Archive for March, 2009

Medicine

Crappy for Six or Shitty for Two: Standard Tuberculosis Prophylaxis Regimens

High-risk patients who’ve been exposed to TB or recently converted to positive PPD’s need some kind of preventative Rx. This is not the same as the Tx options which the CDC recommends based on standard RIPE-S therapy, however we have some tough choices to make.

ISONIAZID for six months? Hmm. It can cause hepatitis, peripheral neuropathy and a “lupus-like” syndrome.

We can get away with only two months of treatment with AE that are much worse, using Rifampin and Pyrazinamide - where we’ll get red-orange piss, sweat and tears, as well as a potential hepatitis and in exchange for something lupus-like we go “flu-like” for the duration with myalgia and gout possibly too.

Either way it is not a pretty way to spend your time but at least better than taking HAART therapy after a needle stick. Jeez. There has to be a better way on the horizon!

Medicine

The Salmonella Outbreak

It is time again to get involved with others. Times are getting increasingly difficult and this is primarily due to selfishness. One of the things we can do is to become more involved in our own governance. Here is a copy of a letter I wrote to lawmakers on the recent salmonella outbreak, something seemingly minor when compared to the collapse of the global economy, but nonetheless a symptom of the same disease: that is, a failure of the people to ensure their own future by allowing government’s role of enforcement to be reversed by the regulated community. Get involved and fight for a civil society!

Salmonella EM

<meta name="GENERATOR" content="OpenOffice.org 2.1 (Win32)" /><meta name="CREATED" content="20090208;13203900" /><meta name="CHANGEDBY" content="Robert Johnson" /><meta name="CHANGED" content="20090208;14170700" /><style> <!-- @page { size: 8.5in 11in; margin: 0.79in } P { margin-bottom: 0.08in } --> </style></p> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">The Honorable Senator Patrick Leahy</font></font></p> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">433 Russell Senate Office Bldg<br /> United States Senate<br /> Washington, DC 20510 FAX (202) 224-3479</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">February 08, 2009</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2"><strong>RE: Salmonella Outbreak</strong></font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">Mr. Leahy,</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">I am writing to express a conceptual framework by which lawmakers should define their approach to the <em>Salmonella typhimurium </em>outbreak attributed to Peanut Corporation of America.</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">To briefly express my background, I am a former Environmental Investigation officer of the Washington, D.C. Department of Health and am currently a third year M.D. student on clinical rotations in New Jersey. In addition I have experience working for a private, food-testing contract laboratory.</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><strong><font face="Arial"><font size="2">If a few months ago I were to discuss with members of Congress a historical incident in which toxigenic bacteria were knowingly distributed to American citizens resulting in several deaths one would likely first recall the Anthrax attacks of 2001.</font></font></strong></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><strong><font face="Arial"><font size="2">Interstingly enough, the species of bacteria implicated in the current peanut contamination was also used for intentional harm in what is considered the most extensive bioterror event in the U.S., that is the 1984 “Rajneeshee” food poisoning attack which sickened over 750 people in The Dalles, Oregon.</font></font></strong></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><strong><font face="Arial"><font size="2">In short the current crisis might come to be differentiated from these aforementioned incidents on the basis of intent, but it is also unique in that the number of fatalities from the current situation exceeds the total loss of life from these other two events combined!</font></font></strong></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">“Testing to compliance” is essentially a practice which puts at risk, not only our nation’s food and pharmaceutical products, but the quality of our water, air, transportation systems and manufactured goods. Unfortunately I have observed this practice in multiple venues. It is therefore imperative that Congress provide for the appropriate regulatory agencies, sophisticated monitoring and enforcement branches in order to ensure compliance.</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">American citizens have collectively chosen a safe society and it is this image we wish to project to the international community and ourselves. It is time that we no longer let some bad apples (or peanuts as it were) spoil the bunch.</font></font></p> <p style="margin-bottom: 0in"> <p style="margin-bottom: 0in"><font face="Arial"><font size="2">Thank you for your attention to this matter. It is sincerely appreciated.</font></font></p> <p style="margin-bottom: 0in"> <!-- <rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:trackback="http://madskills.com/public/xml/rss/module/trackback/"> <rdf:Description rdf:about="http://colorspace.us/wordpress/archives/54" dc:identifier="http://colorspace.us/wordpress/archives/54" dc:title="The Salmonella Outbreak" trackback:ping="http://colorspace.us/wordpress/archives/54/trackback/" /> </rdf:RDF> --> </div> <p class="post-info"> <em class="date">08 Mar 2009</em> <em class="user"><a href="http://colorspace.us/wordpress/archives/author/admin/" title="Posts by agkistrodon">agkistrodon</a></em> <span></span> <span class="post-comments"><a href="http://colorspace.us/wordpress/archives/54#respond" title="Comment on The Salmonella Outbreak">0 comments</a></span> </p> </div> <p align="center"></p> </div> <div id="sidebar"> <ul> <li class="sideitem"> <h2><label for="s">Search</label></h2> <form id="searchform" method="get" action="http://colorspace.us/wordpress/index.php"> <input type="text" class="textbox" name="s" id="s" value="" size="15" /><br /> <input type="submit" name="submit" value="Go" /> </form> </li> <li class="sideitem"> <h2>Archives</h2> <ul> <li><a href='http://colorspace.us/wordpress/archives/date/2009/12/' title='December 2009'>December 2009</a> (1)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2009/10/' title='October 2009'>October 2009</a> (1)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2009/08/' title='August 2009'>August 2009</a> (1)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2009/03/' title='March 2009'>March 2009</a> (2)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2008/11/' title='November 2008'>November 2008</a> (1)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2008/03/' title='March 2008'>March 2008</a> (2)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2007/02/' title='February 2007'>February 2007</a> (2)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2007/01/' title='January 2007'>January 2007</a> (2)</li> <li><a href='http://colorspace.us/wordpress/archives/date/2006/12/' title='December 2006'>December 2006</a> (1)</li> </ul> </li> <li class="sideitem"> <h2>Tags</h2> <ul> <li><a href="http://colorspace.us/wordpress/archives/category/uncategorized/" title="View all posts filed under Uncategorized">Uncategorized</a> (1) </li> <li><a href="http://colorspace.us/wordpress/archives/category/mold/" title="View all posts filed under Mold">Mold</a> (1) </li> <li><a href="http://colorspace.us/wordpress/archives/category/chemistry/" title="View all posts filed under Chemistry">Chemistry</a> (1) </li> <li><a href="http://colorspace.us/wordpress/archives/category/medicine/" title="View all posts filed under Medicine">Medicine</a> (7) </li> <li><a href="http://colorspace.us/wordpress/archives/category/grenada/" title="View all posts filed under Grenada">Grenada</a> (2) </li> <li><a href="http://colorspace.us/wordpress/archives/category/obama/" title="View all posts filed under OBAMA!">OBAMA!</a> (1) </li> <li><a href="http://colorspace.us/wordpress/archives/category/is-it-qualify/" title="View all posts filed under "Is it 'qualify'"?">“Is it ‘qualify’”?</a> (2) </li> </ul> </li> <li class="sideitem"> <h2>Pages</h2> <ul><li class="page_item"><a href="http://colorspace.us/wordpress/environmental-investigations/" title="Environmental Health">Environmental Health</a></li> <li class="page_item"><a href="http://colorspace.us/wordpress/medical-school/" title="Medicine">Medicine</a></li> <li class="page_item"><a href="http://colorspace.us/wordpress/photography/" title="Photography">Photography</a></li> </ul> </li> </ul> </div> </div> <div class="footer"> <div id="copyright"> <p>Copyright © 2010 Colorspace <br/> <span class="feed"><a href="http://colorspace.us/wordpress/feed/">Posts RSS</a></span> <span class="feed"><a href="http://colorspace.us/wordpress/comments/feed/">Comments RSS</a></span></p> </div> <div id="designcredit"> <p> <a href="http://wpthemepark.com/themes/intense/">WordPress Theme</a> <a href="http://saltedsugar.com/" target="_blank">designed</a> to help <a href="http://www.savebabygavin.com/" title="Save Baby Gavin">Save Baby Gavin</a> </p> </div> </div> </div> <div id="bottom"> </div> </div> </body> </html>