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Entering his twenty-fifth year in hospital security, the author looks back on his experiences in an everchanging field including: the Three Mile Island "melt-down" panic; his first injury; the '80s AIDS "epidemic;" handling the victims of a prison riot; changes brought about by a major hospital merger; and the new things he continues to learn.
2-Chloroacetophenone is a potent lacrimator that has been used as a riot control agent and in tear gas formulations for personal protection devices. NTP Toxicology and Carcinogenesis studies were conducted by exposing groups of F344/N rats and B6C3F1 mice of each sex to air containing 2-chloroacetophenone vapor for 14 days, 13 weeks, 15 months, or 2 years. Genetic toxicology studies were conducted in Salmonella typhimurium and Chinese hamster ovary (CHO) cells. Fourteen-Day Studies: In 14-day studies, exposure concentrations of 2-chloroacetophenone ranged from 4.8 to 64 mg/m3. All rats exposed to 19, 43, or 64 mg/m3 died during the first week of the studies and 1/5 male rats exposed to 10 mg/m3 died during the second week of the study. Rats exposed to 10 mg/m3 lost weight; the final mean body weights of male or female rats exposed to 4.8 mg/m3, the lowest concentration used, were 23% or 15% lower than that of controls. During the exposure, rats showed partial closure of the eyelids, excessive lacrimation (dacryorrhea), dyspnea, and erythema. All mice exposed to 10 mg/m3 or higher concentrations of 2-chloroacetophenone died during the first week of the studies. The final mean body weights of mice exposed to 4.8 mg/m3 were similar to those of controls. Dacryorrhea was observed in exposed mice. Thirteen-Week Studies: The exposure concentrations of 2-chloroacetophenone ranged from 0.25 to 4 mg/m3 for rats and mice. All rats lived to the end of the studies. The final mean body weights of rats exposed to 4 mg/m3 were 9% lower than those of controls. Eye irritation during exposure was evident in rats exposed to 0.5 mg/m3 or higher concentrations of 2-chloroacetophenone. One of 10 female mice exposed to 4 mg/m3 and 1/10 female mice exposed to 0.5 mg/m3 died before the end of the study. The final mean body weights of exposed mice were 7%-12% lower than that of controls for males and 12%-15% lower for females. No chemical-related gross or microscopic lesions were observed in rats or mice. In the 2-year studies, groups of 60 rats of each sex were exposed to a vapor of 0 (chamber control), 1, or 2 mg/m3 (0, 0.15, or 0.3 ppm) 2-chloroacetophenone, 6 hours per day, 5 days per week. Groups of 60 mice of each sex were exposed to 0 (chamber control), 2, or 4 mg/m3 (0, 0.3, or 0.6 ppm) on the same schedule. Ten animals from each group were killed and examined at 15 months; the remaining animals continued on study for 2 years. Fifteen-Month Studies: In the 15-month studies, minimal-to-mild focal squamous metaplasia and hyperplasia of the respiratory epithelium were seen at increased incidences in rats exposed to 2 mg/m3. No exposure-related lesions were observed in mice of either sex. Body Weight and Survival in the Two-Year Studies: Mean body weights and survival of exposed and chamber control rats were similar throughout most of the studies (survival-male: control, 14/50; 1 mg/m3, 22/50; 2 mg/m3, 17/50; female: 23/50; 20/50; 24/50). Mean body weights of male mice exposed to 4 mg/m3 were about 5%-12% lower than those of controls after week 30; small differences between mean body weights of exposed and control female mice were not clearly exposure related. The survival of female mice exposed to 2 mg/m3 was significantly lower than that of chamber controls after week 98. No other differences in survival were observed between any groups of mice (male: control, 34/50; 2 mg/m3, 36/50; 4 mg/m3, 33/50; female: 40/50; 28/50; 32/50). Nonneoplastic and Neoplastic Effects in the Two-Year Studies: Fibroadenomas of the mammary gland occurred in female rats with positive trends, and the incidence in the 2 mg/m3 group was greater than that in chamber controls (control, 12/50; 1 mg/m3, 19/50; 2 mg/m3, 23/50). The incidences of adenomas or adenocarcinomas of the mammary gland were not increased in the exposed groups. Minimal-to-mild suppurative inflammation of the nasal mucosa was observed at increased incidences in exposed male rats. Hyperplasia and squamous metaplasia of the nasal respiratory epithelium were observed at increased incidences in exposed ry epithelium were observed at increased incidences in exposed male and female rats. In mice, squamous metaplasia of the respiratory epithelium of the nasal passage was seen in four females and two males exposed to 4 mg/m3 2-chloroacetophenone. Inflammation, ulcers, and squamous hyperplasia of the forestomach were observed at increased incidences in exposed female rats. Genetic Toxicology: 2-Chloroacetophenone was not mutagenic in S. typhimurium strains TA98, TA100, TA1535, or TA1537 with or without exogenous metabolic activation. In cytogenetic tests with CHO cells, 2-chloroacetophenone did not induce sister chromatid exchanges with or without activation, but a weak positive increase in chromosomal aberrations was observed in the absence of metabolic activation. Conclusions: Under the conditions of these 2-year inhalation studies, there was no evidence of carcinogenic activity of 2-chloroacetophenone for male rats exposed to 1 or 2 mg/m3. There was equivocal evidence of carcinogenic activity for female F344/N rats, based on a marginal increase in fibroadenomas of the mammary gland. There was no evidence of carcinogenic activity for male or female B6C3F1 mice exposed to 2 or 4 mg/m3 2-chloroacetophenone. Synonyms: a-chloroacetophenone; 2-chloro-1-phenylethanone; CN; phenacyl chloride; phenylchloromethylketone Trade Names: Mace®.; Chemical Mace®.
CS2 (94% o-chlorobenzalmalononitrile [CS]; 5% Cab-O-Sil(R). colloidal silica; 1% hexamethyldisilizane), an eye and respiratory irritant, is used as an aerosol to control riots. NTP Toxicology and Carcinogenesis studies were conducted by exposing groups of F344/N rats and B6C3F1 mice of each sex for 6 hours per day, 5 days per week for 2 weeks, 13 weeks, or 2 years, to a CS2 aerosol. Genetic toxicology studies with CS2 were conducted in Salmonella typhimurium, mouse lymphoma cells, and Chinese hamster ovary (CHO) cells. Fourteen-Day Studies: At exposure concentrations of 0, 1, 3, 10, 30, or 100 mg/m3 CS2, all rats exposed to 30 or 100 mg/m3 and all mice exposed to 10, 30, or 100 mg/m3 died before the end of the studies. Compound-related clinical signs observed included erythema, blepharospasm, listlessness, nasal discharge, and mouse breathing. Thirteen-Week Studies: At exposure concentrations of 0, 0.4, 0.75, 1.5, 3, or 6 mg/m3, 1/10 male rats exposed to 6 mg/m3 died before the end of the studies. Final mean body weights of rats exposed to 1.5 mg/m3 or more were 17%-44% lower than that of controls for males and 10%-24% lower for females. The absolute and relative thymus weights were reduced for exposed male and female rats, particularly at 6 mg/m3. Compound-related lesions of the nasal passage in rats included focal erosion with regenerative hyperplasia and squamous metaplasia of the respiratory epithelium and suppurative inflammation. Acute inflammation and hyperplasia of the respiratory epithelium were seen in the larynx and trachea of some exposed rats. All mice exposed to 6 mg/m3 and 1/10 males and 1/10 females exposed to 3 mg/m3 died before the end of the studies. Final mean body weights of mice exposed to 3 mg/m3 were 13% lower than that of controls for males and 9% lower for females. Compound-related lesions of the nasal passage in mice included squamous metaplasia of the nasal respiratory epithelium and inflammation. Based on these results, CS2 exposure concentrations for the 2-year studies were 0, 0.075, 0.25, or 0.75 mg/m3 for 6 hours per day, 5 days per week for 105 weeks for groups of 50 rats of each sex. Groups of 50 mice of each sex were exposed to 0, 0.75, or 1.5 mg/m3 on the same schedule. Body Weights and Survival in the Two-Year Studies: Final mean body weights of rats exposed to 0.75 mg/m3 were 7%-11% lower than those of controls. Final mean body weights of mice exposed to CS2 were lower than those of controls (male: 5% and 9%; female: 10% and 17%). No compound-related clinical signs were observed. No significant differences in survival were seen for any group of rats or mice of either sex. Nonneoplastic and Neoplastic Effects in the Two-Year Studies: Compound-related nonneoplastic lesions occurred in the nasal passage of exposed rats and mice. In exposed rats, hyperplasia and squamous metaplasia of the respiratory epithelium and degeneration of the olfactory epithelium with ciliated columnar and/or squamous metaplasia were observed. Focal chronic inflammation and proliferation of the periosteum of the turbinate bones were increased slightly in rats at the top exposure concentration. Suppurative inflammation with hyperplasia and squamous metaplasia of the respiratory epithelium occurred in exposed mice. There were no compound-related increased incidences of neoplasms in rats or mice exposed to CS2. In exposed female mice, there were pronounced decreases in the incidences of adenomas of the pituitary pars distalis (control, 13/47; 0.75 mg/m3, 5/46; 1.5 mg/m3, 1/46) and decreased incidences of malignant lymphomas (21/50; 12/50; 8/50). Genetic Toxicology: The responses in Salmonella gene mutation tests with CS2 were equivocal in one laboratory for strain TA100 in the absence of exogenous metabolic activation (S9) and equivocal in another laboratory for TA97 with S9; in all other strains tested, CS2 was clearly negative with or without S9. CS2 induced trifluorothymidine resistance in mouse L5178Y/TK lymphoma cells in the absence of S9; it was not tested with S9. CS2 induced both sister chromatid exchangeslymphoma cells in the absence of S9; it was not tested with S9. CS2 induced both sister chromatid exchanges and chromosomal aberrations in CHO cells with and without S9. Conclusions: Under the conditions of these inhalation studies, there was no evidence of carcinogenic activity of CS2 for male or female F344/N rats exposed to 0.075, 0.25, or 0.75 mg/m3 in air for up to 2 years. There was no evidence of carcinogenic activity for male or female B6C3F1 mice exposed to 0.75 or 1.5 mg/m3 in air for up to 2 years. Concentration-related decreases in the incidences of pituitary gland adenomas and lymphomas were observed in female mice. Exposure to CS2 caused degeneration and squamous metaplasia of the olfactory epithelium, hyperplasia and metaplasia of the respiratory epithelium, and proliferation of the periosteum of the nasal passage of rats. In mice, exposure to this compound caused suppurative inflammation and hyperplasia and squamous metaplasia of the respiratory epithelium of the nasal passage.
Rapid urban population growth is occurring, particularly in developing countries, and has led to problems of providing adequate water supply and sanitation. Two dominant policy recommendations have been put forward--raise fees to existing users or increase the role of the private sector in the provision of water and sanitation services. A number of civil disturbances and riots have occurred in response to such proposals. More pragmatic policy initiatives are required to prevent and solve water-related conflicts, as well as new institutional structures to better handle competing and conflicting water demands.
Tchizhevsky hypothesis (1922) of historical process heliotaraxia (helios--sun, taracsio--perturb) was empirically tested. Samples of near 13 and 4.6 thousand events mentioned in Chronology sections of two largest Soviet historical handbooks were analyzed. Events were classified into 4 groups on the basis of "strength" and "social contradictions meaning" of their names, called tolerance and polarity: tolerant--intolerant (e.f. riot--roform) and polar--neutral (e.f. civil war-external war). It was found that frequency and polarity of historical events increased in maximum of sunspot cycle and in the next year as compared with minimum and the year before minimum. The probability of revolution (the most polar and intolerant name of historical event) is the highest in maximum and the lowest in the year before minimum. Intolerance of polar events increased and neutral events decreased in maximum. All these relations were highly significant (P < 0.001). It was concluded that heliotaraxic phenomena exist and are basically associated with year of sunspot maximum.
The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems.
In the author's view, anti-Jewishness is the expression of covert anti-Christianism, which in its turn conceals an unconscious revolt against Christ. Unconscious aggression is unleashed against the Jews, who thus become scapegoats against whom three constantly recurring accusations are levelled: the killing of Christ; the desecration of the Host; and the ritual murder of children. The author traces the history of these accusations from the Middle Ages to the present. The search for scapegoats is a universal phenomenon not limited to anti-Jeweshness but encountered more generally in situations of social and political uncertainty. To substantiate his claims, the author draws upon historical documents from the Second World War dealing with the threat to China from Japan's armed forces, and also makes reference to the race riots in Los Angeles early this year.
Mahathir Mohamad was born in 1925 in Alor Star, Kedah. He entered the King Edward VII College of Medicine in Singapore in 1947 and graduated in 1953. His years in the medical school equipped young Mahathir with the training necessary to assess and diagnose a problem, before dispensing the appropriate treatment. Throughout his later years in the political limelight, Dr Mahathir recognised the very important role the medical college had in laying the strong foundation for his successful career. He joined UMNO in 1945, already interested in politics at the tender age of 20; he was first elected into Parliament in 1964. The vigorous expression of his candid views did not go down well during the troubled days following the 13 May 1969 racial riots and he was expelled from UMNO, his writings were banned, and he was considered a racial extremist. Nevertheless, his intellectual and political influence could not be ignored for long; he returned to Parliament in 1974, and became the fourth, and longest serving, Prime Minister of Malaysia in 1981. Dr Mahathir has found fame as a Malay statesman, and an important Asian leader of the twentieth century with much written, locally and internationally, debating his policies. This article, using Dr Mahathir's own writings, starts with his description of his early life, proceeds to look at his medical career, then touches on his diagnosis of the problems plaguing the Malays, before concluding with his views on the need to stand up to the prejudices and pressures of the Western world. Throughout his life, Dr Mahathir behaved as the ever-diligent medical doctor, constantly studying the symptoms to diagnose the cause of the ills in his community and country, before proceeding to prescribe the correct treatment to restore good health. It is a measure of his integrity and intellectual capability that he did not seek to hide his failures, or cite unfinished work in an attempt to cling to political power.
The rubber bullet has been portrayed as a non-lethal weapon and has gained preference in riot-control over live ammunition. Despite the fact that it was designed to be safer than live ammunition, several cases of fatalities have been reported from its use. Most of these fatalities were because of abuse of the weapon in terms of range of fire and anatomical area of the body targeted. This is a case report of such a fatality following shotgun rubber bullet injury, including the circumstance surrounding this unusual occurrence, the autopsy findings and reports of the ballistic analysis. Four projectiles penetrated the right chest lodging in the right lung and injuring the right pulmonary artery, causing death. The mechanism of death in this case is rapid massive pulmonary haemorrhage.
King/Drew Medical Center is the only minority academic medical center west of the Mississippi River. As a result of the McCone Commission investigation into the Watts Riots of 1965, it was initially established as the Martin Luther King Hospital. Upon the establishment of Drew University in the mid-70s, the name change was made to recognize the existence of the College of Medicine at Drew University and its affiliated hospital. The medical school and hospital are known as the King/Drew Medical Complex. Referenced are the issues and challenges faced by the institution that have resulted in the current crisis. Restoration and rehabilitation of the academic medical center can be achieved by identifying the uncommon common goals of stakeholders in a collaborative and integrated process.
Pepper spray is defined as a non-lethal agent used in riot control and personal self-defense. Oleoresin capsicum (OC), derived from the fruit of plants in the Capsicum genus, commonly referred to as hot peppers or chilies, is the active agent used in many of these defense sprays. Although generally assumed to be safe and effective, the consequences of OC cannot be predicted with certainty. Nationwide there have been numerous reports of pepper spray-related injuries, including officers injured in pepper spray-related training exercises. This report details one officer's experience.
A European Union (EU) Summit in Göteborg, Sweden, was held 15-16 June 2001. This meeting presented various security and medical concerns to city officials. In preparation for a large meeting such as the EU Summit, a plan should be established that includes basic facts, management organization, and guidelines. Clear communication beteween city agencies also must be established. Hospital inventories should be recorded daily and reported to medical staff. A command center must be in place for police and medical command. An emergency medical provider should ride in each police vehicle, so in case of a riot situation, victims can be treated quickly. An information officer should be assigned with the task of providing information regarding the injured to the media.
In two separate experiments, the hypothesis that exposure to violence in the context of television drama decreases subjects' emotional responsivity to portrayals of real-life aggression was tested. Subjects were shown either an excerpt from a violent police drama or a segment of an exciting but nonviolent volley-ball game before watching a videotaped scene of real aggression. Emotionality was measured by changes in skin resistance which was measured continuously throughout the session. In Experiment 1, subjects were 8- to 10-year-old children and the real aggression was a film of an argument and fight between two preschoolers. In Experiment 2, college students participated and reactions to real aggression were measured while subjects watched scenes from news films of the riots at the 1968 Democratic National Convention. With the exception of adult females, subjects who previously had viewed the aggression drama were less aroused by the scenes of real aggression than were subjects who had seen the control film. Further support for the hypothesis was provided by the finding that for most groups of subjects, the amount of television violence normally viewed was negatively related to responsivity while viewing aggression.
After a period of unrest in Caracas, Venezuela, in February/March 1989, Amnesty International (AI) received information about torture applied by security forces to people thought to have participated in or organised riots and lootings. In May 1989 a delegation from AI went to Caracas to collect and appraise testimonies of human rights abuses. The delegation consisted of two staff members from the AI International Secretariat, one lawyer and one physician. The primary task of the latter was to assess the validity of the testimonies about torture. A full report (1) including a legal analysis has been published by AI. This paper describes some of the medical aspects of the mission.
Tear gases are used as riot control agents on account of their irritant properties. Five cases of allergic contact dermatitis due to omega-chloroacetophenone (CN) and one case additionally due to 2-chlorobenzylidene-malonitrile (CS) are reported.
The free sale of "self-defence sprays" and the use of such weapons by the police and riot squads account for the increase observed in the frequency of cutaneous accidents. Tear gases. 1. CN, or chloracetophenone, is a compound insoluble in water and soluble in alcohol, ether and carbon sulphide. MACE is CN dissolved in methylchloroform. 2. CS, or orthochlorobenzylidene malononitrile is also insoluble in water and can be used in sprays in concentrations of 2 to 8 p. 100, propelled by such gases as freons. Clinical effects. 1. Experimental. When these gases are suspended in air they mostly act on the eyes, producing blepharospasm, conjunctivitis and photophobia; they have only minor effects on the skin. When applied directly onto the skin they produce extreme irritation with erythema and vesicles. The higher the degree of humidity, the more severe the lesions. In animals and in man CN and CS behave as potential allergens on repeated exposures. 2. Accidental. Tear gases may have two effects: they usually produce irritant dermatitis, but also sometimes a genuine eczema. In aggressors exposed to these sprays the lesions develop in two stages: first, redness and burning sensation on the face--which characteristically is only affected on one side owing to the lateral projection of the tear gas--then, on the following day there appears an oedema similar to Quincke's oedema, with swelling of the eyelids. Oozing rapidly turns to crusts, and in the absence of treatment infection is the rule. Cure requires as many as 10 to 15 days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Chloroacetophenone (CN) is used as a tear gas for riot control and as a kind of chemical Mace against small groups or individuals. Among other side-effects, CN can evoke toxic and allergic contact dermatitis, and more rarely exanthematous or anaphylactic reactions. It is difficult to distinguish between toxic and allergic reactions both in the clinical picture of dermatitis as well as on the basis of skin test reactions. We report on a patient with allergic contact dermatitis, which first appeared 5 days after exposure to CN as a sign of primary sensitization, leading to an intense eczematous reaction in skin tests. Allergy to CN does not appear to represent a handicap in normal daily life because it is solely used as tear gas and is of little significance as regards "cross-allergies" to substances in the environment.
An analysis of the 1992 Amnesty International report demonstrates the nature and global distribution of reports of human rights violations. Systematic torture was reported in 93 of 204 countries. Reports of torture were more common from regions affected by political unrest, including mass demonstrations, riots, outbreaks of violence, killings, coup attempts, civil war, armed tribal conflict, rebellions, and conflicts with various opposition groups demanding social and political reform. These observations suggest that effective measures against torture require a multilevel analysis of underlying social, political, cultural, and psychological factors. Effective care of survivors of organized violence and torture is an indispensable component of the human rights struggle and needs more scientific attention. An integrated approach involving both preventive efforts and care of survivors can promote the human rights cause.