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Biomedical subjects

James H Diaz

Publications and source records attributed to James H Diaz.

14 recordsLinked to original sources
PubMed2005

Evolving global epidemiology, syndromic classification, general management, and prevention of unknown mushroom poisonings.

OBJECTIVE: To assess the evolving global epidemiology of mushroom poisoning and to identify new and emerging mushroom poisonings and their treatments, a descriptive analysis and review of the world's salient scientific literature on mushroom poisoning was conducted. DATA SOURCE: Data sources from observation studies conducted over the period 1959-2002 and describing 28,018 mushroom poisonings since 1951 were collected from case reports, case series, regional descriptive studies, meta-analyses, and laboratory studies of mushroom poisonings and the toxicokinetics of mycotoxins. STUDY SELECTION: Studies included in the review were selected by a MEDLINE search, 1966-2004, an Ovid OLDMEDLINE search, 1951-1965, and a medical library search for sources published before 1951. DATA EXTRACTION: To better guide clinicians in establishing diagnoses and implementing therapies, despite confusing ingestion histories, data were extracted to permit an expanded syndromic classification of mushroom poisoning based on presentation timing and target organ systemic toxicity. DATA SYNTHESIS: The final 14 major syndromes of mushroom poisoning were stratified first by presentation timing and then by target organ systemic toxicity and included early (<6 hrs), late (6-24 hrs), and delayed syndromes (> or =1 day). There were eight early syndromes (four neurotoxic, two gastrointestinal, two allergic); three late syndromes (hepatotoxic, accelerated nephrotoxic, erythromelalgia); and three delayed syndromes (delayed nephrotoxic, delayed neurotoxic, rhabdomyolysis). Four new mushroom poisoning syndromes were classified including accelerated nephrotoxicity (Amanita proxima, Amanita smithiana), rhabdomyolysis (Tricholoma equestre, Russula subnigricans), erythromelalgia (Clitocybe amoenolens, Clitocybe acromelalgia), and delayed neurotoxicity (Hapalopilus rutilans). In addition, data sources were stratified by three chronological time periods with >1,000 confirmed mushroom ingestions reported and tested for any statistically significant secular trends in case fatalities from mushroom ingestions over the entire study period, 1951-2002. CONCLUSIONS: Since the 1950s, reports of severe and fatal mushroom poisonings have increased worldwide. Clinicians must consider mushroom poisoning in the evaluation of all patients who may be intoxicated by natural substances. Since information on natural exposures is often insufficient and incorrect, a new syndromic classification of mushroom poisoning is recommended to guide clinicians in making earlier diagnoses, especially in cases where only advanced critical care, including organ transplantation, may be life saving.

Diagnosis, Differential↗
PubMed2005

Syndromic diagnosis and management of confirmed mushroom poisonings.

OBJECTIVE: To assess the evolving global epidemiology of mushroom poisoning and to identify new and emerging mushroom poisonings and their treatments, a descriptive analysis and review of the world's salient scientific literature on mushroom poisoning was conducted. DATA SOURCE: Data sources from observation studies conducted over the period 1959-2002, and describing 28,018 mushroom poisonings since 1951, were collected from case reports, case series, regional descriptive studies, meta-analyses, and laboratory studies of mushroom poisonings and the toxicokinetics of mycotoxins. STUDY SELECTION: Studies included in the review were selected by a MEDLINE search, 1966-2004, an Ovid OLDMEDLINE search, 1951-1965, and a medical library search for sources published before 1951. DATA EXTRACTION: To better guide clinicians in establishing diagnoses and implementing therapies, despite confusing ingestion histories, data were extracted to permit an expanded syndromic classification of mushroom poisoning based on presentation timing and target organ systemic toxicity. DATA SYNTHESIS: The final 14 major syndromes of mushroom poisoning were stratified first by presentation timing and then by target organ systemic toxicity and included early (<6 hrs), late (6-24 hrs), and delayed syndromes (> or =1 day). There were eight early syndromes (four neurotoxic, two gastrointestinal, two allergic); three late syndromes (hepatotoxic, accelerated nephrotoxic, erythromelalgia); and three delayed syndromes (delayed nephrotoxic, delayed neurotoxic, rhabdomyolysis). Four new mushroom poisoning syndromes were classified including accelerated nephrotoxicity (Amanita proxima, Amanita smithiana), rhabdomyolysis (Tricholoma equestre, Russula subnigricans), erythromelalgia (Clitocybe amoenolens, Clitocybe acromelalgia), and delayed neurotoxicity (Hapalopilus rutilans). In addition, data sources were stratified by three chronological time periods with >1,000 confirmed mushroom ingestions reported and tested for any statistically significant secular trends in case fatalities from mushroom ingestions over the entire study period, 1951-2002. CONCLUSIONS: Since the 1950s, reports of severe and fatal mushroom poisonings have increased worldwide. Clinicians must consider mushroom poisoning in the evaluation of all patients who may be intoxicated by natural substances. Since information on natural exposures is often insufficient and incorrect, a new syndromic classification of mushroom poisoning is recommended to guide clinicians in making earlier diagnoses, especially in cases where only advanced critical care, including organ transplantation, may be life saving.

Agaricales↗
PubMed2005

The evolving global epidemiology, syndromic classification, management, and prevention of caterpillar envenoming.

Caterpillars are the wormlike, larval forms of butterflies and moths of the insect order Lepidoptera. Next to flies, lepidopterans are the most abundant arthropods with more than 165,000 species worldwide, and with most species posing no human threats. However, caterpillar species from approximately 12 families of moths or butterflies worldwide can inflict serious human injuries ranging from urticarial dermatitis and atopic asthma to osteochondritis, consumption coagulopathy, renal failure, and intracerebral hemorrhage. Unlike bees and wasps, envenoming or stinging caterpillars do not possess stingers or modified ovipositors attached to venom glands, but instead bear highly specialized external nettling or urticating hairs and breakaway spines or setae to defend against attacks by predators and enemies. Since the 1970s, there have been increasing reports of mass dermatolgic, pulmonary, and systemic reactions following caterpillar encounters throughout the world.

Animals↗
PubMed2004

The global epidemiology, syndromic classification, management, and prevention of spider bites.

Spiders are carnivorous arthropods that coexist with humans and ambush or ensnare prey. Unlike other arthropods, spiders rarely transmit communicable diseases, and play a critical role in the ecosystem by consuming other arthropods that frequently transmit human diseases, such as mosquitoes and flies. There are more than 30,000 species of spiders, most of which are venomous, but they cannot inflict serious bites due to delicate mouthparts and short fangs. The differential diagnosis of spider bites is extensive and includes other arthropod bites, skin infections, and exposure to chemical or physical agents. However, approximately 200 species from 20 genera of spiders worldwide can cause severe human envenomings, with dermonecrosis, systemic toxicity, and death. Spider bites can usually be prevented by simple personal and domestic measures. Early species identification and specific management may help prevent serious sequelae of spider bites.

Animals↗
PubMed2002

Chronic postoperative epidural abscess with ascending neuromyotonia.

IMPLICATIONS: Clinicians are reminded that epidural abscesses may not follow epidural space violation, may present a confusing constellation of back pain and paraparesis, and may have serious consequences if not diagnosed accurately and managed aggressively with spinal decompression.

Aged↗
PubMedDate not supplied

The public health impact of global climate change.

Accurate predictions of the public health impact of global climatic changes are hampered by the absence of a dose-response relationship between climate change and human health and imprecise, often conflicting, meteorological models of climate change. Public health officials are obligated to educate policy makers and the public about the significant threats posed to population health and quality of life by the inexorable progression of global climate change. Only an enlightened public consciousness can muster the political will required to press for policy changes and to support new technologies to conserve energy and to protect the environment from manmade agents of destruction.

Animals↗
PubMedDate not supplied

Is fish consumption safe?

Louisiana's vital seafood industry provides nearly 40% of domestic seafood production. Unlike Louisianans, most Americans do not enjoy fresh seafood, yet manage to eat over 4 billion pounds of seafood annually, most of it foreign, frozen, and fried! America's commercial fisheries now face crippling economic and environmental pressures from seafood imports, over-fishing, urban and agricultural wastewater runoff, harmful algal blooms, and coastal wetlands loss. As a result of these ecosystem stresses, seafood-borne disease now causes 37% of all foodborne illness in the United States. Despite recent advisories on high mercury-containing finfish consumption, seafood provides more than a third of the world with essential dietary protein, rich in cardiovascular-protective omega-3 polyunsaturated fatty acids. Louisiana and other coastal-state physicians can effectively curtail the rising threat of local seafood-borne disease outbreaks by supporting responsible coastal restoration and regulation of commercial fishing, and by recommending careful inspection, selection, and preparation of seafood.

Botulism↗
PubMedDate not supplied

The public health impact of hurricanes and major flooding.

Accurate predictions of the public health impact of hurricanes and major flooding are hampered by the absence of a dose-response relationship between hurricane-associated flooding and human health and the imprecise, often conflicting, meteorological models of climate change and hurricane landfall. Flooding is now the most common type of disaster worldwide, and flash flooding, usually associated with tropical storms, is the leading cause of weather-related deaths in the United States. As a result of climate changes and more frequently alternating ocean oscillations, hurricanes of category 3 or greater now strike the continental US approximately every 18 months. Public health officials are obligated to educate policymakers and the public about the significant threats posed to population health and quality of life by the inexorable progression of global climate change, including more water-centered disasters, such as tropical storms and hurricanes.

Disasters↗
PubMedDate not supplied

Is shellfish consumption safe?

Louisiana provides nearly 40% of domestic seafood production. America's commercial fisheries, especially coastal shellfish fisheries, now face crippling economic and environmental pressures from seafood imports, over-fishing, urban and agricultural wastewater runoff, harmful algal blooms, and coastal wetlands loss. As a result of these ecosystem stresses, seafood-borne disease now causes 37% of all foodborne illness in the United States. Louisiana and other coastal-state physicians can effectively curtail the rising threat of local shellfish-borne disease outbreaks by supporting responsible coastal restoration and regulation of commercial shell-fishing, especially oyster fishing, and by recommending careful selection and preparation of all shellfish and crustaceans.

Arsenic Poisoning↗
PubMedDate not supplied

The epidemiology, syndromic diagnosis, management, and prevention of spider bites in the South.

Unlike other arthropods, spiders rarely transmit communicable diseases, and thus play a critical role in the ecosystem by consuming other insects that frequently transmit human diseases, such as mosquitoes, ticks, and fleas. There are more than 30,000 species of spiders worldwide, most of which are venomous, but cannot inflict serious bites due to delicate mouthparts and short fangs. Other insect bites, skin infections, and chemical- or physical-agent exposures are often misdiagnosed as spider bites. Approximately 40 species from 4 major genera of spiders in Louisiana and throughout the South, however, can cause severe human envenomings, with dermonecrosis, systemic toxicity, and, rarely, death. Spider bites can usually be prevented by simple personal and domestic measures. Early species identification and specific management may help prevent serious sequelae of spider bites.

Animals↗
PubMedDate not supplied

The epidemiology, diagnosis, and management of caterpillar envenoming in the southern US.

Caterpillars are the wormlike larval forms of butterflies and moths of the insect order Lepidoptera. Next to flies, lepidopterans are the most abundant arthropods with over 165,000 species worldwide, over 11,000 species in the United States alone, and with most species posing no human threats. Caterpillar species from several families of moths in the South can inflict serious human injuries ranging from urticarial dermatitis and conjunctivitis to atopic asthma and pan-uveitis. Since the 1970s, there have been increasing reports of dermatolgic, pulmonary, and systemic reactions following caterpillar encounters throughout the South.

Animals↗