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Biomedical subjects

T Meredith

Publications and source records attributed to T Meredith.

At least 19 recordsLinked to original sources

Global surveillance for chemical incidents of international public health concern.

OBJECTIVE: In December 2001, an expert consultation convened by WHO identified strengthening national and global chemical incident preparedness and response as a priority. WHO is working towards this objective by developing a surveillance and response system for chemical incidents. This report describes the frequency, nature and geographical location of acute chemical incidents of potential international concern from August 2002 to December 2003. METHODS: Acute chemical incidents were actively identified through several informal (e.g. Internet-based resources) and formal (e.g. various networks of organizations) sources and assessed against criteria for public health emergencies of international concern using the then proposed revised International Health Regulations (IHR). WHO regional and country offices were contacted to obtain additional information regarding identified incidents. FINDINGS: Altogether, 35 chemical incidents from 26 countries met one or more of the IHR criteria. The WHO European Region accounted for 43% (15/35) of reports. The WHO Regions for Africa, Eastern Mediterranean and Western Pacific each accounted for 14% (5/35); South-East Asia and the Americas accounted for 9% (3/35) and 6% (2/35), respectively. Twenty-three (66%) events were identified within 24 hours of their occurrence. CONCLUSION: To our knowledge this is the first global surveillance system for chemical incidents of potential international concern. Limitations such as geographical and language bias associated with the current system are being addressed. Nevertheless, the system has shown that it can provide early detection of important events, as well as information on the magnitude and geographical distribution of such incidents. It can therefore contribute to improving global public health preparedness.

Bioterrorism↗

Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial.

OBJECTIVE: To examine long-term safety and efficacy for weight loss of an herbal Ma Huang and Kola nut supplement (90/192 mg/day ephedrine alkaloids/caffeine). DESIGN: Six-month randomized, double-blind placebo controlled trial. SUBJECTS: A total of 167 subjects (body mass index (BMI) 31.8+/-4.1 kg/m(2)) randomized to placebo (n=84) or herbal treatment (n=83) at two outpatient weight control research units. MEASUREMENTS: Primary outcome measurements were changes in blood pressure, heart function and body weight. Secondary variables included body composition and metabolic changes. RESULTS: By last observation carried forward analysis, herbal vs placebo treatment decreased body weight (-5.3+/-5.0 vs. -2.6+/-3.2 kg, P<0.001), body fat (-4.3+/-3.3 vs. -2.7+/-2.8 kg, P=0.020) and LDL-cholesterol (-8+/-20 vs. 0+/-17 mg/dl, P=0.013), and increased HDL-cholesterol (+2.7+/-5.7 vs. -0.3+/-6.7 mg/dl, P=0.004). Herbal treatment produced small changes in blood pressure variables (+3 to -5 mm Hg, P< or =0.05), and increased heart rate (4+/-9 vs. -3+/-9 bpm, P<0.001), but cardiac arrhythmias were not increased (P>0.05). By self-report, dry mouth (P<0.01), heartburn (P<0.05), and insomnia (P<0.01) were increased and diarrhea decreased (P<0.05). Irritability, nausea, chest pain and palpitations did not differ, nor did numbers of subjects who withdrew. CONCLUSIONS: In this 6-month placebo-controlled trial, herbal ephedra/caffeine (90/192 mg/day) promoted body weight and body fat reduction and improved blood lipids without significant adverse events.

Blood Glucose↗

Persistent organic pollutants: potential health effects?

It is not a point of debate that the Stockholm Convention for the prevention of further accumulation of persistent organic pollutants (POPs) should be ratified and implemented by all countries. However, in their article, Schafer and Kegley present an unbalanced "worst case scenario". Approximately 20% of the food supply of the US is contaminated with POPs at extremely low levels; these levels are comparable to those found in many other countries. Furthermore, there is no scientific consensus that these levels are hazardous to most humans. More information is needed to determine the actual risks of extremely low levels of POPs to human health.

Adult↗

Evaluation of a proposed method for representing drug terminology.

In the absence of a single, standard, multipurpose terminology for representing medications, the HL7 Vocabulary Technical Committee has sought to develop a model for such terms in a way that will provide a unified method for representing them and supporting interoperability among various terminology systems. We evaluated the preliminary model by obtaining terms, represented in our model, from three leading vendors of pharmacy system knowledge bases. A total of 2303 terms were obtained, and 3982 pair-wise comparisons were possible. We found that the components of the term descriptions matched 68-87% of the time and that the overall descriptions matched 53% of the time. The evaluation has identified a number of areas in the model where more rigorous definitions will be needed in order to improve the matching rate. This paper discusses the implications of these results.

Artificial Intelligence↗

Evaluation of antidotes: activities of the International Programme on Chemical Safety.

Important developments concerning the role of antidotes in managing poisoning cases have taken place in recent decades due to new toxicodynamic and toxicokinetic studies and to growing international concern regarding the effectiveness of antidotes. A number of activities are carried out by the International Programme on Chemical Safety which aim to: (1) evaluate their effectiveness in clinical practice, (2) disseminate evaluated information, and (3) promote the availability of useful antidotes. The International Programme on Chemical Safety has undertaken the preparation of Antidote Monographs that summarize and assess the clinical use, mode of action, effectiveness, and other evaluated information, and a consolidated International Programme on Chemical Safety List of Antidotes that classifies antidotes and related drugs by their clinical effectiveness and urgency of need. A chart of Antidote Dosages, with information concerning the recommended antidotes and their indications, is being prepared, and the Availability of Antidotes in different countries is being surveyed. Further International Programme on Chemical Safety initiatives are also being undertaken in the area of antidotes and clinical toxicology in order to examine particular issues. The International Programme on Chemical Safety INTOX Project and related activities provide powerful tools for multicenter studies, but such research faces continuing financial and regulatory difficulties. Twinning arrangements between scientists from different parts of the world are being promoted to enhance the capabilities of evaluating treatment procedures and to compare clinical data. International organizations have important aims: to promote adequate and appropriate regulations and increase antidote availability, to establish international consensus and to increase interest in co-operative research. Cooperation with scientific bodies is essential in supporting these aims.

Animals↗

Uveal effusion syndrome associated with primary pulmonary hypertension and vomiting.

PURPOSE: We treated a 69-year-old woman with bilateral uveal effusions associated with primary pulmonary hypertension, congestive heart failure, and vomiting. METHODS: The patient underwent ophthalmoscopic, echocardiographic, and fluorescein angiographic examinations. RESULTS: Increased venous pressure caused by congestive heart failure and vomiting was implicated as the cause of bilateral uveal effusions. The uveal effusions responded well to systemic furosemide. CONCLUSION: Primary pulmonary hypertension with right-sided congestive heart failure and vomiting can lead to the development of uveal effusions.

Aged↗

Pulmonary complications of acquired immunodeficiency syndrome.

Acquired immunodeficiency syndrome (AIDS) is becoming an increasingly important public health problem. This article concerns the pulmonary complications of AIDS, both infectious and neoplastic. After a brief historical introduction, the pathophysiologic mechanisms are presented, followed by a description of the clinical manifestations of AIDS and its pulmonary complications.

Acquired Immunodeficiency Syndrome↗