Importance of Dietary Fiber in Childhood

Dietary fiber has important health benefits in childhood, especially in promoting normal laxation. Currently, children consume amounts of dietary fiber that appear to be inadequate for optimal health promotion and disease prevention. It is prudent to recommend that children older than 2 years of age increase dietary fiber intake to an amount equal to or greater than their age + 5 g/day. According to the “age + 5” rule dietary fiber intake would increase from 8 g/day at age 3 years to 25 g/day by age 20 years. After age 20, dietary fiber levels of 25 to 35 g/day are recommended. Dietary fiber intake should be increased gradually in childhood by increasing consumption of a variety of fruits, vegetables, legumes, cereals, and other whole-grain products. Although very high fiber intake in childhood could have adverse effects, the potential health benefits of a moderate increase in dietary fiber substantially outweigh the possible risks, especially in highly industrialized countries such as the United States. A safe range of dietary fiber intake for children may be between age + 5 and age + 10 g/day. This range is considered safe even for children and adolescents with marginal intakes of some vitamins and minerals; should provide enough dietary fiber for normal laxation; and may provide enough added dietary fiber to help prevent chronic diseases.J Am Diet Assoc. 1995; 1140-1146, 1149.     

The HIV-Positive Physician and Disability Insurance

Occupational exposure to HIV is becoming a daily hazard in many emergency departments. Emergency physicians who are protected by disability insurance policies are likely to believe that if they are unable to continue working because of HIV-positive status, their disability policies will provide them with a source of income. Unfortunately, analysis of case law regarding claims under disability policies shows that the law is unlikely to consider an asymptomatic, HIV-positive physician disabled for purposes of payments under disability policies. Therefore, it is necessary for emergency physicians to make sure this issue is resolved before buying and relying on a disability policy so that an anticipated safety net will be operative over the full range of hazards that emergency physicians face.[Lavely R: The HIV-positive physician and disability insurance. Ann Emerg Med June 1994;23:1355-1362.]     

Echocardiographic demonstration of important abnormalities of the mitral valve in congenitally corrected transposition.

Whereas abnormalities of the morphological tricuspid valve are common in the setting of discordant atrioventricular connections, there are only a few postmortem reports of abnormalities of the mitral valve in this condition. This report describes two patients with discordant atrioventricular connections, in whom important abnormalities of the mitral valve were found during life by cross sectional echocardiography.     

Immunology: High fecundity rates following in- vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin

This study was undertaken to explore whether intervention withheparin and aspirin (H/A) in selected patients undergoing in-vitrofertilization (TVF) and embryo transfer could improve fecundityrates. Specifically, it explored the possibility that womendiagnosed with organic pelvic disease who demonstrated antiphospholipidantibodies (APA) could benefit from H/A administration in asimilar manner to that used in patients with recurrent pregnancyloss. We used an enzyme–linked immunosorbent assay forsix different phospholipids to identify patients who expressedAPA before they underwent IVF/embryo transfer. This study wasconfined to the first IVF/embryo transfer cycle that followedassessment of APA status and accordingly, the number of IVF/embryotransfer cycles corresponds with the number of patients treated.APA seropositive patients were treated with aspirin, 81 mg orallyq.d., and heparin 5000 IU s.c. b.i.d., beginning on day 1 ofcontrolled ovarian stimulation. The endpoint for success wasa live birth or an ultrasound confirming fetal cardiac activity(a viable pregnancy). The prevalence of APA in patients diagnosedwith organic pelvic disease (53%) was much higher than in thosewithout female pathology (14%). The administration of H/A toAPA seropositive patients significantly (P < 0.05) improvedthe viable pregnancy rate (49%) compared to the untreated APAseropositive group (16%). The viable pregnancy rate for APAseropositive women treated with H/A was also significantly (P< 0.001) higher than for untreated APA seronegative patients(27%). We conclude that all women undergoing IVF/embryo transfershould be tested for APA prior to initiating ovarian stimulation,and those with APA seropositivity should be treated with H/A.     

Transfer of occupational health problems from a developed to a developing country: Lessons from the Japan–South Korea experience

Many corporations move their manufacturing facilities or technologies from developed to developing countries. Stringent regulations have made it costly for industries to operate in developed, industrialized countries. In addition, labor costs are high in these countries, and there is increasing awareness among the general public of the health risks associated with industry. The relocation of hazardous industries to developing countries is driven by economic considerations: high unemployment, a cheaper labor force, lack of regulation, and poor enforcement of any existing regulations make certain countries attractive to business. The transfer of certain industries from Japan to Korea has also brought both documented occupational diseases and a new occupational disease caused by chemicals without established toxicities. Typical examples of documented occupational diseases are carbon disulfide poisoning in the rayon manufacturing industry, bladder cancer in the benzidine industry, and mesothelioma in the asbestos industry. A new occupational disease due to a chemical without established toxicities is 2‐bromopropane poisoning. These examples suggest that counter‐measures are needed to prevent the transfer of occupational health problems from a developed to a developing country. Corporate social responsibility should be emphasized, close inter‐governmental collaboration is necessary and cooperation among non‐governmental organizations is helpful. Am. J. Ind. Med. 52:625–632, 2009. © 2009 Wiley‐Liss, Inc.