According to Wiki Risk management is the identification, evaluation, and prioritization of risks (defined in ISO 31000 as the effect of uncertainty on objectives) followed by coordinated and economical application of resources to minimize, monitor, and control the probability or impact of unfortunate events or to maximize the realization of opportunities. Risks can come from various sources including cyber risks, cyber theft, identity theft, uncertainty in financial markets, threats from project failures (at any phase in design, development, production, or sustaining of life-cycles), legal liabilities, credit risk, accidents, natural causes and disasters, deliberate attack from an adversary – competitor or even spouse, or events of uncertain or unpredictable root-cause.

They can also be attacks from a source that tries to steal information from a company or private individual for example trough listening devices known as eavesdropping devises. There are two types of events i.e. negative events can be classified as risks while positive events are classified as opportunities.

Broadly speaking: Risk assessment is the combined effort of:
1. identifying and analyzing potential (future) events that may negatively impact individuals, assets, and/or the environment (i.e. risk analysis); and
2. making judgments “on the tolerability of the risk on the basis of a risk analysis” while considering influencing factors (i.e. risk evaluation).
Put in simpler terms, a risk assessment determines possible mishaps, their likelihood and consequences, and the tolerances for such events. The results of this process may be expressed in a quantitative or qualitative fashion. Risk assessment is an inherent part of a broader risk management strategy to “introduce control measures to eliminate or reduce” any potential risk-related consequences.

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Organisations need to move beyond traditional risk management that usually focuses on specific risks individually. Thinking of risks as a whole allows a coordinated approach to optimise the said risks. At NSI, we use a holistic approach that focuses on all aspects of your security and operational risks to provide our clients with full protection. Our varied skill-set and global resources and reach empower our specialists to manage projects from beginning to end.

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NSI Global Counterintelligence helps to help identify external and internal threats to physical assets, data and intellectual property, to information and espionage-related risks, as well as vulnerabilities that exist within them. We then provide our clients with systems and methodologies to properly assign a value to the risk. By enumerating these risks and threats, our clients ultimately lower their costs and we assist them in developing an effective risk management plan based on our 5 pillar risk strategy which will help improve resilience and provide peace of mind to our clients. We will show you where you are most at risk, then help you lessen and protect against these risks.

Preparing for disasters is a vital part of our service. Data Leakage educate clients on its importance to their core investment strategy and the business case for resilience. Every decision must consider the interplay between natural, human, economic and social systems to protect assets.

When disaster strikes, we respond quickly. Following major incidents such as economic collapse, cyber-attacks, severe weather, fires, earthquakes and criminal attacks, we provide infrastructure damage assessment, forensic evaluations and a range of physical, cyber, information, security, and espionage risk support so as to provide rapid recovery and a return to normalcy.

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With frequent dosing, rarely reported adverse events include retinopathy and cardiac arrhythmias (QT prolongation specifically) in those with liver or kidney dysfunction. Exceeding recommended doses of chloroquine and hydroxychloroquine can lead to death, and fatal overdoses have been reported. Hydroxychloroquine is also FDA approved for use in rheumatoid arthritis and systemic lupus erythematosis. imidazole or macrolide antibiotics and in patients with underlying cardiac or liver diseases. It is hoped that with a better understanding of the arrhythmogenic mechanism of non-sedating antihistamines, one will be able to identify those at risk patients and prevent any cardiac on front page toxicity associated with antihistamines and ultimately death. An 85-year-old lady presented to our institution following multiple episodes of transient loss of consciousness.

Hydroxychloroquine cardiotoxicity presenting as a rapidly evolving biventricular cardiomyopathy: key diagnostic features and literature review

It has now been shown that the molecular target in human ventricle for the potassium channel blockade of antihistamine is HERG gene located in chromosome 7 that expresses the delayed rectifier IKr and appears to be involved in the congenital long QT syndrome. There is also a lack of information on the cardiac actions of newer non-sedating antihistamines.

Chronic toxicity should be considered when conduction disorders (bundle-branch block, AV block) or biventricular hypertrophy are diagnosed.

Many drugs prolong the QT interval and increase the risk of torsade de pointes.

Females, geriatric patients, patients with diabetes, thyroid disease, malnutrition, liver impairment, or those who drink alcohol to excess may also be at increased risk for QT prolongation.

If cardiotoxicity is suspected, prompt discontinuation of hydroxychloroquine may prevent life-threatening cardiac complications.

Using the administrative claims database of a national pharmaceutical benefit manager, we conducted a retrospective cohort study in 4, 825, 345 subjects aged 18 years or older. After identifying 50 drugs with QT-prolonging potential, and an additional 26 drugs that inhibit the metabolic clearance of QT-prolonging drugs, we measured the frequency of overlapping prescriptions for two or more of these drugs in the outpatient setting in 1999. Nearly 1. 1 million subjects (22. 8%) filled 4. 4 million prescriptions for QT-prolonging drugs. Of these, 103, 119 subjects (9. 4%) filled overlapping prescriptions for two or more of the drugs or for a QT-prolonging drug and another drug that inhibits its clearance; 7249 subjects (0. 7%) filled overlapping prescriptions for three or more of these drugs. Twenty-two percent of subjects who filled overlapping prescriptions were aged 65 or older; 74% were women. Females, geriatric patients, patients with diabetes, thyroid disease, malnutrition, liver impairment, or those who drink alcohol to excess may also be at increased risk for QT prolongation.

Chronic toxicity should be considered when conduction disorders (bundle-branch block, AV block) or biventricular hypertrophy are diagnosed. If cardiotoxicity is suspected, prompt discontinuation of hydroxychloroquine may prevent life-threatening cardiac complications. Many drugs prolong the QT interval and increase the risk of torsade de pointes. Concurrent use of two or more of these drugs can further increase the risk, but the prevalence of concurrent prescription of QT-prolonging drugs is not known. Concurrent prescription of QT-prolonging drugs is common in the outpatient setting, and antidepressants are involved in half of these cases. Large pharmaceutical claims databases are useful for detecting potentially harmful prescribing behaviors, but better clinical evidence on medication safety is needed before such a system can be implemented fully. Chloroquine and hydroxychloroquine are FDA-approved drugs used to prevent and treat certain types of malaria. They have a long elimination half-life of 30–45 days, allowing for weekly dosing when used in prevention of malaria, and a short 48-hour treatment course when used to treat malaria.

 

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