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Winter is now in full swing in the Northern Hemisphere as we deal with the continuing impact of erectile dysfunction treatment combined with the usual stresses of cheap levitra 40mg these darker months. This month the journal reflects our current trials as we feature papers on the levitra together with our usual mix of clinical studies.Emergency care for refugees and global healthThis month Njimen et al describe the impact of refugee children and young people accessing healthcare across Europe. This group is clearly vulnerable in many cheap levitra 40mg ways, complicated by their refugee status meaning that they may not be as visible or accessible to healthcare as we would wish. Using a survey methodology revealed several issues, with language, medical records, post traumatic stress disorder and mental health issues being highlighted as areas of particular concern. In a second paper Bruijns et al surveyed members and fellows of the Royal College of Emergency Medicine and found that many are involved in global health initiatives but that it was somewhat unrecognised and often personally led and financed.

RCEM has a newly formed global health committee that we hope will provide cheap levitra 40mg support and help recognition to those who are willing and able to support global emergencty medicine. I’d also recommend reading the accompanying commentary from Anisa Jafar who places the findings in the wider context of an increasing interest in global health issues within the emergency medicine community.Air transport for stroke patientsThe management of stroke has changed dramatically in the last few decades. In the UK the development of new therapies such as thrombolysis (controversial though it may be), stroke networks and improvements in rehab have radically changed the outlook for this devastating disease. Specific management of occlusive lesions takes the form of thrombolysis, and more cheap levitra 40mg recently mechanical thrombectomy are time critical interventions that are not available in all hospitals, thus transfer to specialist centres is needed. Coughlan et al have looked at whether air transportation might be a solution for this group of patients to rapidly access specialist services.

Their modelling suggests that air transport may offer clinical and economic benefits for patients assuming a 60 min reduction in time to intervention. In urban centres this may not be a realistic reduction, but for rural areas cheap levitra 40mg this may be an area for future HEMS (Helicopter Emergency Medical Services) development.Back pain in the ED. What’s the evidence?. Many EM (Emergency Medicine) clinicians find the management of the patient with back pain challenging. While we are always on the look out for the patient with serious underlying pathology cheap levitra 40mg (eg, cauda equina), many patients have simple mechanical low back pain.

What then can we do for these patients?. In this systematic review by Oliveira et al, the authors have sought out those interventions that have been demonstrated to be of value for our patients. There is some sound advice here on analgesic strategies and some areas where we cheap levitra 40mg know that therapies are ineffective (eg, corticosteroids). Sadly, despite the fact that there are many patients with this condition there is still a paucity of high-quality research to guide our treatment.Does the QRS shape predict outcome in pea (pulseless electrical activity)?. We see a lot of papers looking at prognostic factors in cardiac arrest, but I don’t recall one looking at whether QRS morphology is a predictor.

In this study of over 576 patients in OHCA (Out of Hospital Cardiac Arrest) a higher amplitude was associated with successful outcomes, as was a cheap levitra 40mg narrower QRS complex, but not QRS frequency. As an isolated factor it’s not enough to make decisions to stop/continue resus attempts, but it may be useful in planning and prognosticating resuscitation attempts.Does this patient have raised intra-cranial pressure?. One of the harder decisions I find in the resus room is in deciding whether to give mannitol or hypertonic saline for the management of raised intracranial pressure. A key cheap levitra 40mg problem in the decision is whether the patient actually has raised ICP at all?. A recent meta-analysis in the BMJ suggested that clinical signs were poor predictors in hospital but what about in the prehospital setting?.

ter Avest and colleagues looked at data from air ambulance operations in in the KSS (Kent, Surrey, Sussex) HEMS service and found that in 249 patients with traumatic brain injury classical signs such as Cushing’s response and dilated pupils had high specificities (so we can perhaps use them to rule in raised ICP), but no clinical signs had high sensitivities meaning that we may miss a significant group of patients with the condition and thus miss a therapeutic opportunity. Clearly we need more research to help us understand and identify this condition.Magnetocardiography in the EDI was really interested to read this paper by Goodacre et al on the use of magnetocardiography in the ED (Emergency cheap levitra 40mg Department). Partly because it sounds like a science fiction interest and also because we know of the limitations of the traditional ECG in the diagnosis of ACS (Acute Coronary Syndrome) in the ED. Magnetocardiography is a technique that detects magnetic fields around the heart and in this study the authors evaluated its performance in 756 patients presenting to the ED with chest pain. The results showed a reasonable sensitivity but cheap levitra 40mg a poor specificity suggesting that we won’t be seeing this test used in the ED at the moment.

For anyone preparing for exams this is a really good paper to explore from a critical appraisal perspective as the methods and results are well articulated.SONO series case of the monthI hope you are enjoying the SONO case series in the EMJ. I’ve found them really helpful to take myself and colleagues beyond the basic requirements of the RCEM curriculum and to use ultrasound in a wider group of patients. This month the SONO case looks at the diagnosis cheap levitra 40mg of small bowel obstruction which is one of the better evidenced and described techniques for ED ultrasound. The series is a reminder that emergency medicine is a fast moving field and that we must all keep learning to keep pace with ultrasound techniques.What do you need to know about immune checkpoint inhibitor drugs?. There is always something new to learn and this month we have a paper describing the use of potential complications of immune checkpoint inhibitor drugs, something that I’d heard nothing about previously.

In brief, these new drugs cheap levitra 40mg are used to treat many cancers that have an inflammatory component. Previous studies have looked at immune mediated toxicity issues, but it now seems that antibiotic therapy may inhibit the function of these drugs as chemotherapy agents. As we use antibiotics fairly liberally in the febrile oncology patients there is a risk that this may hamper the chemotherapeutic effect. Unfortunately the paper does not provide a guideline as the evidence cheap levitra 40mg base is not there yet, rather it appeals for further research in this area such that we might be able to better differentiate the truly septic oncology patient from those that have fever from other causes.One of the most humbling aspects of emergency medicine (EM) is how up close and personal we are with those living on the fringes of society. With a reflective mindset, our engagement with patients whose lives are beyond their control—for example, due to addiction, homelessness or mental ill health—we can recognise how fine the line is between our position and theirs.

It is possible to empathise and, with a little effort, some attempt to direct such patients to appropriate support can be achieved. However, we still struggle as a specialty to feel adequately skilled in helping these patients, and cheap levitra 40mg this can lead to a sense of frustration.1What then of those patients whose stories we cannot even truly access due to language barriers, wide cultural differences and life experiences so removed from our own that, although we can try, we will struggle to ever fully understand?. Refugees and asylum seekers are frequently used as a political football. Certainly, the UK media are notorious for using populist divisive language to detract the public from the causes of deeper economic problems.2 Healthcare professionals are not immune from such media narratives and we have a ….

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District Court for the cheap generic levitra professional District of Kansas against Wichita, Kansas-based Medova Healthcare Financial Group LLC, its president and CEO Daniel L. Whitney, chief operating officer Michelle Willson and Midlands Casualty Insurance Co. Inc. Concerning the Medova Multiple Employer Welfare Arrangement (MEWA) and the employer-sponsored employee benefit cheap generic levitra professional plans participating in the MEWA that are covered by the Employee Retirement Income Security Act (ERISA).An investigation by the Department’s Employee Benefits Security Administration (EBSA) alleges that the defendants’ misuse of the Medova MEWA’s funds has created a critical funding deficiency for Lifestyle Health Plans, which EBSA previously determined to exceed $18 million. As of Nov.

6, 2020, the Medova MEWA provided benefits and held assets for at least 2,600 participating health plans serving more than 35,000 employees in 38 different states. “The critical funding deficiency leaves thousands of Medova Multiple Employer Welfare Arrangement participants and beneficiaries without the health benefits they were promised when they made contributions to the plan,” said cheap generic levitra professional Acting Assistant Secretary of Labor for the Employee Benefits Security Administration Jeanne Klinefelter Wilson. €œThe alleged violations of the Employee Retirement Income Security Act by the Medova defendants have caused significant harm to the plans and participants. The U.S. Department of Labor is committed to protecting employee’s benefits cheap generic levitra professional and ensuring fiduciaries comply with federal law.” The complaint alleges that the Medova defendants – acting as fiduciaries for the underlying ERISA-covered plans – violated several provisions of ERISA.

Specifically, the Medova defendants allegedly commingled funds, diverted funds to corporate accounts and other companies they controlled, and used funds belonging to one plan to pay the claims of another. The Department alleges the defendants made material omissions to current and prospective participating employers regarding the MEWA’s failure and its ability to pay claims, as well as the overall financially hazardous condition of the MEWA. Lastly, the complaint cheap generic levitra professional alleges that the Medova defendants failed to file the Form M-1 on an annual basis for the Medova MEWA, as required under ERISA. The Form M-1 provides custodial and financial information on MEWAs as well as information on ERISA compliance. The complaint seeks to have the Medova defendants removed and barred from serving as fiduciaries or service providers to the individual employer plans that participate in the Medova MEWA, established by the defendants and the appointment of an independent fiduciary to oversee the MEWA’s operations, marshal and control the assets of the plans as it relates to the underlying participant plans, perform an accounting of the MEWA’s financial position, determine the MEWA’s ability to pay outstanding participant health claims and work to negotiate and pay outstanding health claims and provide sufficient notice of the MEWA’s termination, if such termination is deemed appropriate.

By doing so, participating employers and employees will have an opportunity to obtain new health, dental, vision and prescription drug cheap generic levitra professional coverage that the Medova MEWA had offered. The complaint also asks the court to require the defendants to disgorge to the Medova MEWA all profits and fees and other monies earned in connection with their violations. Medova MEWA and Lifestyles Health Plan participants with unpaid medical claims may contact EBSA at 866-444-3272. EBSA’s mission is to assure the security of the retirement, health and other workplace related benefits of cheap generic levitra professional America’s workers and their families. EBSA accomplishes this by developing effective regulations.

Assisting and educating workers, plan sponsors, fiduciaries and service providers. And vigorously enforcing the cheap generic levitra professional law. The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working conditions. Advance opportunities cheap generic levitra professional for profitable employment.

And assure work-related benefits and rights. # # # Scalia V. Daniel L cheap generic levitra professional. Whitney. Michelle Willson.

Medova Healthcare Financial Group LLC. Midlands Casualty Insurance Company Inc. cheap generic levitra professional. Et. Al. Civil Case cheap generic levitra professional No.

2:20-cv-02624-TC-ADMWASHINGTON, DC – Since the start of the erectile dysfunction levitra through Dec. 10, 2020, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued citations arising from 273 inspections for violations relating to erectile dysfunction, resulting in proposed penalties totaling $3,646,228 cheap generic levitra professional. OSHA inspections have resulted in the agency citing employers for violations, including failures to. OSHA has already announced citations relating to the erectile dysfunction arising out of 263 inspections, which can be found at dol.gov/newsroom.

In addition to those inspections, the 10 inspections below have resulted in erectile dysfunction-related citations totaling $141,883 from OSHA relating to one or more of the above violations from cheap generic levitra professional Dec. 4 to Dec. 10, 2020. OSHA provides cheap generic levitra professional more information about individual citations at its Establishment Search website, which it updates periodically. Establishment Name Inspection # City State Initial Penalty Clearbrook 1483455 Arlington Heights Illinois $20,820 Community First Healthcare of Illinois Inc.

1477929 Chicago Illinois $13,494 Melrose Wakefield Healthcare Inc. 1478751 Melrose Massachusetts $13,494 Villa Crest cheap generic levitra professional Healthcare Center LLC 1488062 Manchester New Hampshire $20,820 Hackensack Meridian Jersey Shore University Medical Center 1480762 Neptune New Jersey $15,422 Willowood Care Center of Brunswick Inc. 1478348 Brunswick Ohio $12,145 Crandall Medical Center 1476308 Sebring Ohio $12,145 Country Lane Gardens 1479898 Thornville Ohio $9,446 Cooper Hatchery Inc. 1480551 Van Wert Ohio $10,603 Life Care Centers of America Inc. 1478208 Westlake Ohio $13,494 A full list of what standards were cited for each establishment – and the inspection number – are available here.

An OSHA standards database can be found here. Resources are available on the agency’s erectile dysfunction treatment webpage to help employers comply with these standards. Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.

The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working conditions. Advance opportunities for profitable employment. And assure work-related benefits and rights..

Department of Labor filed cheap levitra 40mg a complaint in U.S. District Court for the District of Kansas against Wichita, Kansas-based Medova Healthcare Financial Group LLC, its president and CEO Daniel L. Whitney, chief operating officer Michelle Willson and Midlands Casualty Insurance Co. Inc. Concerning the Medova Multiple Employer Welfare Arrangement (MEWA) and the employer-sponsored employee benefit plans participating in the MEWA that are covered by the Employee Retirement Income Security Act (ERISA).An investigation by the Department’s Employee Benefits Security Administration (EBSA) alleges that the defendants’ misuse of the Medova MEWA’s funds has created a critical funding deficiency for Lifestyle Health Plans, which EBSA previously determined to exceed $18 million.

As of Nov. 6, 2020, the Medova MEWA provided benefits and held assets for at least 2,600 participating health plans serving more than 35,000 employees in 38 different states. “The critical funding deficiency leaves thousands of Medova Multiple Employer Welfare Arrangement participants and beneficiaries without the health benefits they were promised when they made contributions to the plan,” said Acting Assistant Secretary of Labor for the Employee Benefits Security Administration Jeanne Klinefelter Wilson. €œThe alleged violations of the Employee Retirement Income Security Act by the Medova defendants have caused significant harm to the plans and participants. The U.S.

Department of Labor is committed to protecting employee’s benefits and ensuring fiduciaries comply with federal law.” The complaint alleges that the Medova defendants – acting as fiduciaries for the underlying ERISA-covered plans – violated several provisions of ERISA. Specifically, the Medova defendants allegedly commingled funds, diverted funds to corporate accounts and other companies they controlled, and used funds belonging to one plan to pay the claims of another. The Department alleges the defendants made material omissions to current and prospective participating employers regarding the MEWA’s failure and its ability to pay claims, as well as the overall financially hazardous condition of the MEWA. Lastly, the complaint alleges that the Medova defendants failed to file the Form M-1 on an annual basis for the Medova MEWA, as required under ERISA. The Form M-1 provides custodial and financial information on MEWAs as well as information on ERISA compliance.

The complaint seeks to have the Medova defendants removed and barred from serving as fiduciaries or service providers to the individual employer plans that participate in the Medova MEWA, established by the defendants and the appointment of an independent fiduciary to oversee the MEWA’s operations, marshal and control the assets of the plans as it relates to the underlying participant plans, perform an accounting of the MEWA’s financial position, determine the MEWA’s ability to pay outstanding participant health claims and work to negotiate and pay outstanding health claims and provide sufficient notice of the MEWA’s termination, if such termination is deemed appropriate. By doing so, participating employers and employees will have an opportunity to obtain new health, dental, vision and prescription drug coverage that the Medova MEWA had offered. The complaint also asks the court to require the defendants to disgorge to the Medova MEWA all profits and fees and other monies earned in connection with their violations. Medova MEWA and Lifestyles Health Plan participants with unpaid medical claims may contact EBSA at 866-444-3272. EBSA’s mission is to assure the security of the retirement, health and other workplace related benefits of America’s workers and their families.

EBSA accomplishes this by developing effective regulations. Assisting and educating workers, plan sponsors, fiduciaries and service providers. And vigorously enforcing the law. The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working conditions.

Advance opportunities for profitable employment. And assure work-related benefits and rights. # # # Scalia V. Daniel L. Whitney.

Michelle Willson. Medova Healthcare Financial Group LLC. Midlands Casualty Insurance Company Inc.. Et. Al.

Civil Case No. 2:20-cv-02624-TC-ADMWASHINGTON, DC – Since the start of the erectile dysfunction levitra through Dec. 10, 2020, the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued citations arising from 273 inspections for violations relating to erectile dysfunction, resulting in proposed penalties totaling $3,646,228. OSHA inspections have resulted in the agency citing employers for violations, including failures to.

OSHA has already announced citations relating to the erectile dysfunction arising out of 263 inspections, which can be found at dol.gov/newsroom. In addition to those inspections, the 10 inspections below have resulted in erectile dysfunction-related citations totaling $141,883 from OSHA relating to one or more of the above violations from Dec. 4 to Dec. 10, 2020. OSHA provides more information about individual citations at its Establishment Search website, which it updates periodically.

Establishment Name Inspection # City State Initial Penalty Clearbrook 1483455 Arlington Heights Illinois $20,820 Community First Healthcare of Illinois Inc. 1477929 Chicago Illinois $13,494 Melrose Wakefield Healthcare Inc. 1478751 Melrose Massachusetts $13,494 Villa Crest Healthcare Center LLC 1488062 Manchester New Hampshire $20,820 Hackensack Meridian Jersey Shore University Medical Center 1480762 Neptune New Jersey $15,422 Willowood Care Center of Brunswick Inc. 1478348 Brunswick Ohio $12,145 Crandall Medical Center 1476308 Sebring Ohio $12,145 Country Lane Gardens 1479898 Thornville Ohio $9,446 Cooper Hatchery Inc. 1480551 Van Wert Ohio $10,603 Life Care Centers of America Inc.

1478208 Westlake Ohio $13,494 A full list of what standards were cited for each establishment – and the inspection number – are available here. An OSHA standards database can be found here. Resources are available on the agency’s erectile dysfunction treatment webpage to help employers comply with these standards. Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance.

For more information, visit www.osha.gov. The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States. Improve working conditions. Advance opportunities for profitable employment.

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As the wind howled and the rain slammed down, a team of nurses, respiratory therapists and a doctor worked through the night to care for where can i buy levitra 19 tiny babies as Hurricane Laura slammed southwestern Louisiana.The babies, some on ventilators or eating through a feeding tube, seemed to weather the storm just fine, said Dr. Juan Bossano, the medical director of the neonatal intensive care unit at Lake Charles Memorial Hospital for Women. "They did very where can i buy levitra well. They tolerated it very well. We had a very good day," he said.Laura made landfall early Thursday morning as a Category 4 storm, packing top winds of 150 mph (241 kph), and where can i buy levitra pushing a storm surge as high as 15 feet in some areas.Hours before it made landfall, officials had to move the babies from the women's hospital to the main hospital in the system after it became clear that storm surge could inundate the women's hospital, located on the southern end of Lake Charles.

The hospital has its own generator and hospital administrator Alesha Alford said it was built to withstand hurricane force winds. But in the single story facility, where can i buy levitra there's no room to move up and storm surge in that area was expected to hit nine feet. In a roughly two-hour operation the babies in the intensive care unit were transferred by ambulance to Lake Charles Memorial Hospital, a ten-story facility on the northern side of the city. Trucks carried needed equipment where can i buy levitra such as incubators.Alford said the storm hadn't yet hit but "the skies looked very ominous." She said everyone pitched in to get supplies moved to the other hospital."It went as smooth as could be because we had everyone helping," she said.Alford said three mothers who couldn't be discharged from the women's hospital were also transferred. Two of them had their newborns with them while the child of the third mom was in the intensive care unit.

Parents of the other children in the neonatal intensive care unit couldn't stay with them during the storm because there wasn't enough room so Bossano said one nurse was tasked with calling parents to keep them informed of how their children were doing. Bossano occasionally posted updates on Facebook.Once they got situated at the larger hospital and the where can i buy levitra winds picked up, Alford said the patients were moved into the hallways. To "protect our babies," mattresses were pushed up against the windows to prevent flying glass although none of the windows ended up breaking.She said as huge gusts of wind started coming in, they could feel the building vibrate. In addition to Bossano, the medical staff consisted of where can i buy levitra two neonatal nurse practitioners, 14 nurses and three respiratory therapists who worked on 12-hour shifts. Some of the staff slept on air mattresses in the hallway, Alford said.

After making it through where can i buy levitra the hurricane, the plan was to have the babies stay in Lake Charles. While electricity was out in the city, the hospital has its own generator. But Alford said the city's water system has been so heavily damaged that it ultimately forced them to transfer the babies as well as other patients to other hospitals around the state Friday.Both Alford and Bossano repeatedly praised the nursing staff for their work in caring for the babies that in some cases were where can i buy levitra born weighing only a pound or two. Some of the nursing staff lost their houses in the storm, and they were worried about their own families, but they put those concerns aside to care for their tiny patients."Really the nurses and the respiratory therapists are the heroes here," Bosanno said. "They showed that very clearly the way they performed."When Dr.

George Wanna saw how where can i buy levitra devastated St. George Hospital University Medical Center was by an explosion that shook Beirut, he felt a need to help his hometown. The Aug where can i buy levitra. 4 blast in the city’s harbor ravaged St. George’s, so Wanna launched where can i buy levitra a GoFundMe page to help the hospital, where a good friend of his, Dr.

Alexander Nehme, is chief medical officer.At deadline, more than $86,600 had been raised, with a goal of $100,000. €œThis is the first time where can i buy levitra in their 140-year history when St. George’s Hospital was damaged so severely that it is unable to function,” said Wanna, chair of the otolaryngology department at New York Eye and Ear Infirmary of Mount Sinai and Mount Sinai Beth Israel in New York. €¨St. George Hospital even remained open where can i buy levitra during Lebanon’s 15-year civil war, a conflict that wracked Beirut and forced Wanna to spend much of his childhood in bomb shelters.

Wanna is also working with Mount Sinai to send medical supplies. €œSt. George Hospital is in need of everything needed to run a hospital—beds, ventilators, protective equipment.” The tragedy also affected Wanna’s family. His parents weren’t home when the blast struck and were unharmed. But “my parents’ home was severely damaged by the blast.

Sadly, we lost the lives of several of my dad’s relatives,” he said via email. Wanna, who spent his residency at Mount Sinai, is grateful to the system. €œThey have given me a chance to have the kind of life I could never have hoped for—they helped me build a home and a life in this great country.”.

As the wind howled and the rain slammed down, a team of nurses, respiratory cheap levitra 40mg therapists and a doctor worked through the night to care for 19 tiny babies as Hurricane Laura slammed southwestern Louisiana.The babies, some on ventilators or eating through a feeding tube, seemed to weather the storm just fine, said Dr. Juan Bossano, the medical director of the neonatal intensive care unit at Lake Charles Memorial Hospital for Women. "They did cheap levitra 40mg very well. They tolerated it very well.

We had a very good day," he said.Laura cheap levitra 40mg made landfall early Thursday morning as a Category 4 storm, packing top winds of 150 mph (241 kph), and pushing a storm surge as high as 15 feet in some areas.Hours before it made landfall, officials had to move the babies from the women's hospital to the main hospital in the system after it became clear that storm surge could inundate the women's hospital, located on the southern end of Lake Charles. The hospital has its own generator and hospital administrator Alesha Alford said it was built to withstand hurricane force winds. But in the single story facility, there's no cheap levitra 40mg room to move up and storm surge in that area was expected to hit nine feet. In a roughly two-hour operation the babies in the intensive care unit were transferred by ambulance to Lake Charles Memorial Hospital, a ten-story facility on the northern side of the city.

Trucks carried needed equipment such as incubators.Alford said the storm hadn't cheap levitra 40mg yet hit but "the skies looked very ominous." She said everyone pitched in to get supplies moved to the other hospital."It went as smooth as could be because we had everyone helping," she said.Alford said three mothers who couldn't be discharged from the women's hospital were also transferred. Two of them had their newborns with them while the child of the third mom was in the intensive care unit. Parents of the other children in the neonatal intensive care unit couldn't stay with them during the storm because there wasn't enough room so Bossano said one nurse was tasked with calling parents to keep them informed of how their children were doing. Bossano occasionally posted updates on Facebook.Once they got situated at the larger hospital and the winds picked cheap levitra 40mg up, Alford said the patients were moved into the hallways.

To "protect our babies," mattresses were pushed up against the windows to prevent flying glass although none of the windows ended up breaking.She said as huge gusts of wind started coming in, they could feel the building vibrate. In addition to Bossano, the medical staff consisted of two neonatal nurse practitioners, 14 nurses and three respiratory therapists cheap levitra 40mg who worked on 12-hour shifts. Some of the staff slept on air mattresses in the hallway, Alford said. After making it through the hurricane, cheap levitra 40mg the plan was to have the babies stay in Lake Charles.

While electricity was out in the city, the hospital has its own generator. But Alford said the city's water system has been so heavily damaged that it ultimately forced them to transfer the babies as well as other patients to other hospitals around the state Friday.Both Alford and Bossano repeatedly praised the nursing staff for cheap levitra 40mg their work in caring for the babies that in some cases were born weighing only a pound or two. Some of the nursing staff lost their houses in the storm, and they were worried about their own families, but they put those concerns aside to care for their tiny patients."Really the nurses and the respiratory therapists are the heroes here," Bosanno said. "They showed that very clearly the way they performed."When Dr.

George Wanna cheap levitra 40mg saw how devastated St. George Hospital University Medical Center was by an explosion that shook Beirut, he felt a need to help his hometown. The Aug cheap levitra 40mg. 4 blast in the city’s harbor ravaged St.

George’s, so Wanna launched a GoFundMe page to help the hospital, where a good friend cheap levitra 40mg of his, Dr. Alexander Nehme, is chief medical officer.At deadline, more than $86,600 had been raised, with a goal of $100,000. €œThis is the first time in cheap levitra 40mg their 140-year history when St. George’s Hospital was damaged so severely that it is unable to function,” said Wanna, chair of the otolaryngology department at New York Eye and Ear Infirmary of Mount Sinai and Mount Sinai Beth Israel in New York.

€¨St. George Hospital even remained open during Lebanon’s 15-year civil cheap levitra 40mg war, a conflict that wracked Beirut and forced Wanna to spend much of his childhood in bomb shelters. Wanna is also working with Mount Sinai to send medical supplies. €œSt.

George Hospital is in need of everything needed to run a hospital—beds, ventilators, protective equipment.” The tragedy also affected Wanna’s family. His parents weren’t home when the blast struck and were unharmed. But “my parents’ home was severely damaged by the blast. Sadly, we lost the lives of several of my dad’s relatives,” he said via email.

Wanna, who spent his residency at Mount Sinai, is grateful to the system. €œThey have given me a chance to have the kind of life I could never have hoped for—they helped me build a home and a life in this great country.”.

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