RESUMO
The August, 1991 eruption of Mt. Hudson (Chile) deposited ash across southern Argentina and contributed to the deaths of thousands of grazing sheep. Early ash analysis revealed high levels of fluoride, a potential ash constituent toxic to humans and animals. In order to evaluate fluorosis as the cause of sheep deaths and to examine the possibility that similar ash and airborne toxins could also have an effect on the human population, we conducted an investigation that included health provider interviews, hospital record review, physical examination of sheep, determination of sheep urine fluoride levels, and complete constituent analysis of ash samples collected at proscribed distances from the volcano. Ash deposited farthest from the volcano had highest fluoride levels; all fluoride measurements were normal after rainfall. There were no signs or symptoms of fluorosis observed in sheep or humans. Sheep deaths resulted from physical, rather than chemical properties of the ash.
Assuntos
Poluentes Ambientais/intoxicação , Intoxicação por Flúor/etiologia , Doenças dos Ovinos/induzido quimicamente , Erupções Vulcânicas/efeitos adversos , Animais , Argentina , Chile , Poluentes Ambientais/análise , Feminino , Intoxicação por Flúor/urina , Intoxicação por Flúor/veterinária , Humanos , Tamanho da Partícula , Doenças das Plantas , Ovinos , Doenças dos Ovinos/urina , Erupções Vulcânicas/análiseAssuntos
Hospitais Gerais/organização & administração , Unidade Hospitalar de Psiquiatria/organização & administração , Encaminhamento e Consulta/organização & administração , Feminino , Prática de Grupo/organização & administração , Humanos , Masculino , Massachusetts , Cultura Organizacional , Objetivos Organizacionais , Encaminhamento e Consulta/normas , Encaminhamento e Consulta/tendências , Estados UnidosRESUMO
The increasing pervasiveness of "business" concerns in a cost-controlled medical care environment underscores the need to target communications regarding the operations of consultation-liaison (C-L) programs to the fiscal concerns of hospital and health care program administrators. Descriptions of what C-L programs have to offer should anticipate the specific interests of those who manage inpatient and ambulatory care programs and be phrased in terminology understandable by those managers.
Assuntos
Comunicação , Marketing de Serviços de Saúde/tendências , Psiquiatria/tendências , Encaminhamento e Consulta/tendências , Sistemas Pré-Pagos de Saúde/tendências , Administração Hospitalar/tendências , Humanos , Estados UnidosAssuntos
Reembolso de Seguro de Saúde , Psiquiatria/economia , Encaminhamento e Consulta/economia , Ponte de Artéria Coronária , Delírio/tratamento farmacológico , Haloperidol/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/tratamento farmacológico , Estados UnidosRESUMO
An outbreak of cadmium intoxication in a jewelry factory provided an opportunity for evaluating the usefulness of diagnostic procedures used to evaluate human cadmium toxicity. Blood cadmium levels in workers exposed to cadmium were higher (.93 micrograms/100ml vs .38 micrograms/100 ml) than in unexposed workers. A dose-response relationship was noted between blood cadmium level and symptom prevalence in four symptoms (dyspnea, chest pain, dysuria, and dizziness). Segmental hair analysis revealed highest cadmium levels (up to 19 micrograms/gm) in segments formed prior to cadmium exposure, suggesting that extrinsic contamination was the primary source of cadmium in the hair. beta2-microglobulin levels were within normal limits. No significant renal or pulmonary dysfunction was noted. Symptoms ceased after a cadmium-containing brazing alloy used in jewelry production was replaced, yet urine cadmium levels remained persistently elevated in four workers. Blood cadmium determinations were found to be useful in evaluating symptoms potentially related to cadmium intoxication.