GIDoc Follow-up

Thank you to everyone for all of the responses. It feels good to have efforts appreciated. Here are some thoughts in response to the previous thread:

http://www.greenspun.com/bboard/q-and-a-fetch-msg.tcl?msg_id=001ZTD

Question 1:

In regard to birth defects in relation to use of potassium iodine prophylaxis in radiation accidents, here are two abstracts. These references suggest that the risk of complications is low.

However, radioactive I-131 used to treat thyroid conditions is associated with birth defects. This is because the radioactive I-131 is concentrated in the bladder and radiates the ovaries.

******Another important reminder-DO NOT take potassium iodine if you are allergic to shellfish, contrast dye used in x-rays such as IVP or CT scans, or are known to be allergic to iodine.

1. Iodine prophylaxis in the aftermath of the Chernobyl accident in the area of Sejny in north-eastern Poland, Zarzycki W; Zonenberg A; Telejko B; Kinalska I, Department of Endocrinology, Medical School, Bialystok, Poland. Horm Metab Res, 1994 Jun, 26:6, 293-6 Abstract The aim of our study was the estimation of the effects, possible side-effects and immunological reactions after the mass iodine prophylaxis following the Chernobyl nuclear disaster. 1457 subjects, aged 6-55 yrs, filled in our questionnaires and in 1191 of them the titres of antithyroid antibodies (TA) including ATMA--Anti-Human Thyroid Membrane Antibodies and TGAb--Anti-Thyreoglobulin Antibodies were estimated. Our study revealed that the prophylaxis, recommended in Poland only for children and teenagers was widely used (more than 90%) and relatively safe. No serious side effects, especially in pregnant women consuming KI were reported. The frequency and mean titres of TA were similar in adults who took and did not take stable iodine. The incidence of TA could be connected with many different factors including iodine deficiency, endemy of goitre as well as iodine prophylaxis. The reason of this phenomenon may be explained in long-term population studies.

2. Potassium iodide for thyroid blockade in a reactor accident: administrative policies that govern its use. Becker DV; Zanzonico P, New York Hospital-Cornell Medical Center, New York 10021, USA. Thyroid, 1997 Apr, 7:2, 193-7 Abstract A marked increase in thyroid cancer among young children who were in the vicinity of the Chernobyl nuclear power plant at the time of the 1986 accident strongly suggests a possible causal relationship to the large amounts of radioactive iodine isotopes in the resulting fallout. Although remaining indoors, restricting consumption of locally produced milk and foodstuffs, and evacuation are important strategies in a major breach-of-containment accident, stable potassium iodide (KI) prophylaxis given shortly before or immediately after exposure can reduce greatly the thyroidal accumulation of radioiodines and the resulting radiation dose. Concerns about possible side effects of large-scale, medically unsupervised KI consumption largely have been allayed in light of the favorable experience in Poland following the Chernobyl accident; 16 million persons received single administrations of KI with only rare occurrence of side effects and with a probable 40% reduction in projected thyroid radiation dose. Despite the universal acceptance of KI as an effective thyroid protective agent, supplies of KI in the US are not available for public distribution in the event of a reactor accident largely because government agencies have argued that stockpiling and distribution of KI to other than emergency workers cannot be recommended in light of difficult distribution logistics, problematic administrative issue, and a calculated low cost-effectiveness. However, KI in tablet form is expensive and has a long shelf life, and many countries have largely stockpiles and distribution programs. The World Health Organization recognizes the benefits of stable KI and urges its general availability. At present there are 110 operating nuclear power plants in the US and more than 300 in the rest of the world. These reactors product 17% of the world's electricity and in some countries up to 60-70% of the total electrical energy. Almost all US nuclear power plants have multistage containment structures with large steel and concrete shells and multiple redundancy of core cooling mechanisms. These successfully prevented the release of major amounts of radionuclides in the Three Mile Island partial loss-of-primary coolant accident in 1979. The Chernobyl accident, in a different type of reactor that is common in Eastern Europe, did not have effective outer shell containment and released almost 50 MCi of 131I compared to the 20 Ci of 131I released at Three Mile Island. Such accidents have precipitated extensive re-evaluation of the design and safety devices of all operating reactors. However, a major contributing factor to the accidents was human error and considerable efforts must be made to train plant operators so they have a better understanding of reactor operation and use of safety mechanisms.

If you want to do additional medline searches please use this link. I do not know how to hot link yet. Will work on it.

http://www.healthgate.com/medline/search-medline.shtml

Question 2:

In regard to the question about anthrax, there are three major routes of anthrax infection. Cutaneous (through the skin) usually occurs in sheep herders and wool handlers in endemic areas. Treatment includes many weeks of antibiotics (six or greater) including either ciprofloxacin, doxyclycline, penicillin, or erthromycin. People at high occupational risk are recommended to have immunization.

Respiratory anthrax acquired via the lungs is invariably fatal. Immunization is available but more potent strains are not covered. High dose i.v. antibiotics are also used. Anthrax can also infect the brain (meningeal form) and is also invariably fatal.

Question 3:

In regard to vet grade antibiotics (Darryl), I don't have an answer yet. I've contacted a vet friend and will get back.

Question 4:

In regard to herbs, I don't have any expertise in this area. The only thing I know about herbs is in cooking.

Question 5:

A couple references I find useful include the "Little Brown Series" of spiral bound references. They are available for Internal Medicine, pediatrics, surgery, neurology, etc. These books are small enough to fit in a black bag, are inexpensive and easy to read. The "Washington Manual of Internal Medicine" is the bible of interns and residents. The "Sandford Quide to Antimicrobial Therapy" is also inexpensive, very small in size but loaded with information. You may need a magnifying glass or bifocals to read it. Don't forget a recent edition of the PDR (Physicians Desk Reference). This won't fit in your black bag and is expensive. Two links for on-line ordering are as follows:

http://www.lb.com

http://medbookstore.com

Thanks again. Will be checking in daily and will follow-up later.

GIDoc

-- Gidoc (gidoc@lurking@now.out), October 13, 1999

Answers

GIDoc,

Thanks for your effort to answer our many questions! Don't stop.

Sincerely, Stan Faryna

-- Stan Faryna (faryna@groupmail.com), October 13, 1999.

Thanks very much GIDoc, sounds like antibiotics vs. anthrax is a lost cause, at least as a home remedy. Ah well, I'll steer clear of tunnels and subways. Appreciate the info.

-- Fiver2000 (fiver2000@yahoo.com), October 13, 1999.

Hi Gidoc,

Thanks for your help in advance...

I have a question concerning the use of Potassium Iodate vs. Potassium Iodide.

Iodide - more expensive, 3 - 5 year shelf life, safe & reliable.

Iodate - less expensive, indefinite shelf life, chewable, palatable.

Most vendors are offering the Iodate which I have read has not yet been tested to be as safe and reliable as the Iodide.

Is this true? I'm having trouble finding supporting documentation. What are your thoughts?

-- (jlinn35323@aol.com), October 13, 1999.

Doc, thank you for entertaining our questions. I have two:

1) I frequently experience wet memes, which result in excessive laundry. This has become the talk of the castle, and is quite embarrassing. Is this something to worry about?

2) Is it true that needlepointing can cause acne? Or even blindness?

Thank you.

-- King of Spain (madrid@al.cum), October 13, 1999.

Thanks Doc,I know your time is valuable. I'll be lurking waiting for an answer on the vet antibiotics. Daryll

-- Daryll (twincrk@hotmail.com), October 13, 1999.

doc a couple of medical questions for post y2k possibles. What is the best first aid for treating Radiation sickness after it has occured ,caused by dynamic venting of melting down reactors worldwide. Would KI work after the fact.

And what safety measures should we take to protect our families from Local plants that use hazardous chemicals or universities that have bio research labs. Will they present a contagion problem if electic is down for a long period of time. Dont they usually freeze the specimens to imobilize them. How big of a problem is this post y2k. Also if Blood samples are not kept kool at hospitals will that pose a bio hazard. What are your thoughts. If this can be a serious problem are hospitals preparing to handle the fallout. Are city disater planners aware of these hazards y2k presents locally.

-- y2k aware mike (y2k aware mike @ conservation . com), October 14, 1999.

Thanks GIdoc, thanks very much.

Found from the link you gave:

The safety and efficacy of the administration of stable iodide to protect the fetal thyroid from exposure to radioactive iodide were investigated in chimpanzees in weeks 19 to 21 of pregnancy. The mean 24-h uptake of iodide in the fetal thyroid, determined with 123I-, was 1.8%. Administration of stable potassium iodide (KI), 0.65, 1.95 or 6.5 mg per kg body weight, 1 h before tracer injection reduced the fetal uptake satisfactorily. Only the higher doses were effective after 20 h. Excess iodide may impair a child's thyroid status. However, adverse effects were not found during the 11 days the animals ingested these doses. Tracer concentrations in the amniotic fluid were 30- to 130-fold lower than in the urine. The dose to the fetus from radioactivity in the maternal bladder was estimated by computer simulation. The potential increment of the risk from this dose during the ingestion of stable iodide is smaller than the reduction of risk achieved by inhibiting the uptake of radioactive iodide by the fetal thyroid. The conclusion of the experiments is that stable iodide can be used safely and effectively to protect the fetal thyroid against contamination with radioactive iodine.

-- Mumsie (Shezdremn@aol.com), October 14, 1999.

More questions for you...

I think what we would like is more basic informaton on biowarfare and what we can do to protect and treat ourselves.

You say respiratory anthrax is fatal... is this 100%? Would you even try treating it?

What about smallpox or bubonic plague or the like?

Medical corp was sold out of their charts last time I checked. I think what most of us would like are basic symptoms and treatments. Can you help us with this?

What antibiotics would you suggest we try to obtain before rollover (per adult/child)?

-- Mumsie (Shezdremn@aol.com), October 14, 1999.

King, you forgot to ask Doc if she mudwrestles. S'okay, Doc, this is King's schtick.

-- wrestling (fan@the.castle), October 14, 1999.

GIDoc

thanx for the info, esp on the ref volumes. however, when i searched your two sources for the washington manual i couldn't find it. the closest i came was finding the washington manual of medical therapeutics. didn't sound like the same thing.

a little help, anybody?

thanx

-- Cowardly Lion (cl0001@hotmail.com), October 14, 1999.