Foodborne Botulism in Western Romania: Ten Years’ Experience at a Tertiary Infectious Disease Hospital

Objectives: The purpose of this study was to analyze epidemiological data concerning foodborne botulism in Western Romania over the last decade. Botulism, the toxin formed by the bacterium Clostridium botulinum, results in a neuroparalytic disorder capable of severe clinical progression that begins in the cranial nerves and progressively descends. Preventing progression to a severe case entails timely diagnosis since curative assets are restricted. Ingesting food containing a preformed toxin (foodborne botulism) is the most typical form. Methods: Medical records were retrospectively analyzed from 2010 to 2020 for all food botulism cases. A seroneutralization test was performed with type A, B and E anti-botulinum sera to establish the kind of toxin involved. Results: Overall, 18 cases of foodborne botulism were admitted to the hospital during this period and confirmed by laboratory analysis. Most of the participants in our study were men (61.1%), and 77.8% of the total lived in rural areas. All the participants showed classic symptoms of botulism, and dysphagia was present in all cases. The trivalent ABE antitoxin was administered by the hospital, and toxin type B was isolated in all patients. The main sources of the toxin were pork, ham and canned pork meat. Conclusions: Stronger efforts are needed to foster community awareness of foodborne botulism, particularly in home-preserved food.

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Differentiation between Types and Strains of Clostridium botulinum by Riboprinting

Journal of Food Protection ◽

10.4315/0362-028x-63.10.1347 ◽

2000 ◽

Vol 63 (10) ◽

pp. 1347-1352 ◽

Cited By ~ 16

Author(s):

GUY E. SKINNER ◽

STEVEN M. GENDEL ◽

GEOFFREY A. FINGERHUT ◽

HAIM A. SOLOMON ◽

JODIE ULASZEK

Keyword(s):

Clostridium Botulinum ◽

Hazard Analysis ◽

Control Point ◽

Egg Yolk ◽

Type B ◽

Critical Control Point ◽

Microbial Characterization ◽

Automated Ribotyping ◽

Degree Of Differentiation ◽

Foodborne Botulism

The ability of automated ribotyping to differentiate between major types and individual strains of Clostridium botulinum was tested using the Qualicon Riboprinter Microbial Characterization System. Pure spores of C. botulinum type A, proteolytic type B, nonproteolytic type B, and type E strains were inoculated onto modified anaerobic egg yolk agar and incubated 24 h at 35°C. Plates were rinsed with buffer (2 mM Tris + 20 mM EDTA) to remove vegetative cells that were heated for 10 min at 80°C, treated with a lysing agent, and ribotyped in the Qualicon Riboprinter utilizing the enzyme EcoRI. Riboprint patterns were obtained for 30 strains of the four major types of C. botulinum most commonly involved in human foodborne botulism. Proteolytic strains yielded the best and most consistent results. Fifteen ribogroups were identified among the 31 strains tested. Interestingly, in two cases, a single ribogroup contained patterns from isolates belonging to evolutionarily distinct Clostridium lineages. This degree of differentiation between strains of C. botulinum may be useful in hazard analysis and identification, hazard analysis and critical control point monitoring and validation, environmental monitoring, and in inoculation studies.

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PREVALENCE OF PARACOCCIDIOIDOMYCOSIS INFECTION BY INTRADERMAL REACTION IN RURAL AREAS IN ALFENAS, MINAS GERAIS, BRAZIL

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652014000400002 ◽

2014 ◽

Vol 56 (4) ◽

pp. 281-285 ◽

Cited By ~ 9

Author(s):

Evandro Monteiro de Sá Magalhães ◽

Carla de Fátima Ribeiro ◽

Carla Silva Dâmaso ◽

Luiz Felipe Leomil Coelho ◽

Roberta Ribeiro Silva ◽

...

Keyword(s):

Rural Areas ◽

Alcohol Intake ◽

Paracoccidioides Brasiliensis ◽

Statistical Significance ◽

Epidemiological Data ◽

Population Based ◽

Minas Gerais ◽

Delayed Type Hypersensitivity ◽

Local Health ◽

Cross Sectional

This study aimed to estimate the prevalence of paracoccidioidal infection by intradermal reaction (Delayed-Type Hypersensitivity, DTH) to Paracoccidioides brasiliensis in rural areas in Alfenas, Southern Minas Gerais (MG) State, Brazil, and to assess risk factors (gender, occupation, age, alcohol intake and smoking) associated with infection. We conducted a population-based cross-sectional study using intradermal tests with gp 43 paracoccidioidin in 542 participants, who were previously contacted by local health agents and so spontaneously attended the test. Participants underwent an interview by filling out a registration form with epidemiological data and were tested with an intradermal administration of 0.1 mL of paracoccidioidin in the left forearm. The test was read 48 hours after injection and was considered positive if induration was greater than or equal to 5 mm. Out of 542 participants, 46.67% were positive to the skin test. Prevalence increased in accordance with an increase of age. There was statistical significance only for males. Occupation, alcohol intake and smoking habits were not significantly associated with the risk of paracoccidioidomycosis infection. There is relevance of paracoccidioidomycosis infection in such rural areas, which suggests that further epidemiological and clinical studies on this mycosis should be done in the southern part of Minas Gerais State.

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Use of breast-conserving surgery for treatment of stage I and stage II breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1998.16.1.101 ◽

1998 ◽

Vol 16 (1) ◽

pp. 101-106 ◽

Cited By ~ 67

Author(s):

E Guadagnoli ◽

J C Weeks ◽

C L Shapiro ◽

J H Gurwitz ◽

C Borbas ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Surgical Treatment ◽

Rural Areas ◽

Medical Records ◽

Retrospective Cohort ◽

Early Stage ◽

Breast Conserving Surgery ◽

Teaching Hospitals ◽

Type Of Surgery

PURPOSE To assess the use of breast-conserving surgery in two states reported to differ with respect to surgical treatment of breast cancer. METHODS A retrospective cohort study based on data collected from medical records and patients was performed among 1,514 patients diagnosed with early-stage breast cancer in Massachusetts and 1,061 patients in Minnesota. Patients were identified at 18 randomly selected hospitals in Massachusetts and at 30 hospitals in Minnesota. The rate of breast-conserving surgery in both states and the correlates of breast-conserving surgery among women eligible for the procedure were determined. RESULTS The rate of breast-conserving surgery in both states was much higher than previously reported. Among those eligible for the procedure, nearly 75% underwent breast-conserving surgery in Massachusetts and nearly half did so in Minnesota. Significantly (P < .003) more women who underwent mastectomy in Minnesota (27%) than in Massachusetts (15%) reported that their surgeon did not discuss breast-conserving surgery with them. Among women who underwent mastectomy and who reported being informed of both surgical alternatives, more women (P < .001) in Minnesota (74%) than in Massachusetts (62%) said they ultimately chose mastectomy because their surgeon recommended it. In Massachusetts, women treated at teaching hospitals were twice as likely as other women to undergo breast-conserving surgery. In Minnesota, women over age 70 and those who lived in rural areas were less likely than other women to undergo breast-conserving surgery. CONCLUSION Although the rate of breast-conserving surgery in each state was higher than expected based on earlier reports, the rates differed considerably between states. Additional studies are needed to determine whether variation in practice between geographic areas is due to differences in patients' preferences and values or to surgeons' propensity for one type of surgery based on where they practice.

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Genome Sequence of Clostridium botulinum Strain Adk2012 Associated with a Foodborne Botulinum Case in Tottori, Japan, in 2012

Genome Announcements ◽

10.1128/genomea.00872-17 ◽

2017 ◽

Vol 5 (34) ◽

Author(s):

Hiroshi Asakura ◽

Shiori Yamamoto ◽

Yoshika Momose ◽

Haru Kato ◽

Masaaki Iwaki ◽

...

Keyword(s):

Genome Size ◽

Genome Sequence ◽

Clostridium Botulinum ◽

Draft Genome ◽

Draft Genome Sequence ◽

Content Type ◽

Foodborne Botulism

ABSTRACT We report here a draft genome sequence of Clostridium botulinum Adk2012 responsible for a foodborne botulism case that occurred in Tottori, Japan, in 2012. Its genome size was 2,904,173 bp, with 46 rRNAs and 54 tRNAs, at a coverage of 14.5×.

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Acne:Clinico-Epidemiological Study In DermatologyVenereology Outpatient Clinic Of Dr. M. Djamil Hospital Padang During January 2016 – December 2018

International Journal of PharmTech Research ◽

10.20902/ijptr.2019.130403 ◽

2020 ◽

Vol 13 (4) ◽

pp. 325-328

Author(s):

Satya Wydya Yenny

Keyword(s):

Retrospective Study ◽

Family History ◽

Epidemiological Study ◽

Clinical Features ◽

Outpatient Clinic ◽

Medical Records ◽

Skin Disorder ◽

Epidemiological Data ◽

Common Type ◽

History Of

Although acne is usually recognized as an adolescent skin disorder, the prevalence of adults with acne is increasing. The clinical and epidemiological data of acne were evaluated with a view to establishing possible contributing etiological factors and observing whether clinical features differ from adolescent acne. Division of Dermatology and Venereology Outpatient Clinic Dr. M. Djamil hospital padang during January 2016 until December 2018.Retrospective study performed in Medical Cosmetic Division of Dermatology and Venereology Outpatient Clinic Dr. M. Djamil hospital padang during January 2016 until December 2018. Data was taken from medical records. Out of 224 patients included in the study 54.01% were women and 45.98 % were men. Majority of the patients had comedonal acne (45.53 %), whereas nodulocystic was the least common (13.39%). Most common predominant site of involvement was cheek (44.20 %), followed by chin (25.45 %), and mandibular area (14.58 %). Family history of acne was present in 57.70 %. Scarring was observed in a 39.2 %. Acne is predominant in women, with the most commonly involved of the cheeks, with the most common type was comedones type.

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Developing Security Solutions for Telemedicine Applications

Advances in Healthcare Information Systems and Administration - Smart Medical Data Sensing and IoT Systems Design in Healthcare ◽

10.4018/978-1-7998-0261-7.ch004 ◽

2020 ◽

pp. 76-96

Author(s):

Pavithra V. ◽

Jeyamala Chandrasekaran

Keyword(s):

Information Technology ◽

Image Encryption ◽

Rural Areas ◽

Medical Records ◽

Medical Image ◽

Slight Modification ◽

Medical Services ◽

Medical Applications ◽

Security Issues

Telemedicine is defined as the means of providing healthcare for people from a distance by the use of telecommunication and information technology. This technology is mainly useful in overcoming the obstacles of distance and provide enhancement in the access of medical services that would not be easily available in different rural areas. Telemedicine security includes issues such as confidentiality, integrity, and authentication that are also present in other systems involving information and data. Maintaining integrity of data stored and used is a huge problem for medical applications because it contains more sensitive medical records of patients which can cause severe ill effects on slight modification. In order to resolve the confidentiality and integrity issues of telemedicine applications, medical image encryption and watermarking comes into play. The security issues in telemedicine applications is to be given higher importance and thus choosing a reliable and effective approach or framework is more essential.

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Challenges of transferring rural adults with chronic HCV infection for further HCV RNA confirmation and free DAAs treatment: a success story of the interdisciplinary collaboration approach

BMC Infectious Diseases ◽

10.1186/s12879-020-05435-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Wei Li ◽

Te-Sheng Chang ◽

Shu-Zhi Chang ◽

Ching-Hwa Chen ◽

Mei-Yen Chen

Keyword(s):

Rural Areas ◽

Medical Records ◽

Interdisciplinary Collaboration ◽

Antiviral Treatment ◽

Hcv Infection ◽

Hcv Rna ◽

National Health Insurance System ◽

Health Clinics ◽

Chronic Hcv ◽

Prospective Study Design

Abstract Background Chronic hepatitis C virus (HCV), which is a concern in many countries, is the leading cause of liver cancer around the world. Since Taiwan launched its national health insurance system in 1995, it has managed to extend health coverage to 99% of the Taiwanese population, providing free but limited antiviral treatment each year since 2017. However, many people in rural areas are unaware that they have chronic HCV; nor do they realize that new drugs with high cure rates could drastically reduce their health burden. The aim of this study is to explore the implementation facilitators of and barriers to inviting potentially infected patients in rural areas to be transferred for HCV ribonucleic acid (RNA) confirmation and new drug treatment. Methods A descriptive and prospective study design with an interdisciplinary collaboration approach was implemented. After five elements of referral were developed, telephone counseling was conducted between August 2018 and May 2019 in Yunlin, Taiwan. The elements of referral developed by the research team were: (1) forming and coordinating physicians’ schedules, (2) recruiting and training volunteers, (3) training the nursing staff, (4) raising funds or resources, and (5) connecting with village leaders. Thereafter, we collaborated with two district health centers, a private local hospital, and health clinics. Based on the medical records provided by these agencies, community adults that were HCV antibody (anti-HCV) positive were invited to join the program. Results Of the 1795 adults who were serum anti-HCV positive, 1149 (64%) accepted transfer to a qualified hospital; of these, 623 (54.2%) had an HCV infection. 552 (88.6%) of those infected started receiving direct-acting antivirals (DAAs) treatment. The top four barriers to accepting transfer were: (1) they perceived themselves to be healthy (n = 98, 32.3%); (2) mistrust of treatment/healthcare (n = 60, 20.2%); (3) limited transportation to the hospital (n = 52, 17.5%); and (4) work conflict (n = 30, 10.1%). Conclusion An interdisciplinary collaboration approach significantly contributed to the invitation of CHC patients, as well as their acceptance of HCV RNA confirmation and free DAAs treatment. Using anti-HCV data from previous medical records for case-finding and collaborating with a hospital and health clinics proved to be an efficient strategy.

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Ownership of mother and children's health book and complete basic immunization status in slums and poor population

Journal of Public Health Research ◽

10.4081/jphr.2020.1809 ◽

2020 ◽

Author(s):

Arief Hargono ◽

Hario Megatsari ◽

Kurnia Dwi Artanti ◽

Triska Susila Nindya ◽

Ratna Dwi Wulandari

Keyword(s):

Rural Areas ◽

Medical Records ◽

Urban Areas ◽

Complete Coverage ◽

The Government ◽

Design And Methods ◽

The Relationship ◽

And Child Health ◽

Improve Access ◽

Poor Population

Background: The percentage of complete immunization in urban areas is higher than rural areas. The purpose of the study was to analyze the relationship between ownership of Maternal and Child Health (MCH) books with Complete Basic Immunization (CBI) coverage in slums and poor areas. Design and Methods: A rapid survey was conducted in selected slums and poor groups based on medical records from Public Health Center. Informants were mothers with a sample of 325 infants aged 12 to 23 months. Results: The lowest coverage of CBI for slum and poor residents is Pasuruan, which is 55.4%. The results of statistical analysis showed that there was a significant relationship between ownership of MCH books and the complete coverage of basic immunization in Malang (P=0.000; PR=3.682); Pasuruan (P=0.002; PR=1.854); Sidoarjo (P=0.000; PR=4.042); Surabaya (P=0.000; PR=2.425). Conclusions: It is recommended that the government should improve access to complete immunization programs in slums and poor population.

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Case 24

10.1093/med/9780190603434.003.0028 ◽

2018 ◽

Author(s):

Bashar Katirji

Keyword(s):

Botulinum Toxin ◽

Neuromuscular Junction ◽

Nerve Stimulation ◽

Clostridium Botulinum ◽

Anaerobic Bacteria ◽

Neuromuscular Disorder ◽

Repetitive Nerve Stimulation ◽

Myasthenic Syndrome ◽

High Index Of Suspicion ◽

Foodborne Botulism

Botulism is an extremely rare neuromuscular disorder, caused by botulinum toxin which is produced by the anaerobic bacteria Clostridium botulinum. It has several forms: classic foodborne, infantile, wound, intestinal, and iatrogenic forms. The presentation is often acute and severe but may be occasionally subacute and moderate. The diagnosis may be difficult and requires a high index of suspicion. This case presents an adult with classic foodborne botulism and highlights the clinical and electrodiagnostic findings that distinguish this disorder from other neuromuscular junction disorders including myasthenia gravis and Lambert-Eaton myasthenic syndrome. Specifically, the findings on repetitive nerve stimulation are discussed and distinguished from the results seen in other neuromuscular junction disorders.

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