Second Death From Flesh-Eating-Bacteria Infection After Hurricane Harvey Is Reported

 

A 31-year-old man who helped to repair homes in Galveston, Texas after flooding caused by Hurricane Harvey was recently diagnosed with flesh-eating bacteria and died on October 16th after being admitted to a hospital on October 10th, according to a statement released by health officials in Galveston on Monday.

He is the second person to die from flesh-eating bacteria since Hurricane Harvey struck the Gulf Coast. Two weeks ago, a 77 year old woman died after a fall inside her flooded home in which she cut her arm and subsequently contracted the flesh-eating bacteria.

When the man initially presented to the hospital on October 10th, officials described an infected wound affecting the upper portion of his left arm.

The aggressive and deadly soft tissue infection is formally referred to as necrotizing fasciitis . It’s a rare infection under normal circumstances, but if promptly recognized, diagnosed and treated with the appropriate antibiotics and surgery to remove dead or dying tissue, the majority of patients recover without any serious consequences.

Necrotizing fasciitis, or “nec fasc”, is most commonly caused by Group A Strep , but a mixed infection with anaerobic bacteria including Clostridium may also develop, leading to what is commonly known as gas gangrene. Necrotizing fasciitis causes pain out of proportion in the affected area, relative to the degree of injury.

A cut, scrape, puncture or any break in the skin may serve as a portal of entry for the dangerous bacteria, which then leads to destruction of blood vessels, fat, nerves and a white fibrous covering of the muscle known as the fascia. The infection then proceeds to enter the muscle, compromising blood flow and leading to death of the tissue.

Its important to realize that bacteria don’t actually digest the tissue, but instead produce a deadly toxin that is responsible for the extensive tissue damage.

As the bacteria enter the bloodstream, fever, chills and vomiting may rapidly develop, leading to a dangerous condition known as sepsis which is characterized by low blood pressure, rapid and difficult breathing and confusion.

Early warning signs include severe pain and tenderness in the infected area, spreading redness and warmth and blue to purple skin discoloration, with darkened tissue in the later stages. The presence of gas or air in the soft tissue known as “crepitus” produces a crackling sound or crunching sensation if the area of skin is palpated. An abscess containing pus may also form as the infection becomes more organized.

Necrotizing fasciitis is a surgical emergency. Aggressive fluid resuscitation along with broad spectrum antibiotics must be started promptly with emergent preparation for surgery to remove or debride the affected area in order to contain the infection.

Persons with diabetes, chronic kidney disease and cancer who are receiving chemotherapy are most at risk for complications, due to poor blood supply to skin, muscle and soft tissue from having such chronic conditions.

Flood waters harboring bacteria (from sewage), along with dirty surfaces or debris contacting the victim’s initial cut or injury, likely led to the onset of this aggressive and deadly infection. As a general rule, it’s best to keep all cuts or blisters covered with a dry gauze and waterproof type dressing if there is any potential to come in contact with floodwater or dirty surfaces or debris.

The CDC describes about 700-1,110 cases annually in the U.S., the result of an active surveillance and reporting network that is set up to monitor such aggressive infections.

Cases of typhoid and cholera, invasive and aggressive diarrheal illnesses typically associated with floods in developing countries, never materialized after the hurricane, according to data from the CDC. In addition, cases of tetanus, which can develop from heavily contaminated wounds after soil exposure, have generally not been a concern with such flooding in the U.S., as supported by data from the CDC.

“Necrotizing fasciitis is caused by strep group A (flesh-eating bacteria) or anaerobic bacteria which thrive in areas without oxygen,” said Debra Spicehandler, MD, Co-Chief of Infectious Diseases, Northern Westchester Hospital.  ”Antibiotics are important but swift surgical debridement is necessary. The cases caused by strep release a toxin which can also cause systemic effects and organ failure leading to mortality.”

Read More: http://snip.ly/rjcse#https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/robertglatter/2017/10/25/second-victim-of-flesh-eating-bacteria-after-hurricane-harvey-dies/&refURL=&referrer=

Sneak Peak into World’s Largest Flying Restaurant [Infographic]

World's largest flying restaurant - first class in Emirates
First class cabin passenger in Emirates Airline enjoying her dinner. Photo-Emirates

How does a global airline like Emirates cater to the needs of its over 55 million customers? Here’s a neat infographic that gives you a glimpse into how Dubai’s flagship airline is able to meet and exceed its customer’s gastronomic requirements!

Emirates serves more than 100 million meals a year with the same attention to detail in First, Business and Economy Class. Catering for more than 55 million dine-in guests a year travelling to and from 144 cities across 6 continents, no one understands global culinary trends better than Emirates as it serves destination-inspired cuisine onboard the world’s largest flying restaurant.

With a catering investment of US$1 billion per year, Emirates runs a round-the-clock kitchen with 1,200 chefs based in Dubai whipping up 12,450 recipes. The finely-tuned operation caters 590 flights a day with authentic local cuisines giving customers a taste of the destination they are going to. The airline also works closely with 25 catering partners around the world to provide the same quality of food for its Dubai-bound flights.

Infographic: Emirate Airline – Catering to the World

Infographic- world's largest flying restaurant
Catering to the world. Infographic courtesy-Emirates

Global delicacies local flavour

Emirates’ focus on local flavour means it has food available from every region it flies to. Flights to Japan for example, offer authentic Kaiseki cuisine and Bento boxes served with Japanese crockery, cutlery and tea sets to ensure an unrivalled food experience on board.

The airline recently launched a new menu for its Australian routes inspired by the breadth of the country’s multicultural flavours and cuisines, after a 14-month process working in consultation with local chefs.

The new menu features a broad range of traditional local favourites such as minted lamb sausages. Reflecting Australia’s multiculturalism, the menu also includes Asian flavours, as well as Middle Eastern flavours and ingredients, catering to Emirates’ diverse passenger mix and representing its global route network.

To keep up with regional and seasonal food trends, Emirates changes its onboard menus monthly and continually reviews its recipes.

The varied menus on each route are also reflected in the bread baskets served on board. Flavoured breads or breads produced with a sourdough base are popular on European routes while parathas, pooris, and naan bread are served on all nine Emirates routes to India. On its Middle Eastern routes, customers get to enjoy Arabic bread – Markook – a very thin unleavened bread common in the region, and Manakesh which is either topped with Zaatar or Cheese.

In premium classes, meals are served on Royal Doulton tableware with Robert Welch cutlery specially designed for Emirates.

Global partners, best of local and artisanal produce

Emirates focuses on simple, well cooked dishes that emphasise fresh ingredients of the highest quality. The airline brings the finest products on board through long standing partnerships worldwide, and supporting local suppliers and artisans. This includes sourcing over 15,000 kilograms of Persian feta from the Yarra Valley in Australia each year. The olive oil served on board is exclusively from carbon neutral producer Monte Vibiano in Italy, a partnership that is now more than 15 years old.

 

Are you ready to Growing Up

Understanding Kidney Tumours

Kidneys are two bean-shaped organs located on the left and right side of the spine. They sit against the back muscles in the upper abdominal cavity. They are responsible for the extraction of waste from the blood, balancing body fluids, formation of urine, and facilitating other important functions of the body.

Kidney tumours are tumours (or growths) on or in a kidney and are also known as renal tumours. They can be benign (harmless) or malignant (leading to cancer).

Understanding Kidney Tumours.jpg

There are many forms of kidney tumours. Among the malignant types, the most commonly occurring type of kidney cancer is Renal Cell Carcinoma (RCC), accounting for 95% of cases in adults. The other types are Mesoblastic Nephroma (a congenital tumour, detected prenatally or after birth, before the age of 4), and Metastatic tumour or ovarian cancer. Among the benign forms of tumours are Renal Oncocytoma (a tumour made by special cells called oncocytes), Cystic Nephroma (a benign tumour that can look like an RCC and has cysts), Angiomyolipoma (most common form of benign tumours, though they can cause blood vessels to dilate and burst, leading to bleeding), Metanephric Adenoma (a rare tumour that can look like a papillary RCC) and Renal Medullary Fibroma (bland spindle-shaped or stellate-shaped cells that form a benign tumour).

Any problem with the kidneys is usually accompanied by symptoms such as difficulty in passing urine, blood in urine, pain in the abdomen, etc. However, not all kidney problems are caused by tumours. The tumours can be detected through:

1) Blood and urine tests

2) Imaging tests such as CT and MRI scans

3) Biopsy (removing a sample tissue of the kidney)

Are you ready to Growing Up

Depression: Is brain inflammation tied to suicidal thoughts?

Depression Is brai.jpg
A new study confirms the link between inflammation of the brain and the prevalence of suicidal thoughts in people diagnosed with major depression. This is the first study of its kind to measure relevant biomarkers in living individuals.

Major depression is a very common mental condition, with 6.7 percent of all adults in the United States having had at least one severe depressive episode in 2014 or 2015.

According to the World Health Organization (WHO), depression is also currently the leading cause of years spent with disability worldwide.

Some people diagnosed with major depression experience suicidal thoughts, which may result in suicide attempts. In the U.S., “suicide is the 10th leading cause of death.” Now, researchers wonder whether or not suicidal ideation in people with major depression may be linked to abnormal inflammation of the brain.

Dr. Peter Talbot and other researchers based at the University of Manchester in the United Kingdom have conducted a study testing the levels of a biomarker associated with brain inflammation in the systems of people diagnosed with clinical depression.

The scientists’ findings were reported in the journal Biological Psychiatry.

 

Read More: https://www.medicalnewstoday.com/articles/319526.php?utm_campaign=sniply&utm_medium=sniply&utm_source=sniply

Mental health staff on long-term stress leave up 22%

Mental health staff on long
Image caption Some trusts saw the number of staff taking long-term leave double in five years

The number of NHS mental health staff who have had to take sick leave because of their own mental health issues has risen by 22% in the past five years.

Those taking long-term leave of a month or more rose from 7,580 in 2012-13 to 9,285 in 2016-17, BBC freedom of information requests found.

The union Unite said cuts to staff and services were putting extra pressure on front-line mental health workers.

The Department of Health said it was transforming mental health care.

Out of 81 mental health authorities in England, Scotland, Wales and Northern Ireland, 58 provided the BBC with comparable information.

Looking after ourselves

One mental health doctor who had to take mental health leave told 5 live anonymously: “I don’t think I realised it was happening until quite a long way down the road.”

She explained that she was getting irritable with her partner, her sleep was disturbed and she couldn’t switch off from work.

“In the end, I went to my GP who offered me a sick note. I was quite taken aback that it was quite so obvious to my GP that I needed to be off work.” she said.

Media captionFormer mental health nurse on why she had to leave the NHS

“As mental health practitioners, we are pretty rubbish at putting our own mental health first. You need to put your own oxygen mask on first before putting it on to someone else.”

5 live also spoke to a group of community mental health nurses at the Leeds and York Partnership NHS Foundation Trust about how they cope with the pressure of the role.

“I think when you’re so passionate about something it’s very easy to overlook just how much you are taking on,” said Kate Ward, an occupational therapist working as a care co-ordinator in the team.

Read More: http://snip.ly/okuj8#http://www.bbc.com/news/health-41172805

FDA Finalizes Guidance on Interoperable Medical Devices

On September 6, 2017, FDA finalized a guidance document entitled “Design Considerations and Pre-Market Submission Recommendations for Interoperable Medical Devices” (“Final Guidance”). In the Final Guidance, the agency outlines design considerations for manufacturers when developing interoperable medical devices, as well as recommendations about information to include in premarket submissions and device labeling. Interoperability of devices can encourage the availability and sharing of information across systems, even when products from different manufacturers are used. A draft of this guidance was issued on January 26, 2016.

The Final Guidance defines “interoperable medical devices” as medical devices “that have the ability to exchange and use information through an electronic interface with another medical/non-medical product, system, or device.” These functions can consist of a one-way data transmission to another device or product, or more complex interactions in which command and control is exercised over another device. An “electronic interface” is defined as the medium by which systems communicate with each other, and includes both the type of connection and the information content.

According to the Final Guidance, the agency considers the management of risks associated with an electronic interface incorporated into a medical device to be part of a comprehensive quality system under 21 C.F.R. Part 820. Manufacturers of interoperable medical devices should perform a risk analysis and conduct appropriate testing addressing the risks associated with interoperability, the anticipated users, reasonably foreseeable misuse, and reasonably foreseeable combinations of events that can result in a hazardous situation. In particular, the Final Guidance identifies the following considerations that manufacturers should take into account and “appropriately tailor[]” to the device’s interface technology, intended use, and use environments

Read More: http://snip.ly/jeird#https://www.lexology.com/library/detail.aspx?g=54c0daa5-aed0-4976-995b-5e0204c336c4

Graham-Cassidy health care bill: What you need to know

unnamed

Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana have drafted the latest Republican attempt to repeal Obamacare. The bill would overhaul or eliminate major sections of the health care law, including its subsidized insurance coverage and Medicaid expansion. Instead, states would receive block grants, or a lump sum of money from the federal government, which they could use largely as they see fit.

How Graham-Cassidy would alter federal funding

Center on Budget and Policy Priorities analysis

The liberal-leaning think tank Center on Budget and Policy Priorities released estimates of how federal funding would change if the bill became law. In its analysis, California would be hardest hit, losing $27.8-billion in funding.

  • $-15,000
  • $-10,000
  • $-5,000
  • $0
  • $5,000
  • $8,500

ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Graham-Cassidy-Heller-Johnson block grant model

Cassidy’s office released its own estimates. Massachusetts takes the hardest hit with a more than $5 billion loss in funding. Overall, Southern states that did not expand Medicaid are poised to receive more in federal funding.

  • $-5,000
  • $-2,000
  • $0
  • $1,000
  • $3,000
  • $5,000
  • $10,000
  • $16,000

ALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

The bill comes after three failed GOP repeal attempts in the Senate, and a proposal from Sen. Bernie Sanders to extend the reach of government subsidized health care to all Americans.

But Republicans are up against a tight deadline. Their budget reconciliation bill, which allows them to overhaul Obamacare with a simple majority, expires on Sept. 30. The deadline could work to Graham’s and Cassidy’s advantage, however, by spurring hesitant Republicans to seize what may be their last opportunity to deliver on their seven-year promise to repeal Obamacare.

 

Read More: http://snip.ly/v5ygq#http://www.politico.com/interactives/2017/graham-cassidy-health-care-bill-what-you-need-to-know/