Proposed Mitigation and Adaptation Strategies Related to Climate Change: Guidance for OEM Professionals.

Climate change is an urgent challenge amplified by socioeconomic factors that demands thoughtful public health responses from OEM professionals. This guidance statement from the American College of Occupational and Environmental Medicine focuses on the different strategies that these health professionals can implement to protect workers from health impacts associated with climate change hazards, foster workplace resilience in the face of rapidly changing environments, and take the necessary steps to mitigate the effects of global climate change.

Improving Patient Outcomes in the Dual Crises of Climate Change and COVID-19: Proceedings of the Third Annual Clinical Climate Change Meeting, January 8, 2021.

The tremendous global toll of the COVID-19 pandemic does not fall equally on all populations. Indeed, this crisis has exerted more severe impacts on the most vulnerable communities, spotlighting the continued consequences of longstanding structural, social, and healthcare inequities. This disparity in COVID-19 parallels the unequal health consequences of climate change, whereby underlying inequities perpetuate adverse health outcomes disproportionately among vulnerable populations.

Outcomes of Osteosarcoma in Children Without High-Dose Methotrexate: Could It Be Less Toxic Without Effecting Survival Rates?

Osteosarcoma (OS) is the most common primary bone sarcoma in childhood. High-dose methotrexate, doxorubicine, cisplatin, and/or ifosfamide combinations are used as standard treatment in chemotherapy and could cause serious toxicity. Another alternative chemotherapy protocol is consisting of epirubicin, ifosfamide, and cisplatin (ECI), which we use in our center.

Coming Together for Climate and Health: Proceedings of the Second Annual Clinical Climate Change Meeting, January 24, 2020.

Climate change is imposing increasingly severe impacts on public health. Addressing these impacts requires heightened awareness of climate-driven health conditions and appropriate clinical practices to manage these conditions. Within this context, the 2 Annual Clinical Climate Change Conference, held January 24, 2020 at the New York Academy of Medicine, brought together more than 150 allied health practitioners from across the United States for a one-day conference showcasing the state of the science on the climate and health.

Strategies for Clinical Discussions About Climate Change.

This commentary links the climate crisis with the pandemic in how both are the subject of campaigns to doubt the science. The authors discuss how clinicians have a clear role to play in countering misinformation.

Health Care Pollution And Public Health Damage In The United States: An Update.

An up-to-date assessment of environmental emissions in the US health care sector is essential to help policy makers hold the health care industry accountable to protect public health. We update national-level US health-sector emissions. We also estimate state-level emissions for the first time and examine associations with state-level energy systems and health care quality and access metrics.

Assessment of Environmental Sustainability and Corporate Social Responsibility Reporting by Large Health Care Organizations.

Importance: Sustainability practices by large corporations are increasingly important to reduce the environmental and social impacts of the business enterprise. The health care industry represents 18% of the US economy, employs more people than any other economic sector, and is responsible for 10% of US carbon emissions. The engagement of large health care delivery organizations in reporting sustainability efforts has not been previously assessed.

Comparison of intravenous pantoprazole and ranitidine in patients with dyspepsia presented to the emergency department: a randomized, double blind, controlled trial.

Background: This study aimed to compare pantoprazole, a proton-pomp inhibitors (PPIs), and ranitidine, a H2 receptor antagonists (H2RA), in ceasing dyspeptic symptoms in the emergency department (ED).

Methods: This randomized, double-blinded study compared the effectiveness of 50 mg ranitidine (Ulcuran(®)) and 40 mg pantoprazole (Pantpas(®)), given in a 100 mL saline solution by an intravenous rapid infusion within 2-4 minutes in patients with dyspepsia presented to the ED. Pain intensity was measured at baseline, 30 and 60 minutes after the drug administration.

Cytomegalovirus Retinitis in Three Pediatric Cases with Acute Lymphoblastic Leukemia: Case Series and Review of the Literature.

Cytomegalovirus (CMV) retinitis is typically diagnosed in patient with AIDS and those who underwent allogeneic hematopoietic cell transplant. However, it may develop in patients with acute lymphoblastic leukemia (ALL) who have not undergone hematopoietic cell transplantation. To increase awareness of CMV retinitis in this group, we describe 3 patients ages 3, 9, and 12, with ALL who developed CMV retinitis.

Personnel response during an internal emergency-unexpected release of an irritant gas in a hospital.

Internal emergencies can occur at any time and location in a hospital. Planning, training, and exercises can prepare personnel to respond effectively to internal emergency situations. All hospital staff should be trained to recognize an internal incident and activate the hospital emergency management system.

Fire-eater's pneumonia: two case reports of accidentally aspirated paraffin oil.

Background: Fire-eater's pneumonia is a chemical pneumonitis that can develop after accidental aspiration of liquid hydrocarbon-based fuel during a flame-blowing or a fire-eating performance. Typical findings of the patient are similar with any infectious pneumonia: chest pain, shortness of breath, cough, fever, and hemoptysis can be seen.

Case Reports: We report two cases of acute paraffin oil-induced pneumonia due to accidental aspiration during fire-eating performance.

Superficial temporal artery pseudoaneurysm: ultrasonographic diagnosis in the ED.

Superficial temporal artery pseudoaneurysm (STAP) is an uncommon complication of blunt and penetrating trauma. It accounts for only 1% of all traumatic aneurysms. Superficial temporal artery pseudoaneurysm usually has the characteristic appearance of a cystic pulsatile mass in the region of the superficial temporal artery.

Clinician validation of Poison Control Center (PCC) intentional exposure cases involving prescription opioids.

Poison Control Center (PCC) cases involving intentional ingestion, injection or inhalation of prescription opioids are a potentially valuable source of information on the abuse and misuse of these products. This study sought to validate PCC classifications of prescription opioid intentional exposure cases against clinical diagnostic criteria. 4,321 cases were reviewed.

The Diversion of Ultram, Ultracet, and generic tramadol HCL.

Ultram (tramadol HCL) was approved by the Food and Drug Administration in 1994 as a non-scheduled drug under the Controlled Substance Act. The non-scheduled status was contingent on the development and implementation of a comprehensive post-marketing surveillance program by an Independent Steering Committee external to Ortho-McNeil Pharmaceutical charged with monitoring abuse and recommending scheduling if unexpectedly high abuse occurred. The program developed by this committee was composed of a variety of studies, and the results of the first three years of the surveillance efforts revealed that the rate of Ultram abuse was low.

A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain.

Concern about abuse/dependence in chronic pain patients taking opioid analgesics may lead to undertreatment of pain, yet little is known about the prevalence of abuse/dependence in these patients and how it differs among analgesic agents. The objective of this study was to assess the prevalence of tramadol abuse compared to nonsteroidal anti-inflammatory drugs (NSAIDs) and hydrocodone-containing analgesics in patients with chronic noncancer pain (CNP). The study had three arms.

Rates of abuse of tramadol remain unchanged with the introduction of new branded and generic products: results of an abuse monitoring system, 1994-2004.

Purpose: The analgesic Tramadol HCl (Ultram) was approved in 1994 as a non-scheduled drug under the CSA provided that a novel risk-management program would be developed by an Independent Steering Committee (ISC). The risk-management program began in 1995 with the launch of Ultram, and has been modified over the past decade to accommodate Ultracet (Ultram and acetaminophen) in 2001 and generic tramadol in 2002. This provided a unique opportunity to study the potential changes in abuse as the generic and combination products became available.

An independent assessment of MEDWatch reporting for abuse/dependence and withdrawal from Ultram (tramadol hydrochloride).

Objective: Assess the validity of medical products reporting program (MEDWatch) reports of abuse/dependence and withdrawal associated with Ultram (tramadol).

Methods: Reports of possible abuse/dependence or withdrawal associated with Ultram during 13 quarters following launch were spontaneously reported to the manufacturer Ortho-McNeil Pharmaceutical (OMP) and also solicited from 255 NIDA grantees and addiction treatment professionals by an Independent Steering Committee (ISC). Reports were classified by the ISC using DSM-IV criteria, by the Drug Safety and Surveillance (DSS) units of Robert Wood Johnson Pharmaceutical Research Institute (PRI) using World Health Organization Adverse Reaction Terms (WHOART) terms, and reported to the food and drug administration (FDA) via MEDWatch.

Physical dependence on Ultram (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur.

In 1994, the Drug Abuse Advisory Committee (DAAC) of the Food and Drug Administration (FDA) concluded that Ultram (tramadol hydrochloride) could be marketed as an analgesic drug without scheduling under the Controlled Substances Act based upon extensive pre-clinical, clinical and European epidemiological data. However, to guard against unexpectedly high levels of abuse in the United States, the DAAC recommended that an independent steering committee (ISC) be appointed to proactively monitor abuse/dependence. In the event that high rates of abuse were found, this ISC was given the authority to immediately recommend to the FDA that Ultram be scheduled.