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The high prevalence of fentanyl in the illicit drug supply has generated concern among first responders regarding occupational exposure. Social media sharing of unconfirmed first responder overdoses after brief exposure to fentanyl may be contributing to an inappropriate risk perception of brief dermal fentanyl exposure. This case details a dermal exposure to a large dose of analytically confirmed pharmaceutical fentanyl (fentanyl citrate, 10 microgram fentanyl base per ml), over a large skin surface area. Additionally, the exposure occurred at a site with some skin barrier compromise, a factor that can increase fentanyl absorption. The patient underwent appropriate decontamination and underwent a brief medical assessment with no clinical effects of opioid exposure observed. This information is of value to first responders and other health care workers who are at risk of occupational fentanyl exposure. Findings are consistent with in vitro and ex vivo data supporting low risk of rapid absorption after brief dermal fentanyl exposure.
The Spanish Influenza Pandemic of 1918-1919 sheds new light on what the World Health Organization described as "the single most devastating infectious disease outbreak ever recorded" by situating the Iberian Peninsula as the key point of connection, both epidemiologically and discursively, between Europe and the Americas. The essays in this volume elucidate specific aspects of the pandemic that have received minimal attention until now, including social control, gender, class, religion, national identity, and military medicine's reactions to the pandemic and its relationship with civilian medicine, all in the context of World War I. As the authors point out, however, the experiences of 1918-19 remain persistently relevant to contemporary life, particularly in view of events such as the 2009 H1N1 swine flu pandemic. Contributors: Mercedes Pascual Artiaga, Catherine Belling, Josep Bernabeu-Mestre, Ryan A, Davis, Esteban Domingo, Magda Fahrni, Hernán Feldman, Pilar León-Sanz, Maria Luísa Lima, Maria deFátima Nunes, María-Isabel Porras-Gallo, Anny Jackeline Torres Silveira, José Manuel Sobral, Paulo Silveira e Sousa, Christiane Maria Cruz de Souza. María-Isabel Porras-Gallo is Professor of History of Science in the Medical Faculty of Ciudad Real at the University of Castile-La Mancha (Spain). She is the author of Un reto para la sociedad madrileña: la epidemia de gripe de 1918-1919 and co-editor of El drama de la polio. Un problema social y familiar en la España franquista. Ryan A. Davis is Assistant Professor in the Department of Languages, Literatures, and Cultures at Illinois State University. He is the author of The Spanish Flu: Narrative and Cultural Identity in Spain, 1918.