Autism Timeline

Autism Timeline      

  in  Newsweek     1943-2009 (full timeline)

  

Advertisements

The Ever-Changing Landscape of Rotavirus Serotypes

The Ever-Changing Landscape of Rotavirus Serotypes

Abstract:

Rotavirus is a double-stranded RNA virus that is characterized by substantial genetic diversity. The various serotypes of rotavirus have been determined by the presence of neutralizing epitopes on the outer capsid of the protein shell. At present, 5 rotavirus serotypes (G1, G2, G3, G4, G9) are the predominant circulating strains, accounting for approximately 95% of strains worldwide, although there is considerable geographic variability. Incidence rates for various serotypes also vary temporally with seasonal and year-to-year fluctuations. Unusual serotypes are generally uncommon, but new serotypes can emerge. In particular, G9[P8], a reassortment virus, was first identified in 1983 and in the last 10 to 15 years has become widely distributed worldwide. Indeed, G9[P8] has become highly prevalent in many countries in Europe and Australia, with somewhat lower incidence rates in South America, Africa, and Asia. The heterogeneity and ever-changing epidemiology of rotavirus underscores the need for continued surveillance to ensure that vaccination programs provide optimal protection.

The Government Push for Electronic Medical Records

The Government Push for Electronic Medical Records  (MedScape Today-) *requires login

The economic stimulus plan currently being considered by Congress allocates $20 billion to health information technology such as electronic medical records (EMRs). Recent postings on Medscape Physician Connect (MPC), a physicians-only discussion board, offer frank opinions about the utility of EMRs in clinical practice — opinions that are decidedly mixed…

 

Waiting may not be an option for much longer, however. One provision of the government stimulus plan would impose reduced payments on physicians who are not “meaningfully using” information technology. Whatever is meant by the provision’s phrasing, one thing is clear: the push is on to go electronic. Physicians must learn how to make information technology work for them. One EMR expert says that it starts with the choice of systems. “Primary care practices should stay away from templates and stick to a new program by Praxis® [Infor-Med Medical Information Systems, Inc., Woodland Hills, California] that uses pattern recognition of similar cases as well as rare cases. It decreases the workload immensely. For specialty practices, I recommend templates, and Visionary™ Dream EHR [Visionary Medical Systems, Inc., Tampa, Florida] is excellent in being very user friendly,” says an MPC contributor whose research in medical management focuses on EMR systems.

Another MPC contributor notes that the technologically adventurous can customize an EMR system by using open-source software. In open-source systems, he explains, the source code needed for programming is included in the software, making the program infinitely adaptable. “When you buy most proprietary software, you have to accept the functions that come with it, as designed by the developers. With open-source systems, you can modify the software to your heart’s content…”

Is a Choice of Systems Really a Choice?

For some physicians, however, EMR systems remain a nonissue, and the heavy government funding of healthcare information technologies is nothing more than a smokescreen obscuring the real issues in primary care.

“The government and the public are not able to deal with the real problems facing medical practice and the real solutions necessary to turn it around (ie, reasonable reimbursement rates, malpractice reform, regulation of the unscrupulous practices of the insurance industry),” says an otolaryngologist. He adds that once healthcare information technology is “fully implemented and solves nothing, we can start to talk about real reform and real answers.”

 

Many prenatal vitamins lack enough iodine: study

Many prenatal vitamins lack enough iodine: study

LOS ANGELES — Many brands of multivitamins for pregnant women may not contain all the iodine they claim, potentially putting babies at risk of poor brain development, a new study suggests.

 

Tests on 60 brands that listed iodine as an ingredient on their labels found many fell short of the stated amount. The risk of too little iodine appears greater with “natural” vitamins that get their iodine from kelp rather than a salt form, the study found.

 

“If these numbers are all real, then they’re not meeting their label claim and that’s a problem,” said William Obermeyer, a former Food and Drug Administration scientist who co-founded ConsumerLab.com, a private testing service. Obermeyer was not part of the research.

 

The study was done by scientists at the Boston University Iodine Research Laboratory. Results were reported in a letter published in Thursday’s New England Journal of Medicine. No brands were named in the analysis.

 

Iodine is commonly added to table salt and can be found in seafood, dairy products and bread. Iodine deficiency affects more than 2 billion people worldwide and is the leading cause of mental retardation.

 

Pregnant and nursing women need 220 to 290 micrograms of iodine a day, according to the Institute of Medicine. Expecting mothers who don’t get enough can put their babies at greater risk of mental retardation and growth, hearing and speech problems.

 

The American Thyroid Association recommends that pregnant women take a daily dose of prenatal multivitamins containing 150 micrograms of iodine, which is needed for proper thyroid function. During pregnancy, having enough thyroid hormones is important for fetal brain development.

 

There is no law requiring vitamin makers to add iodine to prenatal multivitamins, which are available by prescription or bought over-the-counter as dietary supplements.

 

Boston University scientists last year looked at 223 prenatal multivitamins available by prescription or sold over-the-counter in the United States. About half of them — 114 — listed iodine on their labels.

 

Prescription prenatal vitamins face more stringent government scrutiny than their supplement counterparts, which do not have to be proven safe before they are sold.

 

However, researchers found problems with both types when they tested iodine levels in 60 prescription and over-the-counter prenatal multivitamins. The iodine was in the form of kelp or potassium iodide.

 

Among vitamins with potassium iodide, tests found the average iodine level was 119 micrograms per daily dose — less than the recommended amount.

 

Among kelp-containing vitamins, the iodine levels ranged from 33 to 610 micrograms per daily dose. Experts say taking too much iodine can lead to problems, especially for women who already have a thyroid problem.

 

In 10 brands, iodine levels were less than half than what was listed on their labels. Three brands contained iodine levels 50 percent or more higher than advertised. Variations were greater among kelp-containing vitamins.

 

Based on the study’s findings, pregnant women should take prenatal multivitamins that contain potassium iodide instead of kelp, said Dr. Elizabeth Pearce, one of the researchers.

 

Dr. Alex Stagnaro-Green, who specializes in pregnancy thyroid problems at the Touro University College of Medicine in New Jersey, said the findings point out a problem in vitamin marketing and urged the Food and Drug Administration to make iodine a mandatory ingredient in all prenatal multivitamins.

 

The Council for Responsible Nutrition, a Washington-based trade group for vitamin makers, said it supports putting iodine in all prenatal vitamins. The council’s John Hathcock said iodine is difficult to measure and can degrade over time, which can affect its concentration.

 

Some independent groups such as the United States Pharmacopeia test dietary supplements to verify their contents. Consumers can buy brands with a seal of approval from USP.