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10.3.5 Lightning and electrical injuries 1696 SECTION 10  Environmental medicine, occupational medicine, and poisoning 1696 FURTHER READING Bierens J, et  al. (eds) (2006). The handbook on drowning. Springer, Berlin. Hasibeder WR (2003). Drowning. Curr Opin An...

10.3.6 Diseases of high terrestrial altitudes 1701 10.3.6  Diseases of high terrestrial altitudes 1701 resemble the structure of cell membranes, and they can be patched into cell membrane defects including those caused by electroporation. On the one hand they ...

10.3.7 Radiation 1709 10.3.7  Radiation 1709 Imray C, et al. (2011). Acute altitude illness. BMJ, 343, d4943. Lipman GS, et  al. (2012). Ibuprofen prevents altitude illness:  a randomized controlled trial for prevention of altitude illness with nonsteroidal an...

10.3.8 Disasters: Earthquakes, hurricanes, floods, and volcanic eruptions 1713 10.3.8  Disasters 1713 Dainiak N, et al. (2011). Literature review and global consensus on man- agement of acute radiation syndrome affecting non-​hematopoetic organ systems. Disast...

10.3.9 Bioterrorism 1718 SECTION 10  Environmental medicine, occupational medicine, and poisoning 1718 a substantial difference to the health and economic impacts of these severe events. Post-​disaster relief Most traumatic deaths in sudden-​onset disasters wi...

10.4 Poisoning 1725

10.4.1 Poisoning by drugs and chemicals 1725 10.4 Poisoning CONTENTS 10.4.1 Poisoning by drugs and chemicals  1725 John A. Vale, Sally M. Bradberry, and D. Nicholas Bateman 10.4.2 Injuries, envenoming, poisoning, and allergic reactions caused by animals  177...

10.4.2 Injuries, envenoming, poisoning, and allergic reactions caused by animals 1778 SECTION 10  Environmental medicine, occupational medicine, and poisoning 1778 10.4.2  Injuries, envenoming, poisoning, and allergic reactions caused by animals David A. Warre...

10.4.3 Poisonous fungi 1817 10.4.3  Poisonous fungi 1817 Karunaratne AH, et al. (2015). A Rare Case of Vaginal Bleeding in a Child Due to a Leech Bite and Review of the Literature. Wilderness Environ Med, 26, 579–84. Keegan HL (1963). Leeches as pests of man i...

10.4.4 Poisonous plants 1828 SECTION 10  Environmental medicine, occupational medicine, and poisoning 1828 10.4.4  Poisonous plants Michael Eddleston and Hans Persson ESSENTIALS Many plants contain toxic substances—​heterogeneous in chemical composition and di...

10.5 Podoconiosis (nonfilarial elephantiasis) 1833 10.5 Podoconiosis (non​filarial elephantiasis) Gail Davey ESSENTIALS Podoconiosis is the lesser-​known of the two major forms of trop- ical lymphoedema. The disease affects genetically susceptible indi- vidual...

11.1 Nutrition: Macronutrient metabolism 1839 ESSENTIALS Food intake is sporadic and, in many cultures, occurs in three daily boluses. At the same time, energy expenditure is continuous and can vary to a large extent independently of the pattern of energy inta...

11.2 Vitamins 1855 ESSENTIALS The vitamins are a disparate group of organic compounds that are required in small amounts (mg or µg per day) for the maintenance of normal health and metabolic integrity. Four vitamins (A, D, E, and K) are lipid soluble, while th...

11.3 Minerals and trace elements 1871 ESSENTIALS The essential minerals, calcium, phosphorus, potassium, sulphur, so- dium, chlorine, and magnesium (macrominerals) and trace elements chromium, copper, fluorine, iodine, magnesium, manganese, mo- lybdenum, phosp...

11.4 Severe malnutrition 1880 ESSENTIALS Severe malnutrition is the consequence of systemic deficiency of energy and nutrients over a prolonged period: in children de- velopment is stunted and the individual is at risk of fatal (often clinically ‘silent’) infe...

11.5 Diseases of affluent societies and the need for dietary change 1891 ESSENTIALS Nutritional problems of many countries depend increasingly upon the stage of technical and economic development rather than geo- graphical location. People in affluent societie...

11.6 Obesity 1903 ESSENTIALS Obesity is defined as an excess of body fat that is sufficient to affect health adversely. While the quantification of fat mass is usually only performed in the research setting, body mass index (weight in kg/​ height in metres2) i...

11.7 Artificial nutrition support 1914 ESSENTIALS The prevalence and relevance of undernutrition in affluent societies is often unrecognized, but nutritional status significantly impacts out- comes in all disease states. Nutrition screening identifies patients...