Search

Influenza is a concerning disease in terms of risk management for cruise passengers during a voyage. Currently, cruise passengers include children in addition to elderly people. Oral oseltamivir can be used to treat pediatric influenza. In addition, early antiviral treatment may reduce the spread of influenza on board. However, the capsule form of oseltamivir is not of the recommended dosage for children. In this report, we describe 2 siblings who acquired influenza during travel on a world cruise ship and were treated with decapsulated oseltamivir. The siblings' mother was instructed to decapsulate a 75 mg oseltamivir capsule, suspend the powder in 15 mL of water (5 mg·mL-1), stir well, and administer the required amount of medicine orally to each patient using a syringe. Both patients recovered successfully with no complications. The presented case suggests that suspending decapsulated oseltamivir in water and measuring the required amount with a syringe for orally administration to children with influenza can be a safe treatment strategy in resource-limited settings.

Background This study aimed to clarify the effects of underlying diseases on clinical outcomes of patients aboard a world cruise ship. Methods This prospective cohort study included patients who sought physician consultations at an onboard clinic on a 105-day world cruise (September–December 201X) on a ship chartered by a Japanese travel agency. Multivariable logistic regression analysis was performed to ascertain whether any concurrent disease, such as hypertension, was associated with additional onboard treatment by the primary physician or serious events, including unexpected final disembarkation, temporary disembarkation for hospitalization ashore, shore-side referral, and onboard clinic admission. Results Of 313 patients, 182 (58%) had at least one underlying disease. Sixty-eight (22%) required additional treatment, and 24 (8%) experienced serious events. After adjusting for age, sex, and underlying diseases, the 60–69- and 70–74-year age groups had a lower risk of serious events than the ≤59-year age group (odds ratio [OR], 95% confidence interval [CI]: 0.24, 0.069–0.81; p = 0.022 and 0.045, 0.0051–0.47; p = 0.0055). Underlying disease was associated with serious events (OR, 95% CI: 3.2, 1.1–9.5; p = 0.036). Conclusions Unexpected events can occur in patients on world cruises regardless of age. Preexisting diseases may confer higher risk of serious events.

In the solutrean site o[ La Cueva de Ambrosio several engraved and painted figures dated on the Upper palaeolithic, have been found during the field works of[ 1992 and 1994. In the panel I we have identified an excellent representation of a horse, a bird, one bovidae and another protome of a horse. Below this surface there are many red ochre wallpaintings covered by a calcitic path and for the time being we are unable to give any interpretation for it. In the second panel we have discovered one splendid red painted horse, two more engraved horses and a little head of one other black painted horse. There are many engraved lines and pictural rests that must be studied in the future. The exceptionality of this discovery is that we can interrelate perfectly these rock art paintings with the archaeological levels clearly defined chronologically and culturally (ca. 16000 B.P., Upper Solutrean and Final Solutrean) from the same site., En el yacimiento solutrense de La Cueva de Ambrosio se han encontrado durante las campañas de 1992 y 1994 un conjunto de representaciones artísticas parietales pintadas y grabadas del Paleolítico Superior. Entre los grabados del panel I, se ha descifrado una excelente silueta de caballo, una representación de ave, unos protomos de bóvido y de caballo, así como otros trazos todavía no interpretados. En la parte inferior del panel existen pinturas, poco visibles a causa de una colada calcítica y de momento no es posible interpretar ninguna representación figurativa. En el panel II se han identificado un espléndido caballo pintado en ocre rojo, otros dos caballos grabados, un protomos de caballo pintado en negro y gran cantidad de líneas incisas en trazo múltiple, así como otros restos pictóricos todavía por identificar. La excepcionalidad del hallazgo reside en el hecho de poder interrelacionar perfectamente estas muestras de arte con los niveles arqueológicos claramente definidos desde el punto de vista cultural y cronoestratigráfico (ca. 16000 B.P. Solutrense Superior y Solutrense Superior Evolucionado) del mismo yacimiento.