Episodic risk

In addition to pollution episodes, risks may arise due to atmospherie oxygen eoneentrations fluetuating beyond its normal level of 21% posing health (page 72) or fire hazards. Eire and explosion dangers may also arise from the presenee of flammable gases, vapours, or dusts in die atmosphere (Chapter 6). 

If immunocompromised patients experience frequent or severe recurrences, particularly of esophageal candidiasis, chronic maintenance therapy with fluconazole 100 to 200 mg daily should be considered. In patients with infrequent or mild cases, secondary prophylaxis is not recommended. The rationale for not giving prophylaxis includes availability of effective treatments for acute episodes, risk of developing resistant organisms, potential for drug interactions, and the cost of therapy. 

Klein E, Bental E, Lerer B, et al Carbamazepine and halopeiidol vs. placebo and haloperidol in excited psychoses. Arch Gen Psychiatry 41 165-170, 1984a Klein E, Hefez A, Lavie P Effects of clomipramine infusion on sleep in depressed patients. Neuropsychobiology 1 85-88, 1984b Klein E, Lavie P, Meiraz R, et al Increased motor activity and recurrent manic episodes risk factors that predict rapid relapse in remitted bipolar disorder patients after lithium discontinuation—a double blind study. Biol Psychiatry 31 279-284, 1992... 

Pregnancy in bipolar women was found to be a risk-neutral condition, in that it neither protected against nor increased episode risk in a comparison of 42 pregnant with 42 nonpregnant women who stopped lithium either rapidly (over 1-14 days) or gradually (over 15-30 days). Stopping lithium was not risk-neutral, and the risk was especially high in those who stopped rapidly (482) (see... 

Crump K, Viren J, Silvers A, et al. 1995. Reanalysis of dose-response data from the Iraqi methylmercury poisoning episode. Risk Analysis l(4) 523-532. 

Depression is a common psychiatric disorder. The lifetime risk of developing a depressive episode is estimated to be as high as 8—12% for men and 20—26% for women (116). Depression, one of the most widespread of all life-threatening disorders, is almost always a factor in the mote than 30,000 suicides that occur annually in the United States alone (117). 

Estimating the risk to workers or the public from episodic events involving a one-time exposure to potentially harmful substances or activities... 

The acronym for chemical process quantitative risk analysis. It is the process of hazard identification followed by numerical evaluation of incident consequences and frequencies, and their combination into an overall measure of risk when applied to the chemical process industry. It is particularly applied to episodic events. It differs from, but is related to, a probabilistic risk analysis (PRA), a quantitative tool used in the nuclear industry... 

The principal shortcoming with SCREENS is the lack of graphical displays. Interactive graphics that enable plume tracking are invaluable in assessing potential environmental impacts and public health risks from episodic releases. There are a... 

If die tricyclics are administered witii the MAOIs, the patient is at risk for hypertensive episodes, severe convulsions, and hyperpyretic episodes. Use of the MAOIs must be discontinued at least 2 weeks before treatment witii the tricyclics begins. The tricyclics may prevent the therapeutic effect of many antihypertensives. When the tricyclics are administered with dicumarol, the risk for bleeding increases. 

Risk for Injury related to dizziness or light-headedness secondary to postural or orthostatic hypotensive episodes... 

Chen CY, Wagner FA, Anthony JC Marijuana use and the risk of major depressive episode epidemiological evidence from the United States National Comorbidity Survey. Soc Psychiatry Psychiatr Epidemiol 37 199-206, 2002... 

Up to 20% of anaphylaxis episodes in adults, and up to 6% of episodes in children, are biphasic or protracted, and involve recurrent or persistent symptoms without any ongoing or additional exposure to the anaphylaxis trigger. Administering too little epinephrine too late during treatment of the initial symptoms of an anaphylaxis episode is one of the factors reported to increase the risk of biphasic or protracted anaphylaxis [27]. 

Published clinical scenarios outline the available options in making these decisions [36], It is impossible to predict the outcome of a future anaphylaxis episode with certainty based on the history of a previous episode [37]. Therefore, when in doubt, erring on the side of caution is generally advised prescribe one or more epinephrine autoinjectors, and advise the person at risk or the caregiver of a child at risk to inject epinephrine promptly in an anaphylaxis episode [36]. 

Many people who have experienced anaphylaxis in the community and are therefore at risk for recurrence have never received a prescription for an epinephrine autoinjector from an emergency department physician [38, 39] or from their primary care physician. Some of those who have received a prescription for an epinephrine autoinjector do not follow through and get it filled [40]. Even if they do get the epinephrine autoinjector dispensed, they may fail to carry it with them at all times [41]. Adherence to instructions to carry epinephrine can be improved with regular input from a healthcare professional [42] however, healthcare professionals need to master the complexities of epinephrine autoinjector use [43] before instructing others. People who have survived a mild anaphylaxis episode that was not treated at all, or was treated only with an antihistamine or an asthma puffer, sometimes fail to inject epinephrine because they erroneously assume that their subsequent reactions will also be mild [44]. 

First episode of VTE secondary to a transient (reversible) risk factor Warfarin 3 Recommendation applies to both proximal and calf vein thrombosis... 

First episode of idiopathic VTE with or without a documented hypercoagulable abnormality Warfarin 12 Continue warfarin therapy after 12 months if patient is at low risk for bleeding... 

Depression can occur despite the absence of major life stressors, and conversely, major life stressors do not invariably cause depression. Nevertheless, there is an undeniable association between life stressors and depression, and there appears to be a significant interaction between life stressors and genetic liability in causing depression.6 Although acute stressors may precipitate depression, chronic stressors have a longer risk period, cause longer episodes, and are more likely to lead to relapse and recurrence.6... 

The mean age of onset of bipolar disorder is 20, although onset may occur in early childhood to the mid-40s.1 If the onset of symptoms occurs after 60 years of age, the condition is probably secondary to medical causes. Early onset of bipolar disorder is associated with greater comorbidities, more mood episodes, a greater proportion of days depressed, and greater lifetime risk of suicide attempts, compared to bipolar disorder with a later onset. Substance abuse and anxiety disorders are more common in patients with an early onset. Patients with bipolar disorder also have higher rates of suicidal thinking, suicidal attempts, and completed suicides. 

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