagnosed as potentially having arsenic toxicity. The clinical story reveals many instructional lessons that could aid in the evaluation and management of future patients. This man presented with large amounts of blue crystals around his nose and lips from inhaling and eating boric acid (an ant poison) so he could, as he put it, kill the ants "pouring into my mouth and nose and up into my brain." His profound pseudosepsis and sustained delirium were induced by co-ingestion of methamphetamine and a large quantity of boric acid. Delirium is a form of acute brain dysfunction that often is multifactorial in critical illness and, when seen in septic shock, is associated with prolonged mechanical ventilation, increased length of hospital stay, medical costs, higher mortality, and long-term cognitive impairment resembling dementia. Pseudosepsis is a noninfectious condition most commonly seen with ingestions such as salicylate (aspirin) toxicity. This report emphasizes the need to recognize agents that contain boric acid as an etiology of unexplained delirium and profound shock.

Cardiogenic shock caused by a left midventricular obstruction during refeeding in a patient with anorexia nervosa.

Science.gov (United States)

Sakamoto, Yoko; Kioka, Hidetaka; Hashimoto, Ryota; Takeda, Saori; Momose, Kota; Ohtani, Tomohito; Yamaguchi, Osamu; Wasa, Masafumi; Nakatani, Satoshi; Sakata, Yasushi

2017-03-01

Refeeding syndrome occurs when reinstating nutrition to severely malnourished patients. It can sometimes be fatal, particularly as a result of cardiac involvement such as congestive heart failure and arrhythmias. The aim of this study was to report a case of cardiogenic shock that occurred during refeeding in a patient with anorexia nervosa (AN). The cardiogenic shock was due to a previously unrecognized mechanism, namely a transient left midventricular obstruction that completely disappeared after treatment. A 46-y-old woman with AN who had followed a carbohydrate- and a fat-deficient diet for >10 y was hospitalized for dyspnea on exertion. She had severely impaired cardiac systolic function on admission and was considered high risk for refeeding syndrome. During a stepwise increase of calories, she showed no electrolyte or mineral abnormalities characteristic of refeeding syndrome. After intravenous administration of a fat emulsion, the patient suffered from cardiogenic shock due to an unexpected mechanism, namely a left midventricular obstruction caused by cardiac hypercontraction, a thickened left ventricular wall, and intravascular volume depletion. With cessation of the fat emulsion and initiation of volume repletion she recovered from shock immediately and her echocardiogram returned to normal by discharge. This case illustrated a novel cause of cardiogenic shock during refeeding and the need for caution during the intravenous administration of a fat emulsion in patients with initial left ventricular systolic dysfunction. Copyright © 2016 Elsevier Inc. All rights reserved.

Simulations of Converging Shock Collisions for Shock Ignition

Science.gov (United States)

Sauppe, Joshua; Dodd, Evan; Loomis, Eric

2016-10-01

Shock ignition (SI) has been proposed as an alternative to achieving high gain in inertial confinement fusion (ICF) targets. A central hot spot below the ignition threshold is created by an initial compression pulse, and a second laser pulse drives a strong converging shock into the fuel. The collision between the rebounding shock from the compression pulse and the converging shock results in amplification of the converging shock and increases the hot spot pressure above the ignition threshold. We investigate shock collision in SI drive schemes for cylindrical targets with a polystyrene foam interior using radiation-hydrodynamics simulations with the RAGE code. The configuration is similar to previous targets fielded on the Omega laser. The CH interior results in a lower convergence ratio and the cylindrical geometry facilitates visualization of the shock transit using an axial X-ray backlighter, both of which are important for comparison to potential experimental measurements. One-dimensional simulations are used to determine shock timing, and the effects of low mode asymmetries in 2D computations are also quantified. LA-UR-16-24773.

Case fatality as an indicator for the human toxicity of pesticides - a systematic review on the availability and variability of severity indicators of pesticide poisoning

OpenAIRE

Moebus, Susanne; Boedeker, Wolfgang

2017-01-01

Objective: To investigate if case fatality and other indicators of severity of human pesticide poisonings can be used to prioritize pesticides of public health concern. To study the heterogeneity of data across countries, cause of poisonings, and treatment facilities. Methods: We searched literature databases as well as the internet for studies on case-fatality and severity scores of pesticide poisoning. Studies published between 1990 and 2014 providing information on active ingredients in pe...

Buses involved in fatal accidents codebook 2008.

Science.gov (United States)

2011-03-01

This report provides documentation for UMTRIs file of Buses Involved in Fatal Accidents (BIFA), 2008, : including distributions of the code values for each variable in the file. The 2008 BIFA file is a census of all : buses involved in a fatal acc...

Buses involved in fatal accidents codebook 2007.

Science.gov (United States)

2009-12-01

This report provides documentation for UMTRIs file of Buses Involved in Fatal Accidents (BIFA), 2007, : including distributions of the code values for each variable in the file. The 2007 BIFA file is a census of all : buses involved in a fatal acc...

Shock Dynamics in Stellar Outbursts. I. Shock Formation

Energy Technology Data Exchange (ETDEWEB)

Ro, Stephen; Matzner, Christopher D., E-mail: ro@astro.utoronto.ca [Department of Astronomy and Astrophysics, University of Toronto, 50 St. George Street, Toronto, ON M5S 3H4 (Canada)

2017-05-20

Wave-driven outflows and non-disruptive explosions have been implicated in pre-supernova outbursts, supernova impostors, luminous blue variable eruptions, and some narrow-line and superluminous supernovae. To model these events, we investigate the dynamics of stars set in motion by strong acoustic pulses and wave trains, focusing on nonlinear wave propagation, shock formation, and an early phase of the development of a weak shock. We identify the shock formation radius, showing that a heuristic estimate based on crossing characteristics matches an exact expansion around the wave front and verifying both with numerical experiments. Our general analytical condition for shock formation applies to one-dimensional motions within any static environment, including both eruptions and implosions. We also consider the early phase of shock energy dissipation. We find that waves of super-Eddington acoustic luminosity always create shocks, rather than damping by radiative diffusion. Therefore, shock formation is integral to super-Eddington outbursts.

Left ventricular hypertrophy and risk of fatal and non-fatal stroke EUROSTROKE: a collaborative study among research centres in Europe

NARCIS (Netherlands)

M.L. Bots (Michiel); J. Tuomilehto; D.E. Grobbee (Diederick); P.J. Koudstaal (Peter Jan); Y. Nikitin; J.T. Salonen; P.C. Elwood; S. Malyutina; A. Freire de Concalves; J. Sivenius; A. di Carlo; P. Lagiou

2002-01-01

textabstractBACKGROUND: This study investigated the association between electrocardiographically assessed left ventricular hypertrophy (LVH) and fatal, non-fatal, haemorrhagic and ischaemic stroke in four European cohorts participating in EUROSTROKE. METHODS: EUROSTROKE is a

The crucifixion of Jesus: review of hypothesized mechanisms of death and implications of shock and trauma-induced coagulopathy.

Science.gov (United States)

Bergeron, Joseph W

2012-04-01

The crucifixion of Jesus is arguably the most well-known and controversial execution in history. Christian faithful, dating back to the time of Jesus, have believed that Jesus was executed by crucifixion and later returned physically to life again. Others have questioned whether Jesus actually died by crucifixion, at all. From review of medical literature, physicians have failed to agree on a specific mechanism of Jesus' death. A search of Medline/Pubmed was completed with respect to crucifixion, related topics, and proposed mechanisms of Jesus' death. Several hypotheses for the mechanism of Jesus' death have been presented in medical literature, including 1) Pulmonary embolism 2) Cardiac rupture 3) Suspension trauma 4) Asphyxiation 5) Fatal stab wound, and 6) Shock. Each proposed mechanism of Jesus' death will be reviewed. The events of Jesus' execution are described, as they are pertinent to development of shock. Traumatic shock complicated by trauma-induced coagulopathy is proposed as a contributing factor, and possibly the primary mechanism, of Jesus' death by crucifixion. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Fatal accidents among Danes with multiple sclerosis

DEFF Research Database (Denmark)

Brønnum-Hansen, Henrik; Hansen, Thomas; Koch-Henriksen, Nils

2006-01-01

We compared the rate of fatal accidents among Danes with multiple sclerosis (MS) with that of the general population. The study was based on linkage of the Danish Multiple Sclerosis Registry to the Cause of Death Registry and covered all 10174 persons in whom MS was diagnosed during the period 19...... for deaths from burns (SMR = 8.90) and suffocation (SMR = 5.57). We conclude that persons with MS are more prone to fatal accidents than the general population. The excess risk is due not to traffic accidents but to burns and suffocation.......-1996. The end of follow-up was 1 January 1999. We calculated standardized mortality ratios (SMRs) for various types of fatal accidents. A total of 76 persons (48 men and 28 women) died from accidents, whereas the expected number of fatalities from such causes was 55.7 (31.4 men and 24.3 women). Thus, the risk...... for death from accidents among persons with MS was 37% higher than that of the general population (SMR = 1.37). We found no significant excess risk for fatal road accidents (SMR = 0.80). The risk for falls was elevated (SMR = 1.29) but not statistically significantly so. The risks were particularly high...

Has the great recession and its aftermath reduced traffic fatalities?

Science.gov (United States)

Noland, Robert B; Zhou, Yuhan

2017-01-01

An analysis of state-level data from 1984 to 2014 provides evidence on the relationship between economic recessions and US traffic fatalities. While there are large reductions associated with decreases in household median income, other policy variables tend to have additional and in some cases, larger effects. An increase in the inequality of the income distribution, measured by the Gini index, has reduced traffic fatalities. Graduated licensing policies, cell phone laws, and motorcycle helmet requirements are all associated with reductions in fatalities. Other factors include a proxy for medical technology, and access to emergency medical services (based on the percent of vehicle miles traveled in rural areas); reductions in the latter accounted for a substantial reduction in fatalities and is likely another indicator of reduced economic activity. Changes in the road network, mainly increases in the percent of collector roads has increased fatalities. Population growth is associated with increased traffic fatalities and changes in age cohorts has a small negative effect. Overall, results suggest that there has been a beneficial impact on traffic fatalities from reduced economic activity, but various policies adopted by the states have also reduced traffic fatalities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Results from the Hawaii domestic violence fatality review, 2000-2009

Science.gov (United States)

Pobutsky, Ann; Brown, Melissa; Nakao, Lisa; Reyes-Salvail, Florentina

2014-01-01

Abstract: Background: Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Methods: Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Results: Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and ‘Other” ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. Conclusions: In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1%) of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence. PMID:24292165

Results from the Hawaii domestic violence fatality review, 2000-2009

Directory of Open Access Journals (Sweden)

Ann Pobutsky

2014-07-01

Full Text Available Abstract: Background: Patterns of domestic violence fatalities and agency responses in Hawaii have not been explicated. Methods: Retrospective reviews of events leading up to domestic violence related fatalities in Hawaii were assessed from 45 adjudicated cases that resulted in 62 fatalities for the ten year period from 2000-2009. Results: Almost one-half of the fatalities were homicide/suicide combinations. Females were disproportionately more likely to be fatal victims of domestic violence relative to their proportion in the population. Those aged 21-40 years and those over 80 years were more likely to be fatal victims of domestic violence, relative to their proportion in the population. Filipinas and „Other” ethnic groups are disproportionately more likely to be fatal victims of domestic violence while Native Hawaiians and Japanese are less likely to be fatal victims, relative to their proportions in the population. In more than two-thirds of the cases, the victim had made some attempt to leave the relationship prior to the fatality. Conclusions: In the majority of cases there was agency involvement in some form: either the victim alone or the perpetrator alone, or both. However, less than one-third (31.1% of the cases over the past ten years had documentation of prior violence from medical reports, so this may be an area to further document and address domestic violence.

Fatal injuries to teenage construction workers in the US.

Science.gov (United States)

Suruda, Anthony; Philips, Peter; Lillquist, Dean; Sesek, Richard

2003-11-01

The construction industry is second only to agriculture in the annual number of fatal injuries in workers less than 18 years of age. We examined fatal injury reports for youth and adult workers to determine risk factors for injury and applicability of existing child labor regulations. The US Occupational Safety & Health Administration (OSHA) investigation data for fatal work injuries from 1984 through 1998 were reviewed with respect to type of event, employer characteristics, and apparent violations of existing child labor laws under the Fair Labor Standards Act (FLSA). We also examined whether the employer met exemption criteria for federal enforcement of child labor or OSHA regulations. The fatality rate for teenage construction workers age 19 and younger was 12.1 per 100,000 per year, slightly less than for adult workers. Teenage workers who were fatally injured were more likely than adults to have been employed at non-union construction firms (odds ratio (OR) = 4.96, P worker. Fatalities in teenagers were more likely to occur in special construction trades such as roofing. Among fatalities in workers less than 18 years of age, approximately one-half (49%) of the 76 fatal injuries were in apparent violation of existing child labor regulations. We estimated that in 41 of the 76 cases (54%) the employer's gross annual income exceeded the $500,000 threshold for federal enforcement of child labor laws. Only 28 of 76 cases (37%) were at construction firms with 11 or more employees, which are subject to routine OSHA inspections. Fatal injuries in teenage construction workers differed from those in adults in that they were more likely to be at small, non-union firms of which a substantial proportion were exempt from federal enforcement of child labor laws and from routine OSHA inspections. Safety programs for young construction workers should include small, non-union construction firms and those in special construction trades such as roofing. We did not identify

Fatal accidents at railway level crossings in Great Britain 1946-2009.

Science.gov (United States)

Evans, Andrew W

2011-09-01

This paper investigates fatal accidents and fatalities at level crossings in Great Britain over the 64-year period 1946-2009. The numbers of fatal accidents and fatalities per year fell by about 65% in the first half of that period, but since then have remained more or less constant at about 11 fatal accidents and 12 fatalities per year. At the same time other types of railway fatalities have fallen, so level crossings represent a growing proportion of the total. Nevertheless, Britain's level crossing safety performance remains good by international standards. The paper classifies level crossings into three types: railway-controlled, automatic, and passive. The safety performance of the three types of crossings has been very different. Railway-controlled crossings are the best-performing crossing type, with falling fatal accident rates. Automatic crossings have higher accident rates per crossing than railway controlled or passive crossings, and the accident rates have not decreased. Passive crossings are by far the most numerous, but many have low usage by road users. Their fatal accident rate has remained remarkably constant over the whole period at about 0.9 fatal accidents per 1000 crossings per year. A principal reason why fatal accidents and fatalities have not fallen in the second half of the period as they did in the first half is the increase in the number of automatic crossings, replacing the safer railway controlled crossings on some public roads. However, it does not follow that this replacement was a mistake, because automatic crossings have advantages over controlled crossings in reducing delays to road users and in not needing staff. Based on the trends for each type of crossing and for pedestrian and non-pedestrian accidents separately, in 2009 a mean of about 5% of fatal accidents were at railway controlled crossings, 52% were at automatic crossings, and 43% were at passive crossings. Fatalities had similar proportions. About 60% of fatalities were

Aluminum Phosphide; the Most Fatal Rodenticide and Fungicide

International Nuclear Information System (INIS)

Afshari, R.

2007-01-01

Introduction: Aluminum phosphide (AP) is a fumigate agent, which is also used to control rodents and pests in grain storage facilities. This agent is commonly used in low income and agricultural communities. AP is easily available, cheap and highly toxic. Ingestion of even half a fresh tablet invariably results in death. Its suicidal or accidental poisoning is a medical emergency, while in some low income countries it reaches to more than two third of poisoning deaths. Methods: PubMed was systematically searched (December 2006) for articles related to aluminium phosphide poisoning. 24 articles were finally included. Mechanism of action; AP on exposure to moisture, liberates highly toxic gas, phosphine. In animal and human models AP rapidly inhibits cytochrome-c oxidase leading to inhibition of mitochondrial oxidative phosphorylation and inhibits mitochondrial respiration and has cytotoxic action. Clinical Findings: Initial findings of intoxication may be nonspecific and transient. The symptoms may resolve within several hours after removal from exposure. It, however, produces phosphine gas, which is a mitochondrial poison. Its manufacturing and application pose risks of inhalation of phosphine. CNS; GCS is fine at the beginning. Biochemistry; Metabolic acidosis and liver dysfunction are reported. Shock is frequent. Respiratory Tract; Acute dyspnoea, hypotension, bradycardia and other signs of intoxication were also stated. Gastrointestinal; Reported short-segment esophageal strictures in the upper and mid esophagus, successfully managed by endoscopic dilatation. In sub-chronic use, degenerative changes in liver, heart and kidney of rabbits are reported. Cardiovascular; The ECG abnormalities are common and include hypotension, bradycardia, ST-T changes, Supraventricular tachycardia, ventricular ectopics, life threatening ventricular tachycardia, ventricular fibrillation, atrial flutter/fibrillation, variable degrees of heart block and toxic myocarditis. Haematologic

Nordic ski jumping fatalities in the United States: a 50-year summary.

Science.gov (United States)

Wright, J R

1988-06-01

Nordic ski-jumping fatalities are rare events. Six jumping fatalities have occurred in the United States during the past 50 years. The fatality rate for nordic ski jumping, estimated to be roughly 12 fatalities/100,000 participants annually, appears to be within the range of fatality rates for other "risky" outdoor sports. Cervical fractures appear to be the most frequent fatal ski-jumping injury.

Macroeconomic fluctuations and motorcycle fatalities in the U.S.

Science.gov (United States)

French, Michael T; Gumus, Gulcin

2014-03-01

The effects of business cycles on health outcomes in general, and on traffic fatalities in particular, have received much attention recently. In this paper, we focus on motorcycle safety and examine the impact of changing levels of economic activity on fatal crashes by motorcyclists in the United States. We analyze state-level longitudinal data with 1,104 state/year observations from the 1988-2010 Fatality Analysis Reporting System (FARS). Using the extensive motorcycle crash characteristics available in FARS, we examine not only total fatality rates but also rates decomposed by crash type, day, time, and the level of the motorcycle operator's blood alcohol content. Our results are consistent with much of the existing literature showing that traffic fatality rates are pro-cyclical. The estimates suggest that a 10% increase in real income per capita is associated with a 10.4% rise in the total motorcycle fatality rate. Along with potential mechanisms, policymakers and public health officials should consider the effects of business cycles on motorcycle safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

TYPHOID FEVER WITH FATAL OUTCOME IN PEOPLE WITH SEVERE TROPHOLOGICAL FAILURE IN EXTREME CONDITIONS

Directory of Open Access Journals (Sweden)

Yu. I. Lyashenko

2017-01-01

Full Text Available For purpose of clinical and morphological characterization of typhoid fever with fatal outcome was perform analysis of medical documentation as well as postmortem studies of internal tissues in 36men aged 21 to 34 years with severe body weight loss and in the conditions of combat stress in period from 1983 to 1985. The results of the study find a number of clinical and pathomorphological features of typhoid fever in patients with body weight deficiency that were in extreme conditions. Focal changes of the central nervous system were detected. The defeat of the respiratory system was characterized from the first days of the disease by bronchitis, and in the subsequent development of pneumonia, plevritis and empyema of the pleura. Majority of patients had symptoms of cardiovascular and renal failure. In died in the first week of the disease and in 2/3 parts – in a later period were combined with the symptoms of infectious-toxic encephalopathy and severe acute respiratory failure. All died had postmortem dystrophic changes of cardiomyocytes, and in patients had fatal outcome in 2–5 weeks – also focal or diffuse myocarditis. In a third of the patients who died, the disease was complicated by intestinal perforations. In a number of cases, peritonitis was a consequence of necrosis of mesenteric lymph nodes. In all patients with a fatal outcome, hemorrhagic (thrombohemorrhagic syndrome was diagnosed. A significant proportion of patients posthumously detected signs of sepsis and other complications, many of which could be the cause of death.

Characteristics of schools in which fatal shootings occur.

Science.gov (United States)

de Apodaca, Roberto Flores; Brighton, Lauren M; Perkins, Ashley N; Jackson, Kiana N; Steege, Jessica R

2012-04-01

School-based violence, and fatal school shootings in particular, have gained increased attention in the media and psychological literature. Most reports have focused on the characteristics of perpetrators, but there is a growing awareness that school-related factors may also influence the occurrence of fatal school shootings. The current study examined several key characteristics of all schools where random (38) and targeted (96) fatal shootings occurred in the United States between 1966 and 2009. These were compared with a group (138) of schools randomly selected to represent the population of all schools in the United States. The size of a school's enrollment, urban or suburban locale, public funding, and predominantly non-white enrollment were positively associated with fatal shootings. Universities and colleges were disproportionately associated with random shootings and high schools with targeted ones. It was proposed that characteristics of schools that allow feelings of anonymity or alienation among students may help create environmental conditions associated with fatal school shootings. Implications for future research and interventions are considered.

Fatal laboratory-acquired infection with an attenuated Yersinia pestis Strain--Chicago, Illinois, 2009.

Science.gov (United States)

2011-02-25

On September 18, 2009, the Chicago Department of Public Health (CDPH) was notified by a local hospital of a suspected case of fatal laboratory-acquired infection with Yersinia pestis, the causative agent of plague. The patient, a researcher in a university laboratory, had been working along with other members of the laboratory group with a pigmentation-negative (pgm-) attenuated Y. pestis strain (KIM D27). The strain had not been known to have caused laboratory-acquired infections or human fatalities. Other researchers in a separate university laboratory facility in the same building had contact with a virulent Y. pestis strain (CO92) that is considered a select biologic agent; however, the pgm- attenuated KIM D27 is excluded from the National Select Agent Registry. The university, CDPH, the Illinois Department of Public Health (IDPH), and CDC conducted an investigation to ascertain the cause of death. This report summarizes the results of that investigation, which determined that the cause of death likely was an unrecognized occupational exposure (route unknown) to Y. pestis, leading to septic shock. Y. pestis was isolated from premortem blood cultures. Polymerase chain reaction (PCR) identified the clinical isolate as a pgm- strain of Y. pestis. Postmortem examination revealed no evidence of pneumonic plague. A postmortem diagnosis of hereditary hemochromatosis was made on the basis of histopathologic, laboratory, and genetic testing. One possible explanation for the unexpected fatal outcome in this patient is that hemochromatosis-induced iron overload might have provided the infecting KIM D27 strain, which is attenuated as a result of defects in its ability to acquire iron, with sufficient iron to overcome its iron-acquisition defects and become virulent. Researchers should adhere to recommended biosafety practices when handling any live bacterial cultures, even attenuated strains, and institutional biosafety committees should implement and maintain effective

Fatal and non-fatal cardiovascular events in a general population prescribed sibutramine in New Zealand: a prospective cohort study.

Science.gov (United States)

Harrison-Woolrych, Mira; Ashton, Janelle; Herbison, Peter

2010-07-01

The cardiovascular safety of sibutramine is currently under review by medicines regulatory authorities worldwide after the SCOUT (Sibutramine Cardiovascular Outcome Trial) showed an increased risk of cardiovascular events in patients taking sibutramine. Further data regarding the cardiovascular safety of sibutramine in a general population are now required. To quantify the risk of fatal and non-fatal cardiovascular adverse events in a general population prescribed sibutramine in postmarketing use. Observational prospective cohort study of patients dispensed sibutramine during a 3-year period (2001-4) and followed up for at least 1 year after their last prescription. The study included record-linkage to national mortality datasets to identify fatal events. Postmarketing 'real-life' use of sibutramine in a general population in New Zealand. All New Zealand patients dispensed a prescription for sibutramine in a 3-year period (for whom a National Health Identification number could be validated). 15 686 patients were included in the record linkage study for fatal events. A subgroup of 9471 patients was followed up by intensive methods for non-fatal events. (i) Rate of death from all causes and from cardiovascular events; and (ii) rates of non-fatal cardiovascular adverse events. Total exposure to sibutramine for 15 686 patients in the validated cohort was 5431 treatment-years. The rate of death from all causes in this cohort was 0.13 (95% CI 0.05, 0.27) per 100 treatment-years exposure. The rate of death from a cardiovascular event was 0.07 (95% CI 0.02, 0.19) per 100 treatment-years exposure. The most frequent non-fatal cardiovascular events in the intensively followed up cohort were hypertension, palpitations, hypotensive events and tachycardia. Risk of death from a cardiovascular event in this general population of patients prescribed sibutramine was lower than has been reported in other overweight/obese populations. The results of this study suggest that further

Reporting Fatal Neglect in Child Death Review.

Science.gov (United States)

Scott, Debbie

2018-01-01

Child death reviews are conducted with the aim of preventing child deaths however, definitions, inclusion criteria for the review of child deaths and reporting practices vary across Child Death Review Teams (CDRTs). This article aims to identify a common context and understanding of fatal neglect reporting by reviewing definitional issues of fatal neglect and comparing reporting practice across a number of CDRTs. Providing a consistent context for identifying and reporting neglect-related deaths may improve the understanding of the impact of fatal neglect and the risk factors associated with it and therefore, improve the potential of CDRT review to inform prevention programs, policies, and procedures.

Fatal poisoning among patients with drug addiction

DEFF Research Database (Denmark)

Simonsen, Kirsten Wiese; Christoffersen, Dorte J; Banner, Jytte

2015-01-01

INTRODUCTION: Fatal poisonings among drug addicts in Denmark in 2012 were examined. Cause of death, abuse pattern and geographic differences are discussed and data are compared with previous studies. METHODS: All fatal poisonings examined at the three institutes of forensic medicine in Denmark...... on Funen and in South Jutland. Cocaine was most frequently detected in East Denmark, while amphetamine was more frequent in West Denmark. CONCLUSIONS: The number of fatal poisonings among drug addicts has stabilised around 200. The increase in methadone deaths continued and, as in 2007, methadone...... with 2007, indicating that a considerable number of drug addicts also have psychiatric illness. FUNDING: none. TRIAL REGISTRATION: not relevant....

Fatal poisoning among patients with drug addiction

DEFF Research Database (Denmark)

Simonsen, K. W.; Christoffersen, D. J.; Banner, J.

2015-01-01

Introduction: Fatal poisonings among drug addicts in Denmark in 2012 were examined. Cause of death, abuse pattern and geographic differences are discussed and data are compared with previous studies. Methods: All fatal poisonings examined at the three institutes of forensic medicine in Denmark...... on Funen and in South Jutland. Cocaine was most frequently detected in East Denmark, while amphetamine was more frequent in West Denmark. ConclusionS: The number of fatal poisonings among drug addicts has stabilised around 200. The increase in methadone deaths continued and, as in 2007, methadone...... with 2007, indicating that a considerable number of drug addicts also have psychiatric illness....

Silver nanoparticles induced heat shock protein 70, oxidative stress and apoptosis in Drosophila melanogaster.

Science.gov (United States)

Ahamed, Maqusood; Posgai, Ryan; Gorey, Timothy J; Nielsen, Mark; Hussain, Saber M; Rowe, John J

2010-02-01

Due to the intensive commercial application of silver nanoparticles (Ag NPs), risk assessment of this nanoparticle is of great importance. Our previous in vitro study demonstrated that Ag NPs caused DNA damage and apoptosis in mouse embryonic stem cells and fibroblasts. However, toxicity of Ag NPs in vivo is largely lacking. This study was undertaken to examine the toxic effects of well-characterized polysaccharide coated 10 nm Ag NPs on heat shock stress, oxidative stress, DNA damage and apoptosis in Drosophila melanogaster. Third instar larvae of D. melanogaster were fed a diet of standard cornmeal media mixed with Ag NPs at the concentrations of 50 and 100 microg/ml for 24 and 48 h. Ag NPs up-regulated the expression of heat shock protein 70 and induced oxidative stress in D. melanogaster. Malondialdehyde level, an end product of lipid peroxidation was significantly higher while antioxidant glutathione content was significantly lower in Ag NPs exposed organisms. Activities of antioxidant enzyme superoxide dismutase and catalase were also significantly higher in the organisms exposed to Ag NPs. Furthermore, Ag NPs up-regulated the cell cycle checkpoint p53 and cell signaling protein p38 that are involved in the DNA damage repair pathway. Moreover, activities of caspase-3 and caspase-9, markers of apoptosis were significantly higher in Ag NPs exposed organisms. The results indicate that Ag NPs in D. melanogaster induce heat shock stress, oxidative stress, DNA damage and apoptosis. This study suggests that the organism is stressed and thus warrants more careful assessment of Ag NPs using in vivo models to determine if chronic exposure presents developmental and reproductive toxicity. Copyright 2009 Elsevier Inc. All rights reserved.

Silver nanoparticles induced heat shock protein 70, oxidative stress and apoptosis in Drosophila melanogaster

International Nuclear Information System (INIS)

Ahamed, Maqusood; Posgai, Ryan; Gorey, Timothy J.; Nielsen, Mark; Hussain, Saber M.; Rowe, John J.

2010-01-01

Due to the intensive commercial application of silver nanoparticles (Ag NPs), risk assessment of this nanoparticle is of great importance. Our previous in vitro study demonstrated that Ag NPs caused DNA damage and apoptosis in mouse embryonic stem cells and fibroblasts. However, toxicity of Ag NPs in vivo is largely lacking. This study was undertaken to examine the toxic effects of well-characterized polysaccharide coated 10 nm Ag NPs on heat shock stress, oxidative stress, DNA damage and apoptosis in Drosophila melanogaster. Third instar larvae of D. melanogaster were fed a diet of standard cornmeal media mixed with Ag NPs at the concentrations of 50 and 100 μg/ml for 24 and 48 h. Ag NPs up-regulated the expression of heat shock protein 70 and induced oxidative stress in D. melanogaster. Malondialdehyde level, an end product of lipid peroxidation was significantly higher while antioxidant glutathione content was significantly lower in Ag NPs exposed organisms. Activities of antioxidant enzyme superoxide dismutase and catalase were also significantly higher in the organisms exposed to Ag NPs. Furthermore, Ag NPs up-regulated the cell cycle checkpoint p53 and cell signaling protein p38 that are involved in the DNA damage repair pathway. Moreover, activities of caspase-3 and caspase-9, markers of apoptosis were significantly higher in Ag NPs exposed organisms. The results indicate that Ag NPs in D. melanogaster induce heat shock stress, oxidative stress, DNA damage and apoptosis. This study suggests that the organism is stressed and thus warrants more careful assessment of Ag NPs using in vivo models to determine if chronic exposure presents developmental and reproductive toxicity.

Fatal injuries among grounds maintenance workers: United States, 2003--2008.

Science.gov (United States)

2011-05-06

A total of 1,142 grounds maintenance workers (GMWs) were fatally injured at work during 2003--2008, an average of 190 each year. GMWs accounted for 3.4% of all occupational fatalities, and 31% of those GMWs were Hispanic or Latino. Approximately 83% of the Hispanic or Latino GMWs who died were born outside the United States. In 2008, approximately 1.52 million persons were employed as GMWs, constituting 1.0% of the U.S. workforce. During 2003--2007, an average of 13.3 per 100,000 employed GMWs died each year, compared with an overall rate of 4.0 fatalities per 100,000 U.S. workers. The rate of on-the-job fatal injuries among GMWs has remained elevated relative to other workers for >20 years. This report characterizes events leading to GMW fatalities and differences in fatality characteristics across demographic groups among GMWs, based on an evaluation of 2003--2008 data from the U.S. Department of Labor's Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) program. The report also identifies workplace interventions that might reduce the incidence of fatal injuries. Major events leading to GMW occupational fatalities included transportation incidents (31%), contact with objects and equipment (25%), falls (23%), and traumatic acute exposures to harmful substances or environments (e.g., electrocution and drowning) (16%). To reduce the incidence of such fatalities, employers, trade and worker associations, and policy makers should focus on effective, targeted workplace safety interventions such as frequent hazard identification and training for specific hazards. Diversity among the populations of workers requires use of culture- and language-appropriate training techniques as part of comprehensive injury and illness prevention programs.

Clinical diagnosis versus autopsy findings in polytrauma fatalities

Directory of Open Access Journals (Sweden)

Fakler Johannes K

2010-10-01

Full Text Available Abstract Objectives The aim of the study was to determine if differences in clinical diagnosis versus autopsy findings concerning the cause of death in polytrauma fatalities would be detected in 19 cases of fatal polytrauma from a Level 1 trauma centre. Methods Clinical diagnoses determining the cause of death in 19 cases of fatal polytrauma (2007 - 2008 from a Level 1 trauma centre were correlated with autopsy findings. Results In 13 cases (68%, the clinical cause of death and the cause of death as determined by autopsy were congruent. Marginal differences occurred in three (16% patients while obvious differences in interpreting the cause of death were found in another three (16% cases. Five fatalities (three with obvious differences and two with marginal differences were remarked as early death (1-4 h after trauma and one fatality with marginal differences as late death (>1 week after trauma. Obvious and marginal discrepancies mostly occurred in the early phase of treatment, especially when severely injured patients were admitted to the emergency room undergoing continued cardiopulmonary resuscitation, i. e. limiting diagnostic procedures, and thus the clinical cause of death was essentially determined by basic emergency diagnostics. Conclusions Autopsy as golden standard to define the cause of death in fatal polytrauma varies from the clinical point of view, depending on the patient's pre-existing condition, mechanism of polytrauma, necessity of traumatic cardiopulmonary resuscitation, survival time, and thus the possibility to perform emergency diagnostics. An autopsy should be performed at least in cases of early fatal polytrauma to help establishing the definite cause of death. Moreover, autopsy data should be included in trauma registries as a quality assessment tool.

Slow shocks and their transition to fast shocks in the inner solar wind

International Nuclear Information System (INIS)

Wang, Y.C.

1987-01-01

The jump conditions of MHD shocks may be directly calculated as functions of three upstream conditions: the shock Alfven number based on the normal component of the relative shock speed, the shock angle, and the plasma β value. The shock Alfven number is less than 1 for a slow shock and greater than 1 for a fast shock. A traveling, forward shock can be a slow shock in coronal space, where the Alfven speed is of the order of 1000 km/s. The surface of a forward slow shock has a bow-shaped geometry with its nose facing toward the sun. The decrease in the Alfven speed at increasing heliocentric distance causes the shock Alfven number of a forward slow shock to become greater than 1, and the shock eventually evolves from a slow shock into a fast shock. During the transition the shock system consists of a slow shock, a fast shock, and a rotational discontinuity. They intersect along a closed transition line. As the system moves outward from the sun, the area enclosed by the transition line expands, the fast shock grows stronger, and the slow shock becomes weaker. Eventually, the slow shock diminishes, and the entire shock system evolves into a forward fast shock. copyrightAmerican Geophysical Union 1987

Subacute Right Ventricle Perforation by Pacemaker Lead Presenting with Left Hemothorax and Shock

Directory of Open Access Journals (Sweden)

Julianne Nichols

2015-01-01

Full Text Available Cardiac perforation by pacemaker is a rare but potentially fatal complication. Acute perforations occurring within twenty-four hours of insertion of pacemaker can lead to hemopericardium, cardiac tamponade, and death. Hemothorax occurring as an acute complication of pacemaker insertion is reported but extremely rare. Previously, hemothorax and shock as a subacute complication following pacemaker insertion have not been reported. We report the case of an 85-year-old patient who presented with shock from hemothorax caused by pacemaker perforation, two weeks after insertion. Device interrogation showed normal function. Chest X-ray and echocardiogram missed lead dislocation and the diagnosis was made on computed tomogram (CT of the chest. Following surgical repair, a new ventricular pacemaker was placed transvenously in the right ventricular septum. This case illustrates that CT scan of the chest should be performed in all patients in whom cardiac perforation by pacemaker is suspected but not diagnosed on chest X-ray and echocardiogram. Normal functioning of pacemaker on device interrogation does not exclude perforation.

Dehydration Comes on Fast and Can Be Fatal

Science.gov (United States)

... can be fatal Dehydration comes on fast and can be fatal During the hot summer months,the ... and keeping hydrated. “Dehydration is very dangerous. It can lead to an emergency visit, and it can ...

Toxic hazards of underground excavation

International Nuclear Information System (INIS)

Smith, R.; Chitnis, V.; Damasian, M.

1982-09-01

Inadvertent intrusion into natural or man-made toxic or hazardous material deposits as a consequence of activities such as mining, excavation or tunnelling has resulted in numerous deaths and injuries in this country. This study is a preliminary investigation to identify and document instances of such fatal or injurious intrusion. An objective is to provide useful insights and information related to potential hazards due to future intrusion into underground radioactive-waste-disposal facilities. The methodology used in this study includes literature review and correspondence with appropriate government agencies and organizations. Key categories of intrusion hazards are asphyxiation, methane, hydrogen sulfide, silica and asbestos, naturally occurring radionuclides, and various mine or waste dump related hazards

Toxic hazards of underground excavation

Energy Technology Data Exchange (ETDEWEB)

Smith, R.; Chitnis, V.; Damasian, M.; Lemm, M.; Popplesdorf, N.; Ryan, T.; Saban, C.; Cohen, J.; Smith, C.; Ciminesi, F.

1982-09-01

Inadvertent intrusion into natural or man-made toxic or hazardous material deposits as a consequence of activities such as mining, excavation or tunnelling has resulted in numerous deaths and injuries in this country. This study is a preliminary investigation to identify and document instances of such fatal or injurious intrusion. An objective is to provide useful insights and information related to potential hazards due to future intrusion into underground radioactive-waste-disposal facilities. The methodology used in this study includes literature review and correspondence with appropriate government agencies and organizations. Key categories of intrusion hazards are asphyxiation, methane, hydrogen sulfide, silica and asbestos, naturally occurring radionuclides, and various mine or waste dump related hazards.

Alcohol Advertising and Motor Vehicle Fatalities

OpenAIRE

Henry Saffer

1994-01-01

The purpose of this paper is to empirically estimate the effect of alcohol advertising on motor vehicle fatalities. The concept of an industry level advertising response function is developed and other empirical issues in estimating the effects of advertising are reviewed. The data set consists of quarterly observations, from 1986 to 1989, for 75 advertising markets in the United States and includes 1200 observations. Since motor vehicle fatalities and alcohol advertising are jointly determin...

No to fatalism

International Nuclear Information System (INIS)

Pecqueur, Michel

1980-01-01

By saying 'No to fatalism', M. Pecqueur is forming the wish that the recent awarness of the energy situation, far from bringing about resignation, speeds up the implementation of the indispensable measures on which the economic and political stability of the world depends in the decade ahead [fr

Fatal falls in the US construction industry, 1990 to 1999.

Science.gov (United States)

Derr, J; Forst, L; Chen, H Y; Conroy, L

2001-10-01

The Occupational Safety and Health Administration's (OSHA's) Integrated Management Information System (IMIS) database allows for the detailed analysis of risk factors surrounding fatal occupational events. This study used IMIS data to (1) perform a risk factor analysis of fatal construction falls, and (2) assess the impact of the February 1995 29 CFR Part 1926 Subpart M OSHA fall protection regulations for construction by calculating trends in fatal fall rates. In addition, IMIS data on fatal construction falls were compared with data from other occupational fatality surveillance systems. For falls in construction, the study identified several demographic factors that may indicate increased risk. A statistically significant downward trend in fatal falls was evident in all construction and within several construction categories during the decade. Although the study failed to show a statistically significant intervention effect from the new OSHA regulations, it may have lacked the power to do so.

Cannabis, alcohol and fatal road accidents.

Science.gov (United States)

Martin, Jean-Louis; Gadegbeku, Blandine; Wu, Dan; Viallon, Vivian; Laumon, Bernard

2017-01-01

This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates), and to compare the results to a similar study carried out in France between 2001 and 2003. Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers. Information on alcohol and four groups of illicit drugs derived from tests for positivity and potential confirmation through blood analysis. The study compares drivers responsible for causing the accident, that is to say having directly contributed to its occurrence, to drivers involved in an accident for which they were not responsible, and who can be assimilated to drivers in general. The proportion of persons driving under the influence of alcohol is estimated at 2.1% (95% CI: 1.4-2.8) and under the influence of cannabis at 3.4% (2.9%-3.9%). Drivers under the influence of alcohol are 17.8 times (12.1-26.1) more likely to be responsible for a fatal accident, and the proportion of fatal accidents which would be prevented if no drivers ever exceeded the legal limit for alcohol is estimated at 27.7% (26.0%-29.4%). Drivers under the influence of cannabis multiply their risk of being responsible for causing a fatal accident by 1.65 (1.16-2.34), and the proportion of fatal accidents which would be prevented if no drivers ever drove under the influence of cannabis is estimated at 4.2% (3.7%-4.8%). An increased risk linked to opiate use has also been found to be significant, but with low prevalence, requiring caution in interpreting this finding. Other groups of narcotics have even lower prevalence, and the associated extra risks cannot be assessed. Almost a

Cannabis, alcohol and fatal road accidents.

Directory of Open Access Journals (Sweden)

Jean-Louis Martin

Full Text Available This research aims to estimate the relative risks of responsibility for a fatal accident linked to driving under the influence of cannabis or alcohol, the prevalence of these influences among drivers and the corresponding attributable risk ratios. A secondary goal is to estimate the same items for three other groups of illicit drugs (amphetamines, cocaine and opiates, and to compare the results to a similar study carried out in France between 2001 and 2003.Police procedures for fatal accidents in Metropolitan France during 2011 were analyzed and 300 characteristics encoded to provide a database of 4,059 drivers. Information on alcohol and four groups of illicit drugs derived from tests for positivity and potential confirmation through blood analysis. The study compares drivers responsible for causing the accident, that is to say having directly contributed to its occurrence, to drivers involved in an accident for which they were not responsible, and who can be assimilated to drivers in general.The proportion of persons driving under the influence of alcohol is estimated at 2.1% (95% CI: 1.4-2.8 and under the influence of cannabis at 3.4% (2.9%-3.9%. Drivers under the influence of alcohol are 17.8 times (12.1-26.1 more likely to be responsible for a fatal accident, and the proportion of fatal accidents which would be prevented if no drivers ever exceeded the legal limit for alcohol is estimated at 27.7% (26.0%-29.4%. Drivers under the influence of cannabis multiply their risk of being responsible for causing a fatal accident by 1.65 (1.16-2.34, and the proportion of fatal accidents which would be prevented if no drivers ever drove under the influence of cannabis is estimated at 4.2% (3.7%-4.8%. An increased risk linked to opiate use has also been found to be significant, but with low prevalence, requiring caution in interpreting this finding. Other groups of narcotics have even lower prevalence, and the associated extra risks cannot be assessed

Fatal Necrotizing Encephalopathy after Treatment with Nivolumab for Squamous Non-Small Cell Lung Cancer: Case Report and Review of the Literature

OpenAIRE

Markus Leitinger; Mihael V. Varosanec; Slaven Pikija; Romana E. Wass; Dave Bandke; Serge Weis; Michael Studnicka; Susanne Grinzinger; Mark R. McCoy; Larissa Hauer; Johann Sellner; Johann Sellner

2018-01-01

Immune checkpoint inhibitors are antibodies, which enhance cellular and humoral immune responses and are approved for the treatment of various tumors. Immune-related adverse events (irAE) involving different organs and systems are, however, among the side-effects. Recent reports of severe persistent neurological deficits and even fatal cases underpin the need for better understanding of the exact pathomechanisms of central nervous system (CNS) toxicity. To our knowledge, we report the first b...

Aviation-Related Wildland Firefighter Fatalities--United States, 2000-2013.

Science.gov (United States)

Butler, Corey R; O'Connor, Mary B; Lincoln, Jennifer M

2015-07-31

Airplanes and helicopters are integral to the management and suppression of wildfires, often operating in high-risk, low-altitude environments. To update data on aviation-related wildland firefighting fatalities, identify risk factors, and make recommendations for improved safety, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed reports from multiple data sources for the period 2000-2013. Among 298 wildland firefighter fatalities identified during 2000-2013, 78 (26.2%) were aviation-related occupational fatalities that occurred during 41 separate events involving 42 aircraft. Aircraft crashes accounted for 38 events. Pilots, copilots, and flight engineers represented 53 (68%) of the aviation-related fatalities. The leading causes of fatal aircraft crashes were engine, structure, or component failure (24%); pilot loss of control (24%); failure to maintain clearance from terrain, water, or objects (20%); and hazardous weather (15%). To reduce fatalities from aviation-related wildland firefighting activities, stringent safety guidelines need to be followed during all phases of firefighting, including training exercises. Crew resource management techniques, which use all available resources, information, equipment, and personnel to achieve safe and efficient flight operations, can be applied to firefighting operations.

Fatal Child Maltreatment in England, 2005-2009

Science.gov (United States)

Sidebotham, Peter; Bailey, Sue; Belderson, Pippa; Brandon, Marian

2011-01-01

Objective: This paper presents comprehensive and up-to-date data covering 4 years of Serious Case Reviews into fatal child maltreatment in England. Methods: Information on all notified cases of fatal maltreatment between April 2005 and March 2009 was examined to obtain case characteristics related to a systemic classification of 5 broad groups of…

Effects of urban sprawl and vehicle miles traveled on traffic fatalities.

Science.gov (United States)

Yeo, Jiho; Park, Sungjin; Jang, Kitae

2015-01-01

Previous research suggests that urban sprawl increases auto-dependency and that excessive auto use increases the risk of traffic fatalities. This indirect effect of urban sprawl on traffic fatalities is compared to non-vehicle miles traveled (VMT)-related direct effect of sprawl on fatalities. We conducted a path analysis to examine the causal linkages among urban sprawl, VMT, traffic fatalities, income, and fuel cost. The path diagram includes 2 major linkages: the direct relationship between urban sprawl and traffic fatalities and the indirect effect on fatalities through increased VMT in sprawling urban areas. To measure the relative strength of these causal linkages, path coefficients are estimated using data collected nationally from 147 urbanized areas in the United States. Through both direct and indirect paths, urban sprawl is associated with greater numbers of traffic fatalities, but the direct effect of sprawl on fatalities is more influential than the indirect effect. Enhancing traffic safety can be achieved by impeding urban sprawl and encouraging compact development. On the other hand, policy tools reducing VMT may be less effective than anticipated for traffic safety.

Comparison of the acute toxicity for gamma-cyhalothrin and lambda-cyhalothrin to zebra fish and shrimp.

Science.gov (United States)

Wang, Wei; Cai, D J; Shan, Z J; Chen, W L; Poletika, Nick; Gao, X W

2007-03-01

Gamma-cyhalothrin 15CS (GCH) contains only the active stereoisomer of the two isomers found in lambda-cyhalothrin 25EW (LCH). GCH (0.5 x rate) provides equivalent overall insect control as LCH (1 x rate). Both formulations showed high acute toxicity to zebra fish (Brachydanio rerio H.B.) and shrimp (Macrobrachium nippoensis de Haan). The 96-h LC(50(zebra fish,GCH)) is 1.93 microg a.i/L and LC(50(zebra fish,LCH)) is 1.94 microg a.i/L. LC(50(shrimp,GCH)) is 0.28 microg a.i./L and LC(50(shrimp,LCH)) 0.04 microg a.i./L. This indicates that the toxicity to shrimp is likely stereochemistry-dependent. The fates of GCH and LCH are similar in laboratory simulated rice paddy water and their concentrations decrease rapidly, with no GCH or LCH detected after 3 or 4 days. Both are toxic to shrimp in a simulated paddy irrigation reservoir even though treated return water is diluted 5 times. No shrimp fatality is shown in the GCH-treated paddy water after a 4-day holding period, and longer than 5 days is necessary to reach a zero fatality rate for LCH. This is compatible with the 7-day water holding period considered reasonable in agricultural practice.

Insomnia symptoms and risk for unintentional fatal injuries--the HUNT Study.

Science.gov (United States)

Laugsand, Lars Erik; Strand, Linn B; Vatten, Lars J; Janszky, Imre; Bjørngaard, Johan Håkon

2014-11-01

To assess the association between insomnia symptoms and risk of fatal unintentional injuries. Population-based prospective cohort study with a mean follow-up of 14 y, linking health survey data with information on insomnia symptoms to the National Cause of Death Registry. Nord-Trøndelag County, Norway. A total of 54,399 men and women 20-89 y of age who participated in the Nord-Trøndelag Health Study between 1995 and 1997. N/A. There were 277 unintentional fatal injuries, including 57 fatal motor vehicle injuries during follow-up. There was a dose-dependent association between the number of insomnia symptoms and risk of unintentional fatal injuries (P for trend 0.001) and fatal motor vehicle injuries (P for trend 0.023), respectively. The proportion of unintentional fatal injuries cases that could have been prevented in the absence of difficulties initiating sleep, difficulties maintaining sleep, and having a feeling of nonrestorative sleep were 8%, 9%, and 8%, respectively. The corresponding estimates for motor vehicle injuries were 34%, 11%, and 10%. Insomnia is a major contributor to both unintentional fatal injuries in general as well as fatal motor vehicle injuries. Increasing public health awareness about insomnia and identifying persons with insomnia may be important in preventing unintentional fatal injuries.

Crash Fatality Rates After Recreational Marijuana Legalization in Washington and Colorado.

Science.gov (United States)

Aydelotte, Jayson D; Brown, Lawrence H; Luftman, Kevin M; Mardock, Alexandra L; Teixeira, Pedro G R; Coopwood, Ben; Brown, Carlos V R

2017-08-01

To evaluate motor vehicle crash fatality rates in the first 2 states with recreational marijuana legalization and compare them with motor vehicle crash fatality rates in similar states without recreational marijuana legalization. We used the US Fatality Analysis Reporting System to determine the annual numbers of motor vehicle crash fatalities between 2009 and 2015 in Washington, Colorado, and 8 control states. We compared year-over-year changes in motor vehicle crash fatality rates (per billion vehicle miles traveled) before and after recreational marijuana legalization with a difference-in-differences approach that controlled for underlying time trends and state-specific population, economic, and traffic characteristics. Pre-recreational marijuana legalization annual changes in motor vehicle crash fatality rates for Washington and Colorado were similar to those for the control states. Post-recreational marijuana legalization changes in motor vehicle crash fatality rates for Washington and Colorado also did not significantly differ from those for the control states (adjusted difference-in-differences coefficient = +0.2 fatalities/billion vehicle miles traveled; 95% confidence interval = -0.4, +0.9). Three years after recreational marijuana legalization, changes in motor vehicle crash fatality rates for Washington and Colorado were not statistically different from those in similar states without recreational marijuana legalization. Future studies over a longer time remain warranted.

Firearm Legislation and Fatal Police Shootings in the United States.

Science.gov (United States)

Kivisto, Aaron J; Ray, Bradley; Phalen, Peter L

2017-07-01

To examine whether stricter firearm legislation is associated with rates of fatal police shootings. We used a cross-sectional, state-level design to evaluate the effect of state-level firearm legislation on rates of fatal police shootings from January 1, 2015, through October 31, 2016. We measured state-level variation in firearm laws with legislative scorecards from the Brady Center, and for fatal police shootings we used The Counted, an online database maintained by The Guardian. State-level firearm legislation was significantly associated with lower rates of fatal police shootings (incidence rate ratio = 0.961; 95% confidence interval = 0.939, 0.984). When we controlled for sociodemographic factors, states in the top quartile of legislative strength had a 51% lower incidence rate than did states in the lowest quartile. Laws aimed at strengthening background checks, promoting safe storage, and reducing gun trafficking were associated with fewer fatal police shootings. Legislative restrictions on firearms are associated with reductions in fatal police shootings. Public Health Implications. Although further research is necessary to determine causality and potential mechanisms, firearm legislation is a potential policy solution for reducing fatal police shootings in the United States.

Wireless device for activation of an underground shock wave absorber

Science.gov (United States)

Chikhradze, M.; Akhvlediani, I.; Bochorishvili, N.; Mataradze, E.

2011-10-01

The paper describes the mechanism and design of the wireless device for activation of energy absorber for localization of blast energy in underground openings. The statistics shows that the greatest share of accidents with fatal results associate with explosions in coal mines due to aero-methane and/or air-coal media explosion. The other significant problem is terrorist or accidental explosions in underground structures. At present there are different protective systems to reduce the blast energy. One of the main parts of protective Systems is blast Identification and Registration Module. The works conducted at G. Tsulukidze Mining Institute of Georgia enabled to construct the wireless system of explosion detection and mitigation of shock waves. The system is based on the constant control on overpressure. The experimental research continues to fulfill the system based on both threats, on the constant control on overpressure and flame parameters, especially in underground structures and coal mines. Reaching the threshold value of any of those parameters, the system immediately starts the activation. The absorber contains a pyrotechnic device ensuring the discharge of dispersed water. The operational parameters of wireless device and activation mechanisms of pyrotechnic element of shock wave absorber are discussed in the paper.

Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome

Directory of Open Access Journals (Sweden)

David F. Pinal-García

2018-01-01

Full Text Available Spontaneous rupture of hepatocellular carcinoma (HCC is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported.

Coronal mass ejection shock fronts containing the two types of intermediate shocks

International Nuclear Information System (INIS)

Steinolfson, R.S.; Hundhausen, A.J.

1990-01-01

Numerical solutions of the time-dependent, magnetohydrodynamic (MHD) equations in two dimensions are used to demonstrate the formation of both types of intermediate shocks in a single shock front for physical conditions that are an idealization of those expected to occur in some observed coronal mass ejections. The key to producing such a shock configuration in the simulations is the use of an initial atmosphere containing a magnetic field representative of that in a coronal streamer with open field lines overlying a region of closed field lines. Previous attempts using just open field lines (perpendicular to the surface) produced shock configurations containing just one of the two intermediate shock types. A schematic of such a shock front containing both intermediate shock types has been constructed previously based solely on the known properties of MHD shocks from the Rankine-Hugoniot equations and specific requirements placed on the shock solution at points along the front where the shock normal and upstream magnetic field are aligned. The shock front also contains, at various locations along the front, a hydrodynamic (nonmagnetic) shock, a switch-on shock, and a fast shock in addition to the intermediate shocks. This particular configuration occurs when the shock front speed exceeds the upstream (preshock) intermediate wave speed but is less than a critical speed defined in the paper (equation 1) along at least some portion of the shock front. A distinctive feature of the front is that it is concave upward (away from the surface) near the region where the field in the preshock plasma is normal to the front of near the central portion of the shock front

demystifying the shock of shocking

African Journals Online (AJOL)

(with a pulse), atrial fibrillation and atrial flutter. The energy dose in cardioversion is less (0.5. - 2 J/kg) than in defibrillation (2 - 4 J/kg). In cardioversion the shock is discharged synchronously with the native R wave of the patient. Without synchronisation,. VF can be induced if a shock is delivered during the refractory period ...

Shock absorbing structure

International Nuclear Information System (INIS)

Kojima, Naoki; Matsushita, Kazuo.

1992-01-01

Small pieces of shock absorbers are filled in a space of a shock absorbing vessel which is divided into a plurality of sections by partitioning members. These sections function to prevent excess deformation or replacement of the fillers upon occurrence of falling accident. Since the shock absorbing small pieces in the shock absorbing vessel are filled irregularly, shock absorbing characteristics such as compression strength is not varied depending on the direction, but they exhibit excellent shock absorbing performance. They surely absorb shocks exerted on a transportation vessel upon falling or the like. If existing artificial fillers such as pole rings made of metal or ceramic and cut pieces such as alumium extrusion molding products are used as the shock absorbing pieces, they have excellent fire-proofness and cold resistance since the small pieces are inflammable and do not contain water. (T.M.)

Toxic release consequence analysis tool (TORCAT) for inherently safer design plant

International Nuclear Information System (INIS)

Shariff, Azmi Mohd; Zaini, Dzulkarnain

2010-01-01

Many major accidents due to toxic release in the past have caused many fatalities such as the tragedy of MIC release in Bhopal, India (1984). One of the approaches is to use inherently safer design technique that utilizes inherent safety principle to eliminate or minimize accidents rather than to control the hazard. This technique is best implemented in preliminary design stage where the consequence of toxic release can be evaluated and necessary design improvements can be implemented to eliminate or minimize the accidents to as low as reasonably practicable (ALARP) without resorting to costly protective system. However, currently there is no commercial tool available that has such capability. This paper reports on the preliminary findings on the development of a prototype tool for consequence analysis and design improvement via inherent safety principle by utilizing an integrated process design simulator with toxic release consequence analysis model. The consequence analysis based on the worst-case scenarios during process flowsheeting stage were conducted as case studies. The preliminary finding shows that toxic release consequences analysis tool (TORCAT) has capability to eliminate or minimize the potential toxic release accidents by adopting the inherent safety principle early in preliminary design stage.

Investigation of hot air balloon fatalities.

Science.gov (United States)

McConnell, T S; Smialek, J E; Capron, R G

1985-04-01

The rising popularity of the sport of hot air ballooning has been accompanied by several recent incidents, both in this country and other parts of the world, where mechanical defects and the improper operation of balloons have resulted in several fatalities. A study was conducted to identify the location and frequency of hot air ballooning accidents. Furthermore, the study attempted to identify those accidents that were the result of improper handling on the part of the balloon operators and those that were related to specific defects in the construction of the balloon. This paper presents a background of the sport of hot air ballooning, together with an analysis of the construction of a typical hot air balloon, pointing out the specific areas where defects may occur that could result in a potential fatal balloon crash. Specific attention is given to the two recent balloon crashes that occurred in Albuquerque, N.M., hot air balloon capital of the world, and that resulted in multiple fatalities.

Study on Reflected Shock Wave/Boundary Layer Interaction in a Shock Tube

Energy Technology Data Exchange (ETDEWEB)

Kim, Dong Wook; Kim, Tae Ho; Kim, Heuy Dong [Andong Nat’l Univ., Andong (Korea, Republic of)

2017-07-15

The interaction between a shock wave and a boundary layer causes boundary layer separation, shock train, and in some cases, strong unsteadiness in the flow field. Such a situation is also observed in a shock tube, where the reflected shock wave interacts with the unsteady boundary layer. However, only a few studies have been conducted to investigate the shock train phenomenon in a shock tube. In the present study, numerical studies were conducted using the two-dimensional axisymmetric domain of a shock tube, and compressible Navier-Stokes equations were solved to clarify the flow characteristics of shock train phenomenon inside a shock tube. A detailed wave diagram was developed based on the present computational results, which were validated with existing experimental data.

Collisionless electrostatic shocks

DEFF Research Database (Denmark)

Andersen, H.K.; Andersen, S.A.; Jensen, Vagn Orla

1970-01-01

An attempt was made in the laboratory to observe the standing collisionless electrostatic shocks in connection with the bow shock of the earth......An attempt was made in the laboratory to observe the standing collisionless electrostatic shocks in connection with the bow shock of the earth...

Fatal occupational injuries among non-governmental employees in Malaysia.

Science.gov (United States)

Abas, Adinegara Bin Lutfi; Mohd Said, Datuk Abd Razzak B; Aziz Mohammed, Mohammed Azman B; Sathiakumar, Nalini

2013-01-01

In Malaysia, surveillance of fatal occupational injuries is fragmented. We therefore analyzed an alternative data source from Malaysia's Social Security organization, the Pertubuhan Keselamatan Sosial (PERKESO). We conducted a secondary data analysis of the PERKESO database comprised of 7 million employees from 2002 to 2006. Overall, the average annual incidence was 9.2 fatal occupational injuries per 100,000 workers. During the 5-year period, there was a decrease in the absolute number of fatal injuries by 16% and the incidence by 34%. The transportation sector reported the highest incidence of fatal injuries (35.1/100,000), followed by agriculture (30.5/100,000) and construction (19.3/100,000) sectors. Persons of Indian ethnicity were more likely to sustain fatal injuries compared to other ethnic groups. Government and industry should develop rigorous strategies to detect hazards in the workplace, especially in sectors that continuously record high injury rates. Targeted interventions emphasizing worker empowerment coupled with systematic monitoring and evaluation is critical to ensure success in prevention and control measures. Copyright © 2012 Wiley Periodicals, Inc.

Fatal Occupational Injuries among Non-governmental Employees in Malaysia

Science.gov (United States)

Abas, Adinegara bin Lutfi; Mohd Said, Datuk Abd. Razzak B.; Aziz Mohammed, Mohammed Azman B.; Sathiakumar, Nalini

2012-01-01

Background In Malaysia, surveillance of fatal occupational injuries is fragmented. We therefore analyzed an alternative data source from Malaysia’s Social Security organization, the PERKESO. Methods We conducted a secondary data analysis of the PERKESO database comprised of 7 million employees from 2002 to 2006. Results Overall, the average annual incidence was 9.2 fatal occupational injuries per 100,000 workers. During the five-year period, there was a decrease in the absolute number of fatal injuries by 16% and the incidence by 34%. The transportation sector reported the highest incidence of fatal injuries (35.1/100,000), followed by agriculture (30.5/100,000) and construction (19.3/100,000) sectors. Persons of Indian ethnicity were more likely to sustain fatal injuries compared to other ethnic groups. Conclusions Government and industry should develop rigorous strategies to detect hazards in the workplace, especially in sectors that continuously record high injury rates. Targeted interventions emphasizing worker empowerment coupled with systematic monitoring and evaluation is critical to ensure success in prevention and control measures. PMID:22544443

Community Poverty and Child Abuse Fatalities in the United States.

Science.gov (United States)

Farrell, Caitlin A; Fleegler, Eric W; Monuteaux, Michael C; Wilson, Celeste R; Christian, Cindy W; Lee, Lois K

2017-05-01

Child maltreatment remains a problem in the United States, and individual poverty is a recognized risk factor for abuse. Children in impoverished communities are at risk for negative health outcomes, but the relationship of community poverty to child abuse fatalities is not known. Our objective was to evaluate the association between county poverty concentration and rates of fatal child abuse. This was a retrospective, cross-sectional analysis of child abuse fatalities in US children 0 to 4 years of age from 1999 to 2014 by using the Centers for Disease Control and Prevention Compressed Mortality Files. Population and poverty statistics were obtained from US Census data. National child abuse fatality rates were calculated for each category of community poverty concentration. Multivariate negative binomial regression modeling assessed the relationship between county poverty concentration and child abuse fatalities. From 1999 to 2014, 11 149 children 0 to 4 years old died of child abuse; 45% (5053) were poverty concentration had >3 times the rate of child abuse fatalities compared with counties with the lowest poverty concentration (adjusted incidence rate ratio, 3.03; 95% confidence interval, 2.4-3.79). Higher county poverty concentration is associated with increased rates of child abuse fatalities. This finding should inform public health officials in targeting high-risk areas for interventions and resources. Copyright © 2017 by the American Academy of Pediatrics.

Fatal Necrotizing Encephalopathy after Treatment with Nivolumab for Squamous Non-Small Cell Lung Cancer: Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Markus Leitinger

2018-01-01

Full Text Available Immune checkpoint inhibitors are antibodies, which enhance cellular and humoral immune responses and are approved for the treatment of various tumors. Immune-related adverse events (irAE involving different organs and systems are, however, among the side-effects. Recent reports of severe persistent neurological deficits and even fatal cases underpin the need for better understanding of the exact pathomechanisms of central nervous system (CNS toxicity. To our knowledge, we report the first biopsy-proven case of fatal necrotizing encephalopathy after treatment with nivolumab. Nivolumab targets the immune-check point inhibitor programmed cell death-1 and was used for squamous non-small cell lung cancer. Partly reversible neurologic and psychiatric symptoms and unremarkable brain magnetic resonance imaging (MRI were observed after the first course. Neurological symptoms progressed and recurrent seizures developed after the second course. Brain MRI disclosed multiple edematous and confluent supra- and infratentorial lesions, partly with contrast-enhancement. We excluded autoimmune and paraneoplastic causes and performed ancillary investigations to rule out common and opportunistic infections. Eventually, postmortem histopathological analysis of the brain revealed a necrotizing process, which contrasts previous cases reporting parenchymal immune cell infiltration or demyelination. Appropriate diagnostic pathways and treatment algorithms need to be implemented for the work-up of CNS toxicity and irAEs related to immune checkpoint inhibitor treatment.

The New Zealand child work-related fatal injury study: 1985-1998.

Science.gov (United States)

Lilley, Rebbecca; Feyer, Anne-Marie; Langley, John; Wren, John

2004-05-21

To estimate the numbers and rates of work-related fatal injury for children under the age of 15 years. Potential cases of work-related injury deaths of persons aged workplace work-related fatalities were identified. The vast majority of children identified were fatally injured while a bystander to another person's work. Workplace bystander involvement was found to vary by age, with the majority of workers identified aged 10-14 years old. With a third of all fatalities, the agricultural industry was the most common industry for workplace work-related fatalities in children. In the period 1985-94, children New Zealand's total workplace bystander deaths. Children contribute significantly to the overall burden of work-related fatal injury in New Zealand, especially as bystanders to other people's work. The high contribution to bystander deaths by children aged <15 years suggests that hazard control in certain work settings is lacking.

Toxic epidermal necrolysis associated with deflazacort therapy with nephrotic syndrome

Directory of Open Access Journals (Sweden)

Eun Chae Lee

2014-12-01

Full Text Available Toxic epidermal necrolysis (TEN is a drug-related fatal disease. Extensive necrosis of the epidermis can lead to serious complications. This report describes two cases of TEN, associated with deflazacort (DFZ, in two boys, aged 4 years and 14 years, with nephrotic syndrome (NS. The 14-year-old male teenager received DFZ following NS relapse. After 17 days, pruritic papules appeared on the lower extremities. Another case involved a 4-year-old boy receiving DFZ and enalapril. After a 41-day DFZ treatment period, erythematous papules appeared on the palms and soles. Within 3 days, both boys developed widespread skin lesions (>50% and were admitted to the intensive care unit for resuscitative and supportive treatment. The patients showed improvement after intravenous immunoglobulin-G therapy. Owing to the rapid, fatal course of TEN, clinicians need to be aware of the adverse effects of this drug when treating cases of NS.

Case-Based Teaching of Fatal Incidents in Outdoor Education Teacher Preparation Courses

Science.gov (United States)

North, Chris; Brookes, Andrew

2017-01-01

This article examines the use of case-based approaches to fatal incidents in outdoor education (OE) with a view to fatality prevention. Fatalities are rare in OE and therefore it is nearly impossible for teachers to learn how to avoid fatalities from their own past experiences. It is, however, possible to learn from the mistakes of others through…

Pulmonary heat shock protein expression after exposure to a metabolically activated Clara cell toxicant: relationship to protein adduct formation

International Nuclear Information System (INIS)

Williams, Kurt J.; Cruikshank, Michael K.; Plopper, Charles G.

2003-01-01

Heat shock proteins/stress proteins (Hsps) participate in regulation of protein synthesis and degradation and serve as general cytoprotectants, yet their role in lethal Clara cell injury is not clear. To define the pattern of Hsp expression in acute lethal Clara cell injury, mice were treated with the Clara cell-specific toxicant naphthalene (NA), and patterns of expression compared to electrophilic protein adduction and previously established organellar degradation and gluathione (GSH) depletion. In sites of lethal injury (distal bronchiole), prior to organellar degradation (1 h post-NA), protein adduction is detectable and ubiquitin, Hsp 25, Hsp 72, and heme-oxygenase 1 (HO-1) are increased. Maximal Hsp expression, protein adduction, and GSH depletion occur simultaneous (by 2-3 h) with early organelle disruption. Hsp expression is higher later (6-24 h), only in exfoliating cells. In airway sites (proximal bronchiole) with nonlethal Clara cell injury elevation of Hsp 25, 72, and HO-1 expression follows significant GSH depletion (greater than 50% 2 h post-NA). This data build upon our previous studies and we conclude that (1) in lethal (terminal bronchiole) and nonlethal (proximal bronchiole) Clara cell injury, Hsp induction is associated with the loss of GSH and increased protein adduction, and (2) in these same sites, organelle disruption is not a prerequisite for Hsp induction

Can we reduce workplace fatalities by half?

Science.gov (United States)

Koh, David Soo Quee

2012-06-01

Singapore, an island republic of over 5 million inhabitants, has 3.1 million workers. Most are employed in the service, finance and tourist/transport industry. Significant numbers work in manufacturing, construction and heavy industry. Following a series of construction and shipyard accidents with multiple deaths in 2004, the government announced its intention to reduce workplace fatalities from 4.9 to 2.5 per 100,000 by 2015. There was strong political will to achieve this target. The strategic approaches were to build workplace safety and health (WSH) capabilities; implement legislative changes with enforcement; promote benefits of WSH and recognize best practices, and enhance partnership with stakeholders. The anticipated outcomes were to reduce workplace fatality and injury rates; have WSH as an integral part of business; and establish a progressive and pervasive WSH culture. With these measures, the workplace fatality rate declined from 4.9/100,000 in 2004, to 2.2/100,000 in 2010. However, other confounding factors could also account for this decline, and have to be considered. The next target, announced by Singapore's Prime Minister in 2008, is to further reduce the workplace fatality rate to 1.8/100,000 by 2018, and to have "one of the best workplace safety records in the world".

Fatal accidents analysis in Peruvian mining industry

International Nuclear Information System (INIS)

Candia, R. C.; Hennies, W. T.; Azevedo, R. c.; Almeida, I.G.; Soto, J. F.

2010-01-01

Although reductions in the tax of injuries and accidents have been observed in recent years, Mining is still one of the highest risks industries. The basic causes for occurrence of fatalities can be attributed to unsafe conditions and unsafe acts. In this scene is necessary to identify safety problems and to aim the effective solutions. On the other hand, the developing countries dependence on primary industries as mining is evident. In the Peruvian economy, approximately 16% of the GNP and more than 50% of the exportations are due to the mining sector, detaching its competitive position in the worldwide mining. This paper presents fatal accidents analysis in the Peruvian mining industry, having as basis the register of occurred fatal accidents since year 2000 until 2007, identifying the main types of accidents occurred. The source of primary information is the General Mining Direction (DGM) of the Peruvian Mining and Energy Ministry (MEM). The majority of victims belongs to tertiary contractor companies that render services for mine companies. The results of the analysis show also that the majority of accidents happened in the underground mines, and that it is necessary to propose effective solutions to manage risks, aiming at reducing the fatal accidents taxes. (Author)

Can We Reduce Workplace Fatalities by Half?

Directory of Open Access Journals (Sweden)

David Soo Quee Koh

2012-06-01

Full Text Available Singapore, an island republic of over 5 million inhabitants, has 3.1 million workers. Most are employed in the service, finance and tourist/transport industry. Significant numbers work in manufacturing, construction and heavy industry. Following a series of construction and shipyard accidents with multiple deaths in 2004, the government announced its intention to reduce workplace fatalities from 4.9 to 2.5 per 100,000 by 2015. There was strong political will to achieve this target. The strategic approaches were to build workplace safety and health (WSH capabilities; implement legislative changes with enforcement; promote benefits of WSH and recognize best practices, and enhance partnership with stakeholders. The anticipated outcomes were to reduce workplace fatality and injury rates; have WSH as an integral part of business; and establish a progressive and pervasive WSH culture. With these measures, the workplace fatality rate declined from 4.9/100,000 in 2004, to 2.2/100,000 in 2010. However, other confounding factors could also account for this decline, and have to be considered. The next target, announced by Singapore’s Prime Minister in 2008, is to further reduce the workplace fatality rate to 1.8/100,000 by 2018, and to have “one of the best workplace safety records in the world”.

Fatal postoperative systemic pulmonary hypertension in benfluorex-induced valvular heart disease surgery: A case report.

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Baufreton, Christophe; Bruneval, Patrick; Rousselet, Marie-Christine; Ennezat, Pierre-Vladimir; Fouquet, Olivier; Giraud, Raphael; Banfi, Carlo

2017-01-01

Drug-induced valvular heart disease (DI-VHD) remains an under-recognized entity. This report describes a heart valve replacement which was complicated by intractable systemic pulmonary arterial hypertension in a 61-year-old female with severe restrictive mitral and aortic disease. The diagnosis of valvular disease was preceded by a history of unexplained respiratory distress. The patient had been exposed to benfluorex for 6.5 years. The diagnostic procedure documented specific drug-induced valvular fibrosis. Surgical mitral and aortic valve replacement was performed. Heart valve replacement was postoperatively complicated by unanticipated disproportionate pulmonary hypertension. This issue was fatal despite intensive care including prolonged extracorporeal life support. Benfluorex is a fenfluramine derivative which has been marketed between 1976 and 2009. Although norfenfluramine is the common active and toxic metabolite of all fenfluramine derivatives, the valvular and pulmonary arterial toxicity of benfluorex was much less known than that of fenfluramine and dexfenfluramine. The vast majority of benfluorex-induced valvular heart disease remains misdiagnosed as hypothetical rheumatic fever due to similarities between both etiologies. Better recognition of DI-VHD is likely to improve patient outcome.

Effects of Atwood number on shock focusing in shock-cylinder interaction

Science.gov (United States)

Ou, Junfeng; Ding, Juchun; Luo, Xisheng; Zhai, Zhigang

2018-02-01

The evolution of shock-accelerated heavy-gas cylinder surrounded by the air with different Atwood numbers (A_t=0.28, 0.50, 0.63) is investigated, concentrating on shock focusing and jet formation. Experimentally, a soap film technique is used to generate an ideal two-dimensional discontinuous gas cylinder with a clear surface, which can guarantee the observation of shock wave movements inside the cylinder. Different Atwood numbers are realized by different mixing ratios of SF_6 and air inside the cylinder. A high-speed schlieren system is adopted to capture the shock motions and jet morphology. Numerical simulations are also performed to provide more information. The results indicate that an inward jet is formed for low Atwood numbers, while an outward jet is generated for high Atwood numbers. Different Atwood numbers will lead to the differences in the relative velocities between the incident shock and the refraction shock, which ultimately results in the differences in shock competition near the downstream pole. The morphology and feature of the jet are closely associated with the position and intensity of shock focusing. The pressure and vorticity contours indicate that the jet formation should be attributed to the pressure pulsation caused by shock focusing, and the jet development is ascribed to the vorticity induction. Finally, a time ratio proposed in the previous work for determining the shock-focusing type is verified by experiments.

Scorpionism in Ecuador: First report of severe and fatal envenoming cases from northern Manabí by Tityus asthenes Pocock.

Science.gov (United States)

Borges, Adolfo; Morales, Melva; Loor, Wilmer; Delgado, Miguel

2015-10-01

The presence in rural areas of western Ecuador of scorpions in the genus Tityus capable of producing pediatric mortality is hereby evidenced. The medical significance of scorpions in Ecuador has been underestimated partly because of the clinically unimportant stings delivered by Centruroides margaritatus and Teuthraustes atramentarius, which have venom with low toxicity to vertebrates. Five intra-domiciliary cases of scorpion envenoming in victims aged between 1.9 and 16 years old, including one fatality, are reported from rural settings in forest areas of Chone (n = 2) and Flavio Alfaro (n = 3) counties, northern Manabí province, western Ecuador. Three cases were graded as Class II (moderate) and two in Class III (severe) envenoming. Manifestations showed characteristic autonomic nervous system hyper-stimulation and the fatality (a 1.9-year-old boy from Flavio Alfaro) was due to cardio-respiratory failure. Marked leukocytosis in four of the cases (21,800-31,800 cells/mm(3)), with notable neutrophilia (58-82%), suggests induction of a venom-mediated systemic inflammatory response-like syndrome. Specimens responsible for cases in Flavio Alfaro County, including the fatality, were classified as Tityus asthenes Pocock, accountable for severe scorpionism in Colombia. These findings demand implementation of control and therapeutic measures in affected areas in Ecuador, including evaluation of available scorpion antivenoms. Copyright © 2015 Elsevier Ltd. All rights reserved.

Shock parameter calculations at weak interplanetary shock waves

Directory of Open Access Journals (Sweden)

J. M. Gloag

2005-02-01

Full Text Available A large set of interplanetary shock waves observed using the Ulysses spacecraft is analysed in order to determine their local parameters. For the first time a detailed analysis is extended to the thermodynamic properties of a large number of events. The intention is to relate the shock parameters to the requirements set by MHD shock theory. A uniform approach is adopted in the selection of up and downstream regions for this analysis and applied to all the shock waves. Initially, the general case of a 3 component adiabatic plasma is considered. However, the calculation of magnetosonic and Alfvénic Mach numbers and the ratio of downstream to upstream entropy produce some unexpected results. In some cases there is no clear increase in entropy across the shock and also the magnetosonic Mach number can be less than 1. It is found that a more discerning use of data along with an empirical value for the polytropic index can raise the distribution of downstream to upstream entropy ratios to a more acceptable level. However, it is also realised that many of these shocks are at the very weakest end of the spectrum and associated phenomena may also contribute to the explanation of these results.

Direct molecular mimicry enables off-target cardiovascular toxicity by an enhanced affinity TCR designed for cancer immunotherapy.

Science.gov (United States)

Raman, Marine C C; Rizkallah, Pierre J; Simmons, Ruth; Donnellan, Zoe; Dukes, Joseph; Bossi, Giovanna; Le Provost, Gabrielle S; Todorov, Penio; Baston, Emma; Hickman, Emma; Mahon, Tara; Hassan, Namir; Vuidepot, Annelise; Sami, Malkit; Cole, David K; Jakobsen, Bent K

2016-01-13

Natural T-cell responses generally lack the potency to eradicate cancer. Enhanced affinity T-cell receptors (TCRs) provide an ideal approach to target cancer cells, with emerging clinical data showing significant promise. Nevertheless, the risk of off target reactivity remains a key concern, as exemplified in a recent clinical report describing fatal cardiac toxicity, following administration of MAGE-A3 specific TCR-engineered T-cells, mediated through cross-reactivity with an unrelated epitope from the Titin protein presented on cardiac tissue. Here, we investigated the structural mechanism enabling TCR cross-recognition of MAGE-A3 and Titin, and applied the resulting data to rationally design mutants with improved antigen discrimination, providing a proof-of-concept strategy for altering the fine specificity of a TCR towards an intended target antigen. This study represents the first example of direct molecular mimicry leading to clinically relevant fatal toxicity, mediated by a modified enhanced affinity TCR designed for cancer immunotherapy. Furthermore, these data demonstrate that self-antigens that are expressed at high levels on healthy tissue should be treated with extreme caution when designing immuno-therapeutics.

Occupational fatalities due to electrocutions in the construction industry.

Science.gov (United States)

Janicak, Christopher A

2008-01-01

Occupational fatalities due to contact with electricity account for approximately 9% of all deaths in the construction industry and is the fourth leading cause of death in this industry. Differences in the proportions of electrocutions in the construction industry are significantly different from other industries based upon the age of the worker and the source of the electricity. This study found that, in the construction industry, the proportion of occupational fatalities due to contact with electric current is significantly higher for workers in the 16 to 19 years old age group. Contact with overhead power lines occurred more frequently with younger workers, while contact with electric wiring, transformers, and related equipment was found to occur more frequently with older workers. The proportion of fatalities due to this event was also found to account for a significantly greater proportion of fatalities in the construction industry overall. The proportions of electrocution fatalities in the construction industry were found to be significantly higher for younger workers when compared to all other industries. Focusing prevention measures toward younger workers who work near overhead power lines could have a significant impact upon death rates. For older workers, the focus should be on those who work on or near transformers, electrical wiring, and components. Across the construction industry, implementation of effective lockout-tagout programs, and verification of energy isolation, can prevent approximately 125 fatalities per year in the construction industry.

Synthesis of 19-substituted geldanamycins with altered conformations and their binding to heat shock protein Hsp90

Science.gov (United States)

Kitson, Russell R. A.; Chang, Chuan-Hsin; Xiong, Rui; Williams, Huw E. L.; Davis, Adrienne L.; Lewis, William; Dehn, Donna L.; Siegel, David; Roe, S. Mark; Prodromou, Chrisostomos; Ross, David; Moody, Christopher J.

2013-01-01

The benzoquinone ansamycin geldanamycin and its derivatives are inhibitors of heat shock protein Hsp90, an emerging target for novel therapeutic agents both in cancer and in neurodegeneration. However, toxicity of these compounds to normal cells has been ascribed to reaction with thiol nucleophiles at the quinone 19-position. We reasoned that blocking this position would ameliorate toxicity, and that it might also enforce a favourable conformational switch of the trans-amide group into the cis-form required for protein binding. We report here an efficient synthesis of such 19-substituted compounds and realization of our hypotheses. Protein crystallography established that the new compounds bind to Hsp90 with, as expected, a cis-amide conformation. Studies on Hsp90 inhibition in cells demonstrated the molecular signature of Hsp90 inhibitors: decreases in client proteins with compensatory increases in other heat shock proteins in both human breast cancer and dopaminergic neural cells, demonstrating their potential for use in the therapy of cancer or neurodegenerative diseases. PMID:23511419

Uber and Metropolitan Traffic Fatalities in the United States.

Science.gov (United States)

Brazil, Noli; Kirk, David S

2016-08-01

Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Shock Mechanism Analysis and Simulation of High-Power Hydraulic Shock Wave Simulator

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Xiaoqiu Xu

2017-01-01

Full Text Available The simulation of regular shock wave (e.g., half-sine can be achieved by the traditional rubber shock simulator, but the practical high-power shock wave characterized by steep prepeak and gentle postpeak is hard to be realized by the same. To tackle this disadvantage, a novel high-power hydraulic shock wave simulator based on the live firing muzzle shock principle was proposed in the current work. The influence of the typical shock characteristic parameters on the shock force wave was investigated via both theoretical deduction and software simulation. According to the obtained data compared with the results, in fact, it can be concluded that the developed hydraulic shock wave simulator can be applied to simulate the real condition of the shocking system. Further, the similarity evaluation of shock wave simulation was achieved based on the curvature distance, and the results stated that the simulation method was reasonable and the structural optimization based on software simulation is also beneficial to the increase of efficiency. Finally, the combination of theoretical analysis and simulation for the development of artillery recoil tester is a comprehensive approach in the design and structure optimization of the recoil system.

Alfven shock trains

International Nuclear Information System (INIS)

Malkov, M.A.; Kennel, C.F.; Wu, C.C.; Pellat, R.; Shapiro, V.D.

1991-01-01

The Cohen--Kulsrud--Burgers equation (CKB) is used to consider the nonlinear evolution of resistive, quasiparallel Alfven waves subject to a long-wavelength, plane-polarized, monochromatic instability. The instability saturates by nonlinear steepening, which proceeds until the periodic waveform develops an interior scale length comparable to the dissipation length; a fast or an intermediate shock then forms. The result is a periodic train of Alfven shocks of one or the other type. For propagation strictly parallel to the magnetic field, there will be two shocks per instability wavelength. Numerical integration of the time-dependent CKB equation shows that an initial, small-amplitude growing wave asymptotes to a stable, periodic stationary wave whose analytic solution specifies how the type of shock embedded in the shock train, and the amplitude and speed of the shock train, depend on the strength and phase of the instability. Waveforms observed upstream of the Earth's bowshock and cometary shocks resemble those calculated here

Spherical strong-shock generation for shock-ignition inertial fusion

Energy Technology Data Exchange (ETDEWEB)

Theobald, W.; Seka, W.; Lafon, M.; Anderson, K. S.; Hohenberger, M.; Marshall, F. J.; Michel, D. T.; Solodov, A. A.; Stoeckl, C.; Edgell, D. H.; Yaakobi, B.; Shvydky, A. [Laboratory for Laser Energetics and Fusion Science Center, University of Rochester, Rochester, New York 14623 (United States); Nora, R.; Betti, R. [Laboratory for Laser Energetics and Fusion Science Center, University of Rochester, Rochester, New York 14623 (United States); Department of Mechanical Engineering and Department of Physics, University of Rochester, Rochester, New York 14623 (United States); Casner, A.; Reverdin, C. [CEA, DAM, DIF, F-91297 Arpajon (France); Ribeyre, X.; Vallet, A. [Université de Bordeaux-CNRS-CEA, CELIA (Centre Lasers Intenses et Applications) UMR 5107 F-33400 Talence (France); Peebles, J.; Beg, F. N. [University of California, San Diego, La Jolla, California 92093 (United States); and others

2015-05-15

Recent experiments on the Laboratory for Laser Energetics' OMEGA laser have been carried out to produce strong shocks in solid spherical targets with direct laser illumination. The shocks are launched at pressures of several hundred Mbars and reach Gbar upon convergence. The results are relevant to the validation of the shock-ignition scheme and to the development of an OMEGA experimental platform to study material properties at Gbar pressures. The experiments investigate the strength of the ablation pressure and the hot-electron production at incident laser intensities of ∼2 to 6 × 10{sup 15 }W/cm{sup 2} and demonstrate ablation pressures exceeding 300 Mbar, which is crucial to developing a shock-ignition target design for the National Ignition Facility. The timing of the x-ray flash from shock convergence in the center of the solid plastic target is used to infer the ablation and shock pressures. Laser–plasma instabilities produce hot-electrons with a moderate temperature (<100 keV). The instantaneous conversion efficiencies of laser power into hot-electron power reached up to ∼15% in the intensity spike. The large amount of hot electrons is correlated with an earlier x-ray flash and a strong increase in its magnitude. This suggests that hot electrons contribute to the augmentation of the shock strength.

Behavioral effects of ketamine and toxic interactions with psychostimulants

Directory of Open Access Journals (Sweden)

Yamamoto Keiichi

2006-03-01

Full Text Available Abstract Background The anesthetic drug ketamine (KT has been reported to be an abused drug and fatal cases have been observed in polydrug users. In the present study, considering the possibility of KT-enhanced toxic effects of other drugs, and KT-induced promotion of an overdose without making the subject aware of the danger due to the attenuation of several painful subjective symptoms, the intraperitoneal (i.p. KT-induced alterations in behaviors and toxic interactions with popular co-abused drugs, the psychostimulants cocaine (COC and methamphetamine (MA, were examined in ICR mice. Results A single dose of KT caused hyperlocomotion in a low (30 mg/kg, i.p. dose group, and hypolocomotion followed by hyperlocomotion in a high (100 mg/kg, i.p. dose group. However, no behavioral alterations derived from enhanced stress-related depression or anxiety were observed in the forced swimming or the elevated plus-maze test. A single non-fatal dose of COC (30 mg/kg, i.p. or MA (4 mg/kg, i.p. caused hyperlocomotion, stress-related depression in swimming behaviors in the forced swimming test, and anxiety-related behavioral changes (preference for closed arms in the elevated plus-maze test. For the COC (30 mg/kg or MA (4 mg/kg groups of mice simultaneously co-treated with KT, the psychostimulant-induced hyperlocomotion was suppressed by the high dose KT, and the psychostimulant-induced behavioral alterations in the above tests were reversed by both low and high doses of KT. For the toxic dose COC (70 mg/kg, i.p.- or MA (15 mg/kg, i.p.-only group, mortality and severe seizures were observed in some animals. In the toxic dose psychostimulant-KT groups, KT attenuated the severity of seizures dose-dependently. Nevertheless, the mortality rate was significantly increased by co-treatment with the high dose KT. Conclusion Our results demonstrated that, in spite of the absence of stress-related depressive and anxiety-related behavioral alterations following a single

Is shock index associated with outcome in children with sepsis/septic shock?*.

Science.gov (United States)

Yasaka, Yuki; Khemani, Robinder G; Markovitz, Barry P

2013-10-01

To investigate the association between PICU shock index (the ratio of heart rate to systolic blood pressure) and PICU mortality in children with sepsis/septic shock. To explore cutoff values for shock index for ICU mortality, how change in shock index over the first 6 hours of ICU admission is associated with outcome, and how the use of vasoactive therapy may affect shock index and its association with outcome. Retrospective cohort. Single-center tertiary PICU. Five hundred forty-four children with the diagnosis of sepsis/septic shock. None. From January 2003 to December 2009, 544 children met International Pediatric Sepsis Consensus Conference of 2005 criteria for sepsis/septic shock. Overall mortality was 23.7%. Among all patients, hourly shock index was associated with mortality: odds ratio of ICU mortality at 0 hour, 1.08, 95% CI (1.04-1.12); odds ratio at 1 hour, 1.09 (1.04-1.13); odds ratio at 2 hours, 1.09 (1.05-1.13); and odds ratio at 6 hours, 1.11 (1.06-1.15). When stratified by age, early shock index was associated with mortality only in children 1-3 and more than or equal to 12 years old. Area under the receiver operating characteristic curve in age 1-3 and more than or equal to 12 years old for shock index at admission was 0.69 (95% CI, 0.58-0.80) and 0.62 (95% CI, 0.52-0.72) respectively, indicating a fair predictive marker. Although higher shock index was associated with increased risk of mortality, there was no particular cutoff value with adequate positive or negative likelihood ratios to identify mortality in any age group of children. The improvement of shock index in the first 6 hours of ICU admission was not associated with outcome when analyzed in all patients. However, among patients whose shock index were above the 50th percentile at ICU admission for each age group, improvement of shock index was associated with lower ICU mortality in children between 1-3 and more than or equal to 12 years old (p = 0.02 and p = 0.03, respectively). When

The incidence of multiple fatality accidents in the U.K

International Nuclear Information System (INIS)

Griffiths, R.F.; Fryer, L.S.

1978-03-01

The report presents a compilation of available data showing the frequency of occurrence of accidents resulting in multiple fatalities in the United Kingdom (or Great Britain, as the data permits). Frequency vs. number-of-fatalities graphs are plotted for the following five classes of fatalities:- persons killed in fires in the UK; crew members of UK registered ships; railway passengers in Great Britain; passengers of aircraft on the British register; occupants of Public Service Vehicles in Great Britain. The information needed to compile a more comprehensive set of graphs was found to be unobtainable. The report concludes with the suggestion that procedures for reporting and recording details of fatal accidents should be reviewed. (author)

Biomass shock pretreatment

Science.gov (United States)

Holtzapple, Mark T.; Madison, Maxine Jones; Ramirez, Rocio Sierra; Deimund, Mark A.; Falls, Matthew; Dunkelman, John J.

2014-07-01

Methods and apparatus for treating biomass that may include introducing a biomass to a chamber; exposing the biomass in the chamber to a shock event to produce a shocked biomass; and transferring the shocked biomass from the chamber. In some aspects, the method may include pretreating the biomass with a chemical before introducing the biomass to the chamber and/or after transferring shocked biomass from the chamber.

Fatal interstitial lung disease associated with icotinib

OpenAIRE

Zhang, Jiexia; Zhan, Yangqing; Ouyang, Ming; Qin, Yinyin; Zhou, Chengzhi; Chen, Rongchang

2014-01-01

The most serious, and maybe fatal, yet rare, adverse reaction of gefitinib and erlotinib is drug-associated interstitial lung disease (ILD), which has been often described. However, it has been less well described for icotinib, a similar orally small-molecule tyrosine kinase inhibitor (TKI). The case of a 25-year-old female patient with stage IV lung adenocarcinoma who developed fatal ILD is reported here. She denied chemotherapy, and received palliative treatment with icotinib (125 mg po, th...

Disentangling age-gender interactions associated with risks of fatal and non-fatal road traffic injuries in the Sultanate of Oman.

Science.gov (United States)

Al-Aamri, Amira K; Padmadas, Sabu S; Zhang, Li-Chun; Al-Maniri, Abdullah A

2017-01-01

Road traffic injuries (RTIs) are the leading cause of disability-adjusted life years lost in Oman, Saudi Arabia and United Arab Emirates. Injury prevention strategies often overlook the interaction of individual and behavioural risk factors in assessing the severity of RTI outcomes. We conducted a systematic investigation of the underlying interactive effects of age and gender on the severity of fatal and non-fatal RTI outcomes in the Sultanate of Oman. We used the Royal Oman Police national database of road traffic crashes for the period 2010-2014. Our study was based on 35 785 registered incidents: of these, 10.2% fatal injuries, 6.2% serious, 27.3% moderate, 37.3% mild injuries and 19% only vehicle damage but no human injuries. We applied a generalised ordered logit regression to estimate the effect of age and gender on RTI severity, controlling for risk behaviours, personal characteristics, vehicle, road, traffic, environment conditions and geographical location. The most dominant group at risk of all types of RTIs was young male drivers. The probability of severe incapacitating injuries was the highest for drivers aged 25-29 (26.6%) years, whereas the probability of fatal injuries was the highest for those aged 20-24 (26.9%) years. Analysis of three-way interactions of age, gender and causes of crash show that overspeeding was the primary cause of different types of RTIs. In particular, the probability of fatal injuries among male drivers attributed to overspeeding ranged from 3%-6% for those aged 35 years and above to 13.4% and 17.7% for those aged 25-29 years and 20-24 years, respectively. The high burden of severe and fatal RTIs in Oman was primarily attributed to overspeed driving behaviour of young male drivers in the 20-29 years age range. Our findings highlight the critical need for designing early gender-sensitive road safety interventions targeting young male and female drivers.

Cosmic-ray shock acceleration in oblique MHD shocks

Science.gov (United States)

Webb, G. M.; Drury, L. OC.; Volk, H. J.

1986-01-01

A one-dimensional, steady-state hydrodynamical model of cosmic-ray acceleration at oblique MHD shocks is presented. Upstream of the shock the incoming thermal plasma is subject to the adverse pressure gradient of the accelerated particles, the J x B force, as well as the thermal gas pressure gradient. The efficiency of the acceleration of cosmic-rays at the shock as a function of the upstream magnetic field obliquity and upstream plasma beta is investigated. Astrophysical applications of the results are briefly discussed.

Factors associated with the severity of fatal accidents in construction workers.

Science.gov (United States)

Khodabandeh, Farideh; Kabir-Mokamelkhah, Elaheh; Kahani, Mahsa

2016-01-01

Background: Construction work (building houses, roads, workplaces, and repairing and maintaining infrastructures) is a dangerous land-based job. This includes many hazardous tasks and conditions such as working at the following conditions: Height, excavation, noise, dust, power tools and equipment. Construction work has been increased in developed and underdeveloped countries over the past few years. Occupational fatalities have increased with an increase in this type of work. Occupational fatalities refer to individuals who pass way while on the job or performing work related tasks. In the present study, to identify the factors, personal characteristics and work-related factors associated with fatal occupational mortality were assessed using data for Tehran, Iran, 2014-2016. Methods: We conducted a retrospective study, using 967 postmortem reports from fatal occupational injuries collected through postmortem investigations during 2014-2016. A sampling frame of 967 postmortem reports from fatal occupational injuries was used to draw a total sample of 714 fatal construction accidents for this cross-sectional study. Pearson χ2 test and Kruskal-Wallis tests were used for statistical analysis. Results: Based on the results of this study, male gender (n=714; 100%), age range of 30-39 years (n=183; 25.6%), secondary educational level (n=273; 38.2%), being married (317; 44.4%), causal employee (n=389; 54.5%), unskilled performance (389; 54.5%), no insurance coverage (472; 66.1%), and daytime duty work (287; 40.2%) were identified as risk factors for fatality in the event of construction fatal injury. A significant relationship was found between the type of injury and sociodemographic and work related variables. Conclusion: Workers' characteristics such as age, gender, experience, and educational background, and work related variables such as skill training, safety measurement, and close monitoring could be used to discriminate among different severity levels of

Sarcoma de Kaposi clássico fatal Fatal outcome in classic Kaposi's sarcoma

Directory of Open Access Journals (Sweden)

Eugênia Maria Damásio N. Ohe

2010-06-01

Full Text Available Descrito em 1872, o sarcoma de Kaposi é neoplasia multicêntrica rara originária de células endoteliais com manifestação cutânea e extracutânea. A forma clássica é muito mais frequente em homens idosos, com evolução prolongada e boa resposta a quimioterapia e radioterapia. Apresentaremos um caso de sarcoma de Kaposi clássico com comprometimento cutâneo e visceral em paciente do sexo feminino com rápida evolução fatal.First described in 1872, Kaposi's sarcoma is defined as a rare multifocal tumor that originates in the endothelial cells and presents with cutaneous and extracutaneous manifestations. The classic form is most common in elderly men and progression is slow. This tumor responds well to chemotherapy and radiotherapy. This report describes a classic case of Kaposi's sarcoma in a woman with skin and visceral manifestations in whom the disease rapidly progressed to a fatal outcome.

Unique fatality due to claw injuries in a tiger attack: a case report.

Science.gov (United States)

Pathak, Hrishikesh; Dixit, Pradeep; Dhawane, Shailendra; Meshram, Satin; Shrigiriwar, Manish; Dingre, Niraj

2014-11-01

This paper describes a unique case of a fatal tiger attack in the wild. In the present case, a tiger fatally mauled a 34-year-old female with its claws, instead of the usual mechanism of killing by the bite injury to the neck. The autopsy revealed multiple fatal and non-fatal injuries caused by the tiger claws. The characteristic injuries due to the tooth impacts were absent as the teeth of the offending tiger were either fallen or non-functional. To the best of our knowledge, probably this rare case would be the first reported human fatality due to the tiger claw injuries in the world. The purpose of the present article is to highlight the fatal injuries due to the tiger claws, as the claw-induced fatal injuries in a tiger attack are not reported in the medico-legal literature. Moreover, this report would be an illustrative one for differentiation between the fatal injuries due to the claws and tooth impacts in a tiger attack. Furthermore, the present report establishes the importance of the tiger claws as a source of fatal injuries in a tiger attack. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Urban sprawl as a risk factor in motor vehicle occupant and pedestrian fatalities.

Science.gov (United States)

Ewing, Reid; Schieber, Richard A; Zegeer, Charles V

2003-09-01

We sought to determine the association between urban sprawl and traffic fatalities. We created a sprawl index by applying principal components analysis to data for 448 US counties in the largest 101 metropolitan areas. Regression analysis was used to determine associations between the index and traffic fatalities. For every 1% increase in the index (i.e., more compact, less sprawl), all-mode traffic fatality rates fell by 1.49% (P Urban sprawl was directly related to traffic fatalities and pedestrian fatalities. Subsequent studies should investigate relationships at a finer geographic scale and should strive to improve on the measure of exposure used to adjust pedestrian fatality rates.

Bordetella bronchiseptica and fatal pneumonia of dogs and cats

Science.gov (United States)

Bordetella bronchiseptica frequently causes nonfatal tracheobronchitis, but its role in fatal pneumonia is less well-studied. The objectives of this study were to identify the frequency of Bordetella bronchiseptica infection in fatal cases of bronchopneumonia in dogs and cats and to compare the diag...

Lake tourism fatalities: a 46-year history of death at Lake Powell.

Science.gov (United States)

Heggie, Travis W

2018-05-01

This study investigates tourist mortality at Lake Powell over a 46-year period. To date no comprehensive long-term investigation examining the relationship between the lake environment and tourist mortality exists. A retrospective study was conducted of all tourist fatalities between 1959 and 2005. There were 351 fatal incidents resulting in 386 deaths between 1959 and 2005. Over the 46-year period, the average number of fatalities was 8.4 (±5.26) per year. Out of all fatalities, 282 were classified as accidental, 80 were classified as natural deaths, 13 were suicides and 5 were classified as homicides. Males accounted for 80% of fatalities and tourists aged 20-29 years and 10-19 years accounted for 36% of all fatalities. The highest number of fatalities was recorded in July (74), May (64), August (63) and June (59). Out of all accidental deaths, boating (29%) and swimming (22%) were the most common pre-death activities. High winds capsizing boats and carbon monoxide poisoning from boat engines were common factors contributing to 31 boating fatalities. Fatigue and exhaustion contributed to 22 swimming deaths. Recreational boating and swimming account for over half of all accidental deaths. Tourists visiting Lake Powell for recreational purposes should be informed of the risks associated with the lake environment.

Assessing the impact of Syrian refugees on earthquake fatality estimations in southeast Turkey

Science.gov (United States)

Wilson, Bradley; Paradise, Thomas

2018-01-01

The influx of millions of Syrian refugees into Turkey has rapidly changed the population distribution along the Dead Sea Rift and East Anatolian fault zones. In contrast to other countries in the Middle East where refugees are accommodated in camp environments, the majority of displaced individuals in Turkey are integrated into local cities, towns, and villages - placing stress on urban settings and increasing potential exposure to strong earthquake shaking. Yet displaced populations are often unaccounted for in the census-based population models used in earthquake fatality estimations. This study creates a minimally modeled refugee gridded population model and analyzes its impact on semi-empirical fatality estimations across southeast Turkey. Daytime and nighttime fatality estimates were produced for five fault segments at earthquake magnitudes 5.8, 6.4, and 7.0. Baseline fatality estimates calculated from census-based population estimates for the study area varied in scale from tens to thousands of fatalities, with higher death totals in nighttime scenarios. Refugee fatality estimations were analyzed across 500 semi-random building occupancy distributions. Median fatality estimates for refugee populations added non-negligible contributions to earthquake fatalities at four of five fault locations, increasing total fatality estimates by 7-27 %. These findings communicate the necessity of incorporating refugee statistics into earthquake fatality estimations in southeast Turkey and the ongoing importance of placing environmental hazards in their appropriate regional and temporal context.

Meningococcal meningitis: clinical and laboratorial characteristics, fatality rate and variables associated with in-hospital mortality

Directory of Open Access Journals (Sweden)

Vanessa L. Strelow

Full Text Available ABSTRACT Meningococcal meningitis is a public health problem. The aim of this study was to describe the clinical characteristics of patients with meningococcal meningitis, and to identify associated factors with mortality. This was a retrospective study, between 2006 and 2011, at a referral center in São Paulo, Brazil. Logistic regression analysis was used to identify factors associated with mortality. We included 316 patients. The median age was 16 years (IQR: 7–27 and 60% were male. The clinical triad: fever, headache and neck stiffness was observed in 89% of the patients. The cerebrospinal triad: pleocytosis, elevated protein levels and low glucose levels was present in 79% of patients. Factors associated with mortality in the multivariate model were age above 50 years, seizures, tachycardia, hypotension and neck stiffness. The classic clinical and laboratory triads of meningococcal meningitis were variable. The fatality rate was low. Age, seizures and shock signs were independently associated with mortality.

Circumstances of fatal lockout/tagout-related injuries in manufacturing.

Science.gov (United States)

Bulzacchelli, Maria T; Vernick, Jon S; Sorock, Gary S; Webster, Daniel W; Lees, Peter S J

2008-10-01

Over the past few decades, hundreds of manufacturing workers have suffered fatal injuries while performing maintenance and servicing on machinery and equipment. Using lockout/tagout procedures could have prevented many of these deaths. A narrative text analysis of OSHA accident investigation report summaries was conducted to describe the circumstances of lockout/tagout-related fatalities occurring in the US manufacturing industry from 1984 to 1997. The most common mechanisms of injury were being caught in or between parts of equipment, electrocution, and being struck by or against objects. Typical scenarios included cleaning a mixer or blender, cleaning a conveyor, and installing or disassembling electrical equipment. Lockout procedures were not even attempted in the majority (at least 58.8%) of fatal incidents reviewed. Lockout/tagout-related fatalities occur under a wide range of circumstances. Enhanced training and equipment designs that facilitate lockout and minimize worker contact with machine parts may prevent many lockout/tagout-related injuries. Published 2008 Wiley-Liss, Inc.

A fatal forensic intoxication with fenarimol: analysis by HPLC/DAD/MSD.

Science.gov (United States)

Proença, P; Pinho Marques, E; Teixeira, H; Castanheira, F; Barroso, M; Avila, S; Vieira, D N

2003-04-23

Fenarimol (Rubigan) is a pyrimidine ergosterol biosynthesis inhibitor used as a systemic fungicide. The authors present a fatal fenarimol intoxication case analysed in the Forensic Toxicology Service of the National Institute of Legal Medicine. The results were used to compare two different HPLC techniques, regarding selectivity and sensitivity: an HPLC system with a diode array detector (DAD) and an HPLC system with a DAD and a mass spectrometry detector (MSD) with an electrospray interface. All biological samples were submitted to a solid-phase extraction procedure. The detection and quantification limits of fenarimol, linearity, precision and accuracy were evaluated. The fenarimol concentration levels determined were of 89.0 mg/ml in gastric contents, 1.9 mg/g in liver and 0.4 mg/g in kidney. Blood was not available at autopsy. No published data related to fenarimol self-poisoning were found, so it was not possible to interpret the results obtained by comparison with toxic/lethal levels.

The work-related fatal injury study: numbers, rates and trends of work-related fatal injuries in New Zealand 1985-1994.

Science.gov (United States)

Feyer, A M; Langley, J; Howard, M; Horsburgh, S; Wright, C; Alsop, J; Cryer, C

2001-01-26

To determine the number and rates of work-related fatal injuries by employment status, occupation, industry, age and gender in New Zealand 1985-1994. Potential cases of work-related injury deaths of persons aged 15-84 years were identified from the national electronic mortality data files. Main exclusions were deaths due to suicide and deaths due to motor vehicle crashes. The circumstances of the deaths of each fatal incident meeting inclusion criteria were then reviewed directly from coronial files to determine work-relatedness. The rate of work-related fatal injury in New Zealand was 5.03/100000 workers per year for the study period. There was a significant decline in crude rate over the study period. However, this was in substantial part accounted for by changes in occupation and industry mix. Older workers, male workers, self-employed workers, and particular occupational groups, all had substantially elevated rates. Agricultural and helicopter pilots, forestry workers and fishery workers had the highest rates. Farmers, forestry workers, and fishery workers also had high numbers of deaths, together accounting for nearly 40% of all deaths. This study has demonstrated that work-related fatal injury remains a pressing problem for New Zealand. Several areas in urgent need of prevention efforts were highlighted.

Allegheny County Fatal Accidental Overdoses

Data.gov (United States)

Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

49 CFR 219.207 - Fatality.

Science.gov (United States)

2010-10-01

... TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Post-Accident Toxicological Testing § 219.207 Fatality. (a) In the..., United States Code (but not the agent of the Secretary for purposes of the Federal Tort Claims Act...

Fatal crashes of passenger vehicles before and after adding antilock braking systems.

Science.gov (United States)

Farmer, C M; Lund, A K; Trempel, R E; Braver, E R

1997-11-01

Fatal crash rates of passenger cars and vans were compared for the last model year before four-wheel antilock brakes were introduced and the first model year for which antilock brakes were standard equipment. Vehicles selected for analysis had no other significant design changes between the model years being compared, and the model years with and without antilocks were no more than two years apart. The overall fatal crash rates were similar for the two model years. However, the vehicles with antilocks were significantly more likely to be involved in crashes fatal to their own occupants, particularly single-vehicle crashes. Conversely, antilock vehicles were less likely to be involved in crashes fatal to occupants of other vehicles or nonoccupants (pedestrians, bicyclists). Overall, antilock brakes appear to have had little effect on fatal crash involvement. Further study is needed to better understand why fatality risk has increased for occupants of antilock vehicles.

Fatal atypical reversible posterior leukoencephalopathy syndrome: a case report

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Golombeck Stefanie Kristin

2013-01-01

Full Text Available Abstract Introduction Reversible posterior leukoencephalopathy syndrome – a reversible subacute global encephalopathy clinically presenting with headache, altered mental status, visual symptoms such as hemianopsia or cortical blindness, motor symptoms, and focal or generalized seizures – is characterized by a subcortical vasogenic edema symmetrically affecting posterior brain regions. Complete reversibility of both clinical signs and magnetic resonance imaging lesions is regarded as a defining feature of reversible posterior leukoencephalopathy syndrome. Reversible posterior leukoencephalopathy syndrome is almost exclusively seen in the setting of a predisposing clinical condition, such as pre-eclampsia, systemic infections, sepsis and shock, certain autoimmune diseases, various malignancies and cytotoxic chemotherapy, transplantation and concomitant immunosuppression (especially with calcineurin inhibitors as well as episodes of abrupt hypertension. We describe for the first time clinical, radiological and histological findings in a case of reversible posterior leukoencephalopathy syndrome with an irreversible and fatal outcome occurring in the absence of any of the known predisposing clinical conditions except for a hypertensive episode. Case presentation A 58-year-old Caucasian woman presented with a two-week history of subacute and progressive occipital headache, blurred vision and imbalance of gait and with no evidence for raised arterial blood pressure during the two weeks previous to admission. Her past medical history was unremarkable except for controlled arterial hypertension. Cerebral magnetic resonance imaging demonstrated cortical and subcortical lesions with combined vasogenic and cytotoxic edema atypical for both venous congestion and arterial infarction. Routine laboratory and cerebrospinal fluid parameters were normal. The diagnosis of reversible posterior leukoencephalopathy syndrome was established. Within hours after

Tetrodotoxin: Chemistry, Toxicity, Source, Distribution and Detection

Directory of Open Access Journals (Sweden)

Vaishali Bane

2014-02-01

Full Text Available Tetrodotoxin (TTX is a naturally occurring toxin that has been responsible for human intoxications and fatalities. Its usual route of toxicity is via the ingestion of contaminated puffer fish which are a culinary delicacy, especially in Japan. TTX was believed to be confined to regions of South East Asia, but recent studies have demonstrated that the toxin has spread to regions in the Pacific and the Mediterranean. There is no known antidote to TTX which is a powerful sodium channel inhibitor. This review aims to collect pertinent information available to date on TTX and its analogues with a special emphasis on the structure, aetiology, distribution, effects and the analytical methods employed for its detection.

Rising gasoline prices increase new motorcycle sales and fatalities.

Science.gov (United States)

Zhu, He; Wilson, Fernando A; Stimpson, Jim P; Hilsenrath, Peter E

2015-12-01

We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984-2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02-1.28) when gasoline prices increase. Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders.

Assessing the impact of Syrian refugees on earthquake fatality estimations in southeast Turkey

Directory of Open Access Journals (Sweden)

B. Wilson

2018-01-01

Full Text Available The influx of millions of Syrian refugees into Turkey has rapidly changed the population distribution along the Dead Sea Rift and East Anatolian fault zones. In contrast to other countries in the Middle East where refugees are accommodated in camp environments, the majority of displaced individuals in Turkey are integrated into local cities, towns, and villages – placing stress on urban settings and increasing potential exposure to strong earthquake shaking. Yet displaced populations are often unaccounted for in the census-based population models used in earthquake fatality estimations. This study creates a minimally modeled refugee gridded population model and analyzes its impact on semi-empirical fatality estimations across southeast Turkey. Daytime and nighttime fatality estimates were produced for five fault segments at earthquake magnitudes 5.8, 6.4, and 7.0. Baseline fatality estimates calculated from census-based population estimates for the study area varied in scale from tens to thousands of fatalities, with higher death totals in nighttime scenarios. Refugee fatality estimations were analyzed across 500 semi-random building occupancy distributions. Median fatality estimates for refugee populations added non-negligible contributions to earthquake fatalities at four of five fault locations, increasing total fatality estimates by 7–27 %. These findings communicate the necessity of incorporating refugee statistics into earthquake fatality estimations in southeast Turkey and the ongoing importance of placing environmental hazards in their appropriate regional and temporal context.

Shock Producers and Shock Absorbers in the Crisis

OpenAIRE

Sinn, Hans-Werner

2009-01-01

It is not surprising that the U.S. has been by far the world’s largest shock producer in this crisis. The big shock absorbers on the other hand were Japan, Russia and Germany, whose exports shrank more than their imports.

Blast overpressure after tire explosion: a fatal case.

Science.gov (United States)

Pomara, Cristoforo; D'Errico, Stefano; Riezzo, Irene; Perilli, Gabriela; Volpe, Umberto; Fineschi, Vittorio

2013-12-01

Fatal blast injuries are generally reported in literature as a consequence of the detonation of explosives in war settings. The pattern of lesion depends on the position of the victim in relation to the explosion, on whether the blast tracks through air or water, and whether it happens in the open air or within an enclosed space and the distance from the explosion. Tire explosion-related injuries are rarely reported in literature. This study presents a fatal case of blast overpressure due to the accidental explosion of a truck tire occurring in a tire repair shop. A multidisciplinary approach to the fatality involving forensic pathologists and engineers revealed that the accidental explosion, which caused a series of primary and tertiary blast wave injuries, was due to tire deterioration.

Shock loading predictions from application of indicial theory to shock-turbulence interactions

Science.gov (United States)

Keefe, Laurence R.; Nixon, David

1991-01-01

A sequence of steps that permits prediction of some of the characteristics of the pressure field beneath a fluctuating shock wave from knowledge of the oncoming turbulent boundary layer is presented. The theory first predicts the power spectrum and pdf of the position and velocity of the shock wave, which are then used to obtain the shock frequency distribution, and the pdf of the pressure field, as a function of position within the interaction region. To test the validity of the crucial assumption of linearity, the indicial response of a normal shock is calculated from numerical simulation. This indicial response, after being fit by a simple relaxation model, is used to predict the shock position and velocity spectra, along with the shock passage frequency distribution. The low frequency portion of the shock spectra, where most of the energy is concentrated, is satisfactorily predicted by this method.

Occupational fatality risks in the United States and the United Kingdom.

Science.gov (United States)

Mendeloff, John; Staetsky, Laura

2014-01-01

There are very few careful studies of differences in occupational fatality rates across countries, much less studies that try to account for those differences. We compare the rate of work injury fatalities (excluding deaths due to highway motor vehicle crashes and those due to violence) identified by the US Census of Fatal Occupational Injuries in recent years with the number reported to the Health and Safety Executive in the United Kingdom (UK) and by other European Union (EU) members through Eurostat. In 2010, the fatality rate in the UK was about 1/3 the rate in the US. In construction the rate was about ¼ the US rate, a difference that had grown substantially since the 1990s. Several other EU members had rates almost as low as the UK rate. Across EU countries, lower rates were associated with high-level management attention to safety issues and to in-house preparation of "risk assessments." Although work fatality rates have declined in the US, fatality rates are much lower and have declined faster in recent years in the UK. Efforts to find out the reasons for the much better UK outcomes could be productive. © 2013 Wiley Periodicals, Inc.

Quasi-likelihood generalized linear regression analysis of fatality risk data.

Science.gov (United States)

2009-01-01

Transportation-related fatality risks is a function of many interacting human, vehicle, and environmental factors. Statistically valid analysis of such data is challenged both by the complexity of plausible structural models relating fatality rates t...

Shock Isolation Elements Testing for High Input Loadings. Volume II. Foam Shock Isolation Elements.

Science.gov (United States)

SHOCK ABSORBERS ), (*GUIDED MISSILE SILOS, SHOCK ABSORBERS ), (*EXPANDED PLASTICS, (*SHOCK(MECHANICS), REDUCTION), TEST METHODS, SHOCK WAVES, STRAIN(MECHANICS), LOADS(FORCES), MATHEMATICAL MODELS, NUCLEAR EXPLOSIONS, HARDENING.

Road Accidents and Road Fatalities in Denmark from 1968 to 2004

DEFF Research Database (Denmark)

Orozova-Bekkevold, Ivanka; Hels, Tove; Bernhoft, Inger Marie

2008-01-01

The purpose of this article is to describe the road accidents and road fatalities in Denmark in the period 1968-2004. Only accidents registered by the police were used. Crude and gender & age specific fatality rates (counts per 1,000,000 inhabitants) were estimated for all road users...... and for bicyclists. The accident and fatality rates have decreased by around 70% from 1968 to 2004, while the motorisation rate has increased by approximately 90%. The sharpest decrease in the fatality rate was observed among the youngest (below 18 years old) and the older (above 64) road users. Gender related...... and actions targeted to improve road safety have indeed led to a significant reduction in injury accidents and fatalities. Further research and more detailed data, especially on traffic volume and individual exposure are necessary in order to investigate properly a causal relation between the number...

Gravitational shock waves and extreme magnetomaterial shock waves

International Nuclear Information System (INIS)

Lichnerowicz, Andre.

1975-01-01

Within an astrophysical context corresponding to high densities, a self-gravitating model is studied, which is the set of an extreme material medium of infinite conductivity and of a magnetic field. Corresponding shock waves generate necessarily, in general, gravitational shock waves [fr

Fatal motorcycle accidents and alcohol

DEFF Research Database (Denmark)

Larsen, C F; Hardt-Madsen, M

1987-01-01

A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC......); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol...... consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported....

The Role of Sodium Bicarbonate in the Management of Some Toxic Ingestions

Directory of Open Access Journals (Sweden)

Aibek E. Mirrakhimov

2017-01-01

Full Text Available Adverse reactions to commonly prescribed medications and to substances of abuse may result in severe toxicity associated with increased morbidity and mortality. According to the Center for Disease Control, in 2013, at least 2113 human fatalities attributed to poisonings occurred in the United States of America. In this article, we review the data regarding the impact of systemic sodium bicarbonate administration in the management of certain poisonings including sodium channel blocker toxicities, salicylate overdose, and ingestion of some toxic alcohols and in various pharmacological toxicities. Based on the available literature and empiric experience, the administration of sodium bicarbonate appears to be beneficial in the management of a patient with the above-mentioned toxidromes. However, most of the available evidence originates from case reports, case series, and expert consensus recommendations. The potential mechanisms of sodium bicarbonate include high sodium load and the development of metabolic alkalosis with resultant decreased tissue penetration of the toxic substance with subsequent increased urinary excretion. While receiving sodium bicarbonate, patients must be monitored for the development of associated side effects including electrolyte abnormalities, the progression of metabolic alkalosis, volume overload, worsening respiratory status, and/or worsening metabolic acidosis. Patients with oliguric/anuric renal failure and advanced decompensated heart failure should not receive sodium bicarbonate.

The Role of Sodium Bicarbonate in the Management of Some Toxic Ingestions.

Science.gov (United States)

Mirrakhimov, Aibek E; Ayach, Taha; Barbaryan, Aram; Talari, Goutham; Chadha, Romil; Gray, Adam

2017-01-01

Adverse reactions to commonly prescribed medications and to substances of abuse may result in severe toxicity associated with increased morbidity and mortality. According to the Center for Disease Control, in 2013, at least 2113 human fatalities attributed to poisonings occurred in the United States of America. In this article, we review the data regarding the impact of systemic sodium bicarbonate administration in the management of certain poisonings including sodium channel blocker toxicities, salicylate overdose, and ingestion of some toxic alcohols and in various pharmacological toxicities. Based on the available literature and empiric experience, the administration of sodium bicarbonate appears to be beneficial in the management of a patient with the above-mentioned toxidromes. However, most of the available evidence originates from case reports, case series, and expert consensus recommendations. The potential mechanisms of sodium bicarbonate include high sodium load and the development of metabolic alkalosis with resultant decreased tissue penetration of the toxic substance with subsequent increased urinary excretion. While receiving sodium bicarbonate, patients must be monitored for the development of associated side effects including electrolyte abnormalities, the progression of metabolic alkalosis, volume overload, worsening respiratory status, and/or worsening metabolic acidosis. Patients with oliguric/anuric renal failure and advanced decompensated heart failure should not receive sodium bicarbonate.

The legacy of fear: is fear impacting fatal and non-fatal drowning of African American children?

Science.gov (United States)

Irwin, Carol C; Irwin, Richard L; Ryan, Timothy D; Drayer, Joris

2011-01-01

African American children’s rates for fatal and non-fatal drowning events are alarmingly elevated, with some age groups having three times the rate as compared to White peers. Adequate swimming skills are considered a protective agent toward the prevention of drowning, but marginalized youth report limited swimming ability. This research examined minority children’s and parents/caregivers’ fear of drowning as a possible variable associated with limited swimming ability. Results confirmed that there were significant racial differences concerning the fear of drowning, and adolescent African American females were notably more likely to fear drowning while swimming than any other group. The “fear of drowning” responses by parents/ caregivers of minority children were also significantly different from their White counterparts.

Quasilinear simulations of interplanetary shocks and Earth's bow shock

Science.gov (United States)

Afanasiev, Alexandr; Battarbee, Markus; Ganse, Urs; Vainio, Rami; Palmroth, Minna; Pfau-Kempf, Yann; Hoilijoki, Sanni; von Alfthan, Sebastian

2016-04-01

We have developed a new self-consistent Monte Carlo simulation model for particle acceleration in shocks. The model includes a prescribed large-scale magnetic field and plasma density, temperature and velocity profiles and a self-consistently computed incompressible ULF foreshock under the quasilinear approximation. Unlike previous analytical treatments, our model is time dependent and takes full account of the anisotropic particle distributions and scattering in the wave-particle interaction process. We apply the model to the problem of particle acceleration at traveling interplanetary (IP) shocks and Earth's bow shock and compare the results with hybrid-Vlasov simulations and spacecraft observations. A qualitative agreement in terms of spectral shape of the magnetic fluctuations and the polarization of the unstable mode is found between the models and the observations. We will quantify the differences of the models and explore the region of validity of the quasilinear approach in terms of shock parameters. We will also compare the modeled IP shocks and the bow shock, identifying the similarities and differences in the spectrum of accelerated particles and waves in these scenarios. The work has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 637324 (HESPERIA). The Academy of Finland is thanked for financial support. We acknowledge the computational resources provided by CSC - IT Centre for Science Ltd., Espoo.

Disaster-related fatalities among US citizens traveling abroad.

Science.gov (United States)

Partridge, Robert; Bouslough, David; Proano, Lawrence

2013-01-01

To describe the locations and risk of death associated with natural disaster fatalities for US citizens traveling abroad. A retrospective database review of US citizen disaster deaths occurring worldwide. None. Information on fatalities due to disasters was abstracted from the US Department of State Web site reporting deaths of US citizens abroad by non-natural causes from October 2002 through June 2012. The main outcome measures were the frequency of disaster deaths and countries where disasters occurred. Descriptive statistics and rates were used to evaluate the study data. There were 7,963 total non-natural deaths of US citizens traveling abroad during the study period. Of these, 163 (2.0 percent) were disaster-related deaths, involving 19 disaster events in 15 countries. Only two disaster-related events resulted in more than two deaths of US travelers-the 2010 earthquake in Haiti causing 121 fatalities (74.2 percent of disaster deaths), and the 2004 tsunami in Thailand causing 22 fatalities (13.5 percent of disaster deaths). The approximate annual mean death rate for US citizen travelers as a result of disaster events is 0.27 deaths/1 million travelers, compared with 1.4 deaths/1 million residents due to disaster annually within the United States. The risk of disaster-related fatality is low for US citizens traveling abroad. Although disaster-related death among travelers is unpredictable, during a period of almost 10 years, there was only one reported death due to disaster in the five countries most frequently visited by US travelers. Further investigation may identify population-, seasonal-, country-, or location-specific risks from which prevention strategies can be developed.

Epidemiology of subway-related fatalities in New York City, 1990-2003.

Science.gov (United States)

Gershon, Robyn R M; Pearson, Julie M; Nandi, Vijay; Vlahov, David; Bucciarelli-Prann, Angela; Tracy, Melissa; Tardiff, Kenneth; Galea, Sandro

2008-01-01

Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction. Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings. There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention. Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems. These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.

Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance.

Science.gov (United States)

Leidman, Eva; Maliniak, Maret; Sultan, Abdul-Salam Saleh; Hassan, Ahmed; Hussain, Syed Jaffar; Bilukha, Oleg O

2016-01-01

The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity. Iraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members. Analysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population. The injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion caused by methicillin-sensitive Staphylococcus aureus bacteremia with toxic shock syndrome: a case report.

Science.gov (United States)

Kosami, Koki; Kenzaka, Tsuneaki; Sagara, Yuka; Minami, Kensuke; Matsumura, Masami

2016-04-18

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a mild encephalopathy caused by various pathological processes, but encephalopathy due to bacteria is rare. We report the case of a 45-year-old Japanese woman who on receiving chemotherapy for advanced breast cancer developed an altered mental status and dysarthria soon after fever from infection of a subcutaneous implantable port. Staphylococcus aureus was detected in her blood cultures. Magnetic resonance imaging (MRI) revealed an ovoid lesion in the central portion of the splenium of the corpus callosum (SCC). Although hypotension was not observed, we diagnosed probable toxic shock syndrome (TSS) based on fever (temperature: >38.9 °C), altered mental status, erythema, desquamation, thrombocytopenia, liver dysfunction, and creatine phosphokinase elevation. We administered antimicrobial therapy and her neurological symptoms improved gradually. The lesion in the SCC completely disappeared on MRI 7 days after disease onset. We diagnosed this case as MERS caused by S. aureus bacteremia with TSS. This is the first report of such a case, and we suggest that when a TSS patient presents with neurological symptoms, the possibility of MERS should be considered.

Clinical features of severe wasp sting patients with dominantly toxic reaction: analysis of 1091 cases.

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Cuihong Xie

Full Text Available BACKGROUND: Massive wasp stings have been greatly underestimated and have not been systematically studied. The aim of this study was to identify the clinical features and treatment strategies of severe wasp stings. METHODS AND FINDINGS: A multicenter retrospective study was undertaken in 35 hospitals and medical centers including 12 tertiary care hospitals and 23 secondary care hospitals in the Hubei Province, China. The detailed clinical data of 1091 hospitalized wasp sting patients were investigated. Over three-fourths (76.9% of the cases had 10 or more stings and the in-hospital mortality of patients was 5.1%. Forty-eight patients died of organ injury following toxic reactions to the stings, whereas six died from anaphylactic shock. The in-hospital mortality in patients with >10 stings was higher than that of ≤10 stings (5.2% vs. 1.0%, p = 0.02. Acute kidney injury (AKI was seen in 21.0% patients and most patients required blood purification therapy. Rhabdomyolysis was seen in 24.1% patients, hemolysis in 19.2% patients, liver injury in 30.1% patients, and coagulopathy in 22.5% patients. Regression analysis revealed that high creatinine level, shock, oliguria, and anemia were risk factors for death. Blood purification therapy was beneficial for patients with ≥20 stings and delayed hospital admission of patients (≥4 hours after sting. CONCLUSIONS: In China, most patients with multiple wasp stings presented with toxic reactions and multiple organ dysfunction caused by the venom rather than an anaphylactic reaction. AKI is the prominent clinical manifestation of wasp stings with toxic reaction. High creatinine levels, shock, oliguria, and anemia were risk factors for death.

Examination of Conservatism in Early/Latent Fatality Estimation in Level 3 PRA

International Nuclear Information System (INIS)

Kim, Sung-yeop; Lee, Haneol; Yim, Man-Sung

2014-01-01

Due to the computational model driven-nature of the work, there exist various sources of uncertainty in level 3 PRA. They are related with source release, environmental transport and deposition, human behavior involved in dosimetry, health effect and risk assessment. For instance, a total of 376 parameters have been considered in Probabilistic Accident Consequence Uncertainty Assessment Using COSYMA and the details on the number of parameters in each analysis are listed in Table 1. In 2012, the report of NPP accident consequence simulation was distributed by the Korean Federation for Environmental Movement (KFEM). They insisted that Kori Nuclear Power Plant (NPP) accident would lead to 48,000 early fatalities and 850,000 cancer fatalities in Busan and Hanbit NPP accident would lead to 550,000 cancer fatalities in Seoul. This report exemplifies the misuse of collective dose, that is effective dose multiplied by population and time. Even though very low effective dose is considered, collective dose could give over-conservative estimate when high population and long time period is multiplied. International Commission on Radiological Protection (ICRP) forewarned about the misuse of collective dose, in their ICRP Publication 103, such as applying it to simplified calculation of fatality and risk. As part of investigation of conservatism in early and latent fatality estimation, the existing methods of early and latent fatality calculation was reviewed and the results from the use of the existing methodology were examined in this study. The method of early and latent fatality estimation in level 3 PRA was investigated and the conservatism in the result was examined in this study. For the purpose of estimating both early and latent fatality, appropriate dose distributions among the affected population are found to be important. This study showed that large conservatism may be involved in the estimated fatality if the distribution of population dose as a function of

Examination of Conservatism in Early/Latent Fatality Estimation in Level 3 PRA

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung-yeop; Lee, Haneol; Yim, Man-Sung [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

2014-10-15

Due to the computational model driven-nature of the work, there exist various sources of uncertainty in level 3 PRA. They are related with source release, environmental transport and deposition, human behavior involved in dosimetry, health effect and risk assessment. For instance, a total of 376 parameters have been considered in Probabilistic Accident Consequence Uncertainty Assessment Using COSYMA and the details on the number of parameters in each analysis are listed in Table 1. In 2012, the report of NPP accident consequence simulation was distributed by the Korean Federation for Environmental Movement (KFEM). They insisted that Kori Nuclear Power Plant (NPP) accident would lead to 48,000 early fatalities and 850,000 cancer fatalities in Busan and Hanbit NPP accident would lead to 550,000 cancer fatalities in Seoul. This report exemplifies the misuse of collective dose, that is effective dose multiplied by population and time. Even though very low effective dose is considered, collective dose could give over-conservative estimate when high population and long time period is multiplied. International Commission on Radiological Protection (ICRP) forewarned about the misuse of collective dose, in their ICRP Publication 103, such as applying it to simplified calculation of fatality and risk. As part of investigation of conservatism in early and latent fatality estimation, the existing methods of early and latent fatality calculation was reviewed and the results from the use of the existing methodology were examined in this study. The method of early and latent fatality estimation in level 3 PRA was investigated and the conservatism in the result was examined in this study. For the purpose of estimating both early and latent fatality, appropriate dose distributions among the affected population are found to be important. This study showed that large conservatism may be involved in the estimated fatality if the distribution of population dose as a function of

Multiple spacecraft observations of interplanetary shocks Four spacecraft determination of shock normals

Science.gov (United States)

Russell, C. T.; Mellott, M. M.; Smith, E. J.; King, J. H.

1983-01-01

ISEE 1, 2, 3, IMP 8, and Prognoz 7 observations of interplanetary shocks in 1978 and 1979 provide five instances where a single shock is observed by four spacecraft. These observations are used to determine best-fit normals for these five shocks. In addition to providing well-documented shocks for future investigations these data allow the evaluation of the accuracy of several shock normal determination techniques. When the angle between upstream and downstream magnetic field is greater than 20 deg, magnetic coplanarity can be an accurate single spacecraft method. However, no technique based solely on the magnetic measurements at one or multiple sites was universally accurate. Thus, the use of overdetermined shock normal solutions, utilizing plasma measurements, separation vectors, and time delays together with magnetic constraints, is recommended whenever possible.

Are Credit Shocks Supply or Demand Shocks?

OpenAIRE

Bijapur, Mohan

2013-01-01

This paper provides new insights into the relationship between the supply of credit and the macroeconomy. We present evidence that credit shocks constitute shocks to aggregate supply in that they have a permanent effect on output and cause inflation to rise in the short term. Our results also suggest that the effects on aggregate supply have grown stronger in recent decades.

Miniature shock tube for laser driven shocks.

Science.gov (United States)

Busquet, Michel; Barroso, Patrice; Melse, Thierry; Bauduin, Daniel

2010-02-01

We describe in this paper the design of a miniature shock tube (smaller than 1 cm(3)) that can be placed in a vacuum vessel and allows transverse optical probing and longitudinal backside extreme ultraviolet emission spectroscopy in the 100-500 A range. Typical application is the study of laser launched radiative shocks, in the framework of what is called "laboratory astrophysics."

Gas-Forming Pyogenic Liver Abscess with Septic Shock

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Muhammad S. Khan

2015-01-01

Full Text Available The pyogenic liver abscess caused by Clostridium perfringens (C. perfringens is a rare but rapidly fatal infection. The main virulence factor of this pathogen is its α-toxin (lecithinase, which decomposes the phospholipid in cell membranes leading to cell lysis. Once the bacteria are in blood stream, massive intravascular hemolysis occurs. This can present as anemia on admission with evidence of hemolysis as indicated by low serum haptoglobin, high serum lactate dehydrogenase (LDH, elevated indirect bilirubin, and spherocytosis. The clinical course of C. perfringens septicemia is marked by rapidly deteriorating course with a mortality rate ranging from 70 to 100%. The very rapid clinical course makes it difficult to diagnose on time, and most cases are diagnosed at autopsy. Therefore it is important to consider C. perfringens infection in any severely ill patient with fever and evidence of hemolysis. We present a case of seventy-seven-year-old male with septic shock secondary to pyogenic liver abscess with a brief review of existing literature on C. perfringens.

Associations between drug use and motorcycle helmet use in fatal crashes.

Science.gov (United States)

Rossheim, Matthew E; Wilson, Fernando; Suzuki, Sumihiro; Rodriguez, Mayra; Walters, Scott; Thombs, Dennis L

2014-01-01

Helmet use reduces mortality risk for motorcyclists, regardless of drug and alcohol use. However, the association between drug use and motorcycle helmet utilization is not well known. This study examines the relationship between drug use and motorcycle helmet use among fatally injured motorcycle riders. Using data from the 2005-2009 Fatality Analysis Reporting System (FARS), we examined the association between drug use and motorcycle helmet use in a multivariable logistic regression analysis of 9861 fatally injured motorcycle riders in the United States. For fatally injured motorcycle riders, use of alcohol, marijuana, or other drugs was associated with increased odds of not wearing a motorcycle helmet, controlling for the effects of state motorcycle helmet laws and other confounding variables. Predicted probabilities indicate that helmet use substantially decreases among fatally injured riders mixing alcohol with marijuana and other drugs. Furthermore, the likelihood of helmet use between marijuana-only users and other drug users is virtually the same across all blood alcohol content (BAC) levels. This study provides evidence that alcohol, marijuana, and other drug use is associated with not wearing a motorcycle helmet in fatal motorcycle crashes. There is a clear need for additional prevention and intervention efforts that seek to change helmet and drug use norms among motorcycle riders.

Radiation- and pair-loaded shocks

Science.gov (United States)

Lyutikov, Maxim

2018-06-01

We consider the structure of mildly relativistic shocks in dense media, taking into account the radiation and pair loading, and diffusive radiation energy transfer within the flow. For increasing shock velocity (increasing post-shock temperature), the first important effect is the efficient energy redistribution by radiation within the shock that leads to the appearance of an isothermal jump, whereby the flow reaches the final state through a discontinuous isothermal transition. The isothermal jump, on scales much smaller than the photon diffusion length, consists of a weak shock and a quick relaxation to the isothermal conditions. Highly radiation-dominated shocks do not form isothermal jump. Pair production can mildly increase the overall shock compression ratio to ≈10 (4 for matter-dominated shocks and 7 of the radiation-dominated shocks).

Analyses of fatalities from natural catastrophes in different income groups over time

Science.gov (United States)

Grimm, Tobias

2017-04-01

Identifying not only economic and insured losses but also numbers of fatalities from natural catastrophes provides new information on resilience and prevention measures in the countries affected. In this talk, we examine how fatalities from Munich Re's NatCatSERVICE database, caused by natural disasters have developed. In addition to the standard approach based on fatalities by country, we introduced a new measure, "fatalities per million inhabitants", and factored in population development over time. The World Bank definition was used to determine the wealth classification of individual countries. This methodology enables us to compare countries with different population sizes and thus produce an index for humanitarian impact. The analyses are key information on ascertaining whether prevention measures or early-warning systems have in fact reduced the number of fatalities in recent decades (1980-2016).

Ciprofloxacin and Clozapine: A Potentially Fatal but Underappreciated Interaction

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Jonathan M. Meyer

2016-01-01

Full Text Available Objective. Clozapine provides a 50%–60% response rate in refractory schizophrenia but has a narrow therapeutic index and is susceptible to pharmacokinetic interactions, particularly with strong inhibitors or inducers of cytochrome P450 (CYP 1A2. Case Report. We report the case of a 28-year-old nonsmoking female with intellectual disability who was maintained for 3 years on clozapine 100 mg orally twice daily. The patient was treated for presumptive urinary tract infection with ciprofloxacin 500 mg orally twice daily and two days later collapsed and died despite resuscitation efforts. The postmortem femoral clozapine plasma level was dramatically elevated at 2900 ng/mL, and the cause of death was listed as acute clozapine toxicity. Conclusion. Given the potentially fatal pharmacokinetic interaction between clozapine and ciprofloxacin, clinicians are advised to monitor baseline clozapine levels prior to adding strong CYP450 1A2 inhibitors, reduce the clozapine dose by at least two-thirds if adding a 1A2 inhibitor such as ciprofloxacin, check subsequent steady state clozapine levels, and adjust the clozapine dose to maintain levels close to those obtained at baseline.

Factors Associated with Fatal Occupational Accidents among Mexican Workers: A National Analysis

Science.gov (United States)

Gonzalez-Delgado, Mery; Gómez-Dantés, Héctor; Fernández-Niño, Julián Alfredo; Robles, Eduardo; Borja, Víctor H.; Aguilar, Miriam

2015-01-01

Objective To identify the factors associated with fatal occupational injuries in Mexico in 2012 among workers affiliated with the Mexican Social Security Institute. Methods Analysis of secondary data using information from the National Occupational Risk Information System, with the consequence of the occupational injury (fatal versus non-fatal) as the response variable. The analysis included 406,222 non-fatal and 1,140 fatal injuries from 2012. The factors associated with the lethality of the injury were identified using a logistic regression model with the Firth approach. Results Being male (OR=5.86; CI95%: 4.22-8.14), age (OR=1.04; CI95%: 1.03-1.06), employed in the position for 1 to 10 years (versus less than 1 year) (OR=1.37; CI95%: 1.15-1.63), working as a facilities or machine operator or assembler (OR: 3.28; CI95%: 2.12- 5.07) and being a worker without qualifications (OR=1.96; CI95%: 1.18-3.24) (versus an office worker) were associated with fatality in the event of an injury. Additionally, companies classified as maximum risk (OR=1.90; CI 95%: 1.38-2.62), workplace conditions (OR=7.15; CI95%: 3.63-14.10) and factors related to the work environment (OR=9.18; CI95%:4.36-19.33) were identified as risk factors for fatality in the event of an occupational injury. Conclusions Fatality in the event of an occupational injury is associated with factors related to sociodemographics (age, sex and occupation), the work environment and workplace conditions. Worker protection policies should be created for groups with a higher risk of fatal occupational injuries in Mexico. PMID:25790063

The relationship between gasoline price and patterns of motorcycle fatalities and injuries.

Science.gov (United States)

Zhu, He; Wilson, Fernando A; Stimpson, Jim P

2015-06-01

Economic factors such as rising gasoline prices may contribute to the crash trends by shaping individuals' choices of transportation modalities. This study examines the relationship of gasoline prices with fatal and non-fatal motorcycle injuries. Data on fatal and non-fatal motorcycle injuries come from California's Statewide Integrated Traffic Records System for 2002-2011. Autoregressive integrated moving average (ARIMA) regressions were used to estimate the impact of inflation-adjusted gasoline price per gallon on trends of motorcycle injuries. Motorcycle fatalities and severe and minor injuries in California were highly correlated with increasing gasoline prices from 2002 to 2011 (r=0.76, 0.88 and 0.85, respectively). In 2008, the number of fatalities and injuries reached 13,457--a 34% increase since 2002, a time period in which inflation-adjusted gasoline prices increased about $0.30 per gallon every year. The majority of motorcycle riders involved in crashes were male (92.5%), middle-aged (46.2%) and non-Hispanic white (67.9%). Using ARIMA modelling, we estimated that rising gasoline prices resulted in an additional 800 fatalities and 10,290 injuries from 2002 to 2011 in California. Our findings suggest that increasing gasoline prices led to more motorcycle riders on the roads and, consequently, more injuries. Aside from mandatory helmet laws and their enforcement, other strategies may include raising risk awareness of motorcyclists and investment in public transportation as an alternative transportation modality to motorcycling. In addition, universally mandated training courses and strict licensing tests of riding skills should be emphasised to help reduce the motorcycle fatal and non-fatal injuries. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

INTERFERENCE OF UNIDIRECTIONAL SHOCK WAVES

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P. V. Bulat

2015-05-01

Full Text Available Subject of study.We consider interference of unidirectional shock waves or, as they are called, catching up shock waves. The scope of work is to give a classification of the shock-wave structures that arise in this type of interaction of shock waves, and the area of their existence. Intersection of unidirectional shock waves results in arising of a shock-wave structure at the intersection point, which contains the main shock wave, tangential discontinuity and one more reflected gas-dynamic discontinuity of unknown beforehand type. The problem of determining the type of reflected discontinuity is the main problem that one has to solve in the study of catching shock waves interference. Main results.The paper presents the pictures of shock-wave structures arising at the interaction of catching up shock waves. The areas with a regular and irregular unidirectional interaction of shocks are described. Characteristic shock-wave structures are of greatest interest, where reflected gas-dynamic discontinuity degenerates into discontinuous characteristics. Such structures have a number of extreme properties. We have found the areas of existence for such shock-wave structures. There are also areas in which the steady-state solution is not available. The latter has determined revival of interest for the theoretical study of the problem, because the facts of sudden shock-wave structure destruction inside the air intake of supersonic aircrafts at high Mach numbers have been discovered. Practical significance.The theory of interference for unidirectional shock waves and design procedure are usable in the design of supersonic air intakes. It is also relevant for application possibility investigation of catching up oblique shock waves to create overcompressed detonation in perspective detonation air-jet and rocket engines.

Shock/shock interactions between bodies and wings

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Gaoxiang XIANG

2018-02-01

Full Text Available This paper examines the Shock/Shock Interactions (SSI between the body and wing of aircraft in supersonic flows. The body is simplified to a flat wedge and the wing is assumed to be a sharp wing. The theoretical spatial dimension reduction method, which transforms the 3D problem into a 2D one, is used to analyze the SSI between the body and wing. The temperature and pressure behind the Mach stem induced by the wing and body are obtained, and the wave configurations in the corner are determined. Numerical validations are conducted by solving the inviscid Euler equations in 3D with a Non-oscillatory and Non-free-parameters Dissipative (NND finite difference scheme. Good agreements between the theoretical and numerical results are obtained. Additionally, the effects of the wedge angle and sweep angle on wave configurations and flow field are considered numerically and theoretically. The influences of wedge angle are significant, whereas the effects of sweep angle on wave configurations are negligible. This paper provides useful information for the design and thermal protection of aircraft in supersonic and hypersonic flows. Keywords: Body and wing, Flow field, Hypersonic flow, Shock/shock interaction, Wave configurations

The ability of an electrocardiogram to predict fatal and non-fatal cardiac events in asymptomatic middle-aged subjects.

Science.gov (United States)

Terho, Henri K; Tikkanen, Jani T; Kenttä, Tuomas V; Junttila, M Juhani; Aro, Aapo L; Anttonen, Olli; Kerola, Tuomas; Rissanen, Harri A; Knekt, Paul; Reunanen, Antti; Huikuri, Heikki V

2016-11-01

The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined. A total of 9511 middle-aged subjects (mean age 43 ± 8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years. Major ECG abnormalities were classified according to the Minnesota code. Subjects with major ECG abnormalities (N = 1131) had an increased risk of cardiac death after 10-years (adjusted hazard ratio [HR] 1.7; 95% confidence interval [95% CI], 1.1-2.5, p = 0.009) and 30-years of follow-up (HR 1.3, 95% CI, 1.1-1.5, p electrocardiogram are shown to have prognostic significance for cardiac events in elderly subjects without known cardiac disease. Our results suggest that ECG abnormalities increase the risk of fatal cardiac events also in middle-aged healthy subjects.

STEREO interplanetary shocks and foreshocks

Energy Technology Data Exchange (ETDEWEB)

Blanco-Cano, X. [Instituto de Geofisica, UNAM, CU, Coyoacan 04510 DF (Mexico); Kajdic, P. [IRAP-University of Toulouse, CNRS, Toulouse (France); Aguilar-Rodriguez, E. [Instituto de Geofisica, UNAM, Morelia (Mexico); Russell, C. T. [ESS and IGPP, University of California, Los Angeles, 603 Charles Young Drive, Los Angeles, CA 90095 (United States); Jian, L. K. [NASA Goddard Space Flight Center, Greenbelt, MD and University of Maryland, College Park, MD (United States); Luhmann, J. G. [SSL, University of California Berkeley (United States)

2013-06-13

We use STEREO data to study shocks driven by stream interactions and the waves associated with them. During the years of the extended solar minimum 2007-2010, stream interaction shocks have Mach numbers between 1.1-3.8 and {theta}{sub Bn}{approx}20-86 Degree-Sign . We find a variety of waves, including whistlers and low frequency fluctuations. Upstream whistler waves may be generated at the shock and upstream ultra low frequency (ULF) waves can be driven locally by ion instabilities. The downstream wave spectra can be formed by both, locally generated perturbations, and shock transmitted waves. We find that many quasiperpendicular shocks can be accompanied by ULF wave and ion foreshocks, which is in contrast to Earth's bow shock. Fluctuations downstream of quasi-parallel shocks tend to have larger amplitudes than waves downstream of quasi-perpendicular shocks. Proton foreshocks of shocks driven by stream interactions have extensions dr {<=}0.05 AU. This is smaller than foreshock extensions for ICME driven shocks. The difference in foreshock extensions is related to the fact that ICME driven shocks are formed closer to the Sun and therefore begin to accelerate particles very early in their existence, while stream interaction shocks form at {approx}1 AU and have been producing suprathermal particles for a shorter time.

STEREO interplanetary shocks and foreshocks

International Nuclear Information System (INIS)

Blanco-Cano, X.; Kajdič, P.; Aguilar-Rodríguez, E.; Russell, C. T.; Jian, L. K.; Luhmann, J. G.

2013-01-01

We use STEREO data to study shocks driven by stream interactions and the waves associated with them. During the years of the extended solar minimum 2007-2010, stream interaction shocks have Mach numbers between 1.1-3.8 and θ Bn ∼20-86°. We find a variety of waves, including whistlers and low frequency fluctuations. Upstream whistler waves may be generated at the shock and upstream ultra low frequency (ULF) waves can be driven locally by ion instabilities. The downstream wave spectra can be formed by both, locally generated perturbations, and shock transmitted waves. We find that many quasiperpendicular shocks can be accompanied by ULF wave and ion foreshocks, which is in contrast to Earth's bow shock. Fluctuations downstream of quasi-parallel shocks tend to have larger amplitudes than waves downstream of quasi-perpendicular shocks. Proton foreshocks of shocks driven by stream interactions have extensions dr ≤0.05 AU. This is smaller than foreshock extensions for ICME driven shocks. The difference in foreshock extensions is related to the fact that ICME driven shocks are formed closer to the Sun and therefore begin to accelerate particles very early in their existence, while stream interaction shocks form at ∼1 AU and have been producing suprathermal particles for a shorter time.

On the occurrence of fatal landslides in 2008

Science.gov (United States)

Petley, D.

2009-04-01

This paper represents the latest in an annual review of fatal landslide events worldwide, based upon the Durham Fatal Landslide Database. Landslide events were inevitably dominated by the occurrence of the 12th May Wenchuan Earthquake in Sichuan Province of China, which triggered very extensive landsliding. Whilst it will be very difficult to estimate the true impact of this event in terms of landslides, the Chinese authorities estimate that about 29,000 people were killed by landslides, with several thousand more losing their lives whilst trapped in rubble due to the inability of rescuers to pass through landslide affected areas. Considerable work is needed to understand the reasons for the intensity of the landslide processes. Elsewhere the number of fatal landslides recorded totalled 405 worldwide. These caused 3526 fatalities, giving a total for the year of about 32,526 people. To put this into context, according to the CRED EM-DAT database the recorded number of fatalities from volcanic eruptions in the period 2000 to 2008 inclusive is 221! The distribution of fatal landslides followed the familiar patterns observed in previous years, with distinct clusters in Central China, along the southern edge of the Himalayas, in the Caribbean, in Central America, western S. America, along the western edge of the Philippine Sea plate and in Indonesia, plus a scattering elsewhere. The temporal distribution shows strong seasonality, with the peak occurring during the northern hemisphere summer. Unusually however, the peak month was September (usually it is in July), and there were large numbers of landslide events right through to November. The November landslide clusters occurred in SE. Asia and in Central / S. America, reflecting very heavy rains in these regions at that time. The reasons for this are not clear at present, although may be linked to weakening La Nina conditions that have prevailed through much of the year. An analysis is made of the relationship between

Fatal consequences of synergistic anticoagulation

Directory of Open Access Journals (Sweden)

Sen P

2018-05-01

Full Text Available Objective: Novel oral anticoagulants (NOACs are increasingly being preferred by clinicians (and patients because they have a wide therapeutic window and therefore do not require monitoring of anticoagulant effect. Herein, we describe the unfortunate case of a patient who had fatal consequences as a result of switching from warfarin to rivaroxaban. Case Summary: A 90-year-old Caucasian woman, with atrial fibrillation on chronic anticoagulation with warfarin, was admitted to the hospital for pneumonia. She was treated with levofloxacin. In the same admission, her warfarin was switched to rivaroxaban. On Day 3 after the switch, her INR was found to be 6, and she developed a cervical epidural hematoma from C2 to C7. She ultimately developed respiratory arrest, was put on comfort care and died. Discussion: Rivaroxaban and warfarin are known to have a synergistic anticoagulant effect, usually seen shortly after switching. Antibiotics also increase the effects of warfarin by the inhibition of metabolizing isoenzymes. It is hypothesized that these two effects led to the fatal cervical spinal hematoma. Conclusion: The convenience of a wide therapeutic window and no requirement of laboratory monitoring makes the NOACs a desirable option for anticoagulation. However, there is lack of data and recommendations on how to transition patients from Warfarin to NOACs or even how to transition from one NOAC to another. Care should be taken to ensure continuous monitoring of anticoagulation when stopping, interrupting or switching between NOACS to avoid the possibility of fatal bleeding and strokes.

Non-fatal self-poisoning across age groups, in Sri Lanka.

Science.gov (United States)

Rajapakse, Thilini; Christensen, Helen; Cotton, Sue; Griffiths, Kathleen Margaret

2016-02-01

Attempted or non-fatal self-poisoning in common in Sri Lanka, but little is known about variation of psychiatric morbidity and suicidal intent across differing ages. The aim of this study was to investigate factors associated with non-fatal self-poisoning in Sri Lanka across three different age groups (namely 14-24 years, 25-34 years and ≥ 35 years). It was anticipated that the findings of the study would inform and guide development of preventive interventions for non-fatal self-poisoning in this country. 935 participants were interviewed within one week of admission to hospital for medical management of non-fatal self-poisoning, over a consecutive 14-month period. Socio-demographic factors, types of poison ingested, triggers and psychiatric morbidity was examined as a function of age. Results showed that a majority (83%) of participants were aged below 35 years. Younger participants aged aged 25-34 years, and ≥ 35 years), who were more likely to ingest pesticides. Recent interpersonal conflict was a proximal trigger seen in all age groups, but suicidal intent, depression and alcohol use disorders increased with age. The overall study findings indicate that most who carry out acts of non-fatal self-poisoning in Sri Lanka are young (aged age groups, but psychiatric morbidity and suicidal intent is higher in the older age groups, as is pesticide ingestion. Age specific interventions may be efficacious in the prevention of non-fatal self-poisoning in Sri Lanka. Copyright © 2016 Elsevier B.V. All rights reserved.

Collisionless shock waves

International Nuclear Information System (INIS)

Sagdeev, R.Z.; Kennel, C.F.

1991-01-01

Collisionless shocks cannot occur naturally on the earth, because nearly all matter here consists of electrically neutral atoms and molecules. In space, however, high temperatures and ultraviolet radiation from hot stars decompose atoms into their constituent nuclei and electrons, producing a soup of electrically charged particles known as a plasma. Plasma physicists proposed that the collective electrical and magnetic properties of plasmas could produce interactions that take the place of collisions and permit shocks to form. In 1964 the theoretical work found its first experimental confirmation. Norman F. Ness and his colleagues at the Goddard Space Flight Center, using data collected from the iMP-1 spacecraft, detected clear signs that a collisionless shock exists where the solar wind encounters the earth's magnetic field. More recent research has demonstrated that collisionless shocks appear in a dazzling array of astronomical settings. For example, shocks have been found in the solar wind upstream (sunward) of all the planet and comets that have been visited by spacecraft. Violent flares on the sun generate shocks that propagate to the far reaches of the solar system; tremendous galactic outbursts create disruptions in the intergalactic medium that are trillions of times larger. In addition, many astrophysicists think that shocks from supernova explosions in our galaxy accelerate cosmic rays, a class of extraordinarily energetic elementary particles and atomic nuclei that rain down on the earth from all directions

GIS based analysis of Intercity Fatal Road Traffic Accidents in Iran.

Science.gov (United States)

Alizadeh, A; Zare, M; Darparesh, M; Mohseni, S; Soleimani-Ahmadi, M

2015-01-01

Road traffic accidents including intercity car traffic accidents (ICTAs) are among the most important causes of morbidity and mortality due to the growing number of vehicles, risky behaviors, and changes in lifestyle of the general population. A sound knowledge of the geographical distribution of car traffic accidents can be considered as an approach towards the accident causation and it can be used as an administrative tool in allocating the sources for traffic accidents prevention. This study was conducted to investigate the geographical distribution and the time trend of fatal intercity car traffic accidents in Iran. To conduct this descriptive study, all Iranian intercity road traffic mortality data were obtained from the Police reports in the Statistical Yearbook of the Governor's Budget and Planning. The obtained data were for 17 complete Iranian calendar years from March 1997 to March 2012. The incidence rate (IR) of fatal ICTAs for each year was calculated as the total number of fatal ICTAs in every 100000 population in specified time intervals. Figures and maps indicating the trends and geographical distribution of fatal ICTAs were prepared while using Microsoft Excel and ArcGis9.2 software. The number of fatal car accidents showed a general increasing trend from 3000 in 1996 to 13500 in 2012. The incidence of fatal intercity car accidents has changed from six in 100000 population in 1996 to 18 in 100000 population in 2012. GIS based data showed that the incidence rate of ICTAs in different provinces of Iran was very divergent. The highest incidence of fatal ICTAs was in Semnan province (IR= 35.2), followed by North Khorasan (IR=22.7), and South Khorasan (IR=22). The least incidence of fatal ICTAs was in Tehran province (IR=2.4) followed by Khozestan (IR=6.5), and Eastern Azarbayejan (IR=6.6). The compensation cost of fatal ICTAs also showed an increasing trend during the studied period. Since an increasing amount of money was being paid yearly for the car

GIS based analysis of Intercity Fatal Road Traffic Accidents in Iran

Science.gov (United States)

Alizadeh, A; Zare, M; Darparesh, M; Mohseni, S; Soleimani-Ahmadi, M

2015-01-01

Road traffic accidents including intercity car traffic accidents (ICTAs) are among the most important causes of morbidity and mortality due to the growing number of vehicles, risky behaviors, and changes in lifestyle of the general population. A sound knowledge of the geographical distribution of car traffic accidents can be considered as an approach towards the accident causation and it can be used as an administrative tool in allocating the sources for traffic accidents prevention. This study was conducted to investigate the geographical distribution and the time trend of fatal intercity car traffic accidents in Iran. To conduct this descriptive study, all Iranian intercity road traffic mortality data were obtained from the Police reports in the Statistical Yearbook of the Governor’s Budget and Planning. The obtained data were for 17 complete Iranian calendar years from March 1997 to March 2012. The incidence rate (IR) of fatal ICTAs for each year was calculated as the total number of fatal ICTAs in every 100000 population in specified time intervals. Figures and maps indicating the trends and geographical distribution of fatal ICTAs were prepared while using Microsoft Excel and ArcGis9.2 software. The number of fatal car accidents showed a general increasing trend from 3000 in 1996 to 13500 in 2012. The incidence of fatal intercity car accidents has changed from six in 100000 population in 1996 to 18 in 100000 population in 2012. GIS based data showed that the incidence rate of ICTAs in different provinces of Iran was very divergent. The highest incidence of fatal ICTAs was in Semnan province (IR= 35.2), followed by North Khorasan (IR=22.7), and South Khorasan (IR=22). The least incidence of fatal ICTAs was in Tehran province (IR=2.4) followed by Khozestan (IR=6.5), and Eastern Azarbayejan (IR=6.6). The compensation cost of fatal ICTAs also showed an increasing trend during the studied period. Since an increasing amount of money was being paid yearly for the

Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivation.

Science.gov (United States)

Logue, Jennifer; Murray, Heather M; Welsh, Paul; Shepherd, James; Packard, Chris; Macfarlane, Peter; Cobbe, Stuart; Ford, Ian; Sattar, Naveed

2011-04-01

The effect of body mass index (BMI) on coronary heart disease (CHD) risk is attenuated when mediators of this risk (such as diabetes, hypertension and hyperlipidaemia) are accounted for. However, there is now evidence of a differential effect of risk factors on fatal and non-fatal CHD events, with markers of inflammation more strongly associated with fatal than non-fatal events. To describe the association with BMI separately for both fatal and non-fatal CHD risk after accounting for classical risk factors and to assess any independent effects of obesity on CHD risk. In the West of Scotland Coronary Prevention Study BMI in 6082 men (mean age 55 years) with hypercholesterolaemia, but no history of diabetes or CVD, was related to the risk of fatal and non-fatal CHD events. After excluding participants with any event in the first 2 years, 1027 non-fatal and 214 fatal CHD events occurred during 14.7 years of follow-up. A minimally adjusted model (age, sex, statin treatment) and a maximally adjusted model (including known CVD risk factors and deprivation) were compared, with BMI 25-27.4 kg/m² as referent. The risk of non-fatal events was similar across all BMI categories in both models. The risk of fatal CHD events was increased in men with BMI 30.0-39.9 kg/m² in both the minimally adjusted model (HR = 1.75 (95% CI 1.12 to 2.74)) and the maximally adjusted model (HR = 1.60 (95% CI 1.02 to 2.53)). These hypothesis generating data suggest that obesity is associated with fatal, but not non-fatal, CHD after accounting for known cardiovascular risk factors and deprivation. Clinical trial registration WOSCOPS was carried out and completed before the requirement for clinical trial registration.

Relativistic Shock Acceleration

International Nuclear Information System (INIS)

Duffy, P.; Downes, T.P.; Gallant, Y.A.; Kirk, J.G.

1999-01-01

In this paper we briefly review the basic theory of shock waves in relativistic hydrodynamics and magneto-hydrodynamics, emphasising some astrophysically interesting cases. We then present an overview of the theory of particle acceleration at such shocks describing the methods used to calculate the spectral indices of energetic particles. Recent results on acceleration at ultra-relativistic shocks are discussed. (author)

Human fatality due to thallium poisoning: autopsy, microscopy, and mass spectrometry assays.

Science.gov (United States)

Li, Shangxun; Huang, Wen; Duan, Yijie; Xing, Jingjun; Zhou, Yiwu

2015-01-01

Thallium has been responsible for many intoxications since its discovery; however, toxicological profiles for thallium in human fatalities have not been updated recently. Autopsy, microscopic investigations, and toxicological analyses were performed on a married couple who died from thallium sulfate intended homicidal poisoning. The distribution of thallium was established by inductively coupled plasma mass spectrometry with hair samples showing the highest thallium concentration. Electron microscopy revealed a dystrophic condition of hair with disorganized cuticle and atrophy of the hair bulb. Thallium interacts with cells at different levels, with prominent ultrastructural injuries in the mitochondria and endoplasmic reticulum, and high concentration of electron dense granules observed in the cytoplasm and mitochondria of several organs. Alopecia, toxic encephalopathy, and peripheral neuropathy were diagnosed in the victims and suggested to be crucial implications for thallium poisoning. The analytical procedures used in this case are of considerable forensic importance in the diagnosis of thallium poisoning. © 2014 American Academy of Forensic Sciences.

Features of fatal injuries in older cyclists in vehicle-bicycle accidents in Japan.

Science.gov (United States)

Matsui, Yasuhiro; Oikawa, Shoko; Hitosugi, Masahito

2018-01-02

The purpose of this study was to identify and better understand the features of fatal injuries in cyclists aged 75 years and over involved in collisions with either hood- or van-type vehicles. This study investigated the fatal injuries of cyclists aged 75 years old and over by analyzing accident data. We focused on the body regions to which the fatal injury occurred using vehicle-bicycle accident data from the Institute for Traffic Accident Research and Data Analysis (ITARDA) in Japan. Using data from 2009 to 2013, we examined the frequency of fatally injured body region by gender, age, and actual vehicle travel speed. We investigated any significant differences in distributions of fatal injuries by body region for cyclists aged 75 years and over using chi-square tests to compare with cyclists in other age groups. We also investigated the cause of fatal head injuries, such as impact with a road surface or vehicle. The results indicated that head injuries were the most common cause of fatalities among the study group. At low vehicle travel speeds for both hood- and van-type vehicles, fatalities were most likely to be the result of head impacts against the road surface. The percentage of fatalities following hip injuries was significantly higher for cyclists aged 75 years and over than for those aged 65-74 or 13-59 in impacts with hood-type vehicles. It was also higher for women than men in the over-75 age group in impacts with these vehicles. For cyclists aged 75 years and over, wearing a helmet may be helpful to prevent head injuries in vehicle-to-cyclist accidents. It may also be helpful to introduce some safety measures to prevent hip injuries, given the higher level of fatalities following hip injury among all cyclists aged 75 and over, particularly women.

On possible structures of normal ionizing shock waves in electromagnetic shock tubes

International Nuclear Information System (INIS)

Liberman, M.A.; Synakh, V.S.; Zakajdakhov, V.V.; Velikovich, A.L.

1982-01-01

The problem of possible structures of normal ionizing shock waves is studied. On the basis of the general theory of ionizing shock waves in magnetic fields, a similarity solution of the piston problem for an impenetrable piston and a magnetic piston is described and a numerical solution of the non-stationary piston problem is obtained. It is shown that precursor photo-ionization of the neutral gas by the radiation of the shock-heated gas is the dominant factor in shaping normal ionizing shock structures. In particular, it is shown that the strong overheating of atoms and ions in shock fronts is due to the tensor form of Ohm's law in the precursor region. (author)

Multiple spacecraft observations of interplanetary shocks: four spacecraft determination of shock normals

International Nuclear Information System (INIS)

Russell, C.T.; Mellott, M.M.; Smith, E.J.; King, J.H.

1983-01-01

ISEE 1,2,3 IMP8, and Prognoz 7 observations of interplanetary shocks in 1978 and 1979 provide five instances where a single shock is observed by four spacecraft. These observations are used to determine best-fit normals for these five shocks. In addition to providing well-documented shocks for furture techniques. When the angle between upstream and downstream magnetic field is greater than 20, magnetic coplanarity can be an accurate single spacecraft method. However, no technique based solely on the magnetic measurements at one or multiple sites was universally accurate. Thus, we recommend using overdetermined shock normal solutions whenever possible, utilizing plasma measurements, separation vectors, and time delays together with magnetic constraints

Shock absorber

International Nuclear Information System (INIS)

Nemeth, J.D.

1981-01-01

A shock absorber for the support of piping and components in a nuclear power plant is described. It combines a high degree of stiffness under sudden shocks, e.g. seismic disturbances, with the ability to allow for thermal expansion without resistance when so required. (JIW)

System Shock: The Archetype of Operational Shock

Science.gov (United States)

2017-05-25

the battle space. They can also facilitate a much greater understanding of the variables involved in each party’s decision - making process. However...system shock nests within current US Army Unified Land Operations doctrine. In order to test the utility of system shock theory to Gray Zone...23 Neil E. Harrison, “Thinking about the World We Make ” in Chaos Theory in the Social Sciences: Foundations and Applications

Accidental fatal lung injury by compressed air: a case report.

Science.gov (United States)

Rayamane, Anand Parashuram; Pradeepkumar, M V

2015-03-01

Compressed air is being used extensively as a source of energy at industries and in daily life. A variety of fatal injuries are caused by improper and ignorant use of compressed air equipments. Many types of injuries due to compressed air are reported in the literature such as colorectal injury, orbital injury, surgical emphysema, and so on. Most of these injuries are accidental in nature. It is documented that 40 pounds per square inch pressure causes fatal injuries to the ear, eyes, lungs, stomach, and intestine. Openings of body are vulnerable to injuries by compressed air. Death due to compressed air injuries is rarely reported. Many cases are treated successfully by conservative or surgical management. Extensive survey of literature revealed no reports of fatal injury to the upper respiratory tract and lungs caused by compressed air. Here, we are reporting a fatal event of accidental death after insertion of compressed air pipe into the mouth. The postmortem findings are corroborated with the history and discussed in detail.

Unlimited Relativistic Shock Surfing Acceleration

International Nuclear Information System (INIS)

Ucer, D.; Shapiro, V. D.

2001-01-01

Nonrelativistic shock surfing acceleration at quasiperpendicular shocks is usually considered to be a preacceleration mechanism for slow pickup ions to initiate diffusive shock acceleration. In shock surfing, the particle accelerates along the shock front under the action of the convective electric field of the plasma flow. However, the particle also gains kinetic energy normal to the shock and eventually escapes downstream. We consider the case when ions are accelerated to relativistic velocities. In this case, the ions are likely to be trapped for infinitely long times, because the energy of bounce oscillations tends to decrease during acceleration. This suggests the possibility of unlimited acceleration by shock surfing

The profile of wounding in civilian public mass shooting fatalities.

Science.gov (United States)

Smith, Edward Reed; Shapiro, Geoff; Sarani, Babak

2016-07-01

The incidence and severity of civilian public mass shootings (CPMS) continue to rise. Initiatives predicated on lessons learned from military woundings have placed strong emphasis on hemorrhage control, especially via use of tourniquets, as means to improve survival. We hypothesize that both the overall wounding pattern and the specific fatal wounds in CPMS events are different from those in military combat fatalities and thus may require a new management strategy. A retrospective study of autopsy reports for all victims involved in 12 CPMS events was performed. Civilian public mass shootings was defined using the FBI and the Congressional Research Service definition. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author. A total 139 fatalities consisting of 371 wounds from 12 CPMS events were reviewed. All wounds were due to gunshots. Victims had an average of 2.7 gunshots. Relative to military reports, the case fatality rate was significantly higher, and incidence of potentially survivable injuries was significantly lower. Overall, 58% of victims had gunshots to the head and chest, and only 20% had extremity wounds. The probable site of fatal wounding was the head or chest in 77% of cases. Only 7% of victims had potentially survivable wounds. The most common site of potentially survivable injury was the chest (89%). No head injury was potentially survivable. There were no deaths due to exsanguination from an extremity. The overall and fatal wounding patterns following CPMS are different from those resulting from combat operations. Given that no deaths were due to extremity hemorrhage, a treatment strategy that goes beyond use of tourniquets is needed to rescue the few victims with potentially survivable injuries. Prognostic/epidemiologic study, level IV

Fatal neglect of the elderly.

Science.gov (United States)

Ortmann, C; Fechner, G; Bajanowski, T; Brinkmann, B

2001-01-01

Maltreatment of the elderly is a common problem that affects more than 3% of the elderly. We report on two cases of fatal neglect. Risk factors of victims and caregivers were analysed in the context of the social history. In both cases, the victims had a dominant personality and the abusers (the sons) had been strictly controlled and formed by the parent. The victims showed typical risk factors such as living together with the abuser, isolation, dependence on care, income and money administration. Initially, the victims declined help from outside and self-neglect occurred. The unemployed perpetrators lived in social isolation and depended financially and mentally on the victims. In both cases no mental illness was present but there was a decrease of social competence. Legal medicine is predominantly involved in fatal cases in connection with external post-mortem examinations and autopsies. Also in the living, the medico-legal expert can assist in the identification of findings in elderly persons in cases of suspected abuse.

Effect of mobile phone proliferation on crash notification times and fatality rates.

Science.gov (United States)

Stickles, Jimmy L; Kempema, James M; Brown, Lawrence H

2018-01-01

The purpose of this study was to evaluate whether increased proliferation of mobile telephones has been associated with decreased MVC notification times and/or decreased MVC fatality rates in the United States (US). We used World Bank annual mobile phone market penetration data and US Fatality Analysis Reporting System (FARS) fatal MVC data for 1994-2014. For each year, phone proliferation was measured as mobile phones per 100 population. FARS data were used to calculate MVC notification time (time EMS notified - time MVC occurred) in minutes, and to determine the MVC fatality rate per billion vehicle miles traveled (BVMT). We used basic vector auto-regression modeling to explore relationships between changes in phone proliferation and subsequent changes in median and 90th percentile MVC notification times, as well as MVC fatality rates. From 1994 to 2014, larger year-over-year increases in phone proliferation were associated with larger decreases in 90th percentile notification times for MVCs occurring during daylight hours (p=0.004) and on the national highway system (p=0.046) two years subsequent, and crashes off the national highway system three years subsequent (p=0.023). There were no significant associations between changes in phone proliferation and subsequent changes in median crash notification times, nor with subsequent changes in MVC fatality rates. Between 1994 and 2014 increased mobile phone proliferation in the U.S. was associated with shorter 90th percentile EMS notification times for some subgroups of fatal MVCs, but not with decreases in median notification times or overall MVC fatality rates. Copyright © 2017 Elsevier Inc. All rights reserved.

Guidelines for Mass Fatality Management During Terrorist Incidents Involving Chemical Agents

National Research Council Canada - National Science Library

2003-01-01

.... Outside the United States, an earthquake in India produced over 30,000 fatalities in 2001, while an earthquake in El Salvador the same year produced close to 1,000 fatalities. In Bhopal, India (1984...

Effects of response-shock interval and shock intensity on free-operant avoidance responding in the pigeon1

Science.gov (United States)

Klein, Marty; Rilling, Mark

1972-01-01

Two experiments investigated free-operant avoidance responding with pigeons using a treadle-pressing response. In Experiment I, pigeons were initially trained on a free-operant avoidance schedule with a response-shock interval of 32 sec and a shock-shock interval of 10 sec, and were subsequently exposed to 10 values of the response-shock parameter ranging from 2.5 to 150 sec. The functions relating response rate to response-shock interval were similar to the ones reported by Sidman in his 1953 studies employing rats, and were independent of the order of presentation of the response-shock values. Shock rates decreased as response-shock duration increased. In Experiment II, a free-operant avoidance schedule with a response-shock interval of 20 sec and a shock-shock interval of 5 sec was used, and shock intensities were varied over five values ranging from 2 to 32 mA. Response rates increased markedly as shock intensity increased from 2 to 8 mA, but rates changed little with further increases in shock intensity. Shock rates decreased as intensity increased from 2 to 8 mA, and showed little change as intensity increased from 8 to 32 mA. PMID:4652617

The distribution of fatal risk in Ontario industries

International Nuclear Information System (INIS)

Davis, C.K.; Forbes, W.F.; Hayward, L.M.

1986-09-01

The purpose of this study was to estimate non-radiological risks of occupational fatalities in Ontario industries. The distribution of high-risk occupations was found to vary widely between the different industries for a number of reasons including the fact that insufficient data in some instances resulted in less than desirable reliability. However, in spite of various data limitations, a number of occupations had above average fatal risk rates in several industries, including Material Handlers and Related, N.E.C. (SOC-9319), Welders and Flame Cutters (SOC-8335), Truck Drivers (SOC-9175) and Mechanics and Repairmen, except Electrical (SOC-8589). The majority of occupations had rates below or close to the industry average; however, between 15% and 30% of the occupations in any given industry had fatal risk rates above the industry average. When the number of workers involved in different occupations was considered, between 18% and 40% of workers were in occupations with above average risk. Recommendations for future work are also provided

Gasoline Prices and Their Relationship to Rising Motorcycle Fatalities, 1990–2007

Science.gov (United States)

Stimpson, Jim P.; Hilsenrath, Peter E.

2009-01-01

Motor vehicle accidents are the leading cause of death among young adults. Although automobile fatalities have declined in recent years, motorcycle fatalities are rapidly increasing. The purpose of our research was to quantify the relationship between changing fuel prices and motorcycle fatalities. Our findings suggest that people increasingly rely on motorcycles to reduce their fuel costs in response to rising gasoline prices. We estimate that use of motorcycles and scooters instead of 4-wheeled vehicles results in over 1500 additional motorcycle fatalities annually for each dollar increase in gas prices. Motorcycle safety should receive more attention as a leading public health issue. PMID:19696374

Diaphragmless shock wave generators for industrial applications of shock waves

Science.gov (United States)

Hariharan, M. S.; Janardhanraj, S.; Saravanan, S.; Jagadeesh, G.

2011-06-01

The prime focus of this study is to design a 50 mm internal diameter diaphragmless shock tube that can be used in an industrial facility for repeated loading of shock waves. The instantaneous rise in pressure and temperature of a medium can be used in a variety of industrial applications. We designed, fabricated and tested three different shock wave generators of which one system employs a highly elastic rubber membrane and the other systems use a fast acting pneumatic valve instead of conventional metal diaphragms. The valve opening speed is obtained with the help of a high speed camera. For shock generation systems with a pneumatic cylinder, it ranges from 0.325 to 1.15 m/s while it is around 8.3 m/s for the rubber membrane. Experiments are conducted using the three diaphragmless systems and the results obtained are analyzed carefully to obtain a relation between the opening speed of the valve and the amount of gas that is actually utilized in the generation of the shock wave for each system. The rubber membrane is not suitable for industrial applications because it needs to be replaced regularly and cannot withstand high driver pressures. The maximum shock Mach number obtained using the new diaphragmless system that uses the pneumatic valve is 2.125 ± 0.2%. This system shows much promise for automation in an industrial environment.

Drug and Alcohol Involvement in Four Types of Fatal Crashes*

Science.gov (United States)

Romano, Eduardo; Voas, Robert B.

2011-01-01

Objective: The aim of this study was to explore the relationship of drunk and drugged driving to the occurrence of fatal crashes associated with speeding, failure to obey/yield, inattention, and seat belt nonuse. Method: We examined data for fatally injured drivers involved in single-vehicle crashes killed in states in which more than 79% of the drivers were tested for drugs other than alcohol and had a known result. Results: About 25% of the drivers tested positive for drugs, a figure almost double that estimated by the 2007 National Roadside Survey. Cannabinoids and stimulants each contributed to about 23% of the drug-positive results (6% among all fatally injured single-vehicle drivers). Stimulants more than cannabinoids were found to be associated with the four types of crashes under study. Some drugs showed a protective effect over the four crash types under study. Significant interactions between drugs and alcohol were observed. Stimulants contributed to the different types of fatal crashes irrespective of the levels of alcohol consumed by the drivers. Conclusions: This study provides further evidence of a link between drug consumption and fatal crashes. It also opens the door to some interesting and sometimes unexpected questions regarding the way drugs contribute to crashes, which we found varies depending on the type of crash considered, the class of drug, and the presence of alcohol. Research is also needed on drugs that could have a protective effect on the occurrence of fatal crashes. These findings could be highly relevant to the design of drug-related traffic laws and programs targeted at curbing drugged driving. PMID:21683038

Cathelicidin Insufficiency in Patients with Fatal Leptospirosis.

Science.gov (United States)

Lindow, Janet C; Wunder, Elsio A; Popper, Stephen J; Min, Jin-Na; Mannam, Praveen; Srivastava, Anup; Yao, Yi; Hacker, Kathryn P; Raddassi, Khadir; Lee, Patty J; Montgomery, Ruth R; Shaw, Albert C; Hagan, Jose E; Araújo, Guilherme C; Nery, Nivison; Relman, David A; Kim, Charles C; Reis, Mitermayer G; Ko, Albert I

2016-11-01

Leptospirosis causes significant morbidity and mortality worldwide; however, the role of the host immune response in disease progression and high case fatality (>10-50%) is poorly understood. We conducted a multi-parameter investigation of patients with acute leptospirosis to identify mechanisms associated with case fatality. Whole blood transcriptional profiling of 16 hospitalized Brazilian patients with acute leptospirosis (13 survivors, 3 deceased) revealed fatal cases had lower expression of the antimicrobial peptide, cathelicidin, and chemokines, but more abundant pro-inflammatory cytokine receptors. In contrast, survivors generated strong adaptive immune signatures, including transcripts relevant to antigen presentation and immunoglobulin production. In an independent cohort (23 survivors, 22 deceased), fatal cases had higher bacterial loads (P = 0.0004) and lower anti-Leptospira antibody titers (P = 0.02) at the time of hospitalization, independent of the duration of illness. Low serum cathelicidin and RANTES levels during acute illness were independent risk factors for higher bacterial loads (P = 0.005) and death (P = 0.04), respectively. To investigate the mechanism of cathelicidin in patients surviving acute disease, we administered LL-37, the active peptide of cathelicidin, in a hamster model of lethal leptospirosis and found it significantly decreased bacterial loads and increased survival. Our findings indicate that the host immune response plays a central role in severe leptospirosis disease progression. While drawn from a limited study size, significant conclusions include that poor clinical outcomes are associated with high systemic bacterial loads, and a decreased antibody response. Furthermore, our data identified a key role for the antimicrobial peptide, cathelicidin, in mounting an effective bactericidal response against the pathogen, which represents a valuable new therapeutic approach for leptospirosis.

Cathelicidin Insufficiency in Patients with Fatal Leptospirosis.

Directory of Open Access Journals (Sweden)

Janet C Lindow

2016-11-01

Full Text Available Leptospirosis causes significant morbidity and mortality worldwide; however, the role of the host immune response in disease progression and high case fatality (>10-50% is poorly understood. We conducted a multi-parameter investigation of patients with acute leptospirosis to identify mechanisms associated with case fatality. Whole blood transcriptional profiling of 16 hospitalized Brazilian patients with acute leptospirosis (13 survivors, 3 deceased revealed fatal cases had lower expression of the antimicrobial peptide, cathelicidin, and chemokines, but more abundant pro-inflammatory cytokine receptors. In contrast, survivors generated strong adaptive immune signatures, including transcripts relevant to antigen presentation and immunoglobulin production. In an independent cohort (23 survivors, 22 deceased, fatal cases had higher bacterial loads (P = 0.0004 and lower anti-Leptospira antibody titers (P = 0.02 at the time of hospitalization, independent of the duration of illness. Low serum cathelicidin and RANTES levels during acute illness were independent risk factors for higher bacterial loads (P = 0.005 and death (P = 0.04, respectively. To investigate the mechanism of cathelicidin in patients surviving acute disease, we administered LL-37, the active peptide of cathelicidin, in a hamster model of lethal leptospirosis and found it significantly decreased bacterial loads and increased survival. Our findings indicate that the host immune response plays a central role in severe leptospirosis disease progression. While drawn from a limited study size, significant conclusions include that poor clinical outcomes are associated with high systemic bacterial loads, and a decreased antibody response. Furthermore, our data identified a key role for the antimicrobial peptide, cathelicidin, in mounting an effective bactericidal response against the pathogen, which represents a valuable new therapeutic approach for leptospirosis.

Fatal interstitial lung disease associated with icotinib.

Science.gov (United States)

Zhang, Jiexia; Zhan, Yangqing; Ouyang, Ming; Qin, Yinyin; Zhou, Chengzhi; Chen, Rongchang

2014-12-01

The most serious, and maybe fatal, yet rare, adverse reaction of gefitinib and erlotinib is drug-associated interstitial lung disease (ILD), which has been often described. However, it has been less well described for icotinib, a similar orally small-molecule tyrosine kinase inhibitor (TKI). The case of a 25-year-old female patient with stage IV lung adenocarcinoma who developed fatal ILD is reported here. She denied chemotherapy, and received palliative treatment with icotinib (125 mg po, three times daily) on March 1, 2013. One month after treatment initiation, the patient complained of continuous dry cough and rapid progressive dyspnea. Forty one days after icotinib treatment, icotinib associated ILD was suspected when the patient became increasingly dyspnoeic despite of treatment of pericardial effusion, left pleural effusion and lower respiratory tract infection, and X-ray computed tomography (CT) of chest revealed multiple effusion shadows and ground-glass opacities in bilateral lungs. Then, icotinib was discontinued and intravenous corticosteroid was started (methylprednisolone 40 mg once daily, about 1 mg per kilogram) respectively. Forty three days after icotinib treatment, the patient died of hypoxic respiratory failure. ILD should be considered as a rare, but often fatal side effect associated with icotinib treatment.

Five years audit for presence of toxic agents/drug of abuse at autopsy

International Nuclear Information System (INIS)

Ali, S.M.A.; Khalil, I.R.; Saeed, A.; Hussain, Z.

2003-01-01

Objective: To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and year wise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Results: Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38%. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine (heroin) was the most commonly involved agent, 65.38%, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Conclusion: Diacetylmorphine (heroin) was the main causative agent involved in young males due to accidental over-dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives.(author)

New evidence concerning fatal crashes of passenger vehicles before and after adding antilock braking systems.

Science.gov (United States)

Farmer, C M

2001-05-01

Fatal crash rates for passenger cars and vans were compared for the last model year before four-wheel antilock brakes were introduced and the first model year for which antilock brakes were standard equipment. A prior study, based on fatal crash experience through 1995, reported that vehicle models with antilock brakes were more likely than identical but 1-year-earlier models to be involved in crashes fatal to their own occupants, but were less likely to be involved in crashes fatal to occupants of other vehicles. Overall, there was no significant effect of antilocks on the likelihood of fatal crashes. Similar analyses, based on fatal crash experience during 1996-98, yielded very different results. During 1996-98, vehicles with antilock brakes were again less likely than earlier models to be involved in crashes fatal to occupants of other vehicles, but they were no longer overinvolved in crashes fatal to their own occupants.

The interrelation between organophosphate toxicity and the epidemiology of depression and suicide.

Science.gov (United States)

Jaga, Kushik; Dharmani, Chandrabhan

2007-01-01

The literature on an association between organophosphate (OP) toxicity and depression or suicide is scarce. An interrelation exists among populations exposed to OPs, acute OP toxicity, neurobehavioral effects, depression, suicide, and fatality. Acute OP toxicity is characterized by the cholinergic syndrome with systemic and central nervous system effects. Organophosphate-induced neurobehavioral effects result in depression. A potential risk of depression and suicide exists in farm workers exposed to OPs. The sociodemographics of depression include age, gender, race, geographic region, social factors, economics, psychiatric disorders, medical conditions, and hereditary factors. Suicide is a major consequence of depression, with multiple sociodemographic risk factors. Developing countries have a higher incidence of OP toxicity, with limited information on the prevalence of depression. In these countries, the incidence of suicide is high, affecting more females. Suicide is more prevalent in rural areas, and in farming communities, commonly with ingestion of OPs. In industrialized countries, the incidence of OP toxicity is lower, but the prevalence of depression is higher. Suicide rates are lower in industrialized countries, affecting more males, the urban population, and farming communities. Other lethal methods of suicide, such as hanging, firearms, electrocution, and drug overdose are more common in industrialized countries. A potential risk of depression or suicide certainly exists from OP toxicity, largely depending on the epidemiology or sociodemographics of these disorders. Scientific evidence shows that the association between environmental toxicology and psychiatry has important public health implications.

Holographic interferometric observation of shock wave focusing to extracorporeal shock wave lithotripsy

Science.gov (United States)

Takayama, Kazuyoshi; Obara, Tetsuro; Onodera, Osamu

1991-04-01

Underwater shock wave focusing is successfully applied to disintegrate and remove kidney stones or gallbladder stones without using surgical operations. This treatment is one of the most peaceful applications ofshock waves and is named as the Extracorporeal Shock Wave Lithotripsy. Ajoint research project is going on between the Institute ofFluid Science, Tohoku University and the School ofMedicine, Tohoku University. The paper describes a result of the fundamental research on the underwater shock wave focusing applied to the ESWL. Quantitatively to visualize the underwater shock waves, various optical flow visualization techniques were successfully used such as holographic interferometry, and shadowgraphs combined with Ima-Con high speed camera. Double exposure holographic interferometric observation revealed the mechanism of generation, propagation and focusing of underwater shock waves. The result of the present research was already used to manufacture a prototype machine and it has already been applied successfully to ESWL crinical treatments. However, despite of success in the clinical treatments, important fundamental questions still remain unsolved, i.e., effects of underwater shock wave focusing on tissue damage during the treatment. Model experiments were conducted to clarify mechanism of the tissue damage associated with the ESWL. Shock-bubble interactions were found responsible to the tissue damage during the ESWL treatment. In order to interprete experimental findings and to predict shock wave behavior and high pressures, a numerical simulation was carried. The numerical results agreed with the experiments.

Impact of on-site cardiac catheterization on resource utilization and fatal and non-fatal outcomes after acute myocardial infarction

Directory of Open Access Journals (Sweden)

Richard Hugues

2006-11-01

Full Text Available Abstract Background Patterns of care for acute myocardial infarction (AMI strongly depend on the availability of on-site cardiac catheterization facilities. Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes. Methods We identified all patients (n = 35,289 admitted with a first AMI in the province of Quebec between January 1, 1996 and March 31, 1999 using population-based administrative databases. Medical resource utilization and non-fatal and fatal outcomes were compared among patients admitted to hospitals with and without on-site cardiac catheterization facilities. Results Cardiac catheterization and PCI were more frequently performed among patients admitted to hospitals with catheterization facilities. However, non-invasive procedures were not used more frequently at hospitals without catheterization facilities. To the contrary, echocardiography [odds ratio (OR, 2.04; 95% confidence interval (CI, 1.93–2.16] and multi-gated acquisition imaging (OR, 1.24; 95% CI, 1.17–1.32 were used more frequently at hospitals with catheterization, and exercise treadmill testing (OR, 1.02; 95% CI, 0.91–1.15 and Sestamibi/Thallium imaging (OR, 0.93; 95% CI, 0.88–0.98 were used similarly at hospitals with and without catheterization. Use of anti-ischemic medications and frequency of emergency room and physician visits, were similar at both types of institutions. Readmission rates for AMI-related cardiac complications and mortality were also similar [adjusted hazard ratio, recurrent AMI: 1.02, 95% CI, 0.89–1.16; congestive heart failure: 1.02; 95% CI, 0.90–1.15; unstable angina: 0.93; 95% CI, 0.85–1.02; mortality: 0.99; 95% CI, 0.93–1.05]. Conclusion Although on-site availability of cardiac catheterization facilities is associated with greater use of invasive cardiac procedures, non-availability of

Shock Isolation Elements Testing for High Input Loadings. Volume III. Mechanical Shock Isolation Elements.

Science.gov (United States)

SHOCK ABSORBERS ), (*GUIDED MISSILE SILOS, SHOCK ABSORBERS ), (*SPRINGS, (*SHOCK(MECHANICS), REDUCTION), TORSION BARS, ELASTOMERS, DAMPING, EQUATIONS OF MOTION, MODEL TESTS, TEST METHODS, NUCLEAR EXPLOSIONS, HARDENING.

Individual and occupational factors related to fatal occupational injuries: a case-control study.

Science.gov (United States)

Villanueva, Vicent; Garcia, Ana M

2011-01-01

This study has been designed in order to identify factors increasing the risk of a fatal outcome when occupational accidents occur. The aim is to provide further evidence for the design and implementation of preventive measures in occupational settings. The Spanish Ministry of Labour registry of occupational injuries causing absence from work includes information on individual and occupational characteristics of injured workers and events. Registered fatal occupational injuries in 2001 (n=539) were compared to a sample of non-fatal injuries in the same year (n=3493). Risks for a fatal result of occupational injuries, adjusted by individual and occupational factors significantly associated, were obtained through logistic regression models. Compared to non-fatal injuries, fatal occupational injuries were mostly produced by trapping or by natural causes, mostly related to elevation and transport devices and power generators, and injured parts of body more frequently affected were head, multiple parts or internal organs. Adjusted analyses showed increased risk of fatality after an occupational injury for males (adjusted odds ratio aOR=10.92; 95%CI 4.80-24.84) and temporary workers (aOR=5.18; 95%CI 2.63-10.18), and the risk increased with age and with advancing hour of the work shift (p for trends accidents in agricultural or construction companies. These data can help to select and define priorities for programmes aimed to prevent fatal consequences of occupational injuries. Copyright © 2010 Elsevier Ltd. All rights reserved.

PARTICLE ACCELERATION AT THE HELIOSPHERIC TERMINATION SHOCK WITH A STOCHASTIC SHOCK OBLIQUITY APPROACH

International Nuclear Information System (INIS)

Arthur, Aaron D.; Le Roux, Jakobus A.

2013-01-01

Observations by the plasma and magnetic field instruments on board the Voyager 2 spacecraft suggest that the termination shock is weak with a compression ratio of ∼2. However, this is contrary to the observations of accelerated particle spectra at the termination shock, where standard diffusive shock acceleration theory predicts a compression ratio closer to ∼2.9. Using our focused transport model, we investigate pickup proton acceleration at a stationary spherical termination shock with a moderately strong compression ratio of 2.8 to include both the subshock and precursor. We show that for the particle energies observed by the Voyager 2 Low Energy Charged Particle (LECP) instrument, pickup protons will have effective length scales of diffusion that are larger than the combined subshock and precursor termination shock structure observed. As a result, the particles will experience a total effective termination shock compression ratio that is larger than values inferred by the plasma and magnetic field instruments for the subshock and similar to the value predicted by diffusive shock acceleration theory. Furthermore, using a stochastically varying magnetic field angle, we are able to qualitatively reproduce the multiple power-law structure observed for the LECP spectra downstream of the termination shock

Trends and factors associated with dengue mortality and fatality in Brazil

Directory of Open Access Journals (Sweden)

Enny Santos Paixão

2015-08-01

Full Text Available AbstractINTRODUCTION:Studies that generate information that may reduce the dengue death risk are essential. This study analyzed time trends and risk factors for dengue mortality and fatality in Brazil from 2001 to 2011.METHODS:Time trends for dengue mortality and fatality rates were analyzed using simple linear regression. Associations between the dengue mortality and the case fatality rates and socioeconomic, demographic, and health care indicators at the municipality level were analyzed using negative binomial regression.RESULTS:The dengue hemorrhagic fever case fatality rate increased in Brazil from 2001 to 2011 (β=0.67; p=0.036, in patients aged 0-14 years (β=0.48; p=0.030 and in those aged ≥15 years (β=1.1; p<0.01. Factors associated with the dengue case fatality rate were the average income per capita (MRR=0.99; p=0.038 and the number of basic health units per population (MRR=0.89; p<0.001. Mortality rates increased from 2001 to 2011 (β=0.350; p=0.002.Factors associated with mortality were inequality (RR=1.02; p=0.001 high income per capita (MRR=0.99; p=0.005, and higher proportions of populations living in urban areas (MRR=1.01; p<0.001.CONCLUSIONS:The increases in the dengue mortality and case fatality rates and the associated socioeconomic and health care factors, suggest the need for structural and intersectoral investments to improve living conditions and to sustainably reduce these outcomes.

The effectiveness of automatic belts in reducing fatality rates in Toyota Cressidas.

Science.gov (United States)

Nash, C E

1989-12-01

Toyota Cressidas have had motor driven automatic belts since 1981. Their observed use rates have been consistently close to 100%. This paper compares fatality rates in Toyota Cressidas with those in the similar Nissan Maximas (which are equipped with three-point manual belts) using the latest data from the Fatal Accident Reporting System. After making adjustments for differences in the average ages of front seat occupants of the two fleets, the Toyotas have a fatality rate that is about three-quarters that of the Nissans. From this, the fatality-reducing effectiveness for the Toyota automatic belts is estimated to be 40% with an uncertainty of +/- 8%. This effectiveness estimate is consistent with earlier estimates of automatic belt effectiveness.

The cosmic-ray shock structure problem for relativistic shocks

Science.gov (United States)

Webb, G. M.

1985-01-01

The time asymptotic behaviour of a relativistic (parallel) shock wave significantly modified by the diffusive acceleration of cosmic-rays is investigated by means of relativistic hydrodynamical equations for both the cosmic-rays and thermal gas. The form of the shock structure equation and the dispersion relation for both long and short wavelength waves in the system are obtained. The dependence of the shock acceleration efficiency on the upstream fluid spped, long wavelength Mach number and the ratio N = P sub co/cP sub co+P sub go)(Psub co and P sub go are the upstream cosmic-ray and thermal gas pressures respectively) are studied.

Numerical Study of Shock Wave Attenuation in Two-Dimensional Ducts Using Solid Obstacles: How to Utilize Shock Focusing Techniques to Attenuate Shock Waves

Directory of Open Access Journals (Sweden)

Qian Wan

2015-04-01

Full Text Available Research on shock wave mitigation in channels has been a topic of much attention in the shock wave community. One approach to attenuate an incident shock wave is to use obstacles of various geometries arranged in different patterns. This work is inspired by the study from Chaudhuri et al. (2013, in which cylinders, squares and triangles placed in staggered and non-staggered subsequent columns were used to attenuate a planar incident shock wave. Here, we present numerical simulations using a different obstacle pattern. Instead of using a matrix of obstacles, an arrangement of square or cylindrical obstacles placed along a logarithmic spiral curve is investigated, which is motivated by our previous work on shock focusing using logarithmic spirals. Results show that obstacles placed along a logarithmic spiral can delay both the transmitted and the reflected shock wave. For different incident shock Mach numbers, away from the logarithmic spiral design Mach number, this shape is effective to either delay the transmitted or the reflected shock wave. Results also confirm that the degree of attenuation depends on the obstacle shape, effective flow area and obstacle arrangement, much like other obstacle configurations.

Understanding fatal older road user crash circumstances and risk factors.

Science.gov (United States)

Koppel, Sjaan; Bugeja, Lyndal; Smith, Daisy; Lamb, Ashne; Dwyer, Jeremy; Fitzharris, Michael; Newstead, Stuart; D'Elia, Angelo; Charlton, Judith

2018-02-28

This study used medicolegal data to investigate fatal older road user (ORU) crash circumstances and risk factors relating to four key components of the Safe System approach (e.g., roads and roadsides, vehicles, road users, and speeds) to identify areas of priority for targeted prevention activity. The Coroners Court of Victoria's Surveillance Database was searched to identify coronial records with at least one deceased ORU in the state of Victoria, Australia, for 2013-2014. Information relating to the ORU, crash characteristics and circumstances, and risk factors was extracted and analyzed. The average rate of fatal ORU crashes per 100,000 population was 8.1 (95% confidence interval [CI] 6.0-10.2), which was more than double the average rate of fatal middle-aged road user crashes (3.6, 95% CI 2.5-4.6). There was a significant relationship between age group and deceased road user type (χ 2 (15, N = 226) = 3.56, p road" (87.0%), on roads that were paved (94.2%), dry (74.2%), and had light traffic volume (38.3%). Road user error was identified by the police and/or coroner for the majority of fatal ORU crashes (57.9%), with a significant proportion of deceased ORU deemed to have "misjudged" (40.9%) or "failed to yield" (37.9%). Road user error was the most significant risk factor identified in fatal ORU crashes, which suggests that there is a limited capacity of the Victorian road system to fully accommodate road user errors. Initiatives related to safer roads and roadsides, vehicles, and speed zones, as well as behavioral approaches, are key areas of priority for targeted activity to prevent fatal older road user crashes in the future.

Pharyngitis – fatal infectious disease or medical error?

Directory of Open Access Journals (Sweden)

Marta Rorat

2015-08-01

Full Text Available Reporting on adverse events is essential to create a culture of safety, which focuses on protecting doctors and patients from medical errors. We present a fatal case of Streptococcus C pharyngitis in a 56-year-old man. The clinical course and the results of additional diagnostics and autopsy showed that sepsis followed by multiple organ failure was the ultimate cause of death. The clinical course appeared fatal due to a chain of adverse events, including errors made by the physicians caring for the patient for 10 days.

Balanced vs unbalanced crystalloid resuscitation in a near-fatal model of hemorrhagic shock and the effects on renal oxygenation, oxidative stress and inflammation

NARCIS (Netherlands)

Aksu, Ugur; Bezemer, R.; Yavuz, B.; Kandil, Asli; Demirci, C.; Ince, C.

2012-01-01

Background: The aim of the present study was to test the hypothesis that balanced crystalloid resuscitation would be better for the kidney than unbalanced crystalloid resuscitation in a rat hemorrhagic shock model. Methods: Male Wistar rats were randomly assigned to four groups (n = 6/group): (1)

A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

Directory of Open Access Journals (Sweden)

Maziar Khorsandi

2016-11-01

Full Text Available Abstract Background Refractory post-cardiotomy cardiogenic shock (PCCS is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS, namely extra-corporeal membrane oxygenation (ECMO or ventricular assist devices (VAD. In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period. Methods The data was obtained through the Edinburgh, Glasgow and Aberdeen cardiac surgery databases. Our inclusion criteria included any adult patient from April 1995 to April 2015 who had received salvage VA ECMO or VAD for PCCS refractory to intra-aortic balloon pump (IABP and maximal inotropic support following adult cardiac surgery. Results A total of 27 patients met the inclusion criteria. Age range was 34–83 years (median 51 years. There was a large male predominance (n = 23, 85 %. Overall 23 patients (85 % received VA ECMO of which 14 (61 % had central ECMO and 9 (39 % had peripheral ECMO. Four patients (15 % were treated with short-term VAD (BiVAD = 1, RVAD = 1 and LVAD = 2. The most common procedure-related complication was major haemorrhage (n = 10. Renal failure requiring renal replacement therapy (n = 7, fatal stroke (n = 5, septic shock (n = 2, and a pseudo-aneurysm at the femoral artery cannulation site (n = 1 were also observed. Overall survival to hospital discharge was 40.7 %. All survivors were NYHA class I-II at 12 months’ follow-up. Conclusion AMCS for refractory PCCS carries a survival benefit and achieves acceptable functional recovery despite a significant complication rate.

Fatal motorcycle crashes: a growing public health problem in Cambodia.

Science.gov (United States)

Roehler, Douglas R; Ear, Chariya; Parker, Erin M; Sem, Panhavuth; Ballesteros, Michael F

2015-01-01

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007-2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.

Fatal haemorrhage and neoplastic thrombosis in a captive African lion (Panthera leo) with metastatic testicular sex cord-stromal tumour.

Science.gov (United States)

Gonzales-Viera, Omar Antonio; Sánchez-Sarmiento, Angélica María; Fernandes, Natália Coelho Couto de Azevedo; Guerra, Juliana Mariotti; Ressio, Rodrigo Albergaria; Catão-Dias, José Luiz

2017-10-13

The study of neoplasia in wildlife species contributes to the understanding of cancer biology, management practices, and comparative pathology. Higher frequencies of neoplasms among captive non-domestic felids have been reported most commonly in aging individuals. However, testicular tumours have rarely been reported. This report describes a metastatic testicular sex cord-stromal tumour leading to fatal haemorrhage and thrombosis in a captive African lion (Panthera leo). During necropsy of a 16-year-old male African lion, the left testicle and spermatic cord were found to be intra-abdominal (cryptorchid), semi-hard and grossly enlarged with multiple pale-yellow masses. Encapsulated haemorrhage was present in the retroperitoneum around the kidneys. Neoplastic thrombosis was found at the renal veins opening into the caudal vena cava. Metastases were observed in the lungs and mediastinal lymph nodes. Histology revealed a poorly differentiated pleomorphic neoplasm comprised of round to polygonal cells and scattered spindle cells with eosinophilic cytoplasm. An immunohistochemistry panel of inhibin-α, Ki-67, human placental alkaline phosphatase, cytokeratin AE1/AE3, cKit, vimentin and S100 was conducted. Positive cytoplasmic immunolabeling was obtained for vimentin and S100. The gross, microscopic and immunohistochemical findings of the neoplasm were compatible with a poorly differentiated pleomorphic sex cord-stromal tumour. Cause of death was hypovolemic shock from extensive retroperitoneal haemorrhage and neoplastic thrombosis may have contributed to the fatal outcome. To our knowledge, this is the first report of sex cord-stromal tumour in non-domestic felids.

A new shock wave assisted wood preservative injection system

Science.gov (United States)

Rao, K. S.; Ravikumar, G.; Lai, Ram; Jagadeesh, G.

Preservative treatment of many tropical hard woods and bamboo pose severe problem. A number of wood preservatives (chemical formulations toxic to wood decay/ destroying organisms like fungi, wood destroying termites, marine borers etc.) and wood impregnating techniques are currently in use for improving bio resistance of timber and bamboo and thereby enhancing service life for different end uses. How ever, some species of tropical hardwoods and many species of bamboo are difficult to treat, posing technical problems. In this paper we report preliminary results of treatment of bamboo with a novel Shockwave assisted injection treatment. Samples (30×2.5×1.00 cm) of an Indian species of bamboo Dendrocalamus strictus prepared from defect free culms of dry bamboo are placed in the driven section of a vertical shock tube filled with the 4Coppepr-Chrome-Arsenic(CCA) preservative solution.The bamboo samples are subjected to repeated shock wave loading (3 shots) with typical over pressures of 30 bar. The results from the study indicate excellent penetration and retention of CCA preservative in bamboo samples. The method itself is much faster compared to the conventional methods like pressure treatment or hot and cold process.

Converging cylindrical shocks in ideal magnetohydrodynamics

KAUST Repository

Pullin, D. I.

2014-09-01

We consider a cylindrically symmetrical shock converging onto an axis within the framework of ideal, compressible-gas non-dissipative magnetohydrodynamics (MHD). In cylindrical polar co-ordinates we restrict attention to either constant axial magnetic field or to the azimuthal but singular magnetic field produced by a line current on the axis. Under the constraint of zero normal magnetic field and zero tangential fluid speed at the shock, a set of restricted shock-jump conditions are obtained as functions of the shock Mach number, defined as the ratio of the local shock speed to the unique magnetohydrodynamic wave speed ahead of the shock, and also of a parameter measuring the local strength of the magnetic field. For the line current case, two approaches are explored and the results compared in detail. The first is geometrical shock-dynamics where the restricted shock-jump conditions are applied directly to the equation on the characteristic entering the shock from behind. This gives an ordinary-differential equation for the shock Mach number as a function of radius which is integrated numerically to provide profiles of the shock implosion. Also, analytic, asymptotic results are obtained for the shock trajectory at small radius. The second approach is direct numerical solution of the radially symmetric MHD equations using a shock-capturing method. For the axial magnetic field case the shock implosion is of the Guderley power-law type with exponent that is not affected by the presence of a finite magnetic field. For the axial current case, however, the presence of a tangential magnetic field ahead of the shock with strength inversely proportional to radius introduces a length scale R = √μ0/p0 I/(2π) where I is the current, μ0 is the permeability, and p0 is the pressure ahead of the shock. For shocks initiated at r ≫ R, shock convergence is first accompanied by shock strengthening as for the strictly gas-dynamic implosion. The diverging magnetic field then

Converging cylindrical shocks in ideal magnetohydrodynamics

International Nuclear Information System (INIS)

Pullin, D. I.; Mostert, W.; Wheatley, V.; Samtaney, R.

2014-01-01

We consider a cylindrically symmetrical shock converging onto an axis within the framework of ideal, compressible-gas non-dissipative magnetohydrodynamics (MHD). In cylindrical polar co-ordinates we restrict attention to either constant axial magnetic field or to the azimuthal but singular magnetic field produced by a line current on the axis. Under the constraint of zero normal magnetic field and zero tangential fluid speed at the shock, a set of restricted shock-jump conditions are obtained as functions of the shock Mach number, defined as the ratio of the local shock speed to the unique magnetohydrodynamic wave speed ahead of the shock, and also of a parameter measuring the local strength of the magnetic field. For the line current case, two approaches are explored and the results compared in detail. The first is geometrical shock-dynamics where the restricted shock-jump conditions are applied directly to the equation on the characteristic entering the shock from behind. This gives an ordinary-differential equation for the shock Mach number as a function of radius which is integrated numerically to provide profiles of the shock implosion. Also, analytic, asymptotic results are obtained for the shock trajectory at small radius. The second approach is direct numerical solution of the radially symmetric MHD equations using a shock-capturing method. For the axial magnetic field case the shock implosion is of the Guderley power-law type with exponent that is not affected by the presence of a finite magnetic field. For the axial current case, however, the presence of a tangential magnetic field ahead of the shock with strength inversely proportional to radius introduces a length scale R=√(μ 0 /p 0 ) I/(2 π) where I is the current, μ 0 is the permeability, and p 0 is the pressure ahead of the shock. For shocks initiated at r ≫ R, shock convergence is first accompanied by shock strengthening as for the strictly gas-dynamic implosion. The diverging magnetic field

Converging cylindrical shocks in ideal magnetohydrodynamics

Energy Technology Data Exchange (ETDEWEB)

Pullin, D. I. [Graduate Aerospace Laboratories, California Institute of Technology, Pasadena, California 91125 (United States); Mostert, W.; Wheatley, V. [School of Mechanical and Mining Engineering, University of Queensland, Queensland 4072 (Australia); Samtaney, R. [Mechanical Engineering, Physical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal (Saudi Arabia)

2014-09-15

We consider a cylindrically symmetrical shock converging onto an axis within the framework of ideal, compressible-gas non-dissipative magnetohydrodynamics (MHD). In cylindrical polar co-ordinates we restrict attention to either constant axial magnetic field or to the azimuthal but singular magnetic field produced by a line current on the axis. Under the constraint of zero normal magnetic field and zero tangential fluid speed at the shock, a set of restricted shock-jump conditions are obtained as functions of the shock Mach number, defined as the ratio of the local shock speed to the unique magnetohydrodynamic wave speed ahead of the shock, and also of a parameter measuring the local strength of the magnetic field. For the line current case, two approaches are explored and the results compared in detail. The first is geometrical shock-dynamics where the restricted shock-jump conditions are applied directly to the equation on the characteristic entering the shock from behind. This gives an ordinary-differential equation for the shock Mach number as a function of radius which is integrated numerically to provide profiles of the shock implosion. Also, analytic, asymptotic results are obtained for the shock trajectory at small radius. The second approach is direct numerical solution of the radially symmetric MHD equations using a shock-capturing method. For the axial magnetic field case the shock implosion is of the Guderley power-law type with exponent that is not affected by the presence of a finite magnetic field. For the axial current case, however, the presence of a tangential magnetic field ahead of the shock with strength inversely proportional to radius introduces a length scale R=√(μ{sub 0}/p{sub 0}) I/(2 π) where I is the current, μ{sub 0} is the permeability, and p{sub 0} is the pressure ahead of the shock. For shocks initiated at r ≫ R, shock convergence is first accompanied by shock strengthening as for the strictly gas-dynamic implosion. The

Converging cylindrical shocks in ideal magnetohydrodynamics

KAUST Repository

Pullin, D. I.; Mostert, W.; Wheatley, V.; Samtaney, Ravi

2014-01-01

We consider a cylindrically symmetrical shock converging onto an axis within the framework of ideal, compressible-gas non-dissipative magnetohydrodynamics (MHD). In cylindrical polar co-ordinates we restrict attention to either constant axial magnetic field or to the azimuthal but singular magnetic field produced by a line current on the axis. Under the constraint of zero normal magnetic field and zero tangential fluid speed at the shock, a set of restricted shock-jump conditions are obtained as functions of the shock Mach number, defined as the ratio of the local shock speed to the unique magnetohydrodynamic wave speed ahead of the shock, and also of a parameter measuring the local strength of the magnetic field. For the line current case, two approaches are explored and the results compared in detail. The first is geometrical shock-dynamics where the restricted shock-jump conditions are applied directly to the equation on the characteristic entering the shock from behind. This gives an ordinary-differential equation for the shock Mach number as a function of radius which is integrated numerically to provide profiles of the shock implosion. Also, analytic, asymptotic results are obtained for the shock trajectory at small radius. The second approach is direct numerical solution of the radially symmetric MHD equations using a shock-capturing method. For the axial magnetic field case the shock implosion is of the Guderley power-law type with exponent that is not affected by the presence of a finite magnetic field. For the axial current case, however, the presence of a tangential magnetic field ahead of the shock with strength inversely proportional to radius introduces a length scale R = √μ0/p0 I/(2π) where I is the current, μ0 is the permeability, and p0 is the pressure ahead of the shock. For shocks initiated at r ≫ R, shock convergence is first accompanied by shock strengthening as for the strictly gas-dynamic implosion. The diverging magnetic field then

Fatal occupational accidents in Danish fishing vessels 1989-2005

DEFF Research Database (Denmark)

Laursen, Lise Hedegaard; Hansen, Henrik L; Jensen, Olaf

2008-01-01

training for all fishermen and improved safety measures are needed, especially in the underscored areas of sea disasters concerning small vessels and occupational accidents on big vessels. Better registration of time at risk for fishermen is needed to validate the effect of the safety measures......./capsizing due to stability changes in rough weather and collisions; 39 fatal occupational accidents mainly occurred on the larger inspection obligated trawlers during fishing. In the remaining 14 other fatal accidents, the main causal factors were difficult embarking/disembarking conditions by darkness...... in foreign ports and alcohol intoxication. In the period 1995-2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety...

A shock surface geometry - The February 15-16, 1967, event. [solar flare associated interplanetary shock

Science.gov (United States)

Lepping, R. P.; Chao, J. K.

1976-01-01

An estimated shape is presented for the surface of the flare-associated interplanetary shock of February 15-16, 1967, as seen in the ecliptic-plane cross section. The estimate is based on observations by Explorer 33 and Pioneers 6 and 7. The estimated shock normal at the Explorer 33 position is obtained by a least-squares shock parameter-fitting procedure for that satellite's data; the shock normal at the Pioneer 7 position is found by using the magnetic coplanarity theorem and magnetic-field data. The average shock speed from the sun to each spacecraft is determined along with the local speed at Explorer 33 and the relations between these speeds and the position of the initiating solar flare. The Explorer 33 shock normal is found to be severely inclined and not typical of interplanetary shocks. It is shown that the curvature of the shock surface in the ecliptic plane near the earth-Pioneer 7 region is consistent with a radius of not more than 0.4 AU.

Violent and Fatal Youth Trauma: Is There a Missed Opportunity?

Directory of Open Access Journals (Sweden)

Robert Madlinger, DO

2012-05-01

Full Text Available Introduction: Accidents and assaults (homicides are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED as a victim of violent trauma, is a significantly growing public health problem. As 5-year mortality rates for recidivism are as high as 20%,it is important to determine whether victims with a history of violent trauma are at increased risk for fatal outcome with their next trauma. We hypothesized that victims of violent trauma who have had 1 prior ED visit for violent trauma will have increased odds of fatal outcome.Methods: A retrospective chart review was conducted for patients presenting with penetrating trauma to the ED from January 1, 1999 to December 31, 2009. All patients between the ages of 15 to 25 years who presented to the ED for any penetrating trauma were included. Patients with prior presentations for penetrating trauma were compared to those patients who were first-time presenters to determine the odds ratio of fatal outcome.Results: Overall, 15,395 patients were treated for traumatic presentations. Of these, 1,044 met inclusion criteria. Demographically, 79.4% were Hispanic, 19.4% were African American, and 0.96% were Caucasian. The average age was 21 years, and 98% of the population was male. One hundred and forty-seven (14% had prior presentations, and 897 (86% did not. Forty of the 147 patients (27%with prior presentations had a fatal outcome as compared to 29 patients of the 868 (3% without prior presentations, with odds ratio of 10.8 (95% confidence interval, 6.4–18.1; Pearson v2, P , 0.001. The 5-year mortality rate for those patients with fatal outcomes was calculated at 16.5%.Conclusion: Patients who had prior ED visits for penetrating trauma were at greater risk for fatal outcomes compared to those with no prior visits. Therefore, trauma-related ED visits might

Selfsimilar time dependent shock structures

International Nuclear Information System (INIS)

Beck, R.; Drury, L.O.

1985-01-01

Diffusive shock acceleration as an astrophysical mechanism for accelerating charged particles has the advantage of being highly efficient. This means however that the theory is of necessity nonlinear; the reaction of the accelerated particles on the shock structure and the acceleration process must be self-consistently included in any attempt to develop a complete theory of diffusive shock acceleration. Considerable effort has been invested in attempting, at least partially, to do this and it has become clear that in general either the maximum particle energy must be restricted by introducing additional loss processes into the problem or the acceleration must be treated as a time dependent problem (Drury, 1984). It is concluded that stationary modified shock structures can only exist for strong shocks if additional loss processes limit the maximum energy a particle can attain. This is certainly possible and if it occurs the energy loss from the shock will lead to much greater shock compressions. It is however equally possible that no such processes exist and we must then ask what sort of nonstationary shock structure develops. The same argument which excludes stationary structures also rules out periodic solutions and indeed any solution where the width of the shock remains bounded. It follows that the width of the shock must increase secularly with time and it is natural to examine the possibility of selfsimilar time dependent solutions

Selfsimilar time dependent shock structures

Science.gov (United States)

Beck, R.; Drury, L. O.

1985-01-01

Diffusive shock acceleration as an astrophysical mechanism for accelerating charged particles has the advantage of being highly efficient. This means however that the theory is of necessity nonlinear; the reaction of the accelerated particles on the shock structure and the acceleration process must be self-consistently included in any attempt to develop a complete theory of diffusive shock acceleration. Considerable effort has been invested in attempting, at least partially, to do this and it has become clear that in general either the maximum particle energy must be restricted by introducing additional loss processes into the problem or the acceleration must be treated as a time dependent problem (Drury, 1984). It is concluded that stationary modified shock structures can only exist for strong shocks if additional loss processes limit the maximum energy a particle can attain. This is certainly possible and if it occurs the energy loss from the shock will lead to much greater shock compressions. It is however equally possible that no such processes exist and we must then ask what sort of nonstationary shock structure develops. The ame argument which excludes stationary structures also rules out periodic solutions and indeed any solution where the width of the shock remains bounded. It follows that the width of the shock must increase secularly with time and it is natural to examine the possibility of selfsimilar time dependent solutions.

Fatal veno-occlusive disease of the liver after chemotherapy, whole-body irradiation and bone marrow transplantation for refractory acute leukaemia

International Nuclear Information System (INIS)

Jacobs, P.; Miller, J.L.; Uys, C.J.; Dietrich, B.E.

1979-01-01

Rapid onset of liver failure with fatal outcome occured in a young woman after successful bone marrow transplantation undertaken for refractory acute leukaemia. Centrilobular necrosis was demonstrated at autopsy and was attributed to prior cytotoxic chemotherapy, possibly potentiated by the total-body irradiation that was used in preparation for the transplant. This association between liver damage and prolonged drug therapy, coupled with the short median survival currently achieved within these chemotherapy regimens, has initiated an evaluation of bone marrow transplantation in patients with leukaemia during the first complete remission, rather than at a later stage when cumulative drug toxicity to the liver may have taken place

Caso fatal de balantidíase intestinal

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Maria da Conceição Pinheiro

1991-09-01

Full Text Available Caso fatal de balantidíase em mulher desnutrida de 63 anos, criadora de porcos, da zona rural de Uberaba. A doença evoluiu em oito dias com disenteria, náusea e vômitos, culminando em óbito por enterorragia. A necropsia constatou-se colite ulcerada causada por B. coli, facilmente identificado ao exame histológico do intestino grosso.A fatal case of a 63-year old pig-raising country woman with an eight-day course of nausea, vomiting. dysentery with intestinal bleeding the latter being the direct cause of death. The autopsy showed ulcerative colitis due to B. coli, which was easily observed on histological examination of the large bowel.

Effectiveness of antilock braking systems in reducing motorcycle fatal crash rates.

Science.gov (United States)

Teoh, Eric R

2011-04-01

Overbraking and underbraking have been shown to be common factors in motorcycle crashes. Antilock braking systems (ABS) prevent wheels from locking during braking and may make riders less reluctant to apply full braking force. The objective of this study was to evaluate the effect of ABS in fatal motorcycle crashes. Motorcycle drivers involved in fatal crashes per 10,000 registered vehicle years were compared for 13 motorcycle models with optional ABS and those same models without the option during 2003-2008. Motorcycles with optional ABS were included only if the presence of the option could be identified from the vehicle identification number. The rate of fatal motorcycle crashes per 10,000 registered vehicle years was 37 percent lower for ABS models than for their non-ABS versions. ABS appears to be highly effective in preventing fatal motorcycle crashes based on some early adopters of motorcycle ABS technology.

Inferring Pre-shock Acoustic Field From Post-shock Pitot Pressure Measurement

Science.gov (United States)

Wang, Jian-Xun; Zhang, Chao; Duan, Lian; Xiao, Heng; Virginia Tech Team; Missouri Univ of Sci; Tech Team

2017-11-01

Linear interaction analysis (LIA) and iterative ensemble Kalman method are used to convert post-shock Pitot pressure fluctuations to static pressure fluctuations in front of the shock. The LIA is used as the forward model for the transfer function associated with a homogeneous field of acoustic waves passing through a nominally normal shock wave. The iterative ensemble Kalman method is then employed to infer the spectrum of upstream acoustic waves based on the post-shock Pitot pressure measured at a single point. Several test cases with synthetic and real measurement data are used to demonstrate the merits of the proposed inference scheme. The study provides the basis for measuring tunnel freestream noise with intrusive probes in noisy supersonic wind tunnels.

A DOUBLE KNOCKOUT; A NOVEL APPROACH TO UNDERSTANDING STRESS-INDUCIBLE 70 KDA HEAT SHOCK PROTEINS (HSP70S) ON DEVELOPMENT AND REPRODUCTION

Science.gov (United States)

Heat and chemical toxicants which disrupt spermatogenesis and cause male infertility are thought to induce the expression of Hsp70-1 and 70-3, the major inducible heat shock proteins of the 70kDa family. Previous studies from several laboratories including our own have characteri...

Liver transplant in ethylmalonic encephalopathy: a new treatment for an otherwise fatal disease.

Science.gov (United States)

Dionisi-Vici, Carlo; Diodato, Daria; Torre, Giuliano; Picca, Stefano; Pariante, Rosanna; Giuseppe Picardo, Sergio; Di Meo, Ivano; Rizzo, Cristiano; Tiranti, Valeria; Zeviani, Massimo; De Ville De Goyet, Jean

2016-04-01

Ethylmalonic encephalopathy is a fatal, rapidly progressive mitochondrial disorder caused by ETHE1 mutations, whose peculiar clinical and biochemical features are due to the toxic accumulation of hydrogen sulphide and of its metabolites, including thiosulphate. In mice with ethylmalonic encephalopathy, liver-targeted adeno-associated virus-mediated ETHE1 gene transfer dramatically improved both clinical course and metabolic abnormalities. Reasoning that the same achievement could be accomplished by liver transplantation, we performed living donor-liver transplantation in an infant with ethylmalonic encephalopathy. Unlike the invariably progressive deterioration of the disease, 8 months after liver transplantation, we observed striking neurological improvement with remarkable achievements in psychomotor development, along with dramatic reversion of biochemical abnormalities. These results clearly indicate that liver transplantation is a viable therapeutic option for ETHE1 disease. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

THE EFFECTS OF AREA CONTRACTION ON SHOCK WAVE STRENGTH AND PEAK PRESSURE IN SHOCK TUBE

Directory of Open Access Journals (Sweden)

A. M. Mohsen

2012-06-01

Full Text Available This paper presents an experimental investigation into the effects of area contraction on shock wave strength and peak pressure in a shock tube. The shock tube is an important component of the short duration, high speed fluid flow test facility, available at the Universiti Tenaga Nasional (UNITEN, Malaysia. The area contraction was facilitated by positioning a bush adjacent to the primary diaphragm section, which separates the driver and driven sections. Experimental measurements were performed with and without the presence of the bush, at various diaphragm pressure ratios, which is the ratio of air pressure between the driver (high pressure and driven (low pressure sections. The instantaneous static pressure variations were measured at two locations close to the driven tube end wall, using high sensitivity pressure sensors, which allow the shock wave strength, shock wave speed and peak pressure to be analysed. The results reveal that the area contraction significantly reduces the shock wave strength, shock wave speed and peak pressure. At a diaphragm pressure ratio of 10, the shock wave strength decreases by 18%, the peak pressure decreases by 30% and the shock wave speed decreases by 8%.

Causes of fatal accidents for instrument-certified and non-certified private pilots.

Science.gov (United States)

Shao, Bob Siyuan; Guindani, Michele; Boyd, Douglas D

2014-11-01

Instrument certification (IFR) enhances a pilot's skills in precisely controlling the aircraft and requires a higher level of standards in maintaining heading and altitude compared with the less stringent private pilot certificate. However, there have been no prior studies to compare fatal accident causes for airmen with, and without, this rating, The NTSB accident database was queried for general aviation fatal accidents for private pilots with, and without IFR certification. Exact Poisson tests were used to calculate whether two rate parameters were equal (ratio of 1), normalized to the number of IFR-rated pilots and flight hours in the given time period. Proportion tests were used to determine whether there were significant differences in fatal accident causes between IFR-certified and non-certified pilots. A logistic regression for log-odds success was used in determining the trend and effect of age on fatal accident rates. IFR certification was associated with a reduced risk of accidents due to failure to maintain obstacle/terrain clearance and spatial disorientation for day and night operations respectively. In contrast, the likelihood of fatal accident due to equipment malfunction during day operations was higher for IFR-certified pilots. The fatal accident rate decreased over the last decade for IFR-certified but not for non-IFR-certified private pilots. However, the overall accident rate for IFR-certified private pilots was more than double that of the cohort lacking this certification. Finally, we found a trend for an increased fatality rate with advancing age for both group of pilots. Our findings informs on where training and/or technology should be focused. Both training for aerodynamic stalls, which causes over a quarter of all fatal accidents, should be intensified for both IFR-certified and non-certified private pilots. Similarly, adherence to minimum safe altitudes for both groups of pilots should be encouraged toward reducing the fatal accidents

Structure of intermediate shocks and slow shocks in a magnetized plasma with heat conduction

International Nuclear Information System (INIS)

Tsai, C.L.; Wu, B.H.; Lee, L.C.

2005-01-01

The structure of slow shocks and intermediate shocks in the presence of a heat conduction parallel to the local magnetic field is simulated from the set of magnetohydrodynamic equations. This study is an extension of an earlier work [C. L. Tsai, R. H. Tsai, B. H. Wu, and L. C. Lee, Phys. Plasmas 9, 1185 (2002)], in which the effects of heat conduction are examined for the case that the tangential magnetic fields on the two side of initial current sheet are exactly antiparallel (B y =0). For the B y =0 case, a pair of slow shocks is formed as the result of evolution of the initial current sheet, and each slow shock consists of two parts: the isothermal main shock and the foreshock. In the present paper, cases with B y ≠0 are also considered, in which the evolution process leads to the presence of an additional pair of time-dependent intermediate shocks (TDISs). Across the main shock of the slow shock, jumps in plasma density, velocity, and magnetic field are significant, but the temperature is continuous. The plasma density downstream of the main shock decreases with time, while the downstream temperature increases with time, keeping the downstream pressure constant. The foreshock is featured by a smooth temperature variation and is formed due to the heat flow from downstream to upstream region. In contrast to the earlier study, the foreshock is found to reach a steady state with a constant width in the slow shock frame. In cases with B y ≠0, the plasma density and pressure increase and the magnetic field decreases across TDIS. The TDIS initially can be embedded in the slow shock's foreshock structure, and then moves out of the foreshock region. With an increasing B y , the propagation speed of foreshock leading edge tends to decrease and the foreshock reaches its steady state at an earlier time. Both the pressure and temperature downstreams of the main shock decrease with increasing B y . The results can be applied to the shock heating in the solar corona and

Intergenerational differences in occupational injury and fatality rates among Canada's immigrants.

Science.gov (United States)

Tiagi, R

2016-12-01

Empirical evidence on occupational injury and/or fatality rates among Canada's immigrants has been largely mixed and has almost exclusively focused on the first generation. Over time, as immigrants assimilate into the economy, future generations may be expected to work in less hazardous occupations compared with prior generations. There has been no prior analysis of the differences in occupational injury and fatality rates among later generations. To analyse whether there are intergenerational differences in occupational injury and fatality rates among the first, second and third (or more) immigrant generations in Canada. Data drawn from the 2011 National Household Survey and the Association of Workers' Compensation Boards of Canada were used to determine the difference in occupational injury and fatality rates between the first or the third generation and the second generation, using a Poisson regression framework. Second-generation immigrants worked in jobs with lower occupational injury rates compared with the first generation and the third generation (or more). Similar results were observed for occupational fatality rates. Second-generation immigrants worked in less hazardous jobs compared with the first generation and compared with the third (or more) generations. These results suggest that the second generation may not face the same economic hurdles and challenges, in terms of workplace injuries or fatalities, as those faced by the first or third (or more) generations of immigrants. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Characteristics, Classification, and Prevention of Child Maltreatment Fatalities.

Science.gov (United States)

McCarroll, James E; Fisher, Joscelyn E; Cozza, Stephen J; Robichaux, Renè J; Fullerton, Carol S

2017-01-01

Preventing child maltreatment fatalities is a critical goal of the U.S. society and the military services. Fatality review boards further this goal through the analysis of circumstances of child deaths, making recommendations for improvements in practices and policies, and promoting increased cooperation among the many systems that serve families. The purpose of this article is to review types of child maltreatment death, proposed classification models, risk and protective factors, and prevention strategies. This review is based on scientific and medical literature, national reports and surveys, and reports of fatality review boards. Children can be killed soon after birth or when older through a variety of circumstances, such as with the suicide of the perpetrator, or when the perpetrator kills the entire family. Death through child neglect may be the most difficult type of maltreatment death to identify as neglect can be a matter of opinion or societal convention. These deaths can occur as a result of infant abandonment, starvation, medical neglect, drowning, home fires, being left alone in cars, and firearms. Models of classification for child maltreatment deaths can permit definition and understanding of child fatalities by providing reference points that facilitate research and enhance clinical prediction. Two separate approaches have been proposed: the motives of the perpetrator and the circumstances of death of the child victim. The latter approach is broader and is founded on an ecological model focused on the nature and circumstances of death, child victim characteristics, perpetrator characteristics, family and environmental circumstances, and service provision and need. Many risk factors for maternal and paternal filicide have been found, but most often included are young maternal age, no prenatal care, low education level, mental health problems, family violence, and substance abuse. Many protective factors can be specified at the individual, family

Effect of continuous hemofiltration on internal environment and survival rate of severe heatstroke dogs with shock

Directory of Open Access Journals (Sweden)

Guang-ming CHEN

2011-08-01

groups.In CHF group the electrolyte disturbance recovered gradually and reached normal level at 180min after shock,while it did not recover in HS group.The levels of serum sodium,chlorine and potassium in HS group were significantly higher than those in CHF group at each time point after shock(P < 0.05,P < 0.01.The median survival time of CHF group(180 minutes was significantly longer than that of HS group(75 minutes,χ2=6.929,P=0.008.Conclusion CHF could improve the prognosis of severe heatstroke dogs with shock,prolong the survival time and reduce the fatality rate.The mechanism may be associated with fast cooling at early stage,maintenance of hemodynamic stability,and correction the acid-base imbalance and electrolyte disturbance.

Shock waves in gas and plasma

International Nuclear Information System (INIS)

Niu, K.

1996-01-01

A shock wave is a discontinuous surface that connects supersonic flow with subsonic flow. After a shock wave, flow velocity is reduced, and pressure and temperature increase; entropy especially increases across a shock wave. Therefore, flow is in nonequilibrium, and irreversible processes occur inside the shock layer. The thickness of a shock wave in neutral gas is of the order of the mean free path of the fluid particle. A shock wave also appears in magnetized plasma. Provided that when the plasma flow is parallel to the magnetic field, a shock wave appears if the governing equation for velocity potential is in hyperbolic type in relation with the Mach number and the Alfven number. When the flow is perpendicular to the magnetic field, the Maxwell stress, in addition to the pressure, plays a role in the shock wave in plasma. When the plasma temperature is so high, as the plasma becomes collision-free, another type of shock wave appears. In a collision-free shock wave, gyromotions of electrons around the magnetic field lines cause the shock formation instead of collisions in a collision-dominant plasma or neutral gas. Regardless of a collision-dominant or collision-free shock wave, the fluid that passes through the shock wave is heated in addition to being compressed. In inertial confinement fusion, the fuel must be compressed. Really, implosion motion performs fuel compression. A shock wave, appearing in the process of implosion, compresses the fuel. The shock wave, however, heats the fuel more intensively, and it makes it difficult to compress the fuel further because high temperatures invite high pressure. Adiabatic compression of the fuel is the desired result during the implosion, without the formation of a shock wave. (Author)

Drug involvement of fatally injured drivers

Science.gov (United States)

2010-11-01

While data focusing on the danger of driving under the influence : of alcohol is readily available and often cited, less is : known or discussed about drivers under the influence of : other drugs. The Fatality Analysis Reporting System (FARS), : a ce...

Cytotoxicity and Hsp 70 induction in Hep G2 cells in response to zearalenone and cytoprotection by sub-lethal heat shock

International Nuclear Information System (INIS)

Hassen, Wafa; Golli, Emna El; Baudrimont, Isabelle; Mobio, A. Theophile; Ladjimi, M. Moncef; Creppy, E. Edmond; Bacha, Hassen

2005-01-01

Zearalenone (ZEN) is a mycotoxin with several adverse effects in laboratory and domestic animals. The mechanism of ZEN toxicity that involves mainly binding to oestrogen receptors and inhibition of macromolecules synthesis is not fully understood. Using human hepatocytes Hep G2 cells as a model, the aim of this work was (i) to investigate the ability of ZEN to induce heat shock proteins Hsp 70 and (ii) to find out the mechanisms of ZEN cytotoxicity by examining cell proliferation and protein synthesis. Our study demonstrated that ZEN induces Hsp 70 expression in a time and dose-dependant manner; this induction occurs at non-cytotoxic concentrations, it could be therefore considered as a biomarker of toxicity. A cytoprotective effect of Hsp 70 was elicited when Hep G2 cells were exposed to Sub-Lethal heat shock prior to ZEN treatment and evidenced by a reduced ZEN cytolethality. This cytoprotection suggests that Hsp 70 may constitute an important cellular defence mechanism. Finally, our data show that ZEN is cytotoxic in Hep G2 cells by inhibiting cell proliferation and total protein synthesis and pointed out oxidative damage as possible pathway involved in ZEN toxicity; however, other investigations are needed to further confirm Zen induced oxidative stress

Fatal pesticide intoxication - case report of a 2 patients

Directory of Open Access Journals (Sweden)

Jędrzej Tkaczyk

2018-05-01

Full Text Available Pesticides is a collective term for a group of chemicals used predominantly in agriculture and against vectors in vectorborne diseases such as malaria, filariasis, etc. Organophosphates (OP have become nowadays the most widely used pesticides among the world. However, they are very highly toxic to humans. Poisoning with OP is a life - threatening condition. It is responsible for the symptoms due to a cholinergic effects. The Acetylcholinesterase (ACHE enzyme inhibition leads to an acetylcholine accumulation, which causes symptoms such as diarrhea, sweating, vomiting, small pupils, muscle tremors, increased saliva and tears production and confusion. Other type of pesticides are also common used in agriculture. Glyphosate is a broad‐spectrum systemic herbicide used to kill weeds. It is promoted by the manufacturer as having no risks to human health. We present two patients with a fatal pesticide poisoning. First patient drank OP agent, which was decanted in a non-original bottle. Despite the intensive treatment, including high doses of atropine, and toxogonine, patient died after 6 days due to acute respiratory failure. The second one, tried to commit suicide by drinking 2 glasses of a pesticide called ‘Roundap’ (glyphosate. Short time after admission to a hospital, a myocardial infarction occurred. The patient died the same day, due to a cardiac arrest.

Shock therapy: Gris Gun's shock absorber can take the punch

Energy Technology Data Exchange (ETDEWEB)

Anon.

2000-04-01

A newly developed shock impedance tool that isolates downhole tools that measure the effects of well stimulation techniques from being damaged by the violent shaking caused by various well stimulation techniques which combine perforating and propellant technology in a single tool, is discussed. The shock exerted by a perforating gun can exceed 25,000 G forces within 100 to 300 milliseconds, may damage or even destroy the sensitive electronics housed in the various recorders that record data about fracture gradients, permeability and temperature. The shock absorber developed by Tesco Gris Gun and Computalog, incorporates the mechanics of a piston style shock absorber in combination with a progressive spring stack and energy-dampening silicone oil chambers. The end results is an EUE 'slim line' assembly that is adaptable between the gun perforating string and the electronic equipment. It is typically attached below, reducing the shock load by as much as 90 per cent. The shock absorber is now available commercially through Gris Gun's exclusive distributorship. An improved version, currently under development, will be used for wireline perforating and tubing-conveyed perforating applications. 2 figs.

A Clinical Study on the cases of The Pain Shock Patients after Korean Bee-Venom Therapy

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Lee Jin-seon

2001-12-01

Full Text Available Objective:There has been no known report on the pain shock after administering Korean bee-venom therapy. Three accounts of pain shock were observed at the Sangji university affiliated Oriental medicine clinic from July 2001 through September 2001. This thesis will inform clinical progression and cautions on administering Korean bee-venom therapy. Method:We were able to witness different patterns of pain shock during the treatment of degenerative knee joint, progressive oral paralysis, and A.L.S. In order to reduce heat toxicity of the bee venom, needling points were first massaged with the ice for 10 minutes before injecting 0.1～0.2cc of the bee venom. Points of injection were ST36, LI11, LI4 and others. Pain shock occurred after injecting on inner xi-an, outer xi-an and LI4. The phenomena associated with pain shock was recorded in chronological order and local changes were examined. Result Through examining 3 patients with the pain shock, we managed to observe clinical progression, duration, and time linked changes on specific regions. We also managed to determine sensitive needling points for the pain shock. Conclusion:Following results were obtained from 3 patients with the pain shock caused by Korean bee-venom therapy from July 2001 to September 2001. 1. Either positive or negative responses were shown after the pain shock. For case 1, extreme pain was accompanied with muscular convulsion and tremble, ocular hyperemia, delirium, stiffening of extremities, and hyper ventilation which all suggest positive responses. For case 2 and 3, extreme pain was accompanied with facial sweating, asthenia of extremities, pallor face, dizziness, weak voice, and sleepiness which are the signs of negative responses. 2. The time required to recover to stable state took nearly an hour (including sleeping time and there was no side effect. 3. Precautions required to prevent the pain shock includes full concentration from the practitioner, accurate point

Initial ISEE magnetometer results: shock observation

International Nuclear Information System (INIS)

Russell, C.T.

1979-01-01

ISEE-1 and -2 magnetic field profiles across 6 terrestrial bow shock and one interplanetary shock are examined. The inteplanetary shock illustrates the behavior of a low Mach number shock. Three examples of low or moderate β, high Mach number, quasi-perpendicular shocks are examined. These did not have upstream waves, but rather had waves growing in the field gradient. Two examples of high β shocks showed little coherence in field variation even though the two vehicles were only a few hundred kilometers apart. The authors present the joint behavior of wave, particle and field data across some of these shocks to show some of the myriad of shock features whose behavior they are now beginning to investigate. (Auth.)

Analytical solutions of hypersonic type IV shock - shock interactions

Science.gov (United States)

Frame, Michael John

An analytical model has been developed to predict the effects of a type IV shock interaction at high Mach numbers. This interaction occurs when an impinging oblique shock wave intersects the most normal portion of a detached bow shock. The flowfield which develops is complicated and contains an embedded jet of supersonic flow, which may be unsteady. The jet impinges on the blunt body surface causing very high pressure and heating loads. Understanding this type of interaction is vital to the designers of cowl lips and leading edges on air- breathing hypersonic vehicles. This analytical model represents the first known attempt at predicting the geometry of the interaction explicitly, without knowing beforehand the jet dimensions, including the length of the transmitted shock where the jet originates. The model uses a hyperbolic equation for the bow shock and by matching mass continuity, flow directions and pressure throughout the flowfield, a prediction of the interaction geometry can be derived. The model has been shown to agree well with the flowfield patterns and properties of experiments and CFD, but the prediction for where the peak pressure is located, and its value, can be significantly in error due to a lack of sophistication in the model of the jet fluid stagnation region. Therefore it is recommended that this region of the flowfield be modeled in more detail and more accurate experimental and CFD measurements be used for validation. However, the analytical model has been shown to be a fast and economic prediction tool, suitable for preliminary design, or for understanding the interactions effects, including the basic physics of the interaction, such as the jet unsteadiness. The model has been used to examine a wide parametric space of possible interactions, including different Mach number, impinging shock strength and location, and cylinder radius. It has also been used to examine the interaction on power-law shaped blunt bodies, a possible candidate for

Mechanical shock absorber

International Nuclear Information System (INIS)

Vrillon, Bernard.

1973-01-01

The mechanical shock absorber described is made of a constant thickness plate pierced with circular holes regularly distributed in such a manner that for all the directions along which the strain is applied during the shock, the same section of the substance forming the plate is achieved. The shock absorber is made in a metal standing up to extensive deformation before breaking, selected from a group comprising mild steels and austenitic stainless steels. This apparatus is used for handling pots of fast neutron reactor fuel elements [fr

Effects of Alfvénic Drift on Diffusive Shock Acceleration at Weak Cluster Shocks

Science.gov (United States)

Kang, Hyesung; Ryu, Dongsu

2018-03-01

Non-detection of γ-ray emission from galaxy clusters has challenged diffusive shock acceleration (DSA) of cosmic-ray (CR) protons at weak collisionless shocks that are expected to form in the intracluster medium. As an effort to address this problem, we here explore possible roles of Alfvén waves self-excited via resonant streaming instability during the CR acceleration at parallel shocks. The mean drift of Alfvén waves may either increase or decrease the scattering center compression ratio, depending on the postshock cross-helicity, leading to either flatter or steeper CR spectra. We first examine such effects at planar shocks, based on the transport of Alfvén waves in the small amplitude limit. For the shock parameters relevant to cluster shocks, Alfvénic drift flattens the CR spectrum slightly, resulting in a small increase of the CR acceleration efficiency, η. We then consider two additional, physically motivated cases: (1) postshock waves are isotropized via MHD and plasma processes across the shock transition, and (2) postshock waves contain only forward waves propagating along with the flow due to a possible gradient of CR pressure behind the shock. In these cases, Alfvénic drift could reduce η by as much as a factor of five for weak cluster shocks. For the canonical parameters adopted here, we suggest η ∼ 10‑4–10‑2 for shocks with sonic Mach number M s ≈ 2–3. The possible reduction of η may help ease the tension between non-detection of γ-rays from galaxy clusters and DSA predictions.

Produção de enterotoxinas e da toxina da síndrome do choque tóxico por cepas de Staphylococcus aureus isoladas na mastite bovina Production of enterotoxins and toxic shock syndrome toxin by Staphylococcus aureus strains isolated from bovine mastitis

Directory of Open Access Journals (Sweden)

A. Nader Filho

2007-10-01

Full Text Available A total of 72 strains of Staphylococcus aureus were examined for the production of staphylococcal enterotoxins (SE A, B, C, D and toxic shock syndrome toxin (TSST-1. The strains were isolated from milk samples from cows with mastitis in dairy herds of São Paulo State, Brazil. Off 72 isolates, 38 (52.8% produced SEA, 38 (52.8% SEB, 32 (44.4% SED, 28 (38.9% SEC and 27 (37.5% TSST-1. From the 72 strains, 66 (91.7% produced, at least, one or more toxin, including TSST-1.

The Heliospheric Termination Shock

Science.gov (United States)

Jokipii, J. R.

2013-06-01

The heliospheric termination shock is a vast, spheroidal shock wave marking the transition from the supersonic solar wind to the slower flow in the heliosheath, in response to the pressure of the interstellar medium. It is one of the most-important boundaries in the outer heliosphere. It affects energetic particles strongly and for this reason is a significant factor in the effects of the Sun on Galactic cosmic rays. This paper summarizes the general properties and overall large-scale structure and motions of the termination shock. Observations over the past several years, both in situ and remote, have dramatically revised our understanding of the shock. The consensus now is that the shock is quite blunt, is with the front, blunt side canted at an angle to the flow direction of the local interstellar plasma relative to the Sun, and is dynamical and turbulent. Much of this new understanding has come from remote observations of energetic charged particles interacting with the shock, radio waves and radiation backscattered from interstellar neutral atoms. The observations and the implications are discussed.

Unintentional, non-fatal drowning of children: US trends and racial/ethnic disparities.

Science.gov (United States)

Felton, Heather; Myers, John; Liu, Gil; Davis, Deborah Winders

2015-12-15

The current study aimed to better understand trends and risk factors associated with non-fatal drowning of infants and children in the USA using two large, national databases. A secondary data analysis was conducted using the National Inpatient Sample and the Nationwide Emergency Department Sample databases. The analytic sample (n=19,403) included children near-drowning/non-fatal drowning. Descriptive, χ(2) and analysis of variance techniques were applied, and incidence rates were calculated per 100,000 population. Non-fatal drowning incidence has remained relatively stable from 2006 to 2011. In general, the highest rates of non-fatal drowning occurred in swimming pools and in children from racial/ethnic minorities. However, when compared with non-Hispanic Caucasian children, children from racial/ethnic minorities were more likely to drown in natural waterways than in swimming pools. Despite the overall lower rate of non-fatal drowning among non-Hispanic Caucasian children, the highest rate of all non-fatal drowning was for non-Hispanic Caucasian children aged 0-4 years in swimming pools. Children who were admitted to inpatient facilities were younger, male and came from families with lower incomes. Data from two large US national databases show lack of progress in preventing and reducing non-fatal drowning admissions from 2006 to 2011. Discrepancies are seen in the location of drowning events and demographic characteristics. New policies and interventions are needed, and tailoring approaches by age and race/ethnicity may improve their effectiveness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Fatal Rocky Mountain spotted fever in the United States, 1999-2007.

Science.gov (United States)

Dahlgren, F Scott; Holman, Robert C; Paddock, Christopher D; Callinan, Laura S; McQuiston, Jennifer H

2012-04-01

Death from Rocky Mountain spotted fever (RMSF) is preventable with prompt, appropriate treatment. Data from two independent sources were analyzed to estimate the burden of fatal RMSF and identify risk factors for fatal RMSF in the United States during 1999-2007. Despite increased reporting of RMSF cases to the Centers for Disease Control and Prevention, no significant changes in the estimated number of annual fatal RMSF cases were found. American Indians were at higher risk of fatal RMSF relative to whites (relative risk [RR] = 3.9), and children less than 10 years of age (RR=5.1) [corrected] and adults ≥ 70 years of age (RR = 3.0) were also at increased risk relative to other ages. Persons with cases of RMSF with an immunosuppressive condition were at increased risk of death (RR = 4.4). Delaying treatment of RMSF was also associated with increased deaths. These results may indicate a gap between recommendations and practice.

Fatal outbreak of botulism in Greenland

DEFF Research Database (Denmark)

Hammer, Tóra Hedinsdottir; Jespersen, Sanne; Kanstrup, Jakob

2015-01-01

respiratory muscle paralysis. We present five cases of foodborne botulism occurring in Greenland, two with fatal outcome, caused by ingestion of tradionally preserved eider fowl. In the cases of the survivors, antitoxin and supportive care, including mechanical ventilation, were administered. In these cases...

Assessing injury severity in bicyclists involved in traffic accidents to more effectively prevent fatal bicycle injuries in Japan.

Science.gov (United States)

Gomei, Sayaka; Hitosugi, Masahito; Ikegami, Keiichi; Tokudome, Shogo

2013-10-01

The objective of this study was to clarify the relationship between injury severity in bicyclists involved in traffic accidents and patient outcome or type of vehicle involved in order to propose effective measures to prevent fatal bicycle injuries. Hospital records were reviewed for all patients from 2007 to 2010 who had been involved in a traffic accident while riding a bicycle and were subsequently transferred to the Shock Trauma Center of Dokkyo Medical University Koshigaya Hospital. Patient outcomes and type of vehicle that caused the injury were examined. The mechanism of injury, Abbreviated Injury Scale (AIS) score, and Injury Severity Score (ISS) of the patient were determined. A total of 115 patients' records were reviewed. The mean patient age was 47.1 ± 27.4 years. The average ISS was 23.9, with an average maximum AIS (MAIS) score of 3.7. The ISS, MAIS score, head AIS score, and chest AIS score were well correlated with patient outcome. The head AIS score was significantly higher in patients who had died (mean of 4.4); however, the ISS, MAIS score, and head AIS score did not differ significantly according to the type of vehicle involved in the accident. The mean head AIS scores were as high as 2.4 or more for accidents involving any type of vehicle. This study provides useful information for forensic pathologists who suspect head injuries in bicyclists involved in traffic accidents. To effectively reduce bicyclist fatalities from traffic accidents, helmet use should be required for all bicyclists.

A Prognostic Model for Development of Profound Shock among Children Presenting with Dengue Shock Syndrome.

Directory of Open Access Journals (Sweden)

Phung Khanh Lam

Full Text Available To identify risk factors and develop a prediction model for the development of profound and recurrent shock amongst children presenting with dengue shock syndrome (DSS.We analyzed data from a prospective cohort of children with DSS recruited at the Paediatric Intensive Care Unit of the Hospital for Tropical Disease in Ho Chi Minh City, Vietnam. The primary endpoint was "profound DSS", defined as ≥2 recurrent shock episodes (for subjects presenting in compensated shock, or ≥1 recurrent shock episodes (for subjects presenting initially with decompensated/hypotensive shock, and/or requirement for inotropic support. Recurrent shock was evaluated as a secondary endpoint. Risk factors were pre-defined clinical and laboratory variables collected at the time of presentation with shock. Prognostic model development was based on logistic regression and compared to several alternative approaches.The analysis population included 1207 children of whom 222 (18% progressed to "profound DSS" and 433 (36% had recurrent shock. Independent risk factors for both endpoints included younger age, earlier presentation, higher pulse rate, higher temperature, higher haematocrit and, for females, worse hemodynamic status at presentation. The final prognostic model for "profound DSS" showed acceptable discrimination (AUC=0.69 for internal validation and calibration and is presented as a simple score-chart.Several risk factors for development of profound or recurrent shock among children presenting with DSS were identified. The score-chart derived from the prognostic models should improve triage and management of children presenting with DSS in dengue-endemic areas.

Bubble Dynamics and Shock Waves

CERN Document Server

2013-01-01

This volume of the Shock Wave Science and Technology Reference Library is concerned with the interplay between bubble dynamics and shock waves. It is divided into four parts containing twelve chapters written by eminent scientists. Topics discussed include shock wave emission by laser generated bubbles (W Lauterborn, A Vogel), pulsating bubbles near boundaries (DM Leppinen, QX Wang, JR Blake), interaction of shock waves with bubble clouds (CD Ohl, SW Ohl), shock propagation in polydispersed bubbly liquids by model equations (K Ando, T Colonius, CE Brennen. T Yano, T Kanagawa,  M Watanabe, S Fujikawa) and by DNS (G Tryggvason, S Dabiri), shocks in cavitating flows (NA Adams, SJ Schmidt, CF Delale, GH Schnerr, S Pasinlioglu) together with applications involving encapsulated bubble dynamics in imaging (AA Doinikov, A Novell, JM Escoffre, A Bouakaz),  shock wave lithotripsy (P Zhong), sterilization of ships’ ballast water (A Abe, H Mimura) and bubbly flow model of volcano eruptions ((VK Kedrinskii, K Takayama...

Acute lethal toxicity following passive immunization for treatment of murine cryptococcosis.

Science.gov (United States)

Savoy, A C; Lupan, D M; Manalo, P B; Roberts, J S; Schlageter, A M; Weinhold, L C; Kozel, T R

1997-01-01

Passive immunization with monoclonal antibodies (MAbs) specific for the major capsular polysaccharide of Cryptococcus neoformans alters the course of murine cryptococcosis. During studies of passive immunization for treatment of murine cryptococcosis, we noted the occurrence of an acute, lethal toxicity. Toxicity was characterized by scratching, lethargy, respiratory distress, collapse, and death within 20 to 60 min after injection of antibody. The toxic effect was observed only in mice with a cryptococcal infection and was reduced or absent in the early and late stages of disease. The clinical course and histopathology were consistent with those for shock. There was considerable variation between mouse strains in susceptibility to toxicity. Swiss Webster mice from the Charles River colony were most susceptible, followed by C3H/He, BALB/c, and C57BL/6 mice. DBA/2 mice and Swiss Webster mice from the Simonsen colony were resistant. Acute toxicity was mimicked by injection of preformed complexes of MAb and purified polysaccharide. The toxic effect was also produced by injection of MAbs into mice that were preloaded with polysaccharide. The toxic effect was not blocked by treatment of mice with chloropheniramine or anti-tumor necrosis factor alpha antibodies or by depletion of complement components via pretreatment with cobra venom factor. Toxicity was reduced by treatment of mice with high doses of epinephrine, dexamethasone, or chlorpromazine. Finally, the toxic effect was completely blocked by treatment of mice with the platelet-activating factor antagonist WEB 2170 BS or by pretreatment of mice with the liposome-encapsulated drug dichloromethylene diphosphonate, a procedure which depletes macrophages from the spleen and liver. PMID:9125564

Shocks near Jamming

Science.gov (United States)

Gómez, Leopoldo R.; Turner, Ari M.; van Hecke, Martin; Vitelli, Vincenzo

2012-02-01

Nonlinear sound is an extreme phenomenon typically observed in solids after violent explosions. But granular media are different. Right when they jam, these fragile and disordered solids exhibit a vanishing rigidity and sound speed, so that even tiny mechanical perturbations form supersonic shocks. Here, we perform simulations in which two-dimensional jammed granular packings are dynamically compressed and demonstrate that the elementary excitations are strongly nonlinear shocks, rather than ordinary phonons. We capture the full dependence of the shock speed on pressure and impact intensity by a surprisingly simple analytical model.

Shock-wave induced mechanoluminescence: A new technique for studying effects of shock pressure on crystals

Energy Technology Data Exchange (ETDEWEB)

Chandra, B.P.; Parganiha, S.; Sonwane, V.D. [School of Studies in Physics and Astrophysics, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh (India); Chandra, V.K. [Department of Electrical and Electronics Engineering, Chhatrapati Shivaji Institute of Technology, Shivaji Nagar, Kolihapuri, Durg 491001, Chhattisgarh (India); Jha, Piyush, E-mail: piyushjha22@rediffmail.com [Department of Applied Physics, Raipur Institute of Technology, Chhatauna, Mandir Hasuad, Raipur 492101, Chhattisgarh (India); Baghel, R.N. [School of Studies in Physics and Astrophysics, Pt. Ravishankar Shukla University, Raipur 492010, Chhattisgarh (India)

2016-10-15

The impact of a projectile propelled to velocities in the range of 0.5–2.5 km/s on to a target (X-cut quartz crystal) produces shock waves travelling at velocity of nearly 10 km/s in target, in which intense mechanoluminescence (ML) pulses of microsecond duration are produced, both in compression and post-compression conditions. The piezoelectric field produced due to surface charges of fractured target, causes band bending and subsequently, the free charge carriers are generated in the respective bands and the emission of ML occurs. The ML appears after a delay time t{sub th} whose value decreases with increasing value of the shock pressure. Initially, the ML intensity increases with the shock pressure because of the creation of more surfaces; however, for higher values of the shock pressure, the ML intensity tends to attain a saturation value because of the hardening of the crystals due to the creation of small crystallites in which the creation of new surfaces becomes difficult. The ratio between peak ML intensity in the uncompressed region and the maximum ML intensity in the compressed region decreases with increasing shock pressure because more defects produced at high pressure generate higher barrier for the relaxation of blocked cracks under compression. The expressions derived for characteristics of shock-induced ML are able to explain satisfactorily the experimental results. Shock-wave velocity, shock pressure, transit time, lifetime of electrons in conduction band, etc. can be determined by the shock-induced ML.As such, the shock-induced ML provides a new optical technique for the studies of materials under shock pressure.

Mycoplasma ovipneumoniae can predispose bighorn sheep to fatal Mannheimia haemolytica pneumonia.

Science.gov (United States)

Dassanayake, Rohana P; Shanthalingam, Sudarvili; Herndon, Caroline N; Subramaniam, Renuka; Lawrence, Paulraj K; Bavananthasivam, Jegarubee; Cassirer, E Frances; Haldorson, Gary J; Foreyt, William J; Rurangirwa, Fred R; Knowles, Donald P; Besser, Thomas E; Srikumaran, Subramaniam

2010-10-26

Mycoplasma ovipneumoniae has been isolated from the lungs of pneumonic bighorn sheep (BHS). However experimental reproduction of fatal pneumonia in BHS with M. ovipneumoniae was not successful. Therefore the specific role, if any, of M. ovipneumoniae in BHS pneumonia is unclear. The objective of this study was to determine whether M. ovipneumoniae alone causes fatal pneumonia in BHS, or predisposes them to infection by Mannheimia haemolytica. We chose M. haemolytica for this study because of its isolation from pneumonic BHS, and its consistent ability to cause fatal pneumonia under experimental conditions. Since in vitro culture could attenuate virulence of M. ovipneumoniae, we used ceftiofur-treated lung homogenates from pneumonic BHS lambs or nasopharyngeal washings from M. ovipneumoniae-positive domestic sheep (DS) as the source of M. ovipneumoniae. Two adult BHS were inoculated intranasally with lung homogenates while two others received nasopharyngeal washings from DS. All BHS developed clinical signs of respiratory infection, but only one BHS died. The dead BHS had carried leukotoxin-positive M. haemolytica in the nasopharynx before the onset of this study. It is likely that M. ovipneumoniae colonization predisposed this BHS to fatal infection with the M. haemolytica already present in this animal. The remaining three BHS developed pneumonia and died 1-5 days following intranasal inoculation with M. haemolytica. On necropsy, lungs of all four BHS showed lesions characteristic of bronchopneumonia. M. haemolytica and M. ovipneumoniae were isolated from the lungs. These results suggest that M. ovipneumoniae alone may not cause fatal pneumonia in BHS, but can predispose them to fatal pneumonia due to M. haemolytica infection. Copyright © 2010 Elsevier B.V. All rights reserved.

Obesity and non-fatal motor vehicle crash injuries: sex difference effects.

Science.gov (United States)

Ma, X; Laud, P W; Pintar, F; Kim, J-E; Shih, A; Shen, W; Heymsfield, S B; Allison, D B; Zhu, S

2011-09-01

Obesity and motor vehicle crash (MVC) injuries are two parallel epidemics in the United States. An important unanswered question is whether there are sex differences in the associations between the presence of obesity and non-fatal MVC injuries. To further understand the association between obesity and non-fatal MVC injuries, particularly the sex differences in these relations. We examined this question by analyzing data from the 2003 to 2007 National Automotive Sampling System Crashworthiness Data System (NASS CDS). A total of 10,962 drivers who were aged 18 years or older and who survived frontal collision crashes were eligible for the study. Male drivers experienced a lower rate of overall non-fatal MVC injuries than did female drivers (38.1 versus 52.2%), but experienced a higher rate of severe injuries (0.7 versus 0.2%). After adjusting for change in velocity (ΔV) during the crashes, obese male drivers showed a much higher risk (logistic coefficients of body mass index (BMI) for moderate, serious and severe injury are 0.0766, 0.1470 and 0.1792, respectively; all Pobese male drivers and these risks increased with injury severity. Non-fatal injury risks were not found to be increased in obese female drivers. The association between obesity and risk of non-fatal injury was much stronger for male drivers than for female drivers. The higher risk of non-fatal MVC injuries in obese male drivers might result from their different body shape and fat distribution compared with obese female drivers. Our findings should be considered for obesity reduction, traffic safety evaluation and vehicle design for obese male drivers and provide testable hypotheses for future studies.

Prediction of massive bleeding. Shock index and modified shock index.

Science.gov (United States)

Terceros-Almanza, L J; García-Fuentes, C; Bermejo-Aznárez, S; Prieto-Del Portillo, I J; Mudarra-Reche, C; Sáez-de la Fuente, I; Chico-Fernández, M

2017-12-01

To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. Retrospective cohort. Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015. We studied the sensitivity (Se), specificity (Sp), positive and negative predictive value (PV+ and PV-), positive and negative likelihood ratio (LR+ and LR-), ROC curves (Receiver Operating Characteristics) and the area under the same (AUROC) for prediction of massive hemorrhage. 287 patients were included, 76.31% (219) were male, mean age was 43,36 (±17.71) years and ISS was 26 (interquartile range [IQR]: 21-34). The overall frequency of massive bleeding was 8.71% (25). For Shock Index: AUROC was 0.89 (95% confidence intervals [CI] 0.84 to 0.94), with an optimal cutoff at 1.11, Se was 91.3% (95% CI: 73.2 to 97.58) and Sp was 79.69% (95% CI: 74.34 to 84.16). For the Modified Shock Index: AUROC was 0.90 (95% CI: 0.86 to 0.95), with an optimal cutoff at 1.46, Se was 95.65% (95% CI: 79.01 to 99.23) and Sp was 75.78% (95% CI: 70.18 to 80.62). Shock Index and Modified Shock Index are good predictors of massive bleeding and could be easily incorporated to the initial workup of patients with severe trauma. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Fuel economy and traffic fatalities: multivariate analysis of international data

International Nuclear Information System (INIS)

Noland, Robert B.

2005-01-01

In the US motor vehicle fuel economy standards were imposed in the late 1970s, in response to the oil crises of that decade. Since then, efforts to increase the standards have not occurred, one reason being the argument that smaller vehicles (which are generally more efficient) are considered less safe. Recent analyses (Energy J.( 2004)) suggests that variance in vehicle weights may be more important than the absolute weights of vehicles in making the highway network less safe. In Europe and other countries, which generally have smaller more efficient vehicle fleets, due to relatively high gasoline taxes, this debate has not occurred. In particular, countries such as Great Britain and Sweden have far safer road transport systems than the US but also have much more efficient vehicle fleets. This suggests that either vehicle weight and size are unimportant or if they have an effect it is small compared to other factors. This paper uses international data to build econometric models that examine whether average vehicle fuel economy has any association with road traffic fatalities, while controlling for other factors that are associated with fatalities. The effect on pedestrian fatalities is also analyzed. Cross-sectional time-series data on traffic fatalities from OECD countries is used and negative binomial regression models are developed using panel data to determine whether any associations are present. Results find that changes in vehicle efficiency are not associated with changes in traffic fatalities, suggesting either that size and weight changes over time have not had a strong effect or are not associated with fuel economy improvements

Modeling wrong-way crashes and fatalities on arterials and freeways

Directory of Open Access Journals (Sweden)

Raj V. Ponnaluri

2018-04-01

Full Text Available Wrong way driving (WWD research and mitigation measures have primarily focused on limited access facilities. This is most likely due to the higher incidence of fatal WWD crashes with dramatic consequences on freeways, media attention, and a call for innovative solutions to address the problem. While public agencies and published literature address WWD incidence on freeway systems, the crash analyses on non-limited access facilities, i.e., arterial corridors, remains untouched. This research extends previous works and attempts to provide many new perspectives on arterial WWD incidence. In particular, one work showed that while WWD fatalities are more likely to occur on freeways, the likelihood of these crashes is higher on arterials. Hence this work with univariate and multivariate analyses of WWD and non-WWD crashes, and fatal and non-fatal WWD incidents. Results show the impressive negative impacts of alcohol use, driver defect, nighttime and weekend incidence, poor street lighting, low traffic volumes, rural geography, and median and shoulder widths. The objective here is to highlight the need for paying greater attention to WWD crashes on arterial corridors as is done with fatal WWD incidents on freeway systems. It suffices to say that while engineering countermeasures should evolve from the traditional signing and pavement markings to connected vehicle technology applications, there is a clear and compelling need to focus on educational campaigns specifically targeting drunken driving, and enforcement initiatives with an objective to mitigate WWD in the most efficient manner possible. Keywords: Wrong-way driving, Modeling, Arterials and freeways, Logistic regression, Likelihood

A FOCUSED TRANSPORT APPROACH TO THE TIME-DEPENDENT SHOCK ACCELERATION OF SOLAR ENERGETIC PARTICLES AT A FAST TRAVELING SHOCK

International Nuclear Information System (INIS)

Le Roux, J. A.; Webb, G. M.

2012-01-01

Some of the most sophisticated models for solar energetic particle (SEP) acceleration at coronal mass ejection driven shocks are based on standard diffusive shock acceleration theory. However, this theory, which only applies when SEP pitch-angle anisotropies are small, might have difficulty in describing first-order Fermi acceleration or the shock pre-heating and injection of SEPs into first-order Fermi acceleration accurately at lower SEP speeds where SEP pitch-angle anisotropies upstream near the shock can be large. To avoid this problem, we use a time-dependent focused transport model to reinvestigate first-order Fermi acceleration at planar parallel and quasi-parallel spherical traveling shocks between the Sun and Earth with high shock speeds associated with rare extreme gradual SEP events. The focused transport model is also used to investigate and compare three different shock pre-heating mechanisms associated with different aspects of the nonuniform cross-shock solar wind flow, namely, the convergence of the flow (adiabatic compression), the shear tensor of the flow, and the acceleration of the flow, and a fourth shock pre-heating mechanism associated with the cross-shock electric field, to determine which pre-heating mechanism contributes the most to injecting shock pre-heated source particles into the first-order Fermi acceleration process. The effects of variations in traveling shock conditions, such as increasing shock obliquity and shock slowdown, and variations in the SEP source with increasing shock distance from the Sun on the coupled processes of shock pre-heating, injection, and first-order Fermi acceleration are analyzed. Besides the finding that the cross-shock acceleration of the solar wind flow yields the dominant shock pre-heating mechanism at high shock speeds, we find that first-order Fermi acceleration at fast traveling shocks differs in a number of respects from the predictions and assumptions of standard steady-state diffusive shock

30th International Symposium on Shock Waves

CERN Document Server

Sadot, Oren; Igra, Ozer

2017-01-01

These proceedings collect the papers presented at the 30th International Symposium on Shock Waves (ISSW30), which was held in Tel-Aviv Israel from July 19 to July 24, 2015. The Symposium was organized by Ortra Ltd. The ISSW30 focused on the state of knowledge of the following areas: Nozzle Flow, Supersonic and Hypersonic Flows with Shocks, Supersonic Jets, Chemical Kinetics, Chemical Reacting Flows, Detonation, Combustion, Ignition, Shock Wave Reflection and Interaction, Shock Wave Interaction with Obstacles, Shock Wave Interaction with Porous Media, Shock Wave Interaction with Granular Media, Shock Wave Interaction with Dusty Media, Plasma, Magnetohyrdrodynamics, Re-entry to Earth Atmosphere, Shock Waves in Rarefied Gases, Shock Waves in Condensed Matter (Solids and Liquids), Shock Waves in Dense Gases, Shock Wave Focusing, Richtmyer-Meshkov Instability, Shock Boundary Layer Interaction, Multiphase Flow, Blast Waves, Facilities, Flow Visualization, and Numerical Methods. The two volumes serve as a reference ...

Advanced and Exploratory Shock Sensing Mechanisms.

Energy Technology Data Exchange (ETDEWEB)

Nelsen, Nicholas H. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kolb, James D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kulkarni, Akshay G. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Sorscher, Zachary [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Habing, Clayton D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mathis, Allen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Beller, Zachary J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-09-01

Mechanical component response to shock environments must be predictable in order to ensure reliability and safety. Whether the shock input results from accidental drops during transportation to projectile impact scenarios, the system must irreversibly transition into a safe state that is incapable of triggering the component . With this critical need in mind, the 2017 Nuclear Weapons Summer Product Realization Institute (NW SPRINT) program objective sought the design of a passive shock failsafe with emphasis on additively manufactured (AM) components. Team Advanced and Exploratory (A&E) responded to the challenge by designing and delivering multiple passive shock sensing mech anisms that activate within a prescribed mechanical shock threshold. These AM failsafe designs were tuned and validated using analytical and computational techniques including the shock response spectrum (SRS) and finite element analysis (FEA). After rapid prototyping, the devices experienced physical shock tests conducted on Sandia drop tables to experimentally verify performance. Keywords: Additive manufacturing, dynamic system, failsafe, finite element analysis, mechanical shock, NW SPRINT, shock respon se spectrum

Mesenteric thrombosis in patient victim of blunt abdominal trauma with fatal outcome Trombose mesentérica em vítima de trauma abdominal fechado com desfecho fatal

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Iwan Augusto Collaço

2010-03-01

Full Text Available BACKGROUND: Mesenteric thrombosis related to trauma is an uncommon entity and has poor prognosis when have low flow and hemorrhagic shock. It usually presents with a challenging diagnosis and high mortality rates, despite appropriate treatment. CASE REPORT: Patient with blunt trauma was admitted and initial treatment, complementary exams showed ribs and humerus fractures. Computerized tomography showed aerial distension in small bowels along with gastric stasis and hidropneumothorax. The patient had hypotension during clinical observation and cardiopulmonary arrest, responding to reanimation. Taken to surgery for damage control, it was found extensive necrosis of right colon, which was excised and performed primary anastomosis. He was admitted in the intensive care unit, evolving with oliguria, miosis, convulsion, and pulseless electric activity, dying three days after hospital admission. CONCLUSION: Although uncommon, mesenteric ischemia with venous thrombosis might be secondary to systemic hypotension, frequently followed by fatal outcomes.INTRODUÇÃO: Trombose mesentérica, relacionada a trauma é entidade incomum, com pobre prognóstico quando seguida de estados de baixo fluxo e choque hipovolêmico. Geralmente apresenta-se com quadro de difícil diagnóstico, cuja mortalidade é elevada a despeito de tratamento adequado. RELATO DO CASO: Paciente submetido a trauma, após admissão hospitalar e atendimento inicial, exames radiológicos demonstraram fratura de costela e úmero. Tomografia computadorizada evidenciou distensão aérea em intestino delgado associada à estase gástrica e hidropneumotórax. O paciente evoluiu com hipotensão durante o período de observação clínica e parada cardiorrespiratória que respondeu à reanimação. Levado para operação para controle de danos, encontrou-se extensa necrose de cólon ascendente. Realizou-se hemicolectomia direita com íleotransversostomia. Levado à unidade de terapia intensiva

Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report

Directory of Open Access Journals (Sweden)

Raka Lul

2006-10-01

Full Text Available Abstract Crimean-Congo haemorrhagic fever (CCHF is an often fatal viral infection described in about 30 countries around the world. The authors report a fatal case of Crimean-Congo hemorrhagic fever (CCHF observed in a patient from Kosova. The diagnosis of CCHF was confirmed by reverse transcription-PCR. Late diagnosis decreased the efficacy of treatment and patient died due to severe complications of infection.

A fatal pseudo-tumour: disseminated basidiobolomycosis

Directory of Open Access Journals (Sweden)

Bemelman Willem A

2006-09-01

with amphotericin B (Itraconazol contra-indicated because of renal insufficiency. A few days later the patient died of a septic shock. After autopsy Basidiobolus ranarum was cultured from liver, gallbladder and colon. Conclusion Our patient died of gastrointestinal basidiobolomycosis with an obstructing colon tumour and a large hepatic mass. This was a rare presentation of basidiobolomycosis and the second fatal case described worldwide.

Is the societal burden of fatal occupational injury different among NORA industry sectors?

Science.gov (United States)

Biddle, Elyce Anne

2013-02-01

Since the implementation of the Occupational Safety and Health Act, safety and health in the work environment has seen marked improvement. Although these improvements are laudable, workplace hazards continue to plague the American worker. Understanding the economic burden of fatalities by industry sector is important to setting broad occupational safety and health research priorities. Cost estimates provide additional information about how fatal injuries affect society and hence can improve injury prevention program planning, policy analysis, evaluation, and advocacy. This study estimated the total, mean, and median societal costs by worker and case characteristic in 2003-2006 for the industry sectors identified in the National Institute for Occupational Safety and Health National Occupational Research Agenda (NORA). Analyses were conducted with restricted access to the Bureau of Labor Statistics Census of Fatal Occupational Injuries data. These data exclude military personnel, decedents with unknown age or sex, and fatalities occurring in New York City. Societal costs were estimated using the cost-of-illness approach, which combines direct and indirect costs to yield an overall cost of an fatal occupational injury. During this period, the cost of the 22,197 fatal occupational injuries exceeded $21 billion. The mean and median costs of these fatalities were $960,000 and $944,000 respectively. Total societal costs by NORA sector ranged from a high of $5.8 billion in Services to a low of $530 million in Healthcare and Social Assistance with mean costs ranging from the nearly $800,000 in Agriculture, Forestry, and Fishing to almost $1.1 million in Mining. The societal costs-total, mean, and median costs-of case and worker characteristics for occupational fatal injuries varied within each NORA sector. To have the greatest societal impact, these costs can be used to target resources for public and private sector research by industry. Published by Elsevier Ltd.

Is the Societal burden of fatal occupational injury different among NORA industry sectors?

Science.gov (United States)

Biddle, Elyce Anne

2015-01-01

Problem Since the implementation of the Occupational Safety and Health Act, safety and health in the work environment has seen marked improvement. Although these improvements are laudable, workplace hazards continue to plague the American worker. Understanding the economic burden of fatalities by industry sector is important to setting broad occupational safety and health research priorities. Cost estimates provide additional information about how fatal injuries affect society and hence can improve injury prevention program planning, policy analysis, evaluation, and advocacy. Method This study estimated the total, mean, and median societal costs by worker and case characteristic in 2003–2006 for the industry sectors identified in the National Institute for Occupational Safety and Health National Occupational Research Agenda (NORA). Analyses were conducted with restricted access to the Bureau of Labor Statistics Census of Fatal Occupational Injuries data. These data exclude military personnel, decedents with unknown age or sex, and fatalities occurring in New York City. Societal costs were estimated using the cost-of-illness approach, which combines direct and indirect costs to yield an overall cost of an fatal occupational injury. Results During this period, the cost of the 22,197 fatal occupational injuries exceeded $21 billion. The mean and median costs of these fatalities were $960,000 and $944,000 respectively. Total societal costs by NORA sector ranged from a high of $5.8 billion in Services to a low of $530 million in Healthcare and Social Assistance with mean costs ranging from the nearly $800,000 in Agriculture, Forestry, and Fishing to almost $1.1 million in Mining. Discussion The societal costs—total, mean, and median costs—of case and worker characteristics for occupational fatal injuries varied within each NORA sector. Impact on Industry To have the greatest societal impact, these costs can be used to target resources for public and private sector

The MHD intermediate shock interaction with an intermediate wave: Are intermediate shocks physical?

International Nuclear Information System (INIS)

Wu, C.C.

1988-01-01

Contrary to the usual belief that MHD intermediate shocks are extraneous, the authors have recently shown by numerical solutions of dissipative MHD equations that intermediate shocks are admissible and can be formed through nonlinear steepening from a continuous wave. In this paper, he clarifies the differences between the conventional view and the results by studying the interaction of an MHD intermediate shock with an intermediate wave. The study reaffirms his results. In addition, the study shows that there exists a larger class of shocklike solutions in the time-dependent dissiaptive MHD equations than are given by the MHD Rankine-Hugoniot relations. it also suggests a mechanism for forming rotational discontinuities through the interaction of an intermediate shock with an intermediate wave. The results are of importance not only to the MHD shock theory but also to studies such as magnetic field reconnection models

Fatal occupational injuries in the Malaysian construction sector–causes and accidental agents

Science.gov (United States)

Ayob, A.; Shaari, A. A.; Zaki, M. F. M.; Munaaim, M. A. C.

2018-04-01

The construction sector is associated with various accidents and fatal injuries. These occupational accidents are caused by numerous factors, such as lack of supervision; lack of adherence to safe work technique; failure to wear personal protective equipment; and failure to comply with the safe use of tools, vehicles, and machines. Using 2013–2016 secondary data from the Department of Occupational Safety and Health and Social Security Organization, this study conducted a descriptive exploration survey to identify common fatal occupational injuries associated with the Malaysian construction sector, as well as their causes and accidental agents. Results indicated that construction, followed by manufacturing, agriculture, forestry, logging, and fishery, are the riskiest job sectors in Malaysia. The highest incidences of occupational casualties were reported in Sarawak, Johor, and Selangor. These states accounted for approximately 13.33% to 18.18% of all cases of fatal occupational accidents. In these states, the lack of safety and health regulations and poor execution of risk management increased the risk of occupational accidents. Falls from heights accounted for 46.28% of fatal occupational injuries. Furthermore, being crushed by objects, materials, or vehicles accounted for 9.09% to 17.36% of fatal occupational injuries. Substandard work environment and transportation and lifting equipment, such as scaffolds, are primary accidental agents. Results of this study could enhance the knowledge and awareness of construction workers and management of job-related injuries to decrease the incidence of fatal occupational accidents.

Use of the Trauma Embolic Scoring System (TESS) to predict symptomatic deep vein thrombosis and fatal and non-fatal pulmonary embolism in severely injured patients.

Science.gov (United States)

Ho, K M; Rao, S; Rittenhouse, K J; Rogers, F B

2014-11-01

Fatal pulmonary embolism is the third most common cause of death after major trauma. We hypothesised that the Trauma Embolic Scoring System (TESS) would have adequate calibration and discrimination in a group of severely injured trauma patients in predicting venous thromboembolism (VTE), and could be used to predict fatal and non-fatal symptomatic pulmonary embolism. Calibration and discrimination of the TESS were assessed by the slope and intercept of the calibration curve and the area under the receiver operating characteristic curve, respectively. Of the 357 patients included in the study, 74 patients (21%) developed symptomatic VTE after a median period of 14 days following injury. The TESS predicted risks of VTE were higher among patients who developed VTE than those who did not (14 versus 9%, P=0.001) and had a moderate ability to discriminate between patients who developed VTE and those who did not (area under the receiver operating characteristic curve 0.71, 95% confidence interval 0.65 to 0.77). The slope and intercept of the calibration curve were 2.76 and 0.34, respectively, suggesting that the predicted risks of VTE were not sufficiently extreme and overall, underestimated the observed risks of VTE. Using 5% predicted risk of VTE as an arbitrary cut-point, TESS had a high sensitivity and negative predictive value (both ≥0.97) in excluding fatal and non-fatal pulmonary embolism. The TESS had a reasonable ability to discriminate between patients who developed VTE and those who did not and may be useful to select different strategies to prevent VTE in severely injured patients.

Deconstructing fatalism: ethnographic perspectives on women's decision making about cancer prevention and treatment.

Science.gov (United States)

Drew, Elaine M; Schoenberg, Nancy E

2011-06-01

Researchers have long held that fatalism (the belief in a lack of personal power or control over destiny or fate) constitutes a major barrier to participation in positive health behaviors and, subsequently, adversely affects health outcomes. In this article, we present two in-depth, ethnographic studies of rural women's health decisions surrounding cancer treatments to illustrate the complexity and contestability of the long-established fatalism construct. Narrative analyses suggest that for these women, numerous and complex factors--including inadequate access to health services, a legacy of self-reliance, insufficient privacy, combined with a culturally acceptable idiom of fatalism--foster the use of, but not necessarily a rigid conviction in, the notion of fatalism.

The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience.

Science.gov (United States)

Russell, James A; Lee, Terry; Singer, Joel; Boyd, John H; Walley, Keith R

2017-06-01

The Septic Shock 3.0 definition could alter treatment comparisons in randomized controlled trials in septic shock. Our first hypothesis was that the vasopressin versus norepinephrine comparison and 28-day mortality of patients with Septic Shock 3.0 definition (lactate > 2 mmol/L) differ from vasopressin versus norepinephrine and mortality in Vasopressin and Septic Shock Trial. Our second hypothesis was that there are differences in plasma cytokine levels in Vasopressin and Septic Shock Trial for lactate less than or equal to 2 versus greater than 2 mmol/L. Retrospective analysis of randomized controlled trial. Multicenter ICUs. We compared vasopressin-to-norepinephrine group 28- and 90-day mortality in Vasopressin and Septic Shock Trial in lactate subgroups. We measured 39 cytokines to compare patients with lactate less than or equal to 2 versus greater than 2 mmol/L. Patients with septic shock with lactate greater than 2 mmol/L or less than or equal to 2 mmol/L, randomized to vasopressin or norepinephrine. Concealed vasopressin (0.03 U/min.) or norepinephrine infusions. The Septic Shock 3.0 definition would have decreased sample size by about half. The 28- and 90-day mortality rates were 10-12 % higher than the original Vasopressin and Septic Shock Trial mortality. There was a significantly (p = 0.028) lower mortality with vasopressin versus norepinephrine in lactate less than or equal to 2 mmol/L but no difference between treatment groups in lactate greater than 2 mmol/L. Nearly all cytokine levels were significantly higher in patients with lactate greater than 2 versus less than or equal to 2 mmol/L. The Septic Shock 3.0 definition decreased sample size by half and increased 28-day mortality rates by about 10%. Vasopressin lowered mortality versus norepinephrine if lactate was less than or equal to 2 mmol/L. Patients had higher plasma cytokines in lactate greater than 2 versus less than or equal to 2 mmol/L, a brisker cytokine response to infection. The Septic

Role of motorcycle type in fatal motorcycle crashes.

Science.gov (United States)

Teoh, Eric R; Campbell, Marvin

2010-12-01

Motorcycles vary in design and performance capability, and motorcyclists may select certain motorcycle types based on driving preferences. Conversely, motorcycle performance capability may influence the likelihood of risky driving behaviors such as speeding. Both mechanisms may affect fatal crash risk when examined by motorcycle type. Although it was not possible to estimate the effect of each mechanism, the current study analyzed fatal crash data for evidence of motorcycle type differences in risky driving behaviors and risk of driver death. Street legal motorcycles were classified into 10 types based on design characteristics and then further grouped as cruiser/standard, touring, sport touring, sport/unclad sport, supersport, and all others. For each motorcycle type, driver death rates per 10,000 registered vehicle years and the prevalence of fatal crash characteristics such as speeding were analyzed. Differences among motorcycle types concerning the effect of engine displacement were examined using Poisson regression. Overall, driver death rates for supersport motorcycles were four times as high as those for cruiser/standard motorcycles. Fatally injured supersport drivers were most likely to have been speeding and most likely to have worn helmets, but least likely to have been impaired by alcohol compared with drivers of other motorcycle types. The patterns in driver factors held after accounting for the effects of age and gender. Increased engine displacement was associated with higher driver death rates for each motorcycle type. Strong effects of motorcycle type were observed on driver death rates and on the likelihood of risky driving behaviors such as speeding and alcohol impairment. Although the current study could not completely disentangle the effects of motorcycle type and rider characteristics such as age on driver death rates, the effects of both motorcycle type and rider age on the likelihood of risky driving behaviors were observed among fatally

Motion of shocks through interplanetary streams

International Nuclear Information System (INIS)

Burlaga, L.F.; Scudder, J.D.

1975-01-01

A model for the motion of flare-generated shocks through interplanetary streams is presented, illustrating the effects of a stream-shock interaction on the shock strength and geometry. It is a gas dynamic calculation based on Whitham's method and on an empirical approximation for the relevant characteristics of streams. The results show that the Mach number of a shock can decrease appreciably to near unity in the interaction region ahead of streams and that the interaction of a spherically symmetric shock with a spiral-shaped corotating stream can cause significant distortions of the initial shock front geometry. The geometry of the February 15--16, 1967, shock discussed by Lepping and Chao (1972) is qualitatively explained by this model

Hemorrhagic shock caused by sigmoid colon volvulus: An autopsy case

Science.gov (United States)

Sato, Hiroaki; Tanaka, Toshiko; Tanaka, Noriyuki

2011-01-01

Summary Background Many reports have described sigmoid volvulus, but fatal hemorrhagic shock resulting from the rupture of the involved artery has not been reported as a complication of a sigmoid volvulus. Case Report A 71-year-old man with slight abdominal pain and obstipation in hypotension died at a nursing home without seeing a doctor. At autopsy, a mesenteric hematoma and hemoperitoneum was observed with approximately 1,000 ml of blood in the abdominal cavity. The sigmoid colon and the mesentery were twisted at an adhesion site of a sigmoid colon to an ileum, and the condition was determined to be a sigmoid volvulus. The volvulus was observed to be loosened. The inferior mesenteric artery was incorporated into the twisted part of the mesentery, but remained patent, and its peripheral branch near the hematoma ruptured without histological abnormality. Conclusions Since ischemic-reperfusion injury occurs with a temporarily occluded artery, the acute re-loading of blood flow may injure the distal vessels after spontaneous reduction of compression by loosening of the volvulus. PMID:22129905

Car crash fatalities associated with fire in Sweden.

Science.gov (United States)

Viklund, Åsa; Björnstig, Johanna; Larsson, Magnus; Björnstig, Ulf

2013-01-01

To study the epidemiology and causes of death in fatal car crashes on Swedish roads in which the victim's vehicle caught fire. The data set is from the Swedish Transport Administrations in-depth studies of fatal crashes 1998-2008. Autopsies from all cases provided data on injuries, toxicological analyses, and cause of death. In total, 181 people died in 133 burning cars, accounting for 5 percent of all deaths in passenger cars, sport utility vehicles, vans, and minibuses during 1998 to 2008. The cause of death for a third of the victims was fire related, as burns and/or smoke inhalation injuries, with no fatal trauma injuries. Twenty-five of these 55 deaths were persons 19 years or younger and included 15 of 18 rear seat deaths. Over half of the 181 deaths were in vehicles that had collided with another vehicle and, of these cases, half were killed in collisions with heavy vehicles. The percentage of drivers with illegal blood alcohol concentrations (27%) and suicides (5.5%) were not higher than in other fatal crashes on Swedish roads. The ignition point of the fire was indicated in only half of the cases and, of those, half started in the engine compartment and one fourth started around the fuel tank or lines. Car fires are a deadly postcrash problem. Reducing this risk would be primarily a responsibility for the automotive industry. A multifactor approach could be considered as follows: risk-reducing design, insulation, reduced flammability in motor compartment fluids and plastics, and automatic fire extinguishing equipment. Inspiration could be found in how, for example, the auto racing and aviation industries handle this problem.

[Risk of fatal/non-fatal events in patients with previous coronary heart disease/acute myocardial infarction and treatment with non-steroidal anti-inflammatory drugs].

Science.gov (United States)

Muñoz Olmo, L; Juan Armas, J; Gomariz García, J J

2017-09-04

Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk. We present a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The objective is to determine the relationship between the consumption of different NSAIDs and the fatal and non-fatal events among patients with known coronary disease. This is a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The literature review was conducted in PubMed search engines like Tripdatabase and with certain keywords. Of the 15 original papers found, 9 did not correspond completely to the central focus, so the approach was decided from 6 original articles from the past 5 years, which address the central focus of increased cardiovascular risk found (fatal and non-fatal events) in patients with prior cardiovascular disease or AMI being prescribed NSAIDs for any reason. The risk of fatal/non-fatal events in each of the studies is expressed by the odds ratio (OR)/hazard ratio (HR), defined as the probability of an event occurring. A moderate risk was observed for ibuprofen. It increases the risk of acute coronary syndrome after 5 years of cardiovascular event, especially in the 2nd year (OR 1.63; 95% CI 1.42-1.87). It also increases the risk of stroke (HR 1.23; 95% IC 1.10-1.38). Cyclo-oxygenase-2 inhibitors were the third risk group, after nabumetone and diclofenac. Celecoxib increases risk from the 14th day of treatment (HR 2.3; 95% CI 1.79-3.02), having an OR

Hydrocarbon toxicity: an analysis of AAPCC TESS data.

Science.gov (United States)

Cobaugh, Daniel J; Seger, Donna L; Krenzelok, Edward P

2007-01-01

Human hydrocarbon exposures have the potential to cause significant morbidity and mortality. To determine which hydrocarbons were associated with the most severe adverse outcomes, human exposure data reported to American poison information centers were analyzed. Outcome data for single-substance, hydrocarbon exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System from 1994 through 2003 were analyzed. Only cases with definitive medical outcomes were included. Analyses were stratified by five age groups: 59 years. Hazard factors were determined by calculating the sum of the major effects and fatalities for each hydrocarbon category and dividing this by the total number of exposures for that category. To normalize the data, the overall rate of major effects and deaths for each age group was assigned hazard factor value of 1. Hydrocarbon categories with a HF of > or = 1.5 were included in the final analyses. Estimated rates of major effect and fatal outcomes (outcomes/1000 people) were also calculated. 318,939 exposures were analyzed. Exposures to benzene, toluene/xylene, halogenated hydrocarbons, kerosene and lamp oil resulted in the highest hazard factor values. These data demonstrate that hydrocarbons that are absorbed systemically and those with low viscosities are associated with higher hazard factors. The risks associated with hydrocarbons often implicated in abuse by older children and adolescents are also confirmed.

Comparing avian and bat fatality rate estimates among North American wind energy projects

Energy Technology Data Exchange (ETDEWEB)

Smallwood, Shawn

2011-07-01

Full text: Wind energy development has expanded rapidly, and so have concerns over bird and bat impacts caused by wind turbines. To assess and compare impacts due to collisions, investigators use a common metric, fatalities/MW/year, but estimates of fatality rates have come from various wind turbine models, tower heights, environments, fatality search methods, and analytical methods. To improve comparability and asses large-scale impacts, I applied a common set of assumptions and methods to data in fatality monitoring reports to estimate fatality rates of birds and bats at 71 wind projects across North America (52 outside the Altamont Pass Wind Resource Area, APWRA). The data were from wind turbines of 27 sizes (range 0.04-3.00 MW) and 28 tower heights (range 18.5-90 m), and searched at 40 periodic intervals (range 1-90 days) and out to 20 distances from turbines (range 30-126 m). Estimates spanned the years 1982 to 2010, and involved 1-1,345 turbines per unique combination of project, turbine size, tower height, and search methodology. I adjusted fatality rates for search detection rates averaged from 425 detection trials, and for scavenger removal rates based on 413 removal trials. I also adjusted fatality rates for turbine tower height and maximum search radius, based on logistic functions fit to cumulative counts of carcasses that were detected at 1-m distance intervals from the turbine. For each tower height, I estimated the distance at which cumulative carcass counts reached an asymptote, and for each project I calculated the proportion of fatalities likely not found due to the maximum search radius being short of the model-predicted distance asymptote. I used the same estimator in all cases. I estimated mean fatalities/MW/year among North American wind projects at 12.6 bats (80% CI: 8.1-17.1) and 11.1 birds (80% CI: 9.5-12.7), including 1.6 raptors (80% CI: 1.3-2.0), and excluding the Altamont Pass I estimated fatality rates at 17.2 bats (80% CI: 9

Toxic compounds in honey.

Science.gov (United States)

Islam, Md Nazmul; Khalil, Md Ibrahim; Islam, Md Asiful; Gan, Siew Hua

2014-07-01

There is a wealth of information about the nutritional and medicinal properties of honey. However, honey may contain compounds that may lead to toxicity. A compound not naturally present in honey, named 5-hydroxymethylfurfural (HMF), may be formed during the heating or preservation processes of honey. HMF has gained much interest, as it is commonly detected in honey samples, especially samples that have been stored for a long time. HMF is a compound that may be mutagenic, carcinogenic and cytotoxic. It has also been reported that honey can be contaminated with heavy metals such as lead, arsenic, mercury and cadmium. Honey produced from the nectar of Rhododendron ponticum contains alkaloids that can be poisonous to humans, while honey collected from Andromeda flowers contains grayanotoxins, which can cause paralysis of limbs in humans and eventually leads to death. In addition, Melicope ternata and Coriaria arborea from New Zealand produce toxic honey that can be fatal. There are reports that honey is not safe to be consumed when it is collected from Datura plants (from Mexico and Hungary), belladonna flowers and Hyoscamus niger plants (from Hungary), Serjania lethalis (from Brazil), Gelsemium sempervirens (from the American Southwest), Kalmia latifolia, Tripetalia paniculata and Ledum palustre. Although the symptoms of poisoning due to honey consumption may differ depending on the source of toxins, most common symptoms generally include dizziness, nausea, vomiting, convulsions, headache, palpitations or even death. It has been suggested that honey should not be considered a completely safe food. Copyright © 2013 John Wiley & Sons, Ltd.

Grain destruction in interstellar shocks

International Nuclear Information System (INIS)

Seab, C.G.; Shull, J.M.

1984-01-01

One of the principal methods for removing grains from the Interstellar Medium is to destroy them in shock waves. Previous theoretical studies of shock destruction have generally assumed only a single size and type of grain; most do not account for the effect of the grain destruction on the structure of the shock. Earlier calculations have been improved in three ways: first, by using a ''complete'' grain model including a distribution of sizes and types of grains; second, by using a self-consistent shock structure that incorporates the changing elemental depletions as the grains are destroyed; and third, by calculating the shock-processed ultraviolet extinction curves for comparison with observations. (author)

Cirrus Airframe Parachute System and Odds of a Fatal Accident in Cirrus Aircraft Crashes.

Science.gov (United States)

Alaziz, Mustafa; Stolfi, Adrienne; Olson, Dean M

2017-06-01

General aviation (GA) accidents have continued to demonstrate high fatality rates. Recently, ballistic parachute recovery systems (BPRS) have been introduced as a safety feature in some GA aircraft. This study evaluates the effectiveness and associated factors of the Cirrus Airframe Parachute System (CAPS) at reducing the odds of a fatal accident in Cirrus aircraft crashes. Publicly available Cirrus aircraft crash reports were obtained from the National Transportation Safety Board (NTSB) database for the period of January 1, 2001-December 31, 2016. Accident metrics were evaluated through univariate and multivariate analyses regarding odds of a fatal accident and use of the parachute system. Included in the study were 268 accidents. For CAPS nondeployed accidents, 82 of 211 (38.9%) were fatal as compared to 8 of 57 (14.0%) for CAPS deployed accidents. After controlling for all other factors, the adjusted odds ratio for a fatal accident when CAPS was not deployed was 13.1. The substantial increased odds of a fatal accident when CAPS was not deployed demonstrated the effectiveness of CAPS at providing protection of occupants during an accident. Injuries were shifted from fatal to serious or minor with the use of CAPS and postcrash fires were significantly reduced. These results suggest that BPRS could play a significant role in the next major advance in improving GA accident survival.Alaziz M, Stolfi A, Olson DM. Cirrus Airframe Parachute System and odds of a fatal accident in Cirrus aircraft crashes. Aerosp Med Hum Perform. 2017; 88(6):556-564.

Fatal Cervical Spine Injury Following a Bicycle Crash

Directory of Open Access Journals (Sweden)

Uhrenholt Lars

2017-06-01

Full Text Available Spinal injury following direct loading of the head and neck is a rare sequel of bicycle crashes. Fatal head injuries following bicycle crashes have been described in great detail and safety measures such as bicycle helmets have been developed accordingly. Less frequently, however, potentially severe cervical spine injuries have been described. We present the case of a middle-aged female who sustained an ultimately fatal cervical spine injury following a collision with a car whilst biking wearing a helmet. We discuss the literature regarding the protective effects of bicycle helmets, the relevance to cervical spine injury and legislation on mandatory use of helmets for injury prevention.

Influence of civil defense on strategic countervalue fatalities

International Nuclear Information System (INIS)

Harvey, T.F.

1982-01-01

Two modeling studies were conducted to simulate the effect of fallout shelters on the outcome of a massive countervalue nuclear exchange between the Soviet Union and the United States. One was to determine the number of nuclear weapons required to mount an effective fallout attack against a country with dispersed population; the other was to determine the number of expected US fatalities resulting from a countervalue attack against US urban population centers. The results of these studies indicate that the number of weapons required to mount such an attack depends on the adequacy of the shelter system and that the evacuation of urban populations can substantially reduce expected fatality levels

Impact of Shock Front Rippling and Self-reformation on the Electron Dynamics at Low-Mach-number Shocks

Science.gov (United States)

Yang, Zhongwei; Lu, Quanming; Liu, Ying D.; Wang, Rui

2018-04-01

Electron dynamics at low-Mach-number collisionless shocks are investigated by using two-dimensional electromagnetic particle-in-cell simulations with various shock normal angles. We found: (1) The reflected ions and incident electrons at the shock front provide an effective mechanism for the quasi-electrostatic wave generation due to the charge-separation. A fraction of incident electrons can be effectively trapped and accelerated at the leading edge of the shock foot. (2) At quasi-perpendicular shocks, the electron trapping and reflection is nonuniform due to the shock rippling along the shock surface and is more likely to take place at some locations accompanied by intense reflected ion-beams. The electron trapping process has a periodical evolution over time due to the shock front self-reformation, which is controlled by ion dynamics. Thus, this is a cross-scale coupling phenomenon. (3) At quasi-parallel shocks, reflected ions can travel far back upstream. Consequently, quasi-electrostatic waves can be excited in the shock transition and the foreshock region. The electron trajectory analysis shows these waves can trap electrons at the foot region and reflect a fraction of them far back upstream. Simulation runs in this paper indicate that the micro-turbulence at the shock foot can provide a possible scenario for producing the reflected electron beam, which is a basic condition for the type II radio burst emission at low-Mach-number interplanetary shocks driven by Coronal Mass Ejections (CMEs).

Clash of Desires: Detective vs. Femme Fatale

Directory of Open Access Journals (Sweden)

Veronika Pituková

2013-06-01

Full Text Available This article discusses the theme of desire presented in American hard-boiled detective fiction and its subsequent transformation on the screen in form of films noir of the 1940’s. The works in focus are novels The Maltese Falcon by Dashiell Hammett, Farewell, My Lovely by Raymond Chandler and Build My Gallows High by Daniel Mainwaring and their film noir adaptations – The Maltese Falcon (1941, Murder, My Sweet (1944 and Out of the Past (1947. The proposed paper seeks to offer a contrastive analysis of the novels and the films and situate them in their respective social and cultural contexts. The central conflict of this article is presented by the clash between the femme fatale’s and detective’s desires. Hard-boiled novels present femme fatale as a dame with a past, a spider woman, and the detective as a hero with no future, caught in her web of intrigues. The only way out for the detective is to suppress the sexual desire for the woman and hold strong to his professional code. The femme fatale’s desire for more and for better is deadly and dangerous for those who succumb to her lure, but the detective’s desire for truth can be fatal for the dark lady too.  This clash presented in the novels is confronted with the 1940’s Hollywood production. When the detective frees himself from the sexual lure of the fatal woman he has a chance to live and even bring her to justice, but she can still escape or decide herself what to do with her destiny. Both, the dame and the hero are victims of their desires. The 1940’s films noir’s femme fatales have to pay for their crimes, no matter how crafty, seductive or manipulative they are.  Thus these films present the masculine dominance as strong and undefeated.

Smeed's law and expected road fatality reduction: An assessment of the Italian case.

Science.gov (United States)

Persia, Luca; Gigli, Roberto; Usami, Davide Shingo

2015-12-01

Smeed's law defines the functional relationship existing between the fatality rate and the motorization rate.While focusing on the Italian case and based on the Smeed's law, the study assesses the possibility for Italy of reaching the target of halving the number of road fatalities by 2020, in light of the evolving socioeconomic situation. A Smeed's model has been calibrated based on the recorded Italian data. The evolution of the two indicators, fatality and motorization rates, has been estimated using the predictions of the main parameters (population, fleet size and fatalities). Those trends have been compared with the natural decreasing trend derived from the Smeed's law. Nine scenarios have been developed showing the relationship between the fatality rate and the motorization rate. In case of a limited increase (logistic regression) of the vehicle fleet and according to the estimated evolution of the population, the path defined by motorization and fatality rate is very steep, diverging from the estimated confidence interval of the Smeed's model. In these scenarios the motorization rate is almost constant during the decade. In the actual economic context, a limited development of the vehicle fleet is more plausible. In these conditions the target achievement of halving the number of fatalities in Italy may occur only in case of a structural break (i.e., the introduction of highly effective road safety policies). Practical application: The proposed tools can be used both to evaluate retrospectively the effectiveness of road safety improvements and to assess if a relevant effort is needed to reach the established road safety targets.

Toxic isolectins from the mushroom Boletus venenatus.

Science.gov (United States)

Horibe, Masashi; Kobayashi, Yuka; Dohra, Hideo; Morita, Tatsuya; Murata, Takeomi; Usui, Taichi; Nakamura-Tsuruta, Sachiko; Kamei, Masugu; Hirabayashi, Jun; Matsuura, Masanori; Yamada, Mina; Saikawa, Yoko; Hashimoto, Kimiko; Nakata, Masaya; Kawagishi, Hirokazu

2010-04-01

Ingestion of the toxic mushroom Boletus venenatus causes a severe gastrointestinal syndrome, such as nausea, repetitive vomiting, diarrhea, and stomachache. A family of isolectins (B. venenatus lectins, BVLs) was isolated as the toxic principles from the mushroom by successive 80% ammonium sulfate-precipitation, Super Q anion-exchange chromatography, and TSK-gel G3000SW gel filtration. Although BVLs showed a single band on SDS-PAGE, they were further divided into eight isolectins (BVL-1 to -8) by BioAssist Q anion-exchange chromatography. All the isolectins showed lectin activity and had very similar molecular weights as detected by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS) analysis. Among them, BVL-1 and -3 were further characterized with their complete amino acid sequences of 99 amino acids determined and found to be identical to each other. In the hemagglutination inhibition assay, both proteins failed to bind to any mono- or oligo-saccharides tested and showed the same sugar-binding specificity to glycoproteins. Among the glycoproteins examined, asialo-fetuin was the strongest inhibitor. The sugar-binding specificity of each isolectin was also analyzed by using frontal affinity chromatography and surface plasmon resonance analysis, indicating that they recognized N-linked sugar chains, especially Galbeta1-->4GlcNAcbeta1-->4Manbeta1-->4GlcNAcbeta1-->4GlcNAc (Type II) residues in N-linked sugar chains. BVLs ingestion resulted in fatal toxicity in mice upon intraperitoneal administration and caused diarrhea upon oral administration in rats. Copyright 2009 Elsevier Ltd. All rights reserved.

Parallel implementation of geometrical shock dynamics for two dimensional converging shock waves

Science.gov (United States)

Qiu, Shi; Liu, Kuang; Eliasson, Veronica

2016-10-01

Geometrical shock dynamics (GSD) theory is an appealing method to predict the shock motion in the sense that it is more computationally efficient than solving the traditional Euler equations, especially for converging shock waves. However, to solve and optimize large scale configurations, the main bottleneck is the computational cost. Among the existing numerical GSD schemes, there is only one that has been implemented on parallel computers, with the purpose to analyze detonation waves. To extend the computational advantage of the GSD theory to more general applications such as converging shock waves, a numerical implementation using a spatial decomposition method has been coupled with a front tracking approach on parallel computers. In addition, an efficient tridiagonal system solver for massively parallel computers has been applied to resolve the most expensive function in this implementation, resulting in an efficiency of 0.93 while using 32 HPCC cores. Moreover, symmetric boundary conditions have been developed to further reduce the computational cost, achieving a speedup of 19.26 for a 12-sided polygonal converging shock.

Cures for the shock instability: Development of a shock-stable Roe scheme

CERN Document Server

Kim, S S; Rho, O H; Kyu-Hong, S

2003-01-01

This paper deals with the development of an improved Roe scheme that is free from the shock instability and still preserves the accuracy and efficiency of the original Roe's Flux Difference Splitting (FDS). Roe's FDS is known to possess good accuracy but to suffer from the shock instability, such as the carbuncle phenomenon. As the first step towards a shock-stable scheme, Roe's FDS is compared with the HLLE scheme to identify the source of the shock instability. Through a linear perturbation analysis on the odd-even decoupling problem, damping characteristic is examined and Mach number-based functions f and g are introduced to balance damping and feeding rates, which leads to a shock-stable Roe scheme. In order to satisfy the conservation of total enthalpy, which is crucial in predicting surface heat transfer rate in high-speed steady flows, an analysis of dissipation mechanism in the energy equation is carried out to find out the error source and to make the proposed scheme preserve total enthalpy. By modif...

Shock dynamics in layered periodic media

KAUST Repository

Ketcheson, David I.

2012-01-01

Solutions of constant-coeffcient nonlinear hyperbolic PDEs generically develop shocks, even if the initial data is smooth. Solutions of hyperbolic PDEs with variable coeffcients can behave very differently. We investigate formation and stability of shock waves in a one-dimensional periodic layered medium by a computational study of time-reversibility and entropy evolution. We find that periodic layered media tend to inhibit shock formation. For small initial conditions and large impedance variation, no shock formation is detected even after times much greater than the time of shock formation in a homogeneous medium. Furthermore, weak shocks are observed to be dynamically unstable in the sense that they do not lead to significant long-term entropy decay. We propose a characteristic condition for admissibility of shocks in heterogeneous media that generalizes the classical Lax entropy condition and accurately predicts the formation or absence of shocks in these media.

Experimental Shock Transformation of Gypsum to Anhydrite: A New Low Pressure Regime Shock Indicator

Science.gov (United States)

Bell, Mary S.; Zolensky, Michael E.

2011-01-01

The shock behavior of gypsum is important in understanding the Cretaceous/Paleogene event and other terrestrial impacts that contain evaporite sediments in their targets (e.g., Mars Exploration Rover Spirit detected sulfate at Gusev crater, [1]). Most interest focuses on issues of devolatilization to quantify the production of SO2 to better understand its role in generating a temporary atmosphere and its effects on climate and biota [2,3]. Kondo and Ahrens [4] measured induced radiation emitted from single crystal gypsum shocked to 30 and 40 GPa. They observed greybody emission spectra corresponding to temperatures in the range of 3,000 to 4,000 K that are a factor of 2 to 10 times greater than calculated pressure-density energy equation of state temperatures (Hugoniot) and are high enough to melt gypsum. Chen et al. [5] reported results of shock experiments on anhydrite, gypsum, and mixtures of these phases with silica. Their observations indicated little or no devolatilization of anhydrite shocked to 42 GPa and that the fraction of sulfur, by mass, that degassed is approx.10(exp -2) of theoretical prediction. In another report of shock experiments on calcite, anhydrite, and gypsum, Badjukov et al. [6] observed only intensive plastic deformation in anhydrite shock loaded at 63 GPa, and gypsum converted to anhydrite when shock loaded at 56 GPa but have not experimentally shocked gypsum in a step-wise manner to constrain possible incipient transformation effects. Schmitt and Hornemann [7] shock loaded anhydrite and quartz to a peak pressure of 60 GPa and report the platy anhydrite grains were completely pseudomorphed by small crystallized anhydrite grains. However, no evidence of interaction between the two phases could be observed and they suggested that recrystallization of anhydrite grains is the result of a solid-state transformation. They concluded that significant decomposition of anhydrite requires shock pressures higher than 60 GPa. Gupta et al. [8

Radiologic evaluation of adriamycin induced toxic cardiomyopathy in childhood leukemia

International Nuclear Information System (INIS)

Kim, Young Joo; Moon, Young Hee; Kang, Kyung Jin; Kim, Ok Hwa; Kim, Choon Yul; Bahk, Yong Whee

1992-01-01

The cardiomyopathy associated with Adriamycin is frequently fatal and full clinical recovery is uncommon. To evaluate the radiological manifestation and the outcome of Adriamycin induced cardiac toxicity, we retrospectively reviewed the serial chest X-ray films of children treated with Adriamycin. Among 154 children with leukemia, fourteen patients developed clinical and radiologic evidence of congestive heart failure (CHF). Six out of 14 (43%) died of CHF within 2 weeks after attack and eight children survived after their acute episodes of CHF, were controlled following digoxin and diuretic therapy. Despite the improving clinical evidence of heart failure, the follow-up chest roentgenograms of these 8 children showed definite cardiomegaly as compared with the pre-treatment chest X-ray. Three children among 8 had minimal cardiomegaly and the remaining five children showed persistent, marked cardiomegaly during the period of 9-25 months of follow up. In summary, when CHF develops during chemotherapy in leukemic children, the possibility of Adriamycin induced cardiac toxicity should be suspected. Our findings showed that persistence of cardiomegaly represented significant cardiomyopathy despite clinical improvement of CHF

Shock-induced chemistry in organic materials

Energy Technology Data Exchange (ETDEWEB)

Dattelbaum, Dana M [Los Alamos National Laboratory; Sheffield, Steve [Los Alamos National Laboratory; Engelke, Ray [Los Alamos National Laboratory; Manner, Virginia [Los Alamos National Laboratory; Chellappa, Raja [Los Alamos National Laboratory; Yoo, Choong - Shik [WASHINGTON STATE UNIV

2011-01-20

The combined 'extreme' environments of high pressure, temperature, and strain rates, encountered under shock loading, offer enormous potential for the discovery of new paradigms in chemical reactivity not possible under more benign conditions. All organic materials are expected to react under these conditions, yet we currently understand very little about the first bond-breaking steps behind the shock front, such as in the shock initiation of explosives, or shock-induced reactivity of other relevant materials. Here, I will present recent experimental results of shock-induced chemistry in a variety of organic materials under sustained shock conditions. A comparison between the reactivity of different structures is given, and a perspective on the kinetics of reaction completion under shock drives.

Quantification of inhaled aerosol particles composed of toxic household disinfectant using radioanalytical method.

Science.gov (United States)

Shim, Ha Eun; Lee, Jae Young; Lee, Chang Heon; Mushtaq, Sajid; Song, Ha Yeon; Song, Lee; Choi, Seong-Jin; Lee, Kyuhong; Jeon, Jongho

2018-05-25

To assess the risk posed by a toxic chemical to human health, it is essential to quantify its uptake in a living subject. This study aims to investigate the biological distribution of inhaled polyhexamethylene guanidine (PHMG) aerosol particle, which is known to cause severe pulmonary damage. By labeling with indium-111 ( 111 In), we quantified the uptake of PHMG for up to 7 days after inhalation exposure in rats. The data demonstrate that PHMG is only slowly cleared, with approximately 74% of inhaled particles persisting in the lungs after 168 h. Approximately 5.3% of inhaled particles were also translocated to the liver after 168 h, although the level of redistribution to other tissues, including the kidneys and spleen, was minimal. These observations suggest that large uptake and slow clearance may underlie the fatal inhalation toxicity of PHMG in humans. Copyright © 2018 Elsevier Ltd. All rights reserved.

Shocks in fragile matter

Science.gov (United States)

Vitelli, Vincenzo

2012-02-01

Non-linear sound is an extreme phenomenon typically observed in solids after violent explosions. But granular media are different. Right when they unjam, these fragile and disordered solids exhibit vanishing elastic moduli and sound speed, so that even tiny mechanical perturbations form supersonic shocks. Here, we perform simulations in which two-dimensional jammed granular packings are continuously compressed, and demonstrate that the resulting excitations are strongly nonlinear shocks, rather than linear waves. We capture the full dependence of the shock speed on pressure and compression speed by a surprisingly simple analytical model. We also treat shear shocks within a simplified viscoelastic model of nearly-isostatic random networks comprised of harmonic springs. In this case, anharmonicity does not originate locally from nonlinear interactions between particles, as in granular media; instead, it emerges from the global architecture of the network. As a result, the diverging width of the shear shocks bears a nonlinear signature of the diverging isostatic length associated with the loss of rigidity in these floppy networks.

Chronic non-fatal Datura abuse in a patient of paranoid schizophrenia: a case report.

Science.gov (United States)

Khanra, Sourav; Khess, C R J; Srivastava, Naveen

2015-04-01

A range of psychoactive substances used by patients suffering from schizophrenia varies and may include those which are fatal and may cause serious toxicity leading to death. We here present a case report of a patient suffering from paranoid schizophrenia, who was abusing Datura stramonium over a prolonged period. A 32 year old male presented with aggressive behaviour, irritability for 6 years and regular intake of Datura seeds for 3 years. After taking detailed history and mental status examination (MSE), diagnoses of paranoid schizophrenia and mental and behavioral disorder due to use of hallucinogen were made. He had shown improvement on standard treatment with antipsychotics. D. stramonium is recognized among emerging new psychoactive substances being used across the world. Among various theories we discuss self-medication hypothesis as a mediating factor for this case. Though D. stramonium is notorious for its life threatening sequelae, clinicians should be aware of its chronic abuse as self-medication. Copyright © 2014 Elsevier Ltd. All rights reserved.

Energetic ion acceleration at collisionless shocks

Science.gov (United States)

Decker, R. B.; Vlahos, L.

1985-01-01

An example is presented from a test particle simulation designed to study ion acceleration at oblique turbulent shocks. For conditions appropriate at interplanetary shocks near 1 AU, it is found that a shock with theta sub B n = 60 deg is capable of producing an energy spectrum extending from 10 keV to approx. 1 MeV in approx 1 hour. In this case total energy gains result primarily from several separate episodes of shock drift acceleration, each of which occurs when particles are scattered back to the shock by magnetic fluctuations in the shock vicinity.

Energetic ion acceleration at collisionless shocks

International Nuclear Information System (INIS)

Decker, R.B.; Vlahos, L.

1985-01-01

An example is presented from a test particle simulation designed to study ion acceleration at oblique turbulent shocks. For conditions appropriate at interplanetary shocks near 1 AU, it is found that a shock with theta sub B n = 60 deg is capable of producing an energy spectrum extending from 10 keV to approx 1 MeV in approx 1 hour. In this case total energy gains result primarily from several separate episodes of shock drift acceleration, each of which occurs when particles are scattered back to the shock by magnetic fluctuations in the shock vicinity

Particle Acceleration in Two Converging Shocks

Energy Technology Data Exchange (ETDEWEB)

Wang, Xin; Wang, Na; Shan, Hao [Xinjiang Astronomical Observatory, Chinese Academy of Sciences, Urumqi 830011 (China); Giacalone, Joe [Lunar and Planetary Laboratory, University of Arizona, Tucson AZ 85721 (United States); Yan, Yihua [CAS Key Laboratory of Solar Activity, National Astronomical Observatories, Beijing 100012 (China); Ding, Mingde, E-mail: wangxin@xao.ac.cn [Key Laboratory of Modern Astronomy and Astrophysics (Nanjing University) Ministry of Education, Nanjing 210093 (China)

2017-06-20

Observations by spacecraft such as ACE , STEREO , and others show that there are proton spectral “breaks” with energy E {sub br} at 1–10 MeV in some large CME-driven shocks. Generally, a single shock with the diffusive acceleration mechanism would not predict the “broken” energy spectrum. The present paper focuses on two converging shocks to identify this energy spectral feature. In this case, the converging shocks comprise one forward CME-driven shock on 2006 December 13 and another backward Earth bow shock. We simulate the detailed particle acceleration processes in the region of the converging shocks using the Monte Carlo method. As a result, we not only obtain an extended energy spectrum with an energy “tail” up to a few 10 MeV higher than that in previous single shock model, but also we find an energy spectral “break” occurring on ∼5.5 MeV. The predicted energy spectral shape is consistent with observations from multiple spacecraft. The spectral “break,” then, in this case is caused by the interaction between the CME shock and Earth’s bow shock, and otherwise would not be present if Earth were not in the path of the CME.

Underwater electrical wire explosion: Shock wave from melting being overtaken by shock wave from vaporization

Science.gov (United States)

Li, Liuxia; Qian, Dun; Zou, Xiaobing; Wang, Xinxin

2018-05-01

The shock waves generated by an underwater electrical wire explosion were investigated. A microsecond time-scale pulsed current source was used to trigger the electrical explosion of copper wires with a length of 5 cm and a diameter of 200 μm. The energy-storage capacitor was charged to a relatively low energy so that the energy deposited onto the wire was not large enough to fully vaporize the whole wire. Two shock waves were recorded with a piezoelectric gauge that was located at a position of 100 mm from the exploding wire. The first and weak shock wave was confirmed to be the contribution from wire melting, while the second and stronger shock wave was the contribution from wire vaporization. The phenomenon whereby the first shock wave generated by melting being overtaken by the shock wave due to vaporization was observed.

INTERFERENCE OF COUNTERPROPAGATING SHOCK WAVES

Directory of Open Access Journals (Sweden)

P. V. Bulat

2015-03-01

Full Text Available The subject of study. We examined the interaction of counterpropagating shock waves. The necessity of counterpropagating shock waves studying occurs at designing of high Mach number modern internal compression air intakes, Ramjets with subsonic and supersonic combustion, in asymmetrical supersonic nozzles and in some other cases. In a sense, this problem is a generalization of the case of an oblique shock reflection from the wall or from the plane of symmetry. With the renewed vigor, the interest to this problem emerged at the end of the 90s. This was due to the start of the programs for flight study at hypersonic speeds. The first experiments performed with air intakes, which realized the interaction of counterpropagating shock waves have shown that the change in flow velocity is accompanied by abrupt alteration of shock-wave structure, the occurrence of nonstationary and oscillatory phenomena. With an increase of flow velocity these phenomena undesirable for aircraft structure became more marked. The reason is that there are two fundamentally different modes of interaction of counterpropagating shock waves: a four-wave regular and a five-wave irregular. The transition from one mode to another can be nonstationary abrupt or gradual, it can also be accompanied by hysteresis. Main results. Criteria for the transition from regular reflection of counterpropagating shock waves to irregular are described: the criterion of von Neumann and the stationary Mach configuration criterion. We described areas in which the transition from one reflection type to another is possible only in abrupt way, as well as areas of possible gradual transition. Intensity dependences of the reflected shock waves from the intensity of interacting counterpropagating shocks were given. Qualitative pictures of shock-wave structures arising from the interaction of counterpropagating shock waves were shown. Calculation results of the intensity of outgoing gas

Subarachnoid haemorrhage in Sweden 1987-2002 : regional incidence and case fatality rates

NARCIS (Netherlands)

Koffijberg, H.; Buskens, E.; Granath, F.; Adami, J.; Ekbom, A.; Rinkel, G. J. E.; Blomqvist, P.

Background: Incidence estimates of subarachnoid haemorrhage (SAH) in Sweden vary, which may be caused by regional variations. Reliable estimates of age-specific case fatality rates are lacking. We analysed regional incidence rates and case fatality rates of SAH in Sweden. Methods: The Swedish