Iodine Deficiency, Iodine Content of Salt and Knowledge of Iodine Supplementation in the Dominican Republic

Astrovirus Infection in Young Kenyan Children with Diarrhoea
Human astroviruses (HAstV) have been commonly identified worldwide as important aetiological agents of acute gastroenteritis in all age groups including the young, elderly and immunocompromised. However, limited data exist on the prevalence of this important pathogen in Kenya. The aim of this study was therefore to determine the prevalence of astrovirus (AstV) infection in Kenyan children younger than 10 years of age with diarrhoea. During the period February 1999 to September 2005, stool samples were collected from 476 children attending clinics in Nairobi (and its environs) and the Maua Methodist Hospital, Meru North, Kenya. The faecal specimens were tested by a commercial enzyme immunoassay kit for HAstV. AstV prevalence rates were found to be 6.3%. There was significantly high prevalence of AstV infection in children ≤5 years [5.3% (25/476)] than those >5 years [0.2% (1/476)] ( p < 0.01). Also, we showed a significantly high prevalence of AstV infection in children of ≤5 years [5.8% (20/341)] in Nairobi (urban setting) as compared with those of similar age in Maua (a rural setting) [3.7% (5/135)] ( p < 0.01). This study indicates that HAstV is an important pathogen associated with diarrhoea in young Kenyan children.

Is the CAN-SPAM Act Working?
In December 2003, with a great deal of fanfare, Congress passed the Controlling the Assault of Non-Solicited Pornography and Marketing Act, which is far better known by its acronym, the CAN-SPAM Act. Speaking on the floor of the Senate, Ron Wyden (D-Or.) said at the time of its passage that the CAN-SPAM legislation would not be a silver bullet. “But when this bill takes effect,” he said, “the big-time spammers who up to this point faced no consequences, for all practical purposes, will suddenly be at risk for criminal prosecution, Federal Trade Commission enforcement, and million-dollar lawsuits by State attorneys general and Internet service providers.” The intervening four years have shown mixed results for Senator Wyden’s prediction. Mixed Results According to a new survey released Wednesday by the Pew Internet and American Life Project, more e-mail users today report an increase in spam (37 percent) than did so in February 2004 (24 percent), which is just after the CAN-SPAM Act went into effect. On the other hand, over the same time period, there has been a significant drop in the number of people (52 percent, down from 71) who report receiving pornographic spam, which was obviously one of the main legislative targets of the CAN-SPAM Act. The author of the Pew study, Deborah Fallows, said in an e-mail interview that she felt that the CAN-SPAM Act has had a positive effect on the spam problem. “The CAN-SPAM Act has gone a long way toward giving teeth to legal efforts,” she said. “The law makes it riskier to be a spammer.” Better Spam Filters Mark Rotenberg, the Executive Director of the Electronic Privacy Information Center, said that in his view, the results of the Pew survey show that antispam filters have improved over the last few years. “It is much less likely that offensive text messages will make…

Prevalence of Pervasive Developmental Disorders in Preschool Children in the UAE
Available evidence from the literature suggests that the prevalence of autistic disorder may be on the rise world wide, but no prevalence studies have been carried out till date in the Arabian Gulf region. A representative random sample of 694 three-year-old United Arab Emirates national children was evaluated in a two-stage study in the community. In the first stage, using Autism Screening Questionnaire, 58 per 10 000 children were noted to have autistic features. In the second stage using clinical interview, the weighted prevalence was estimated to be 29 per 10 000 for a DSM-IV diagnosis of pervasive developmental disorder (PDD). However, none of these children had been diagnosed prior to the study. Presence of autistic features was associated with male gender, presence of behavioural problems and a family history of developmental delay. The rate of PDD observed in the UAE is comparable with that reported from western countries. However, the lack of recognition of these disorders suggests the need for a comprehensive screening program, as early diagnosis can open the door for early intervention which in turn may improve the prognosis.

The Risks and Impacts of Portering on the Well-Being of Children in Nepal
A variety of underlying conditions increase the likelihood of children entering the labor force. Nearly half of Nepal’s population between 5 and 14 years of age is economically active, many in conditions classified by the International Labor Organization as ‘the worst forms of child labor’. In order to assess the relationship between portering and well-being outcomes, including diet, nutrition status, injury and social and behavioral risks, a cross-sectional study was conducted among long distance child porters in Eastern Nepal. Porters were consistently less well off than their non-portering peers according to a variety of indicators. Porters were 2.2 (95% CI: 1.4–3.4) times as likely not to have attended school in the past month and frequency of attendance was significantly lower among porters. Porters had worse diets and significantly lower Body mass indexes than controls; prevalence of anemia was 30% and the risk of anemia was 1.9 (95% CI: 1.1–3.1) times greater for porters as compared with controls. Injury rates within the past year were similar between the two groups, with 88% of participants reporting being injured. Prevalence of alcohol use among porters was 38% and porters were 2.9 (95 CI: 1.7–4.9) times more likely to consume alcohol than controls. Risk of sexual assault was 10.1 (95 CI: 2.3–43.9) times greater among porters as compared with their non-portering peers, and 91% indicated they felt portering negatively impacted their general well-being. Findings indicate that despite the Nepalese government’s legislative efforts to regulate to the portering industry, portering children experience a substantially increased risk of negative physical, emotional and educational outcomes due to their involvement in exploitive and dangerous work. The long-term ramifications of portering are harmful to the well-being of children, and in the long run, lack of education may reduce employment options and the chance to escape from a life of continued poverty.

Emergency correction of coagulation before major surgery in two elderly patients on oral anticoagulation
Recommendations for urgent reversal of oral anticoagulation with vitamin K1 antagonists are largely derived from case series employing empirical dosing regimens with vitamin K1 and prothrombin complex concentrates. Data on the use of prothrombin complex concentrates in this indication are scarce in the elderly who are at high risk of both hemorrhagic and thrombotic complications. The two cases presented here describe patients older than 75 years who underwent rapid International Normalized Ratio (INR) reversal with prothrombin complex concentrates for surgical treatment of a bleeding ruptured spleen and for emergency surgery of a dissecting aorta. Both patients had their INRs rapidly corrected to 1.6 and underwent operation without complications. Evidence on treatment of patients who present with elevated INR and who have major bleeding or need to undergo emergency surgery is based mainly on observational studies. The two elderly patients presented here underwent successful emergency surgery after their INRs had been corrected with the intravenous use of vitamin K1 in combination with prothrombin complex concentrate that was administered according to current guideline recommendations.

Hundreds of Email Ideas Aim To Help Wayward Whales
Everyone seems to have a suggestion to get two wayward whales lingering in the Sacramento River to swim 70 miles back to the Pacific Ocean. One suggested towing life-sized replicas of orcas behind the whales to scare the recalcitrant mother humpback and her calf. Another proposed placing a giant magnet downriver, since humpbacks are thought to navigate by an internal compass that can sense magnetic north. While rescuers have not tried the hundreds of suggestions they have received via e-mail — most of which are unfeasible — they acknowledge that they are running out of ideas. “This is very much a work in progress,” said Trevor Spradlin, a marine mammal biologist with the National Oceanic and Atmospheric Administration working at the rescue scene. Two weeks after the whales were first spotted in fresh water, the giant mammals’ behavior remained a mystery, even to scientists. Biologists hastily drew up plans to spray the whales with fire hoses Friday after nearly a week of pipe-banging and whale recordings failed. Scientists used recordings to nudge a male humpback dubbed Humphrey out of the Sacramento-San Joaquin River Delta in 1985. The pair got stranded after marking an apparent wrong turn earlier this month and heading upstream until they reached the Port of Sacramento and could go no farther. They turned around on their own Sunday, and swam some 20 miles downriver to the Rio Vista Bridge. The central problem facing scientists trying to engineer new whale-herding techniques is that, while gentle coaxing has proved ineffective, they fear anything too forceful might make the situation worse. Nets pose a threat of entanglement, biologists said. Any method that induces panic could separate the whales or send them fleeing, increasing the danger they could become stranded in the mud among the delta’s labyrinthine network of sloughs, they said. During the week, rescuers grew concerned that some…

Unusual Presentation of Plasmodium vivax Malaria with Severe Thrombocytopenia and Acute Renal Failure
Renal failure and uremic encephalopathy are rare findings in Plasmodium vivax malaria. Thrombocytopenia is also an unusual manifestation of P. vivax malaria. This report highlights the occurrence of these rare manifestations in an 8-year-old boy who presented to us with fever, rash and progressive deterioration of renal functions.

Survival Analysis: a practical approach, 2nd edn * Machin D, Cheung YB, Parmar MKB

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