When the snow finally melted in late spring of 1881, huge sections of the plains were flooded. Massive ice jams clogged the Missouri River and when they broke the downstream areas were ravaged. Most of the town of Yankton, in what is now South Dakota, was washed away when the river overflowed its banks. The Storm of the Century
The Storm of the Century, also known as the Great Blizzard of 1993, was a large cyclonic storm that formed over the Gulf of Mexico on March 12, 1993, and dissipated in the North Atlantic Ocean on March 15. It is unique for its intensity, massive size and wide-reaching effect. At its height, the storm stretched from Canada towards Central America, but its main impact was on the United States and Cuba. The cyclone moved through the Gulf of Mexico, and then through the Eastern United States before moving into Canada. Areas as far south as northern Alabama and Georgia received a dusting of snow and areas such as Birmingham, Alabama, received up to 12 in (30 cm)  with hurricane-force wind gusts and record low barometric pressures. Between Louisiana and Cuba, hurricane-force winds produced high storm surges across northwestern Florida, which along with scattered tornadoes killed dozens of people. In the United States, the storm was responsible for the loss of electric power to over 10 million customers. It is purported to have been directly experienced by nearly 40 percent of the countrys population at that time.
Measurement by equilibrium dialysis or mass spectroscopy is generally required for accurate results, particularly for free testosterone which is normally present in very small concentrations. Screening
Screening males who do not have symptoms for hypogonadism is not recommended as of 2018. Treatment
Male primary or hypergonadotropic hypogonadism is often treated with testosterone replacement therapy if they are not trying to conceive. Adverse effects of testosterone replacement therapy include increased cardiovascular events (including strokes and heart attacks) and death. The Food and Drug Administration (FDA) stated in 2015 that neither the benefits nor the safety of testosterone have been established for low testosterone levels due to aging. The FDA has required that testosterone pharmaceutical labels include warning information about the possibility of an increased risk of heart attacks and stroke.While historically, men with prostate cancer risk were warned against testosterone therapy, that has shown to be a myth.Other side effects can include an elevation of hematocrit to levels that require blood withdrawal (phlebotomy) to prevent complications from excessively thick blood. Gynecomastia (growth of breasts in men) sometimes occurs. Finally, some physicians worry that obstructive sleep apnea may worsen with testosterone therapy, and should be monitored.Another treatment for hypogonadism is human chorionic gonadotropin (hCG). This stimulates the LH receptor, thereby promoting testosterone synthesis. This will not be effective in men whose testes simply cannot synthesize testosterone anymore (primary hypogonadism), and the failure of hCG therapy is further support for the existence of true testicular failure in a patient.