Differential Diagnosis

The differential diagnosis for PTSD includes major depression, adjustment disorder, panic disorder, generalized anxiety disorder, acute stress disorder, obsessive compulsive disorder, depersonalization disorder, factitious disorder, or malingering. Occasionally, a physical injury may have occurred during the stressor so that a mental disorder secondary to brain injury must be considered as well. Many patients with PTSD meet criteria for another Axis I disorder (e.g., major depression, panic...

Historical Significance

The term posttraumatic stress disorder was introduced in 1980 in the DSM-III, although the concept of this disturbance has a long history. In the past, it the syndrome was recognized in wartime as shell shock or war neurosis, because it was seen most commonly in wartime situations. Many of its typical symptoms, however, such as intrusive thoughts and autonomic arousal, were also recognized in victims of other traumatic events, such as natural disasters.

Ramona Sunderworth md

At the turn of the 21st century, the number of children in developing countries will account for greater than 50 of the world's population. A mind-shattering thought indeed, for all of us in the medical profession. Recent reports from WHO, UNICEF, and several international conferences have emphasized the need for a stronger focus on the issue of the well-being of children, and taking the necessary steps to prevent potential disasters. The widening economic disparity between the rich and poor...

Liudvikas Jagminas md Robert E Antosia md mph

The twentieth century witnessed the creation and development of Weapons of Mass Destruction (WMDs) nuclear, chemical, and biological. While such weapons have been used in major wars, regional conflicts, and terrorism, this chapter will focus on the latter. WMDs all have the potential to create mass casualties, public panic, and enormous property destruction. They represent an existing and growing security and safety risk for all the citizens of the world. Terrorists now have an improved ability...

Barbara Kilian md

The scope of the Internet can make doing research a frustrating task. Before listing resources, a primer of web-based research is offered. The first step in web-based research is to find a search engine directory you are comfortable using. A search engine directory is a website tool that allows users to find information on the World Wide Web (WWW). The primary problem that most people encounter when searching the web is encountering too much information, as there are millions upon millions of...

Crush Injurycrush Syndrome

Earthquakes and manmade disasters are the leading causes of crush injuries and an increased incidence of crush syndrome. The estimated incidence are 20 and 2-5 , respectively. However, given the global climate of war and acts of terrorism, we should anticipate a rise in manmade disasters in the future. Bywaters and Beall offered the first classic description of crush syndrome in Londoners treated during the German Blitz in 1940-41. Zhi-Yong described its devastation in one of history's worst...

Biologics

Biological agents are the oldest of the Chemical, Biological and Radiological triad, and have been used in warfare for over 2,500 years. Biologic agents occur naturally in the environment, but many have been refined and can be made more virulent and resistant to therapy in weapons laboratories. Some bacterial toxins have also been developed for use as weapons. Most notable is botulism, which can produce death after being ingested or inhaled in minute quantities. The eradication of smallpox as...

Irritant Gases

The health effects of an acute exposure to an irritant gas or vapor are dependent on the physiochemical properties of that particular gas or vapor, as well as specific host factors. The extent of exposure varies considerably and is most pronounced in subjects with preexisting airway diseases. Acid and alkaline gases such as chlorine and ammonia produce extreme alterations in pH that cause tissue damage by direct contact. Other gases produce chemical reactions that cause free radical release,...

Robert E Antosia md mph

Logistics generally refers to the method of procuring, distributing, maintaining, and replacing goods, equipment, and personnel. The basic task of a logistics system is to provide essential operations support by delivering the appropriate supplies, in the quantities required, at the places and times they are needed. In reality, disaster logistics is a systems exercise involving integrated and coordinated performance from a diverse group of skilled specialists and support staff. It is both the...

Clinical Features

After an incubation period that can range from a minimum 2 days RVF to a maximum of 35 days Hantaviruses , a nonspecific clinical picture of fever, myalgia, and prostration emerges. Subsequently, devolution to florid shock and multi-system organ failure may occur. A petechial rash can also be a leading clue to the presence of a VHF. Hepatic inflammation dysfunction can be seen as well. Important distinguishing features can be used to delineate the various hemor-rhagic fever viruses. The...