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By: John Alexander Bartlett, MD

  • Professor of Medicine
  • Director of the AIDS Research and Treatment Center
  • Research Professor of Global Health
  • Professor in the School of Nursing
  • Affiliate of the Duke Initiative for Science & Society
  • Member of the Duke Cancer Institute

https://medicine.duke.edu/faculty/john-alexander-bartlett-md

H e knew precisely by their heart action when the subjects were in danger of dying percentil 95 arteria uterina purchase coreg 6.25mg fast delivery. Not only did he do nothing while the helpless victims died before his very eyes blood pressure patch discount 12.5 mg coreg fast delivery, but he assisted in the a~t~opsies blood pressure quotes cheap coreg 6.25 mg fast delivery. After all these murders had occurred and were hlown to heart attack fever 12.5 mg coreg with visa them, Ruff and Itomberg still went on. They issued a joint report on the experiments in the name of Ruff, Romberg, and Rascher in July 1942. Romberg received a medal for his work in the experiments on the reconimendation of Rascher. H e wrote: "Oberstarzt I h l k stated that he was willing to report to the State Secretary (Milch) our wishes concerning the distribution of the report and the continuation of the experiments. The State Secretary had approved the distribution schedule, and said that a continuation of the experiment was not urgent. The defendant Romberg stated that four series of expwiments were conducted (a) slow descent without oxygen, (b) slow descent with oxygen, (c) falling without oxygen, and (d) falling with oxygen. Experiments testing the length of life of a human being above the normal breathing limits (4, 5, 6 km. Romberg proved the following: "Experiments on parachute jumps proved that the lack of oxygen and the low atmospheric pressure a t 12 or 13 km. Altogether 15 extreme experiments of this type were carried out in which none of V P died. Very severe bends together with unconsciousness occurred, but completely normal functions of the senses returned when a height of 7 km. The extent to which deterioration of the organism may occur due to continuously repeated experiments can only be established a t the end of the series of experiments. This report covered the period up to the first week in April and mention of deaths and autopsies is made. This quite obviously was the instance when Romberg says he saw his first death and autopsy, although he tends to place the date as the latter part of April. The defendants argue that, while the experiments may have killed persons, they did not involve torture and pain. This is on the theory that the subjects lost consciousness before any sensation of pain. This anomalous defense is completely disproved by the photographic exhibits sliowing the expressions of pain of the subjects. A t the same time there were most severe headaches as though the skull were being burst apart. The pains became continually more severe so that a t last the discontinuation of the experiment became necessary. Ruff and Romberg take the position that they would be most unwilling to kill prisoners in the course of an experiment. This again is the artificial division of the experiments into the criminal and noncriminal which has already been proved to be spurious. The only reason that this experiment did not end fatally was the fact that it was 1 interrupted in time because of intense pain. Moreover, on page 1 of the final report by Ruff, Itomberg, and Weltz the following is said: "This is worthy of special attention because in this case a person has fully recovered mentally at an altitude of 8. When the skull and the cavities of the breast and of the abdomen had been opened nnder water, an enormous amount of air embolism +Jews who had had sexual intercourse with German women with their consent. Romberg testified that he mas present at the death of three of these prisoners, one in April and two in May 1942, and witnessed an autopsy of one, in which gas bubbles were present in the blood vessels of the brain. H e observed the experiments, took notes, and studied the electrocardiogram and thus was able to determine when an experimental subject in the chamber was about to die. Ruff was not informed regarding the finding of bubbles in the blood vessels of the brain since such observations in human beings who have died following too rapid atmospheric decompression is a very, very unique event, though bubbles had been observed many times prior to 1942 in the blood vessels of laboratory animals. Ruff,or anyone else in the field of aviation medicine, had not heard of the bubble theory of the cause of joint pains, coughing, blindness, or paralysis, or the symptoms of the pressure drop sickness, which may occur on exposure to high altitude, since this theory was well known in literature and text books of aviation medicine available since 1938. He either learned of the theory during a course in aviation medicine or was told about it by Ruff and Romberg, who knew much more than Rascher about aviation medicine. It is fantastic that Ruff, Romberg, and Rascher did not have in mind the observations of bubbles in the blood vessels of the murdered prisoners, when, in the final joint report of 28 July 1942, they wrote: "In spite of the relatively large number of experiments, the actual cause of the severe mental disturbances and bodily failures (paralysis, blindness, etc.

Trade Representative heart attack quizzes discount coreg 12.5 mg online, at the direction of the President blood pressure medication alcohol buy coreg 6.25mg amex, determined to hypertension uncontrolled icd 9 code buy coreg 25 mg line modify the action being taken in the investigation by increasing the rate of additional duty from 10 to blood pressure lowering herbs order 12.5 mg coreg with amex 15 percent ad valorem on the goods of China specified in Annex A and Annex C of the August 20 notice. Trade Representative announced a determination to suspend until further notice the additional duties on products set out in Annex C of the August 20 notice. Trade Representative later determined to modify the action being taken by reducing the additional duties for the products covered in Annex A of the August 20 notice from 15 percent to 7. Under the October 24 notice, requests for exclusion had to identify the product subject to the request in terms of the physical characteristics that distinguish the product from other products within the relevant 8-digit subheading covered by the $300 billion action. Requestors were asked to provide the quantity and value of the Chinese-origin product that the requestor purchased in the last three years, among other information. With regard to the rationale for the requested exclusion, requests had to address the following factors: ยท Whether the particular product is available only from China and specifically whether the particular product and/or a comparable product is available from sources in the United States and/or third countries. Trade Representative would take into account whether an exclusion would undermine the objective of the Section 301 investigation. The October 24 notice required submission of requests for exclusion from List 1 of the $300 billion action no later than January 31, 2020, and noted that the U. The Office of the United States Trade Representative regularly updates the status of each pending request on the Exclusions Portal at exclusions. Determination To Grant Certain Exclusions Based on evaluation of the factors set out in the October 24 notice, which are summarized above, pursuant to sections 301(b), 301(c), and 307(a) of the Trade Act of 1974, as amended, and in accordance with the advice of the interagency Section 301 Committee, the U. Trade Representative has determined to grant the product exclusions set out in the Annex to this notice. As set out in the Annex, the exclusions are reflected in 19 specially prepared product descriptions, which cover 39 separate exclusion requests. In accordance with the October 24 notice, the exclusions are available for any product that meets the description in the Annex, regardless of whether the importer filed an exclusion request. As stated in the October 24 notice, the exclusions will apply from September 1, 2019, the effective date of the $300 billion action, and will extend for one year to September 1, 2020. Customs and Border Protection will issue instructions on entry guidance and implementation. Trade Representative will continue to issue determinations on pending requests on a periodic basis. Neither publication of this notice nor the inclusion or omission of information in the summary is intended to affect the legal status of the petition or its final disposition. This notice contains a summary of a petition seeking relief from specified requirements of Federal Aviation Regulations. Any committee-related request should be sent to the person listed in this section. Public Participation the first day of the meeting will be closed to the public due to the discussion of specific test questions, which are not available for release to the public. The second day of the meeting will be open to the public on a firstcome, first served basis as space is limited. Department of Transportation is committed to providing equal access to this meeting for all participants. Description of Relief Sought: If granted, this exemption would allow the petitioner to use flight time acquired as a U. More specifically, the petitioner requests this flight time as a navigator be logged in the same manner as flight engineer time towards meeting the aeronautical experience requirements of an airline transport pilot certificate. To accommodate as many speakers as possible, the time for each commenter may be limited. All prepared remarks submitted on time will be accepted and considered as part of the record. Any member of the public may present a written statement to the committee at any time. TriMet states that, at these three crossings, their use of a 60 dB(A) bell provides a level of safety equivalent to that of the required locomotive horn.

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After undergoing a careful review of the initial medical certification in 1962-64 heart attack survival rate discount coreg 25 mg with visa, death certificates assigned to pulse pressure less than 20 cheap coreg 6.25mg amex influenza/pneumonia/bronchitis in ten cities in Latin America blood pressure zero order 12.5 mg coreg free shipping, San Francisco arrhythmia means cheap 12.5 mg coreg overnight delivery, and Bristol, England, suffered a net loss of 1. In a similar study of deaths before age 5 in thirteen Latin American and two North American areas between 1968 and 1972, respiratory diseases forfeited 22 % of their originally assigned deaths, while the specific infectious diseases gained 23% (Puffer and Serrano 1973, pp. Nevertheless, the "name" infectious diseases remain relatively submerged compared with popular accounts of their role, a point also stressed by McDermott (1966). Part of the reason for overemphasis on the role of the "name" diseases in mortality decline is probably their preeminent importance in the relatively small-scale English decline from 1851 to 1901, as has been elegantly documented in a widely cited paper by McKeown and Record (1962). Mortality changes during long periods will be considered in order to avoid sampling periods during which specific public health interventions may have badly distorted the cause pattern of change. By and large, they support the previous estimate of the relative importance of respiratory tuberculosis and diarrheal diseases. Influenza/pneumonia/bronchitis is somewhat less important a source of decline than depicted in table 5. This cause is generally a more important source of mortality decline in movements between high and intermediate levels than between intermediate and low ones (Preston and Nelson 1974, pp. The epidemic nature of typhoid, cholera, and plague add even more uncertainty to these figures. If estimates for British Guiana and India are to be believed, malaria by itself has accounted for 18-35 % of large-scale mortality declines, equaling or exceeding the contribution we have estimated for all infectious and parasitic diseases combined. It should be noted that both estimates are based upon assignment to malaria of an arbitrary portion of deaths originally ascribed to "fever. The relative contribution of such a decline to the total mortality reduction depends, of course, on the size of the latter. As a component of the smaller decline during the shorter period considered by Newman in Sri Lanka, it represented 42%. Simple inspection of time-series data on crude death rates suggests that virtually complete malaria eradication reduced the crude death rate by 297 Table 5. Data on cholera, plague, and smallpox are probably most accurate because they were most consistently "notifiable" causes of death at the provincial level. Distribution of deaths by cause from United Nations, Demographic Yearbook (1967), table 24. Data are for medically certified deaths in Poona and Bombay corporations and deaths in public hospitals in Rajasthan. The World Health Organization provides some confirmation of the virtual eradication of malaria from India by noting a hundredfold decline in reported cases between 1952 and 1972. World Health Organization, Fifth Report 011 the World Health Situation, Official Records no. The importance of malaria reduction as a source of declining mortality in a country obviously depends upon initial endemicity and the success of antimalarial campaigns. Southern Africa, southern Latin America, and northern Asia were never seriously afflicted with the disease; malaria in tropical Africa is highly endemic but, with few excep- 299 Mortality Declines in Less Developed Countries tions, it has not been successfully attacked (World Health Organization 1975a). Newman calculates for Ceylon that each death assigned to malaria represented approximately four deaths that were directly or indirectly caused by it. But such an inflation factor is simply not tenable in Guatemala or Venezuela, where contemporaneous declines in crude death rates and malarial crude death rates suggest that a 2: 1 ratio is the most that could have been sustained. Spraying with residual insecticides reduces not only malaria but other vector-borne diseases such as yellow fever, typhus, and especially diarrheal disease. As Newman points out, an indirect approach that bases estimates on relations between regional changes in aggregate mortality and changes in spleen rates may well overascribe mortality decline to malaria reductions (but not to insecticide campaigns themselves). Finally, there is an often-quoted estimate, the basis of which is unknown, that worldwide malarial deaths have declined from 2. Sri Lanka, the best-docume,1ted case, falls within this range, and Sri Lanka was apparently intermediate in terms of initial endemicity, although the program there probably enjoyed unusual success and malaria reduction may not be solely responsible for the mortality decline produced by insecticide spraying. Smallpox Measles Diphtheria Whooping cough Immunization 45 7 l Immunization; identification and isolation Immunization Immunization Chemotherapy Chemotherapy Antibiotics Antibiotics Rehydration Rehydration, antibiotics Water-, food-, and fecesborne Diarrhea, enteritis, gastroenteritis Typhoid Cholera 1 9 Rehydration Insectborne 13-33 I Malaria Typhus I Quinine drugs Antibiotics Plague 15-35 Purification and increased supply of water; sewage disposal; personal sanitation Purification and increased supply of water; sewage disposal; personal sanitation; partially effective vaccine Purification and increased supply of water; sewage disposal; personal sanitation; partially effective vaccine; quarantine Insecticides, drainage, larvicides Insecticides, partially effective vaccines Insecticides, rat control, quarantine a Major sources: Paul (1964); Morley (1973); Hinman (1966).

Five prisoners were put into each cell although orle cell was only intended for one person heart attack mayo clinic order coreg 6.25mg overnight delivery. The next day we were given a breakfast consisting of black coffee and a piece of dark bread blood pressure medication that doesn't cause ed buy coreg 12.5mg low cost. I told him that I did not agree to heart attack 101 generic 6.25mg coreg mastercard it because I had already undergone two operations jugular pulse pressure order 25mg coreg otc. He told me that this was going to be a very small operation and that it would not harm me. I told him that I was a political prisoner and that operations could not be performed on political prisoners without their consent. Standing in front of the cell I noticed a cell on the opposite side of the staircase, and I also noticed some men in operating gowns. With his other hand he tried to gag me, putting a piece of rag into my mouth, because I shouted. Then I noticed that a German nurse was taking off my dress, I then lost consciousness again; I regained i t in the morning. Then I noticed that both my legs were in iron splints and were bandaged from the toes up to the groin. On the afternoon of the same day, a German nurse came and gave me an injection, in spite of my protests; she gave me this injection in my thigh and told me that she had to do it. Four days after this operation a doctor from Hohenlychen arrived, again I was given an injection to put me to sleep, and as I protested he told me that he would change the dressing; I felt a higher temperature and a greater pain in my legs. I will ask that the record show that the witness properly identifled the defendant Gebhardt. Chances are that this tibial graft was either implanted in another person or that grafts had been exchanged. Of course today, 3 years after the experiment, no trace o transplantaf tion is left in this individual. Or if the object was, as alleged in some statements I have seen, that tibial grafts were exchanged between the two legs, one must conclude that the experiment was negative because there is no evidence that a graft took. All we see now are the consequences of removal of a graft, and the graft had included the entire compact part of the bone, otherwise the repair would have been better. I f some part of the compact had remained, the periosteum would have probably regenerated and today, 3 years after the operation, no X-ray would have shown the defect. Whether anything was replaced that later was destroyed, I do not know, except the patient stated that there was a purulent discharge, indicating that the wound had become infected, and her statement of a subsequent operation, in fact, if I am not mistaken, two subsequent operations, indicates the probability that the grafts did not take and that they were removed after infection had become obvious. Introduction the defendants Karl Brandt, Handloser, Rostock, Schroeder, Gebhardt, Rudolf Brandt, Mrugowsky, Poppendick, Sievers, BeckerBreyseng, Schaefer, and Beiglboeck were charged with special responsibility for and participation in criminal conduct involving sea-water experiments (par. In the course of the trial the prosecution withdrew the charge in the case of Mrugowsky. On this charge the defendants Schroeder, Gebhardt, Sievers, BeckerFreyseng, and Beiglboeck were convicted and the defendants KarI Brandt, Handloser, Rostock, Rudolf Brandt, Poppendick, and Schaefer were acquitted. A corresponding summation of the evidence by the defense on these experiments has been selected from the final plea for the defendant Schroeder and from the closing brief for the defendant Beiglboeck. This argumentation is followed by selections from the evidence on pages 447 to 494. Two methods of making sea water drinkable were then available to the Medical Service of the Luftwaffe. One, the so-called Schaefer method, had been chemically tested and apparently produced potable sea water. I t had the disadvantage, however, of requiring substantial amounts of silver which was available only in limited quantities. The second method, socalled Berkatit, was a substance which changed the taste of sea water but did not remove the salt. At the conference on 19 May the defendant Becker-Freyseng reported on certain clinical experiments which had been conducted by von Sirany to test Berkatit. He came to the conclusion that the experiments had not been conducted under sufficiently realistic conditions of sea distress. He reported that the Chief of the Medical Service of the Luftwaffe was"* * " convinced that, if the Berka method is used, damage to health had to be expected not later than 6 days after taking Berkatit, which damage will result in permanent injuries to health and-according to the opinion of Unterarzt Dr, Schaefer-will finally result in death after not later than 12 days. External symptoms are to be expected such as dehydration, diarrhea, convulsions, hallucinations, and finally death.

References:

  • https://www.rand.org/content/dam/rand/pubs/research_reports/RR1400/RR1481/RAND_RR1481.pdf
  • https://www.pharmasug.org/download/sde/sd2016/PharmaSUG_SD2016SDE_04_Minjoe.pdf
  • https://www.medicaid.nv.gov/Downloads/provider/Binder_DUR_2017_04.pdf