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WHO responding to health needs caused by Typhoon Haiyan (“Yolanda”)

WHO responding to health needs caused by Typhoon Haiyan (“Yolanda”)

11 NOVEMBER2013 | MANILA, PHILIPPINES – WHO has activated an organization-wide mobilization to work closely with the Department of Health, Philippines (DoH) to organize relief efforts for the survivors of Typhoon Haiyan.

The typhoon – locally known as Yolanda – ravaged the central part of the archipelago Friday morning with winds reaching speeds of more than 250 km per hour causing storm surges of up to 5 metres. Many people living in these affected areas were injured and the devastating effects of this typhoon left already vulnerable health facilities damaged or completely destroyed. As a result of the breadth and severity of the storm, health services in the worst affected areas no longer exist or are severely stretched, with medical supplies in very short supply.

“We are working closely with the Philippine Government and local authorities to assess and rapidly address the life-saving needs of the people affected by this typhoon,” says Dr Julie Hall, WHO Representative to the Philippines. “WHO has an assessment team on the ground in Bohol, and we are sending teams to Cebu and Tacloban with the United Nations Disaster Assessment and Coordination (UNDAC) teams in support of national response efforts. WHO is flying in more than two dozen health emergency relief experts and emergency health kits for the initial response.”

The Government estimates that some 4.5 million people have been affected in the Central Philippines. WHO is mobilizing supplies to assist the Government in providing a coordinated, effective and rapid response:

  • An initial shipment of four emergency kits with medicines and supplies to cover basic health needs of 120 000 persons during one month and supplies to perform 400 surgical interventions are being deployed. Four diarrhoeal disease kits with medicines and supplies to treat 3000 cases of acute diarrhoea are also being sent.
  • WHO is also supporting the Department of Health (DoH) in strengthening its early warning alert and response network (EWARN) to rapidly detect disease outbreaks and other public health threats related to food and environmental hazards.
  • The Government is receiving international assistance such as field hospitals and medical teams, and WHO is working closely with the Government to ensure those supplies and teams go where they are needed most.
  • Medical storage spaces have also been damaged, and WHO is working to re-establish logistics bases for new supplies that are arriving.

In the aftermath of the typhoon, reaching the affected areas and people has proven to be a sizeable logistical challenge. The true extent of the death and destruction has yet to be quantified. The super typhoon ripped roofs off houses and uprooted trees, interrupting telecommunications and electricity supplies. Many air- and sea-ports in the affected areas are closed. Until roads are cleared, movement will be difficult in these areas, posing significant logistical challenges to emergency relief operations.

Adding to the complexity of this response, another tropical storm is expected to hit the Philippines later this week. Foreign governments and international aid agencies have already pledged support in the form of air transportation and equipment, but more help is urgently needed to save the lives of the survivors.

WHO’s rapid deployment of health experts and supplies to the Philippines has been possible thanks to the financial support for surge capacity provided by numerous international partners, including the European Commission. Due to the magnitude of the disaster, WHO is seeking immediate financial contributions to cover initial response operations. A joint appeal by United Nations and non-governmental organizations will be issued in the coming days.

For more information, or for an interview with Dr Julie Hall, WHO Representative, please contact:

Ms Christine “Tiffany” Domingo-Cool
Event Response operations/Risk communications
Telephone: +639 15 710 4361
E-mail: domingoc@wpro.who.int

Christy Feig
Director of Communications
Telephone: +41 79 251 7055
E-mail: feigc@who.int

Gregory Härtl
Coordinator, News and Social Media
Telephone: +41 79 203 6715
E-mail: hartlg@who.int

Are air pollution and traffic noise independently associated with atherosclerosis: the Heinz Nixdorf Recall Study.

Are air pollution and traffic noise independently associated with atherosclerosis: the Heinz Nixdorf Recall Study.

Source

West German Heart Center Essen, University Hospital, University of Duisburg-Essen, Essen, Germany.

Abstract

AIMS:

Living close to high traffic has been linked to subclinical atherosclerosis, however it is not clear, whether fine particulate matter (PM) air pollution or noise, two important traffic-related exposures, are responsible for the association. We investigate the independent associations of long-term exposure to fine PM and road traffic noise with thoracic aortic calcification (TAC), a reliable measure of subclinical atherosclerosis.

METHODS AND RESULTS:

We used baseline data (2000-2003) from the German Heinz Nixdorf Recall Study, a population-based cohort of 4814 randomly selected participants. We assessed residential long-term exposure to PM with a chemistry transport model, and to road trafficnoise using façade levels from noise models as weighted 24 h mean noise (Lden) and night-time noise (Lnight). Thoracic aortic calcification was quantified from non-contrast enhanced electron beam computed tomography. We used multiple linear regression to estimate associations of environmental exposures with ln(TAC+1), adjusting for each other, individual, and neighbourhood characteristics. In 4238 participants (mean age 60 years, 49.9% male), PM2.5 (aerodynamic diameter ≤2.5 µm) and Lnight are both associated with an increasing TAC-burden of 18.1% (95% CI: 6.6; 30.9%) per 2.4 µg/m3 PM2.5 and 3.9% (95% CI 0.0; 8.0%) per 5dB(A) Lnight, respectively, in the full model and after mutual adjustment. We did not observe effect measure modification of the PM2.5 association by Lnight or vice versa.

CONCLUSION:

Long-term exposure to fine PM and night-time traffic noise are both independently associated with subclinical atherosclerosis and may both contribute to the association of traffic proximity with atherosclerosis.

Iterative Reconstruction Algorithm for CT: Can Radiation Dose Be Decreased While Low-Contrast Detectability Is Preserved?

Iterative Reconstruction Algorithm for CT: Can Radiation Dose Be Decreased While Low-Contrast Detectability Is Preserved?

Source

Department of Medical Imaging, University Health Network, University of Toronto, Toronto, Ont, Canada; Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland.

Abstract

Purpose: To compare the low-contrast detectability and image quality of computed tomography (CT) at different radiation dose levels reconstructed with iterative reconstruction (IR) and filtered back projection (FBP). Materials and Methods: A custom liver phantom with 12 simulated hypoattenuating tumors (diameters of 5, 10, 15, and 20 mm; tumor-to-liver contrast values of -10, -20, and -40 HU) was designed. The phantom was scanned with a standard abdominal CT protocol with a volume CT dose index of 21.6 mGy (equivalent 100% dose) and four low-dose protocols (20%, 40%, 60%, and 80% of the standard protocol dose). CT data sets were reconstructed with IR and FBP. Image noise was measured, and the tumors’ contrast-to-noise ratios (CNRs) were calculated. Tumor detection was independently assessed by three radiologists who were blinded to the CT technique used. A total of 840 simulated tumors were presented to the radiologists. Statistical analyses included analysis of variance. Results: IR yielded an image noise reduction of 43.9%-63.9% and a CNR increase of 74.1%-180% compared with FBP at the same dose level (P < .001). The overall sensitivity for tumor detection was 64.7%-85.3% for IR and 66.3%-85.7% for FBP at the 20%-100% doses, respectively. There was no significant difference in the sensitivity for tumor detection between IR and FBP at the same dose level (P = .99). The sensitivity of the protocol at the 20% dose with FBP and IR was significantly lower than that of the protocol at the 100% dose with FBP and IR (P = .019). Conclusion: As the radiation dose at CT decreases, the IR algorithm does not preserve the low-contrast detectability. © RSNA, 2013 Supplemental material:http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13122349/-/DC1.

The reversal of cardiology practices: interventions that were tried in vain http://www.thecdt.org/article/view/2854

The reversal of cardiology practices: interventions that were tried in vain http://www.thecdt.org/article/view/2854

Authors: Vinay Prasad, Adam Cifu

Abstract

Medical reversal happens when new trials—better powered, designed or controlled than predecessors–contradict current standard of care. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial and CAST study are notable examples of investigations that overturned current practice by demonstrating that these interventions offered no survival benefits. In this mini-review, we summarize our experience reviewing a decade of original articles in the New England Journal of Medicine with an eye towards investigations that reversed cardiology practice. From the management of arrhythmias to lipids to percutaneous coronary intervention (PCI) and finally, hemodynamics, reversals in the cardiology literature cover a broad set of practices. These reversals are instructive in that many of the therapies overturned were widely adopted and based on either sound physiologic reasoning or observational trials.