scholarly journals An apple a day: an outbreak of cryptosporidiosis in Norway associated with self-pressed apple juice

2019 ◽  
Vol 147 ◽  
Author(s):  
L. J. Robertson ◽  
T. T. Temesgen ◽  
K. R. Tysnes ◽  
J. E. Eikås
Keyword(s):  
Apple Juice ◽  
Clinical Signs ◽  
Commercial Production ◽  
Duration Of Symptoms ◽  
Food Borne ◽  
Prolonged Duration ◽  
Hygienic Measures ◽  
Contamination Event ◽  
Salad Vegetables ◽  
Timely Reminder

AbstractIn the autumn of 2018, an outbreak of cryptosporidiosis affected adult employees from the same company in Western Norway. The organism wasCryptosporidium parvum, GP60 subtype IIaA14G1R1. All those infected had drunk from the same container of self-pressed apple juice. Incubation period (1 week) and clinical signs were similar among those infected, although some experienced a more prolonged duration of symptoms (up to 2–3 weeks) than others. The infections resulted after consumption from only one of 40 containers of juice and not from any of the other containers. It seems that althoughCryptosporidiumoocysts were detected in a sample from another container, the contamination did not affect the whole batch. This is perhaps indicative of a restricted contamination event, either from contaminated ground in the orchard, or during collection of the fruit, or during processing. Although outbreaks of food-borne cryptosporidiosis have previously been associated with consumption of contaminated apple juice, most of the more recent outbreaks of food-borne cryptosporidiosis have been associated with salad vegetables or herbs. This outbreak, the first outside USA reported to be associated with apple juice, is a timely reminder that such juice is a suitable transmission vehicle forCryptosporidiumoocysts, and that appropriate hygienic measures are essential in the production of such juice, including artisanal (non-commercial) production.

Diagnosis of Menière’s disease according to the criteria of 2015: Characteristics and challenges in 96 patients

2021 ◽  
pp. 1-13
Author(s):  
Friedrich Ihler ◽  
Ivelina Stoycheva ◽  
Jennifer L. Spiegel ◽  
Daniel Polterauer ◽  
Joachim Müller ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Signs ◽  
Real Life ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Duration Of Symptoms ◽  
Ménière's Disease

BACKGROUND: The diagnosis of Menière’s disease (MD) is made according to diagnostic criteria, the last revision of which was in 2015. For diagnosis, symptoms are weighted with audiometric findings and this can be challenging in individual patients. OBJECTIVE: To analyze patient’s characteristics and symptoms in a real-life cohort of 96 patients with diagnosed MD regarding sociodemographic parameters, clinical specifics, and audiometry. METHODS: Prospective clinical patient registry containing demographic and socioeconomic parameters, symptoms, as well as pure-tone audiometry data. RESULTS: 31 patients with definite MD, and 36 with probable MD were identified. 29 patients showed typical clinical signs of MD, but did not meet the full diagnostic criteria, and were considered separately. Mean duration of symptoms prior to presentation was 3.9±4.6 years. Significant differences between categories were found regarding aural fullness, tinnitus, and fluctuating hearing. If multiple audiograms were available, 28.6 %(6/21) documented fluctuating hearing. CONCLUSIONS: Current diagnostic criteria probably do not represent patients with monosymptomatic presentation or an early stage very well. Long-term follow-up with repeated audiometry is advisable.

Food Handlers Manual. Instructor

2017 ◽  
Keyword(s):  
Public Health ◽  
Latin American ◽  
Food Contamination ◽  
Economic Damage ◽  
Food Handlers ◽  
Food Handling ◽  
Food Borne ◽  
Hygienic Measures ◽  
Food Workers ◽  
Latin American And Caribbean

[Introduction]. Food-borne diseases (FBDs) are one of the most frequent public health problems in daily life. The hazards that cause FBD may occur in the different stages of the food chain (from primary production to the table). Independently from its origin, once the food reaches the consumer it may have an impact on public health and cause severe economic damage to the establishments devoted to its preparation and sale. These two events may cause loss of confidence and the closing down of a business. Fortunately, the measures for preventing food contamination are very simple and may be applied by anyone who handles food, by following easy rules for hygienic food handling. This Manual’s purpose is to provide to people who handle food, and particularly to food-handlers’ instructors, the information they need to facilitate the teaching of proper procedures to food workers. In addition, it seeks to provide basic information about food safety that Latin American and Caribbean countries may adapt to their own needs. The Manual is organized into three Modules and Appendixes focusing on the following topics: (1) food hazards; (2) FBDs; and (3) hygienic measures to prevent food contamination. The evaluation at the end, forms part of the Manual. Its purpose is to assess the knowledge learned during the course regarding the importance of hygienic food handling for public health.

Abstract W P172: Prevalence of Positive Dwi Findings in Relation to Tia Etiology

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Yasufumi Gon ◽  
Manabu Sakaguchi ◽  
Syuhei Okazaki ◽  
Hideki Mochizuki ◽  
Kazuo Kitagawa
Keyword(s):  
Symptom Onset ◽  
Clinical Symptoms ◽  
Motor Symptom ◽  
Unknown Etiology ◽  
Symptom Duration ◽  
Motor Symptoms ◽  
Duration Of Symptoms ◽  
Prolonged Duration ◽  
History Of ◽  
Toast Classification

Objective: Previous studies have shown that the prolonged duration of TIA symptoms or ABCD2 score are associated with DWI abnormality, and the presence of DWI abnormality is associated with an increased early risk of stroke. However, there are few reports that show the relation between TIA clinical etiology and DWI abnormality. Our aim of this study is to clarify the prevalence of positive DWI in relation to characteristics of patients and TIA. Methods: The subjects were enrolled from patients who were admitted to our stroke unit within 7 days after symptom onset from January 2006 to July 2013. The diagnosis of TIA was done by NINDS criteria, and we classified TIA etiology by TOAST classification based on clinical symptoms, ECG monitoring, carotid ultrasound, MR angiography and transesophageal echocardiography. All patients underwent DWI-MRI within 7 days after symptom onset. We examined an association between TIA etiology, symptom, duration of symptoms and DWI abnormality. Results: A total of 141 patients (mean 64 years; 63% men) were admitted with TIA during this period. Those included lacuna TIA (n=17, 12.1%), atherothrombotic TIA (n=32, 22.7%), cardioembolic TIA (n=23, 16.3%), TIA due to other causes (n=35, 24.8%), and TIA with unknown etiology (n=34, 24.1%). Prevalence of positive DWI findings were 47.1% in lacunar TIA, 43.7% in atherothrombotic TIA, 52.1% in cardioembloic TIA, 42.8% in TIA due to other causes, and 23.5% in TIA with unknown etiology. DWI abnormality was the most frequent in cardiogenic TIA. In relation to symptom duration, the prevalence of DWI positive findings were 45.2% in less than 1 hour (N=53), 36.6% in 1-3 hour (N=41), 25.0% in 3-6 hour (N=12) and 42.9% in 6-24 hours (N=35). In relation to motor symptoms, there was no difference in prevalence of DWI abnormality between patient with motor symptoms (39.8%, N=113) and without (42.8%, N=28). There was no relation between DWI abnormalities and age, a history of stroke/TIA episode or vascular risk factors. Conclusion: Prevalence of DWI positive findings was high in cardiogenic TIA, and low in TIA with unclassified etiology. There were no relation between DWI abnormality, duration of symptom, and motor symptom.

Radial Tunnel Syndrome

1995 ◽  
Vol 20 (4) ◽  
pp. 454-459 ◽  
Author(s):  
T. LAWRENCE ◽  
P. MOBBS ◽  
Y. FORTEMS ◽  
J. K. STANLEY
Keyword(s):  
Radial Nerve ◽  
Tennis Elbow ◽  
Free Edge ◽  
Wrist Pain ◽  
Duration Of Symptoms ◽  
Supinator Muscle ◽  
Prolonged Duration ◽  
Tunnel Syndrome ◽  
Manual Tasks ◽  
Radial Tunnel Syndrome

Radial tunnel syndrome results from compression of the radial nerve by the free edge of the supinator muscle or closely related structures in the vicinity of the elbow joint. Despite numerous reports on the surgical management of this disorder, it remains largely unrecognized and often neglected. The symptoms of radial tunnel syndrome can resemble those of tennis elbow, chronic wrist pain or tenosynovitis. Reliable objective criteria are not available to differentiate between these pathologies. These difficulties are discussed in relation to 29 patients who underwent 30 primary explorations and proximal decompressions of the radial nerve. Excellent or good results were obtained in 70%, fair results in 13% and poor results in 17% of patients. The results can be satisfactory despite the prolonged duration of symptoms. We believe that a diagnosis of radial tunnel syndrome should always be born in mind when dealing with patients with forearm and wrist pain that has not responded to more conventional treatment. Patients with occupations requiring repetitive manual tasks seem to be particularly at risk of developing radial tunnel syndrome and it is also interesting to note that 66% of patients with on-going medico-legal claims had successful outcomes following surgery.

LINEAR INCREASE IN RISK OF APPENDICEAL RUPTURE WITH PROLONGED DURATION OF SYMPTOMS

2007 ◽  
Vol 23 (10) ◽  
pp. 766
Author(s):  
Eden J. Kahle ◽  
Daniel S. Kim ◽  
Edward R. Feller ◽  
Angela C. Anderson ◽  
Francois I. Luks
Keyword(s):  
Linear Increase ◽  
Duration Of Symptoms ◽  
Prolonged Duration ◽  
Increase In Risk

scholarly journals Nitrofurantoin associated pulmonary fibrosis

2020 ◽  
Vol 9 (6) ◽  
pp. 985
Author(s):  
Olayinka A. Ogundipe
Keyword(s):  
Pulmonary Fibrosis ◽  
Relevant Literature ◽  
Clinical Signs ◽  
Computerised Tomography ◽  
Medication History ◽  
Prolonged Duration ◽  
Bilateral Lung ◽  
Tract Infections ◽  
Tomography Scan

This report describes the case of an 83 years old woman presenting to hospital due to a fall, and acute confusion. On admission, she was diagnosed as having clinical and plain X-ray features of a pneumonia. Following treatment and recovery from the pneumonia, she was noted to have persistent clinical signs of bilateral lung crackles on auscultation. A high-resolution computerised tomography scan showed signs of interstitial lung disease consistent with pulmonary fibrosis. Of relevance was a medication history that indicated oral nitrofurantoin had been initiated in primary care for the long-term prophylaxis of recurrent urinary tract infections. Given the prolonged duration of use of ten years, we considered the possibility of this being an adverse drug reaction in the form of nitrofurantoin associated pulmonary fibrosis. This report also briefly reviews the relevant literature on nitrofurantoin associated pulmonary fibrosis and to promote objectivity in the pharmacovigilance related reporting. The report has been reviewed with the aid of two validated causality assessment systems.

Background and history of hydroponics and protected cultivation.

2021 ◽  
pp. 1-10
Author(s):  
Lynette Morgan
Keyword(s):  
High Technology ◽  
Commercial Production ◽  
Medicinal Herbs ◽  
Cut Flower ◽  
Potted Plants ◽  
Protected Cultivation ◽  
History Of ◽  
Ornamental Crops ◽  
Culinary Herbs ◽  
Salad Vegetables

Abstract Along with new types of protected cropping structures, materials and technology, the range and diversity of hydroponic crops grown are also expanding. While the greenhouse mainstays of nursery plants, tomatoes, capsicum, cucumber, salad vegetables and herbs will continue to expand in volume, newer, speciality and niche market crops are growing in popularity. These include new cut flower species, potted plants and ornamental crops, and a growing trend in the commercial production of medicinal herbs using high-technology methods such as aeroponics. Exotic culinary herbs such as wasabi, dwarf fruiting trees and spices such as ginger and vanilla are now grown commercially in protected cropping structures, while many home gardeners continue to take up hydroponics and protected cropping as both a hobby and a means of growing produce. Protected cropping and hydroponic methods will further their expansion into hostile climates which never previously allowed the production of food.

THE IMPORTANCE OF CHEST-X-RAY (TIMIKA SCORE) TO PREDICT THE CLINICO-BACTERIOLOGICAL PROFILE OF PULMONARY TUBERCULOSIS PATIENTS

2021 ◽  
pp. 55-58
Author(s):  
Surinder Pal Singh ◽  
Harjinder Singh ◽  
Komal Deep Kaur ◽  
Kailash Meena ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sputum Smear ◽  
Karnofsky Performance Score ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Cavitary Lesion ◽  
X Ray ◽  
Chest X Ray

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

scholarly journals 1384. Mycobacterium marinum Infection: 21 Years of Experience at a Tertiary-Care Hospital

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S502-S503
Author(s):  
Natalia E Castillo Almeida ◽  
Pooja Gurram ◽  
Omar Abu Saleh
Keyword(s):  
Upper Limb ◽  
Tertiary Care ◽  
Granulomatous Inflammation ◽  
Drug Regimen ◽  
Skin Lesions ◽  
Mycobacterium Marinum ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Length Of Treatment ◽  
Prolonged Duration

Abstract Background Mycobacterium marinum is a slow-growing, non-tuberculous mycobacterium responsible for skin and soft-tissue infections (SSTIs), tenosynovitis, and osteomyelitis (OM). We conducted a retrospective study describing the risk, clinical course, and outcome of M. marinum infection. Methods Adult patients with culture-confirmed M. marinum infections were identified from the mycology laboratory at Mayo Clinic, Rochester from January 1998 to December 2018. M. marinum infection was defined as uncomplicated (limited to SST) and complicated (tenosynovitis, OM, or disseminated). Results Forty-six cases of culture-confirmed infection with M. marinum were included (Table 1). Only 16 cases (35%) reported a water exposure and 22 (48%) involved finger and/or hand trauma. The median time to diagnosis was 3.6 months. Most patients (76%) presented with uncomplicated M. marinum infection with skin lesions mainly localized in the upper limb (Table 2). QuantiFERON and PPD were positive in 4 (8%) and 2 (4%) cases, respectively. Granulomatous inflammation and positive special stains were noted in 34 (74%) and 11 (24%) cases, respectively. Cases with complicated M. marinum infection had a longer duration of symptoms and length of treatment (P < 0.05) (Table 3). Prior to diagnosis, 63% of patients received at least one antibiotic for bacterial SSTIs. More than 50% of the patients diagnosed with M. marinum received a one drug regimen and 8% did not initiate therapy. Median treatment duration was 4.4 months. Twenty-six cases (56%) had susceptibilities performed and treatment modifications were made in 10 cases (38%). From the patients that started therapy, 73% completed therapy and 33% were lost to follow up. Cured was achieved in 87% of cases that completed therapy, 2 cases (6%) had a recurrence, and only one patient with active malignancy had a positive blood culture and died. Twelve (44%) and 10 cases (37%) were cured with one and two-drug regimens, respectively. Conclusion Most patients with M. marinum infection present as an uncomplicated infection in the upper limb. Classical exposure was only suspected in a third of the cases. Patients with complicated M. marinum infection had a prolonged duration of symptoms and lengthy treatment. Most patients were successfully treated with a one and two-drug regimen. Disclosures All authors: No reported disclosures.

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