Findings from researchers at Northwestern University’s Feinberg School of Medicine may offer physicians further help in quickly and accurately distinguishing early inhalational anthrax from other respiratory conditions—a vitally important skill if a widespread anthrax emergency were to occur.The scientists, whose report is published in the Jul 31 issue of The Lancet, found that the definitive predictor of inhalational anthrax was the chest radiograph. The presence of mediastinal widening or pleural effusion was 100% sensitive (95% confidence interval [CI], 84.6-100.0) for inhalational anthrax, 71.8% specific (CI, 64.8-78.1) for inhalational anthrax when compared with community-acquired pneumonia (CAP), and 95.6% specific (CI, 90.0-98.5) for inhalational anthrax compared with influenza-like illness (ILI).The matched case-control study involved 47 historical cases of confirmed inhalational anthrax, 36 of them naturally occurring from 1880 through 1976 and 11 of them from the 2001 anthrax attack, and 376 cases of CAP or ILI seen in the emergency department of Northwestern Memorial Hospital, Chicago, between January 2000 and February 2003.Before comparing the anthrax patients with the controls, the authors compared laboratory, chest radiograph, and autopsy findings between the naturally occurring and the bioterorrism-related anthrax cases and found no significant differences. “The chest radiograph findings of the two case groups were remarkably similar,” according to the authors. An accompanying commentary points out that the similarity of the two anthrax groups suggests that “the weaponisation process might not influence disease progression.” The anthrax spores used in the 2001 attack were electrostatically charged to make them more easily dispersible, and they were covered with polymerized glass and silica to prevent clumping.In addition to the chest film findings, additional clinical characteristics found in the study to be more common in inhalational anthrax patients than in those with CAP or ILI included nausea, vomiting, pallor or cyanosis, diaphoresis, altered mental status, and elevated hematocrit levels. Similar results have been reported in other studies, but the authors of the present study point out that they included substantially more anthrax cases and used matched controls for comparison.The authors acknowledge several limitations of their study, including the fact that because they used historical reports for the anthrax cases, their measurements of predictor variables are “inherently incomplete.” That they found such clear similarity between the naturally occurring and the more recent, more completely documented bioterrorism-related cases may dispel this concern somewhat, however. They also point out the possibility of misclassification of some of the CAP and ILI controls in their study. Finally, they note that clinical characteristics of inhalational anthrax may be subtle or even absent early in the disease, which could have affected the results. Because of these limitations, “Studies using prospectively colleced information from controls should be done to corroborate, modify, or refute our findings,” they conclude.Kyriacou DN, Stein AD, Yarnold P, et al. Clinical predictors of bioterrorism-related inhalational anthrax. Lancet 2004 Jul 31;364(9432):449-52 [Abstract]See also:CDC document on distinguishing ILI from inhalational anthrax (Nov 9, 2001)http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5044a5.htmCDC interim guidelines for clinical evaluation of suspected anthrax cases (Nov 2, 2001)http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5043a1.htmArticle in Feb 1, 2003, Clinical Infectious Diseases: “Clinical features that discriminate inhalational anthrax from other acute respiratory illnesses”http://www.journals.uchicago.edu/doi/full/10.1086/346035
The suspect was detained in the custodialfacility of the Mandurriao police station, facing charges./PN Seven sachets of suspected shabu valued ataround P15,000 were seized from 25-year-old resident Jorry Rubinas, a policereport showed. ILOILO City – Police nabbed a drug suspect ina sting operation in Barangay Bakhaw, Mandurriao district. Rubinas was arrested after he sold suspectedshabu to an undercover cop for P10,000 on Sept. 16, it added.
pic.twitter.com/nhIV9PL7cM— Alan Duda (@alanduda) April 21, 2019pic.twitter.com/ON4VvxJ0B5— Alan Duda (@alanduda) April 21, 2019But the response of the day touched on his marathon “success.” Rovell completed his first marathon — the Chicago Marathon — this past October, finishing in 21,463rd place, a feat that he enjoyed bragging about, even having his sneakers from the race plated in gold. He also criticized the race organizers for misspelling “division” on his certificate.The guy saying second-best-in-the-nation LSU doesn’t deserve a billboard? He placed 21,463rd in a marathon and got the shoes he ran it in plated in gold. https://t.co/QFiZ0gJDRw— Lauren Hopkins (@LaurenHopkins96) April 21, 2019pic.twitter.com/yHpxDSfZx3— Box Seat 1971 (@BoxSeat2009) April 21, 2019The onslaught continued.Rovell trying to defend the comments he made about #LSU and their billboards pic.twitter.com/g90HAqiDO1— Madeline Adams (@TheMadAdams) April 21, 2019pic.twitter.com/jJ4xSw47us— Taylor Bourgeois (@tbourge_) April 21, 2019It’s safe to say Rovell’s tweet didn’t go as planned. Looks like LSU took the gold after all. Before you go criticizing something on Twitter, be sure there’s nothing in your tweet history that may leave you exposed. Someone will find it.Action Network sports business reporter Darren Rovell learned that lesson the hard way after tweeting about the LSU women’s gymnastics team this past weekend. MORE: LSU reinstating Wade isn’t madness if there’s a method to itThe Tigers finished as the national runner-up on Saturday for the third time in four years, losing to Oklahoma despite earning the second-highest score ever recorded in an NCAA final. Even with the disappointment, the Tigers put up a billboard thanking local fans for their support.But Rovell, a noted Twitter troll, had a problem with the team celebrating second and took the time on Easter Sunday to rip the Tigers.No, you can’t put up a billboard for coming in second. https://t.co/wxDPqBNzNr— Darren Rovell (@darrenrovell) April 21, 2019 LSU gymnasts and fans were quick to fire back. Several members of the team called him out shortly after his initial shot.I’m not even going to entertain you, Dan, Derek, David, Dicky, whatever your name is.Queens don’t look down. 👑— Sarah Finnegan (@sfinnegan37) April 21, 2019Sounds like someone was runner up in their Easter egg hunt. There’s always next year, Dave. https://t.co/QfVqsvkIv2— Ashlyn (@Ashlynkirby98) April 21, 2019“nO, yOU cAn’t PuT uP a BillbOaRD fOr cOmiNg iN sEcOnd.” whatever Daniel🙄 https://t.co/VOpG8Pd4dm— Reagan Campbell (@ReagzC) April 21, 2019Even the team’s associate coach got involved.Hey “D” Happy to talk to u about something u clearly don’t get or appreciate. Keep making your $ on those who lose and measure success based on %. This sport is based on perfection. But thx for the exposure. Our billboard is 4 r fans, who have helped us achieve a great deal.— Jay Clark (@jayclark886) April 22, 2019And then things really went south for Rovell. The former ESPN reporter is notorious for posting any and every “accomplishment” he achieves and consistently shares videos of himself training for marathons, a habit Twitter users were happy to throw in his face.
Mary Donnelly, Sinead McDevitt and Seamus McDevitt from Fintown and Ramelton arrived early for the match today between Donegal and Louth in Ballyshannon. Picture by Brian McDaid from Cristeph Gallery.DONEGAL FANS ARRIVE EARLY TO SUPPORT THEIR TEAM ‘LOUTH’ AND CLEAR! was last modified: March 30th, 2014 by StephenShare this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to share on Pocket (Opens in new window)Click to share on Telegram (Opens in new window)Click to share on WhatsApp (Opens in new window)Click to share on Skype (Opens in new window)Click to print (Opens in new window) Tags:BallyshannondonegalLouth