External emergency medical disaster response: does a need exist?
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Health action programme planning is an approach that attempts to resolve the public health problems that are defined as priority. It is upon this approach that the determination of strategies, planning of objectives, the operational plan of activities and the pragmatic/professional evaluation of results, process, resources, community participation, partnerships and staff, are based. The goal concerning this is to provide the foundation of a conceptual and methodological reflection on humanitarian interventions as a planning approach within a community, and to propose elements of methods for programme planning and comprehensive, quantitative evaluation. The approach and tool presented here were tested within the context of humanitarian missions carried out in other countries, and result from a two year collaboration with Médecins du Monde.
OBJECTIVE: To describe the work of a moorland rescue team and, in particular, the medical aspects of this work. METHODS: A retrospective study of 25 years of callouts of the Dartmoor Rescue Group (DRG)-the mountain rescue team (MRT) for Dartmoor. These were analysed by cause, year, month, day of the week, and time of day. Injuries and other medical problems in casualties are described. RESULTS: 276 callouts are described. The most common cause was searching for missing persons, but 62 callouts were to known casualties. The most common medical problem was cold exhaustion. The most common injuries were to the lower leg. However, a wide variety of other medical problems including heat exhaustion was also seen. CONCLUSIONS: The Mountain Rescue Council represents MRTs in mountainous regions and those covering lower hills and moorland. It produces an annual report containing details of the incidents attended by its affiliated teams. The work of the DRG is very different from that of the Mountain Rescue Council as a whole. Medical problems other than cold exhaustion and lower leg injuries are uncommon and moorland rescue teams do not need to equip themselves to treat other medical problems but in view of the wide variety of medical problems encountered a long way from a road, good first aid training of team members is essential.
The outcome of 162 patients replacing protease inhibitors (PIs) by nonnucleoside reverse transcriptase inhibitors (NNRTIs) was retrospectively assessed. After 48 weeks of follow-up, nevirapine (NVP) and efavirenz (EFV) performed similarly well in simplification interventions in patients with undetectable viremia, while EFV provided significantly better results in rescue interventions after PI failure. Previous suboptimal exposure to nucleoside analogs conditioned lower chances of virologic success using either NVP or EFV. Both drugs were generally well tolerated, although specific toxicities could make one drug more suitable than the other for certain patients.
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This work aimed at identifying essential residues on the alpha subunit of Vibrio harveyi luciferase and elucidating their functional roles. Four conserved alpha-subunit residues at the proposed luciferase active site were initially mutated to Ala. Screening of the in vivo bioluminescence of cells expressing these mutated luciferases allowed the work to focus on alphaGlu328 for additional mutations to Phe, Leu, Gln, His, and Asp. V. harveyi luciferase is known to contain, at the same proposed active site, an unusual cis-peptide linkage between alphaAla74 and alphaAla75. To explore the structure-function relationship, luciferase variants alphaA74F and alphaA74G were constructed. The six alphaGlu328-mutated and the two alphaAla74-mutated luciferase variants were purified and characterized with respect to Vmax, Michaelis constants, light and dark decays, quantum yield, and, for alphaE328F and alphaA74F, yield of the 4a-hydroperoxyFMN intermediate and the ability to oxidize aldehyde substrate. Results indicated that the structural integrities of both alphaGlu328 and alphaAla74 were essential to luciferase bioluminescence activity. Moreover, the essentiality of alphaGlu328 was linked to the acidic nature of its side chain. The low activity of alphaE328A was sensitive to chemical rescue by sodium acetate, an effect that was not reproduced by phosphate. The efficiency of activity rescue by acetate progressively increased at lower pH in the range from 6.0 to 8.0, supporting the interpretation of alphaGlu328 as a catalytic general acid. The rescuing effect of acetate was on a reaction step after the formation of the 4a-hydroperoxyFMN intermediate. The exact catalytic function of alphaGlu328 is unclear, but possibilities are discussed.
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BACKGROUND: Hurricane Katrina resulted in partial or complete devastation of dialysis services throughout the Gulf Coast, including the New Orleans metropolitan area. In the immediate aftermath, dialysis had to be provided to patients by surrounding communities in Louisiana, and ultimately by dialysis programs throughout the nation. Peritoneal dialysis patients, though typically more independent, also endured challenges in continuing dialysis following Hurricane Katrina. Hurricane Rita caused similar damage to the western Gulf Coast at Lake Charles, Louisiana and Beaumont, Texas and further delayed recovery of dialysis services in the New Orleans metropolitan area. SETTING: A review of the problems created by the disaster provided many opportunities to improve healthcare delivery and to prepare for recovery from the event. Understanding what happened to the delivery of dialysis and chronic kidney disease services allows the opportunity to develop better systems to support this particularly vulnerable population of patients. CONCLUSION: Many lessons can be learned from these events to minimize future interruption of dialysis services in the face of natural disasters such as hurricanes.
Gene-targeted mice lacking the AMPA receptor subunit GluR-A (also called GluR1 encoded by the gene Gria1,) have deficits in hippocampal CA3-CA1 long-term potentiation (LTP) and have profoundly impaired hippocampus-dependent spatial working memory (SWM) tasks, although their spatial reference memory remains normal. Here we show that forebrain-localized expression of GFP-tagged GluR-A subunits in GluR-A-deficient mice rescues SWM, paralleling its rescue of CA3-CA1 LTP. This provides powerful new evidence linking hippocampal GluR-A-dependent synaptic plasticity to rapid, flexible memory processing.
The applications of space communications technology to various critical human needs are discussed. Satellite communications, telemetry, and biotelemetry have provided timely and crucial communications capabilities over remote distances. The use of satellite/beacon systems have been used for disaster relief as well as search and rescue operations. The combination of telemetry and electronic medical systems (telemedicine) have augmented existing health care delivery and have provided consultation links between remotely located health care specialists working with patients and physicians at a central location. This has been expanded into networks to respond to victims of disasters in need of critical medical assistance with the hope that with further work, telemedicine may become available to all nations through an international network.
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