Protection enhancement strategies of potential outbreaks during Hajj.

Objective: This study aimed to assist governments and organizers of mass gathering events in reviewing existing preventive measures for disease outbreaks to inform the adoption of enhanced strategies for risk reduction and impacts on public health.

Design: A cross-sectional, quantitative, descriptive study.

Setting: This study was conducted in a mass gathering of Hajj, an annual religious event in Mecca, Saudi Arabia.

A Survey of Disaster Medical Education in Osteopathic Medical School Curricula.

Parrillo SJ , Christensen D , Teitelbaum HS , Glassman ES . A survey of disaster medical education in osteopathic medical school curricula. Prehosp Disaster Med.

Management of ionizing radiation injuries and illnesses, part 5: local radiation injury.

This final article in the series on the medical management of ionizing radiation injuries and illnesses focuses on the effects of acute ionizing radiation exposure to one of the largest organ systems of the body-the skin. These injuries may extend beyond the skin into deeper tissues and cause local radiation injury. There are numerous causes of these injuries, ranging from industrial incidents to medical procedures.

Public health aspects of nuclear and radiological incidents.

Radiological and nuclear incidents are low probability but very high risk events. Measures can be, and have been, implemented to limit or prevent the impact on the public. Preparedness, however, remains the key to minimizing morbidity and mortality.

Management of ionizing radiation injuries and illnesses, part 4: acute radiation syndrome.

To provide proper medical care for patients after a radiation incident, it is necessary to make the correct diagnosis in a timely manner and to ascertain the relative magnitude of the incident. The present article addresses the clinical diagnosis and management of high-dose radiation injuries and illnesses in the first 24 to 72 hours after a radiologic or nuclear incident. To evaluate the magnitude of a high-dose incident, it is important for the health physicist, physician, and radiobiologist to work together and to assess many variables, including medical history and physical examination results; the timing of prodromal signs and symptoms (eg, nausea, vomiting, diarrhea, transient incapacitation, hypotension, and other signs and symptoms suggestive of high-level exposure); and the incident history, including system geometry, source-patient distance, and the suspected radiation dose distribution.

Use of alternate healthcare facilities as alternate transport destinations during a mass-casualty incident.

The purpose of this discussion is to review the use of destinations other than the hospital emergency department, to transport patients injured as a result of a mass-casualty incident (MCI). A MCI has the ability to overwhelm traditional hospital resources normally thought of as appropriate destinations for the transport of injured patients. As a result, those with less severe injuries often are required to wait before they can receive definitive treatment.

Principles of disaster planning for the pediatric population.

Unique physiological, developmental, and psychological attributes of children make them one of the more vulnerable populations during mass-casualty incidents. Because of their distinctive vulnerabilities, it is crucial that pediatric needs are incorporated into every stage of disaster planning. Individuals, families, and communities can help mitigate the effects of disasters on pediatric populations through ongoing awareness and preventive practices.

Stevens-Johnson syndrome and toxic epidermal necrolysis.

Since their first descriptions in 1922 and 1948, respectively, Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) have become recognized as manifestations--with different severity--of the same disease process along a spectrum of illness. Even today, decades after their description, there is still disagreement about when a particular bullous disease evolves from erythema multiforme to SJS/TEN. There is no disagreement, however, about the potentially life-threatening nature of the disease.

Incidence of occult upper gastrointestinal bleeding in patients presenting to the ED with hematochezia.

Objective: The aim of the study was to determine the incidence of nasogastric (NG) aspiration revealing a clinically unsuspected upper gastrointestinal (GI) bleeding in patients presenting to the emergency department (ED) with hematochezia. A secondary aim was to identify factors associated with an upper GI source.

Methods: Data were prospectively collected from patients 18 years or older with either bright red blood per rectum or maroon stools.