RESUMO
In the preceding chapter, the biological agents designated as Category A agents by the Centers for Disease Control and Prevention (CDC) are described in detail. These agents are considered the highest priority for response planning because they pose the greatest potential threats if used in biological attacks. The focus of this chapter is on early recognition and detection of such biological events so that prevention and control efforts can be instituted quickly, thereby limiting morbidity and mortality. Attention is focused on the role nurses can play in recognizing and detecting potential outbreaks in their practice setting. Bot clinical and epidemiological approaches to recognition in their practice setting. For clinical recognition, emphasis is plced on using a syndrome approach. Laboratory methods for detection are also briefly discussed (AU)
Assuntos
Guerra Biológica , Alerta Rápido , Sinais e Sintomas , Planejamento em Desastres , Organização e AdministraçãoRESUMO
A clinical syndrome that arises insidiously as a result of a severe, prolonged deficiency of thiamine in the diet, manifested in the initial stages by anorexia, malaise, and weakness of the legs, frequently with paraesthesia; there may be slight oedema and palpitations. The disorder may persist in this chronic state or may at any time progress to an acute condition characterized either by cardiac involvement with oedema or by peripheral neuropathy; forms intermediate between these two extremes may also occur. It is thought that the basic cause is the inhibition of a series of enzyme-catalysed cleavages of carbon-carbon bonds in which thiamine diphosphate is a coenzyme. This document is intended primarily as a basis for ensuring adequate thiamine intake among populations in emergency settings. It reviews strategies for preventing thiamine deficiency among refugees and analyses factors influencing success and failure. Also included are a review of the literature on the epidemiology of thiamine deficiency and its signs and symptoms; thiamine's properties and functions and the recommended daily allowance; and a discussion of food sources of this vitamin and its stability. Thiamine deficiency and its prevention and control in major emergencies is the second in an occasional WHO series on the prevention and control of micronutrient deficiencies during emergencies. Reviews concerning scurvy and pellagra are also available
Assuntos
Tiamina , Deficiência de Tiamina , Deficiência de Tiamina , Deficiência de Tiamina , Deficiência de Tiamina , Distúrbios Nutricionais , Sinais e Sintomas , Monitoramento Epidemiológico , Epidemiologia , Avaliação de Processos e Resultados em Cuidados de Saúde , Estratégias de SaúdeAssuntos
Clima Frio , Mortalidade , Sinais e Sintomas , Hipotermia , Medição de Risco , Fatores de RiscoRESUMO
Clinical assessment of persons exposed to external stress events requires careful inquiry into both kinds of deflection from a homeostatic (or homeokinetic) state: extreme warding-off of the stress event and its implications, resulting in ideational denial and emotional numbing; and intrusive repetitiousness of memories and associations to the stress event, with pangs of painful feeling. Across groups of persons, there is a general tendency to denial first and the intrusion, in a progression of phasic responses to stress. Individuals will vary in the order of entry into such phases, time spent in a phase, degree of ascillation between phases, and specific manifestations during any phase. Treatment, in addition to orientation according to individual personality, should be phase-specific (AU)
