Food insecurity: How to orchestrate a global health crisis

In 2007-2008, the world experienced over 1 billion people going hungry. This complex food security and public health crisis have many levels, actors and stakeholders. There lacks equity in access food markets, unbalanced consumption of nutrients and poor state institutions that, all negatively impact food security. Global financial products and regimes can greatly influence food prices, and if not properly regulated, this can lead to whole market manipulation and starvation. This paper discusses the basics of food security in a public health framework and describes the legal and financial mechanisms that lead to food insecurity.

Food Is Security: The Nexus of Health Security in Fragile and Failed States

Global food security is a major development challenge dictated by state stability, resilience to geopolitical and economic shocks and is linked to health security. Fragile and failed nation-states are at risk of extreme poverty and lead to war and conflict. Fragile states experience, corrupt financial regimes and are influenced by skewed global market systems and reduced equitable market access that decrease food and health security. This qualitative review describes the critical cross sections of food security, the influence of global market systems and state stability and institutions that form the nexus of global health security. We outline how the manipulation of free market systems and decreased state capacity not only decrease food and health security but also contribute to state fragility and failure. Improved public health policy mechanisms, decreased dependence on foreign financial structures and extractive mechanisms are crucial to improving food and health security at present, and to further increase state stability in the future.

First Masquerading as Gallstones, Pulmonary Hypertension Mimics PE

Patients presenting to emergency and urgent care centers with calf pain after long and short-haul flights are a common presentation throughout Europe. Patients fitting an epidemiological risk profile for cholelithiasis and presenting with right upper quadrant abdominal pain can also be a common presentation fitting of a specific patient profile. However, pulmonary hypertension can present in a nuanced and possible missed chronic and acute presentation. The patient case we present profiles a mildly obese 54-year-old Caucasian woman and recent holiday maker with unilateral calf pain and shortness of breath after traveling on a long-haul flight with tertiary symptoms of indigestion and epigastric discomfort indicative of gastroenteritis. This case highlights the required diligence for emergency physicians to maintain a high index of suspicion and broad differential diagnosis in the undifferentiated patient with seemingly common or classic presentations. We find that a serendipitous definitive diagnosis is made by following a systematic and organized approach.

Carbon Monoxide Poisoning: The Culture of Indoor Burning

This patient case report describes a 40-year-old African woman presenting with a classic acute presentation of carbon monoxide poisoning from an unlikely source responding to conventional treatment. This case highlights the classic presenting features of carbon monoxide poisoning and the requirement to maintain a high index of suspicion and immediate use of rapid empirical treatment in the undifferentiated patient, sometimes before diagnostics and definitive diagnosis can be determined. The definitive diagnosis and cause of poisoning are also discussed to educate the emergency physician to new and foreign cultural habits and encourage best medical practices within multicultural societies.