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Papers by Debra Forsha
Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IN... more Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe...
Genetics in medicine: …, 2011
PurposeWe evaluated the prevalence of cardiovascular abnormalities and the efficacy and safety of... more PurposeWe evaluated the prevalence of cardiovascular abnormalities and the efficacy and safety of enzyme replacement therapy (ERT) in patients with late onset Pompe disease.MethodsNinety patients were randomized 2:1 to ERT or placebo in a double-blind protocol. Electrocardiograms (ECG) and echocardiograms were obtained at baseline and scheduled intervals over the 78-week study period. Baseline cardiovascular abnormalities, and efficacy and safety of ERT were described. Three pediatric patients were excluded.ResultsEighty-seven patients were included. Median age was 44 years; 51% were male. At baseline, a short PR interval was present in 10%, 7% had decreased left ventricular systolic function, and 5% had elevated left ventricular mass on echocardiogram (all in mild range). There was no change in cardiovascular status associated with ERT. No significant safety concerns related to ERT were identified.ConclusionsAlthough some patients with late onset Pompe disease had abnormalities on baseline ECG or echocardiogram, those classically seen in infantile Pompe disease, such as significant ventricular hypertrophy, were not noted. Cardiovascular parameters were not impacted by ERT and there were no cardiovascular safety concerns. The cardiovascular abnormalities identified may be related to Pompe disease or other comorbid conditions.
Prehospital and disaster medicine: the official journal of the National Association of EMS Physicians and the World Association for Emergency and Disaster Medicine in association with the Acute Care Foundation
Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IN... more Developing a mass-casualty medical response to the detonation of an improvised nuclear device (IND) or large radiological dispersal device (RDD) requires unique advanced planning due to the potential magnitude of the event, lack of warning, and radiation hazards. In order for medical care and resources to be collocated and matched to the requirements, a [US] Federal interagency medical response-planning group has developed a conceptual approach for responding to such nuclear and radiological incidents. The "RTR" system (comprising Radiation-specific TRiage, TReatment, TRansport sites) is designed to support medical care following a nuclear incident. Its purpose is to characterize, organize, and efficiently deploy appropriate materiel and personnel assets as close as physically possible to various categories of victims while preserving the safety of responders. The RTR system is not a medical triage system for individual patients. After an incident is characterized and safe...
Genetics in medicine: …, 2011
PurposeWe evaluated the prevalence of cardiovascular abnormalities and the efficacy and safety of... more PurposeWe evaluated the prevalence of cardiovascular abnormalities and the efficacy and safety of enzyme replacement therapy (ERT) in patients with late onset Pompe disease.MethodsNinety patients were randomized 2:1 to ERT or placebo in a double-blind protocol. Electrocardiograms (ECG) and echocardiograms were obtained at baseline and scheduled intervals over the 78-week study period. Baseline cardiovascular abnormalities, and efficacy and safety of ERT were described. Three pediatric patients were excluded.ResultsEighty-seven patients were included. Median age was 44 years; 51% were male. At baseline, a short PR interval was present in 10%, 7% had decreased left ventricular systolic function, and 5% had elevated left ventricular mass on echocardiogram (all in mild range). There was no change in cardiovascular status associated with ERT. No significant safety concerns related to ERT were identified.ConclusionsAlthough some patients with late onset Pompe disease had abnormalities on baseline ECG or echocardiogram, those classically seen in infantile Pompe disease, such as significant ventricular hypertrophy, were not noted. Cardiovascular parameters were not impacted by ERT and there were no cardiovascular safety concerns. The cardiovascular abnormalities identified may be related to Pompe disease or other comorbid conditions.