Tropical Cyclone Exposures and Risks of Emergency Medicare Hospital Admission for Cardiorespiratory Diseases in 175 Urban United States Counties, 1999-2010.

BACKGROUND: Although injuries experienced during hurricanes and other tropical cyclones have been relatively well-characterized through traditional surveillance, less is known about tropical cyclones' impacts on noninjury morbidity, which can be triggered through pathways that include psychosocial stress or interruption in medical treatment. METHODS: We investigated daily emergency Medicare hospitalizations (1999-2010) in 180 US counties, drawing on an existing cohort of high-population counties. We classified counties as exposed to tropical cyclones when storm-associated peak sustained winds were ≥21 m/s at the county center; secondary analyses considered other wind thresholds and hazards. We matched storm-exposed days to unexposed days by county and seasonality. We estimated change in tropical cyclone-associated hospitalizations over a storm period from 2 days before to 7 days after the storm's closest approach, compared to unexposed days, using generalized linear mixed-effect models. RESULTS: For 1999-2010, 175 study counties had at least one tropical cyclone exposure. Cardiovascular hospitalizations decreased on the storm day, then increased following the storm, while respiratory hospitalizations were elevated throughout the storm period. Over the 10-day storm period, cardiovascular hospitalizations increased 3% (95% confidence interval = 2%, 5%) and respiratory hospitalizations increased 16% (95% confidence interval = 13%, 20%) compared to matched unexposed periods. Relative risks varied across tropical cyclone exposures, with strongest association for the most restrictive wind-based exposure metric. CONCLUSIONS: In this study, tropical cyclone exposures were associated with a short-term increase in cardiorespiratory hospitalization risk among the elderly, based on a multi-year/multi-site investigation of US Medicare beneficiaries ≥65 years.

Chemical and sensory evaluation of dark chocolate with addition of quinoa (Chenopodium quinoa Willd.).

Quinoa (Chenopodium quinoa Willd) is a good source of vitamin E containing high quality protein. A dark chocolate with the addition of 12, 16 or 20% quinoa was developed. The protein concentration of the products increased as the percentage of quinoa increased. The product containing 20% quinoa showed only 9% increase in vitamin E, while the quantity of polyphenols decreased from 23.5 to 18 µmol pirocatechin/g. The amount of essential amino acids was improved in samples containing quinoa. Cysteine, tyrosine and methionine increased by 104, 72, 70%, respectively in chocolate containing 20% quinoa. The amino acid pattern was as per WHO standards, which was adequate to human needs. The chocolate with quinoa was approved by 92% of the sensory panel. All the samples showed an index of acceptance above 70%. Quinoa could be used at the levels evaluated in this study adding its potential health benefit to the dark chocolate.