Fortification of curry powder with NaFe(111)EDTA in an iron-deficient population: initial survey of iron status

A survey of iron status was conducted in 984 volunteers (404 males and 580 females) from an Fe-deficient population before an Fe-fortification trial. Hemoglobin, percentage saturation of transferrin, and serum ferritin were used to assess Fe status and to calculate body Fe stores. Almost 30% of males and 60% of females had evidence of Fe deficiency. The distribution of body Fe stores for both males and females was shifted to the left compared with a population in the United States. In females 24% had Fe-deficiency anemia, 13% Fe-deficient erythropoiesis, and 16% depleted stores. Multiple regression analysis failed to show any relationship in women between age, parity, and duration of menses and measurements of Fe status. In males Fe deficiency was more frequent for those less than 18 y and alcohol abusers had increased serum ferritin and calculated body Fe compared with nondrinkers.     

Survey of Alcohol,Tobacco, and Cannabis Use in the French Army

ABSTRACT

The aim of the current study is to describe the consumption rate of alcohol, tobacco, and cannabis in the French Army. A cross-sectional two strata randomized survey was performed between October 2006 and March 2007 using self-report questionnaires (n = 990) to collect individual characteristics, consumption, and addictive behaviors with urinal tests for cannabis (n = 985). The surveyed sample comprised 59% privates, 26% non-commissioned officers, and 6% officers, was predominantly male (89%) and young (median age: 29 years), and had a low level of education (60% attended secondary school). The consumption rate was high: 54.1% were active tobacco smokers, 56.0% were heavy drinkers, 20.5% declared drunkenness more than once per month, 52.6% at least experienced cannabis while 12.3% were occasional users, 8.2% were regular users, and 15.0% displayed multi-risk behaviors. Consumption was higher in the younger age (18 to 25 years) and lower educational group, leading to a high prevalence among privates and suggesting an “army effect.” However, large scale behavioral social studies may help distinguish between personal and peer effect among the targeted population.     

Myocardial ischemia in aortic stenosis: Insights from arterial pulse-wave dynamics after percutaneous aortic valve replacement

Wave-intensity analysis is a technique that can qualify both the direction and magnitude of the forces accelerating and decelerating coronary blood flow and is derived from simultaneously acquired measures of coronary pressure and velocity using invasive intracoronary wires. Using this technique during TAVI, the dominant force (or ‘wave’) acting to increase the coronary blood flow which originates from microvascular relaxation is shown to be elevated in severe aortic stenosis and decreased post-implantation. Additionally, with increasing heart rate a progressive fall in the magnitude of this wave is noted and after TAVI this effect is reversed (returning towards the physiological norm). The potential causes of myocardial ischemia in aortic stenosis are clearly multi-factorial but this observation suggests a decoupling between the aorta and myocardium in aortic stenosis, the effects of which are magnified during increased heart rate.     

Loss of Smell (Anosmia) and Taste (Ageusia) in a Patient Treated with Pegylated Interferon Alfa and Ribavirin

Introduction: Anosmia, the loss of the sense of smell, is a rare adverse event associated with interferon alpha (INF-α). Millions of patients with hepatitis B and hepatitis C virus (HCV) infection are currently treated with INF-alfa-2a daily. Only 5 cases of anosmia have been reported in the literature, and none was associated with pegylated INF-alfa.Case summary: A 55-year-old Arab male (height, 5′1″; weight, 81 kg) with chronic HCV developed anosmia and ageusia (loss of the sense of taste) after 36 weeks of treatment for HCV with subcutaneous pegylated INF-alfa-2a 180 μg and ribavirin 1200 mg. Treatment was continued for 12 additional weeks before being discontinued. Twenty-four weeks after treatment was discontinued, HCV-RNA was undetectable and, during the same visit, the patient reported that he had regained his sense of smell a few weeks previously. The Naranjo algorithm score was 7, representing a probable association of anosmia with INF-alfa-2a treatment. Other etiologies for loss of smell and taste were ruled out.Conclusions: We report a case of anosmia and ageusia in a patient treated with pegylated INF-alfa-2b and ribavirin for HCV infection. The patient regained his sense of smell and taste within 24 weeks of stopping treatment.     

Morbidity from urinary schistosomiasis in relation to intensity of infection in the Natal Province of South Africa

Morbidity from urinary schistosomiasis was assessed on clinical, radiological, parasitologic and biochemical evidence in 510 schoolchildren living in a Schistosoma haematobium endemic area. The results were viewed against the background of the prevalence and intensity of infection in the subjects. Clinical morbidity correlated well with the intensity of infection, the latter in turn being influenced by factors such as water contact pattern, sex and water source. A surprisingly high prevalence (42%) of abnormalities was observed in the urinary tract of subjects, but no relationship could be demonstrated between the intensity of infection and structural damage to the urinary tract. Urographic changes were more severe in the 11-15 year age group than in the 6-10 year group. Significant rectal involvement (76%) in S. haematobium-infected subjects was regarded as a reflection of the heavy worm burdens borne by these children. The morbidity described in this study indicates a definite degree of pathology in the infected children but the impression was that they suffered only mild disability. However, given the structural lesions seen on urography and the limited sensitivity of the biochemical tests used for the assessment of renal function, renal pathology cannot be ruled out. Further studies on the renal status of these subjects are essential.     

Anticoagulation for cardioversion of atrial fibrillation

The cardioversion of chronic atrial fibrillation to sinus rhythm carries a thromboembolic risk of 1.5-6%. These events occasionally occur at the time of cardioversion, but more often happen hours or days later. These strokes and other embolic events may occur even where atrial thrombus has been excluded before cardioversion and it has become apparent that, although atrial electrical activity may be restored by cardioversion, normal mechanical atrial function may take longer to recover. Numerous studies have addressed the role of anticoagulation following cardioversion in patients with atrial fibrillation, however, the mechanism of embolic complications as well as the justification of a standard anticoagulation therapy are not fully established. In this review we will try to present an overview of the mechanisms of thrombosis following cardioversion and give an insight into current anticoagulation strategies.