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  1. Classification of non-O157 shiga toxin-producing escherichia coli(STEC) serotypes with hyperspectral microscope imaging

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    Non-O157 Shiga toxin-producing Escherichia coli (STEC) strains such as O26, O45, O103, O111, O121 and O145 are recognized as serious outbreak to cause human illness due to their toxicity. A conventional microbiological method for cell counting is laborious and needs long time for the results. Since ...

  2. Bacterial genetic determinants of non-O157 STEC outbreaks and hemolytic-uremic syndrome after infection.

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    Wickham, Mark E; Lupp, Claudia; Mascarenhas, Mariola; Vazquez, Alejandra; Coombes, Brian K; Brown, Nat F; Coburn, Bryan A; Deng, Wanyin; Puente, Jose L; Karmali, Mohamed A; Finlay, B Brett

    2006-09-15

    Although O157:H7 Shiga toxin-producing Escherichia coli (STEC) are the predominant cause of hemolytic-uremic syndrome (HUS) in the world, non-O157:H7 serotypes are a medically important cause of HUS that are underdetected by current diagnostic approaches. Because Shiga toxin is necessary but not sufficient to cause HUS, identifying the virulence determinants that predict severe disease after non-O157 STEC infection is of paramount importance. Disease caused by O157:H7 STEC has been associated with a 26-gene pathogenicity island known as O island (OI) 122. To assess the public-health significance of this pathogenicity island, we examined the association between OI122 genes and outbreaks and HUS after non-O157 STEC infection. We found that a subset of OI122 genes is independently associated with outbreaks and HUS after infection with non-O157 STEC. The presence of multiple virulence genes in non-O157 serotypes strengthened this association, which suggests that the additive effects of a variable repertoire of virulence genes contribute to disease severity. In vivo, Citrobacter rodentium mutants lacking outbreak- and HUS-associated genes were deficient for virulence in mice; in particular, nleB mutant bacteria were unable to cause mortality in mice. The present study shows that virulence genes associated epidemiologically with outbreaks and HUS after non-O157 STEC infection are pivotal to the initiation, progression, and outcome of in vivo disease.

  3. Detection of non-O157 STEC in ground beef using the GeneDisc real-time PCR system

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    Certain non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups have emerged as important public health threats. The development of methods for rapid and reliable detection of this heterogeneous group of pathogens has been challenging. A GeneDisc real-time PCR assay was evaluated for det...

  4. Assessment of commercial chromogenic solid media for the detection of non-O157 Shiga toxin-producing Escherichia coli (STEC).

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    Zelyas, Nathan; Poon, Alan; Patterson-Fortin, Laura; Johnson, Roger P; Lee, Winki; Chui, Linda

    2016-07-01

    Detection of Shiga toxin-producing Escherichia coli (STEC) has evolved significantly since the introduction of sorbitol-MacConkey agar. This study compares four chromogenic media (CHROMagar™ STEC, Rainbow® O157 agar, CHROMagar™ O157, and Colorex® O157) in their identification of non-O157 STEC. When 161 non-O157 STEC were directly inoculated onto each medium, detection rates on CHROMagar™ STEC, Rainbow® O157 agar, CHROMagar™ O157 and Colorex® O157 were 90%, 70%, 3.7% and 6.8%, respectively. Tellurite minimal inhibitory concentrations (MICs) correlated with growth on CHROMagar™ STEC as 20 of 22 isolates with poor or no growth had MICs ≤1μg/mL. Stool spiking experiments revealed that CHROMagar™ STEC had the highest recovery of the six most common non-O157 STEC, ranging from 30% (in mucoid stool) to 98% (in watery stool). When using clinical stool samples, CHROMagar™ STEC had a sensitivity, specificity, positive predictive value, and negative predictive value of 84.6%, 87%, 13.9%, and 99.6%, respectively.

  5. Comparison of Six Chromogenic Agar Media for the Isolation of a Broad Variety of Non-O157 Shigatoxin-Producing Escherichia coli (STEC) Serogroups.

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    Verhaegen, Bavo; De Reu, Koen; Heyndrickx, Marc; De Zutter, Lieven

    2015-06-17

    The isolation of non-O157 STEC from food samples has proved to be challenging. The selection of a suitable selective isolation agar remains problematic. The purpose of this study was to qualitatively and quantitatively evaluate six chromogenic agar media for the isolation of STEC: Tryptone Bile X-glucuronide agar (TBX), Rainbow® Agar O157 (RB), Rapid E. coli O157:H7 (RE), Modified MacConkey Agar (mMac), CHROMagarTM STEC (Chr ST) and chromIDTM EHEC (Chr ID). During this study, 45 E. coli strains were used, including 39 STEC strains belonging to 16 different O serogroups and 6 non-STEC E. coli. All E. coli strains were able to grow on TBX and RB, whereas one STEC strain was unable to grow on Chr ID and a number of other STEC strains did not grow on mMac, CHROMagar STEC and Rapid E. coli O157:H7. However, only the latter three agars were selective enough to completely inhibit the growth of the non-STEC E. coli. Our conclusion was that paired use of a more selective agar such as CHROMagar STEC together with a less selective agar like TBX or Chr ID might be the best solution for isolating non-O157 STEC from food.

  6. VIABILIDADE DE Escherichia coli PRODUTORA DE TOXINA SHIGA (STEC NÃO-O157 EM QUEIJO TIPO MINAS FRESCAL. VIABILITY OF NON-O157 SHIGA TOXIN-PRODUCING Escherichia coli (STEC IN MINAS FRESCAL CHEESE

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    Tammy Priscila Chioda

    2009-07-01

    Full Text Available Escherichia coli, produtora de toxina Shiga (STEC, um patógeno emergente capaz de causar diarreia, colite hemorrágica e síndrome hemolítica urêmica em humanos, representa um grave problema de saúde pública em todo o mundo. O principal reservatório de STEC são os bovinos. STEC são transmitidas aos humanos, principalmente através de alimentos contaminados, destacando-se aqueles de origem bovina como carne, leite e seus derivados. O objetivo deste trabalho foi avaliar a viabilidade de STEC não-O157 em queijo minas frescal preparado com leite artificialmente contaminado com diferentes cepas dessas bactérias. Os queijos foram mantidos a 4°C e analisados no 1º, 2º, 4º, 6º e 10º dias de estocagem. As cepas de STEC mantiveram-se viáveis em 100% (32/32 dos queijos mantidos sob refrigeração por até dez dias. Os resultados mostram que o queijo minas pode ser veículo de transmissão de STEC. Recomenda-se a adoção de métodos higiênicos e sanitários desde a ordenha até o processo de produção do queijo para reduzir a possibilidade de contaminação com STEC.

    PALAVRAS-CHAVES: PCR, queijo minas, segurança alimentar, STEC.

    Shiga toxin-producing Escherichia coli (STEC an emergent foodborne pathogen that cause diarrhea, hemorrhagic colitis and haemolytic uremic syndrome in humans, represents a public health problem all over the world. Cattle are the main source of STEC. STEC are transmitted to humans by contaminated food, mainly those of bovine origin as meat and dairy products. This study aimed evaluates the non-O157 STEC viability of artificially inoculated in the milk used for the Minas Frescal cheese’s production. The cheese was kept at 4°C and analyzed at 1st, 2nd, 4th, 6th and 10th days after its production. 100% (32/32 of the cheese storad under refrigeration during 10 days had been the STEC strains viable. These results show that minas frescal cheese can transmit STEC. The adoption of good

  7. Hyperspectral imaging for detection of non-O157 Shiga-toxin producing Escherichia coli (STEC) serogroups on spread plates of mixed cultures

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    Yoon, Seung Chul; Windham, William R.; Ladely, Scott; Heitschmidt, Gerald W.; Lawrence, Kurt C.; Park, Bosoon; Narang, Neelam; Cray, William C.

    2012-05-01

    We investigated the feasibility of visible and near-infrared (VNIR) hyperspectral imaging for rapid presumptive-positive screening of six representative non-O157 Shiga-toxin producing Escherichia coli (STEC) serogroups (O26, O45, O103, O111, O121, and O145) on spread plates of mixed cultures. Although the traditional culture method is still the "gold standard" for presumptive-positive pathogen screening, it is time-consuming, labor-intensive, not effective in testing large amount of food samples, and cannot completely prevent unwanted background microflora from growing together with target microorganisms on agar media. A previous study was performed using the data obtained from pure cultures individually inoculated on spot and/or spread plates in order to develop multivariate classification models differentiating each colony of the six non-O157 STEC serogroups and to optimize the models in terms of parameters. This study dealt with the validation of the trained and optimized models with a test set of new independent samples obtained from colonies on spread plates of mixed cultures. A new validation protocol appropriate to a hyperspectral imaging study for mixed cultures was developed. One imaging experiment with colonies obtained from two serial dilutions was performed. A total of six agar plates were prepared, where O45, O111 and O121 serogroups were inoculated into all six plates and each of O45, O103 and O145 serogroups was added into the mixture of the three common bacterial cultures. The number of colonies grown after 24-h incubation was 331 and the number of pixels associated with the grown colonies was 16,379. The best model found from this validation study was based on pre-processing with standard normal variate and detrending (SNVD), first derivative, spectral smoothing, and k-nearest neighbor classification (kNN, k=3) of scores in the principal component subspace spanned by 6 principal components. The independent testing results showed 95% overall

  8. Genetically marked strains of Shiga toxin-producing O157:H7 and non-O157 Escherichia coli: Tools for detection and modelling

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    Shiga toxin-producing E. coli (STEC) are among the most important foodborne pathogens in the United States and worldwide. Nearly half of all STEC-induced diarrheal disease in the United States is caused by STEC O157:H7 while non-O157 STEC account for the remaining illnesses. Thus, the USDA Food Safe...

  9. Influence of primer sequences and DNA extraction method on detection of non-O157 Shiga toxin-producing Escherichia coli in ground beef by real-time PCR targeting the eae, stx, and serogroup-specific genes

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    Non-O157 Shiga toxin-producing E. coli (STEC) infections, particularly those caused by the “big six”/”top six” non-O157 serogroups (O26, O45, O103, O111, O121, and O145) can result in severe illness and complications. Due to their significant public health impact and the notable prevalence of STEC ...

  10. Numbers of coliforms, Escherichia coli, F-RNA phage, rotavirus, bovine enteric calicivirus and presence of non-O157 STEC on commercial vacuum packaged beef.

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    Jones, T H; Nattress, F M; Dilts, B; Olsen, D; Muehlhauser, V

    2014-09-01

    The numbers of coliforms, Escherichia coli, F-RNA coliphages, bovine enteric calicivirus (BEC) and rotavirus (RV) and presence of non-O157 shiga toxigenic E. coli (STEC) were determined on commercial vacuum packaged beef subprimals at the retail level from swabs obtained from the entire surfaces of 150 cuts that originated from federally and provincially registered plants. The prevalence and log mean numbers of E. coli were higher in provincially registered plants than in federally registered plants; 64% vs 20%, respectively, and -0.3 vs -1.22 log cfu/100 cm(2), respectively. In contrast, the prevalence and mean log numbers of F-RNA coliphages were lower for the provincially registered plants than for the federally registered plants; 31% vs 68% and -0.86 vs -0.13 log cfu/100 cm(2), respectively. One E. coli sample tested positive for stx2 and eae. F-RNA coliphages associated with human origin (GII/GIII) were detected in 12% and 30% of samples that originated from provincially and federally registered plants, respectively. RV RNA was detected in 4% of samples while BEC RNA was not detected. Although the infectivity of RV is unknown, the presence of viable F-RNA coliphages suggests that consumers could potentially be at risk when consuming undercooked meat that is contaminated with RV. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  11. Comparison of different sample preparation procedures for the detection and isolation of Escherichia coli O157:H7 and Non-O157 STECs from leafy greens and cilantro.

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    Kase, Julie A; Maounounen-Laasri, Anna; Son, Insook; Deer, Deanne M; Borenstein, Stacey; Prezioso, Samantha; Hammack, Thomas S

    2012-12-01

    The FDA Bacteriological Analytical Manual (BAM) method for the detection/isolation of Shiga toxin-producing Escherichia coli (STEC) involves enrichment of produce rinses, blended homogenates or stomached homogenates. However, the effectiveness of rinsing produce to remove attached bacteria is largely unknown. Moreover, PCR inhibitors can be released under physical treatment. The study objective was to determine the relative effectiveness of recovery methods for STEC contaminated produce. Spinach, lettuce, and cilantro were contaminated with E. coli O157:H7 or a non-O157 STEC, subjected to both the BAM method and a soak method, and tested by real-time PCR and cultural methods. For O157:H7 and non-O157:H7 STECs, the soak method was significantly more productive than leafy green rinses. Of 320 test portions, PCR of recovered colonies confirmed 148 were positive by rinsing and 271 were positive by soaking (an 83% increase in sensitivity). For recovery of O157:H7 from cilantro, of 60 test portions, positives were 38 by soaking, 41 by stomaching, and 28 by blending. Soaking and stomaching were significantly more productive than blending, although soaking was only arithmetically superior to stomaching. Based upon these results, it is recommended that a soak method replace the current BAM procedures. Published by Elsevier Ltd.

  12. Comparison of Clinical and Epidemiological Features of Shiga Toxin-Producing Escherichia coli O157 and Non-O157 Infections in British Columbia, 2009 to 2011

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    Xuetao Wang

    2013-01-01

    Full Text Available INTRODUCTION: Shiga toxin-producing Escherichia coli (STEC are major foodborne agents that have the potential to cause severe enteric illnesses and large outbreaks worldwide. Several studies found non-O157 infections to be clinically milder than O157 STEC infections.

  13. Thermal tolerance of O157 and non-O157 Shiga toxigenic strains of Escherichia coli, Salmonella, and potential pathogen surrogates, in frankfurter batter and ground beef of varying fat levels.

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    Vasan, Akhila; Geier, Renae; Ingham, Steve C; Ingham, Barbara H

    2014-09-01

    The non-O157 Shiga toxigenic Escherichia coli (STEC) serogroups most commonly associated with illness are O26, O45, O103, O111, O121, and O145. We compared the thermal tolerance (D55°C) of three or more strains of each of these six non-O157 STEC serogroups with five strains of O157:H7 STEC in 7% fat ground beef. D55°C was also determined for at least one heat-tolerant STEC strain per serogroup in 15 and 27% fat ground beef. D55°C of single-pathogen cocktails of O157 and non-O157 STEC, Salmonella, and potential pathogen surrogates, Pediococcus acidilactici and Staphylococcus carnosus, was determined in 7, 15, and 27% fat ground beef and in frankfurter batter. Samples (25 g) were heated for up to 120 min at 55°C, survivors were enumerated, and log CFU per gram was plotted versus time. There were significant differences in D55°C across all STEC strains heated in 7% fat ground beef (P < 0.05), but no non-O157 STEC strain had D55°C greater than the range observed for O157 STEC. D55°C was significantly different for strains within serogroups O45, O145, and O157 (P < 0.05). D55°C for non-O157 STEC strains in 15 and 27% fat ground beef were less than or equal to the range of D55°C for O157. D55°C for pathogen cocktails was not significantly different when measured in 7, 15, and 27% fat ground beef (P ≥ 0.05). D55°C of Salmonella in frankfurter batter was significantly less than for O157 and non-O157 STEC (P < 0.05). Thermal tolerance of pathogen cocktails in ground beef (7, 15, or 27% fat) and frankfurter batter was significantly less than for potential pathogen surrogates (P < 0.05). Results suggest that thermal processes in beef validated against E. coli O157:H7 have adequate lethality against non-O157 STEC, that thermal processes that target Salmonella destruction may not be adequate against STEC in some situations, and that the use of pathogen surrogates P. acidilactici and S. carnosus to validate thermal processing interventions in ground beef and

  14. Genotypic analyses of shiga toxin-producing Escherichia coli O157 and non-O157 recovered from feces of domestic animals on rural farms in Mexico.

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    Amézquita-López, Bianca A; Quiñones, Beatriz; Cooley, Michael B; León-Félix, Josefina; Castro-del Campo, Nohelia; Mandrell, Robert E; Jiménez, Maribel; Chaidez, Cristóbal

    2012-01-01

    Shiga toxin-producing Escherichia coli (STEC) are zoonotic enteric pathogens associated with human gastroenteritis worldwide. Cattle and small ruminants are important animal reservoirs of STEC. The present study investigated animal reservoirs for STEC in small rural farms in the Culiacan Valley, an important agricultural region located in Northwest Mexico. A total of 240 fecal samples from domestic animals were collected from five sampling sites in the Culiacan Valley and were subjected to an enrichment protocol followed by either direct plating or immunomagnetic separation before plating on selective media. Serotype O157:H7 isolates with the virulence genes stx2, eae, and ehxA were identified in 40% (26/65) of the recovered isolates from cattle, sheep and chicken feces. Pulse-field gel electrophoresis (PFGE) analysis grouped most O157:H7 isolates into two clusters with 98.6% homology. The use of multiple-locus variable-number tandem repeat analysis (MLVA) differentiated isolates that were indistinguishable by PFGE. Analysis of the allelic diversity of MLVA loci suggested that the O157:H7 isolates from this region were highly related. In contrast to O157:H7 isolates, a greater genotypic diversity was observed in the non-O157 isolates, resulting in 23 PFGE types and 14 MLVA types. The relevant non-O157 serotypes O8:H19, O75:H8, O111:H8 and O146:H21 represented 35.4% (23/65) of the recovered isolates. In particular, 18.5% (12/65) of all the isolates were serotype O75:H8, which was the most variable serotype by both PFGE and MLVA. The non-O157 isolates were predominantly recovered from sheep and were identified to harbor either one or two stx genes. Most non-O157 isolates were ehxA-positive (86.5%, 32/37) but only 10.8% (4/37) harbored eae. These findings indicate that zoonotic STEC with genotypes associated with human illness are present in animals on small farms within rural communities in the Culiacan Valley and emphasize the need for the development of control

  15. Classification of shiga toxin-producing escherichia coli (STEC) serotypes with hyperspectral microscope imagery

    Science.gov (United States)

    Non-O157:H7 Shiga toxin-producing Escherichia coli (STEC) strains such as O26, O45, O103, O111, O121 and O145 are recognized as serious outbreak to cause human illness due to their toxicity. Since a conventional microbiological method for cell counting is laborious and time-consuming process, optica...

  16. Novel sequence types of non-O157 Shiga toxin-producing Escherichia coli isolated from cattle.

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    Isiko, J; Khaitsa, M; Bergholz, T M

    2015-06-01

    The objective of this study was to assess the genetic diversity of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolates from cattle. Multi-locus sequence typing (MLST) was used to identify and compare the sequence types (STs) of 43 non-O157 STEC cattle isolates using the EcMLST database curated by the STEC Center at Michigan State University. For the 43 isolates, 19 STs were identified and 10 of those STs were novel compared to those in EcMLST. For the 43 isolates, 19 different serotypes were identified. STEC O22:H8, O174:H28 and O8:H19 were most common, and STEC O8 isolates were the most diverse, with seven different STs for isolates with that O group. STEC strains with O types identified in this study have been isolated from cattle by other researchers, as well as from cases of human gastroenteritis. Of the 10 novel STs identified, six were found to be closely related to previously identified STs, indicating that populations of non-O157 STEC in cattle are similar to those from other sources, including human clinical cases. Significance and impact of the study: The foodborne pathogen Shiga toxin-producing Escherichia coli (STEC) is a significant public health concern. One of the main reservoirs for STEC are cattle, which can directly or indirectly contribute to STEC in the food supply. The genetic subtype data presented here highlight the diversity of STEC that can be isolated from cattle. These results further our understanding of the ecology of STEC in the primary production environment, which is important for developing effective control measures to reduce this pathogen in the food supply.

  17. Prolonged and mixed non-O157 Escherichia coli infection in an Australian household.

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    Staples, M; Graham, R M A; Doyle, C J; Smith, H V; Jennison, A V

    2012-05-01

    An Australian family was identified through a Public Health follow up on a Shiga-toxigenic Escherichia coli (STEC) positive bloody diarrhoea case, with three of the four family members experiencing either symptomatic or asymptomatic STEC shedding. Bacterial isolates were submitted to stx sequence sub-typing, multi-locus variable number tandem repeat analysis (MLVA), multi-locus sequence typing (MLST) and binary typing. The analysis revealed that there were multiple strains of STEC being shed by the family members, with similar virulence gene profiles and the same serogroup but differing in their MLVA and MLST profiles. This study illustrates the potentially complicated nature of non-O157 STEC infections and the importance of molecular epidemiology in understanding disease clusters.

  18. Isolation and characterization of non-O157 Shiga toxin-producing Escherichia coli from beef carcasses, cuts and trimmings of abattoirs in Argentina

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    Brusa, Victoria; Restovich, Viviana; Galli, Lucía; Teitelbaum, David; Signorini, Marcelo; Brasesco, Hebe; Londero, Alejandra; García, Diego; Padola, Nora Lía; Superno, Valeria; Sanz, Marcelo; Petroli, Sandra; Costa, Magdalena; Bruzzone, Mariana; Sucari, Adriana; Ferreghini, Marcela; Linares, Luciano; Suberbie, Germán; Rodríguez, Ricardo

    2017-01-01

    Several foods contaminated with Shiga toxin-producing Escherichia coli (STEC) are associated with human diseases. Some countries have established microbiological criteria for non-O157 STEC, thus, the absence of serogroups O26, O45, O103, O104, O111, O121, and O145 in sprouts from the European Union or ground beef and beef trimmings from the United States is mandatory. While in Argentina screening for O26, O103, O111, O145 and O121 in ground beef, ready-to-eat food, sausages and vegetables is mandatory, other countries have zero-tolerance for all STEC in chilled beef. The aim of this study was to provide data on the prevalence of non-O157 STEC isolated from beef processed in eight Argentinean cattle slaughterhouses producing beef for export and local markets, and to know the non-O157 STEC profiles through strain characterization and genotypic analysis. Samples (n = 15,965) from 3,205 beef carcasses, 9,570 cuts and 3,190 trimmings collected between March and September 2014 were processed in pools of five samples each. Pools of samples (n = 3,193) from 641 carcasses, 1,914 cuts and 638 trimming were analyzed for non-O157 STEC isolation according to ISO/CEN 13136:2012. Of these, 37 pools of carcasses (5.8%), 111 pools of cuts (5.8%) and 45 pools of trimmings (7.0%) were positive for non-O157 STEC. STEC strains (n = 200) were isolated from 193 pools of samples. The most prevalent serotypes were O174:H21, O185:H7, O8:H19, O178:H19 and O130:H11, and the most prevalent genotypes were stx2c(vh-b) and stx2a/saa/ehxA. O103:H21 strain was eae-positive and one O178:H19 strain was aggR/aaiC-positive. The prevalence of non-O157 STEC in beef carcasses reported here was low. None of the non-O157 STEC strains isolated corresponded to the non-O157 STEC serotypes and virulence profiles isolated from human cases in Argentina in the same study period. The application of microbiological criteria for each foodstuff should be determined by risk analysis in order to have a stringent

  19. Antimicrobial resistance in Escherichia coli O157 and non-O157 recovered from feces of domestic farm animals in Northwestern Mexico

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    Antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC) O157 and non-O157 is a matter of increasing concern. Inappropriate antimicrobial use in human and animal therapy has been associated with an acquired resistance in enteric microorganisms. The aim of the present study was to de...

  20. Growth of Stressed Strains of Four Non-O157 Shiga Toxin-Producing Escherichia coli Serogroups in Five Enrichment Broths.

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    Verhaegen, Bavo; De Reu, Koen; Heyndrickx, Marc; Van Damme, Inge; De Zutter, Lieven

    2015-11-01

    The purpose of this study was to evaluate (i) the behavior of several strains of non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups (O26, O103, O111, and O145) exposed to different stress conditions and (ii) the growth dynamics of stressed and nonstressed non-O157 STEC cells in five enrichment media. STEC strains were exposed to acid, cold, and freeze stresses. Lethal and sublethal injuries were determined by plating in parallel on selective and nonselective agar media. Freeze stress (8 days, 20°C) caused the most lethal (95.3% ± 2.5%) injury, as well as the most sublethal (89.1% ± 8.8%) injury in the surviving population. Growth of stressed and nonstressed pure cultures of non-O157 STEC on modified tryptic soy broth, buffered peptone water (BPW), BPW with sodium pyruvate, Brila, and STEC enrichment broth (SEB) was determined using total viable counts. To compare growth capacities, growth after 7 and 24 h of enrichment was measured; lag phases and maximum growth rates were also calculated. In general, growth on BPW resulted in a short lag phase followed by a high maximum growth rate during the enrichment of all tested strains when using all three stress types. Furthermore, BPW ensured the highest STEC count after 7 h of growth. Supplementing the medium with sodium pyruvate did not improve the growth dynamics. The two selective media, Brila and SEB, were less efficient than BPW, but Brila's enrichment performance was remarkably better than that of SEB. This study shows that irrespective of the effect of background flora, BPW is still recommended for resuscitation of non-O157 STEC.

  1. Antimicrobial resistance profiles of Shiga toxin-producing Escherichia coli O157 and Non-O157 recovered from domestic farm animals in rural communities in Northwestern Mexico

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    Bianca A. Amézquita-López

    2016-01-01

    Full Text Available Abstract Background Antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC O157 and non-O157 is a matter of increasing concern. The aim of the present study was to investigate the antimicrobial resistance profiles of STEC O157 and non-O157 recovered from feces of domestic farm animals in the agricultural Culiacan Valley in Northwestern Mexico. Findings All of the examined STEC strains showed susceptibility to five antimicrobials, ceftazidime, ceftriaxone, ciprofloxacin, nalidixic acid, and trimethoprim-sulfamethoxazole. However, resistance to the four antimicrobials, ampicillin, cephalothin, chloramphenicol, and kanamycin was commonly observed. Interestingly, non-susceptibility to cephalothin was predominant among the examined STEC strains, corresponding to 85 % (22/26 of the O157:H7 from cattle, sheep and chicken and 73 % (24/33 of the non-O157 strains from cattle and sheep. Statistical analyses revealed that resistance to ampicillin was significantly correlated to 38 % (10/26 of STEC O157:H7 strains from multiple animal sources. Another significant correlation was found between serotype, source, and antimicrobial resistance; all of the O20:H4 strains, recovered from sheep, were highly resistant to tetracycline. Multidrug resistance profiles were identified in 42 % (22/53 of the non-susceptible STEC strains with clinically-relevant serotypes O8:H9, O75:H8, O146:H21, and O157:H7. Conclusions STEC O157 and non-O157 strains, recovered from domestic farm animals in the Culiacan Valley, exhibited resistance to classes of antimicrobials commonly used in Mexico, such as aminoglycosides, tetracyclines, cephalosporins and penicillin but were susceptible to fluoroquinolones, quinolones, and sulfonamides. These findings provide fundamental information that would aid in the surveillance of antimicrobial resistance in an important agricultural region in Northwestern Mexico.

  2. Non-O157 Shiga toxin-producing Escherichia coli in U. S. retail ground beef.

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    Liao, Yen-Te; Miller, Markus F; Loneragan, Guy H; Brooks, J Chance; Echeverry, Alejandro; Brashears, Mindy M

    2014-07-01

    Shiga toxin-producing Escherichia coli (STEC) serotype O157:H7 and serogroups O26, O45, O103, O111, O121, and O145 are the leading cause of STEC-associated infections in humans in the United States. In the United States, these organisms are considered adulterants in raw nonintact beef products and in intact beef destined to be made into or used in nonintact raw beef products. The objective of this study was to provide an estimate of the burden of the six serogroups of non-O157 STEC in ground beef obtained from retail stores across the United States. A convenience sample of commercial ground beef products (n = 1,129) were purchased from retail stores in 24 states from October 2011 to May 2012. The samples had various lean/fat proportions, muscle group of origin (chuck, round, sirloin, or not specified), and packaging types. For each ground beef sample, 25 g was inoculated in 225 ml of modified tryptic soy broth, stomached for 1 min, and then incubated at 41°C for 18 ± 2 h. These enrichment cultures were then screened for stx, eae, and O group genes using a commercially available, closed-platform PCR-based method. The potential positive samples were subjected to immunomagnetic separation and plated on modified Rainbow agar. Morphologically typical colonies were subjected to latex agglutination and PCR determination of stx and eae genes. Nine (0.8%) of the ground beef samples were potentially positive for at least one STEC serogroup after PCR screening. The serogroups detected by PCR assay were O26 (four samples), O103 (four samples), O145 (three samples), O45 (two samples), and O121 (one sample). No STEC isolates belonging to these serogroups were recovered from the sample cultures. The current research provides updated surveillance data for non-O157 STEC isolates among commercial ground beef products and information regarding the potential sources of contamination from different parts of beef trims destined for ground beef production.

  3. Topological data analysis of Escherichia coli O157:H7 and non-O157 survival in soils

    Science.gov (United States)

    Shiga toxin-producing E. coli O157:H7 and non-O157 have been implicated in many foodborne illnesses caused by the consumption of contaminated fresh produce. However, data on their persistence in major fresh produce-growing soils are limited due to the complexity in datasets generated from different ...

  4. Mathematical modeling and numerical analysis of the growth of non-O157 Shiga toxin-producing Escherichia coli in spinach leaves.

    Science.gov (United States)

    Huang, Lihan

    2012-11-01

    This study was conducted to investigate the growth of non-O157 Shiga toxin-producing Escherichia coli (STEC) in spinach leaves and to develop kinetic models to describe the bacterial growth. Six serogroups of non-O157 STEC, including O26, O45, O103, O111, O121, and O145, were used in the growth studies conducted isothermally at 4, 8, 15, 20, 25, 30, and 35 °C. Both STEC and background microflora were enumerated to develop kinetic models. Growth of STEC in spinach leaves was observed at elevated temperatures (15-35 °C), but not at 4 and 8 °C. This study considered the dynamic interactions between the STEC cells and the background microflora. A modified Lotka-Volterra and logistic equation was used to simulate the bacterial growth. In combination with an unconstrained optimization procedure, the differential growth equations were solved numerically to evaluate the dynamic interactions between the STEC cells and the background microflora, and to determine the kinetic parameters by fitting each growth curve to the growth equations. A close agreement between the experimental growth curves and the numerical analysis results was obtained. The analytical results showed that the growth of STEC in spinach leaves was unhindered when the population was low, but the growth was suppressed by the background microflora as the STEC population approached the maximum population density. The effect of temperature on the growth of both STEC and background microflora was also evaluated. Secondary models, evaluating the effect of temperature on growth rates, were also developed. The estimated apparent minimum growth temperature for STEC was 11 °C in commercial spinach leaves. The methodology and results of this study can be used to examine the dynamic interactions and growth between different bacteria in foods, and to conduct risk assessments of STEC in spinach leaves. Published by Elsevier B.V.

  5. Feces of feedlot cattle contain a diversity of bacteriophages that lyse non-O157 Shiga toxin-producing Escherichia coli.

    Science.gov (United States)

    Wang, Jiaying; Niu, Yan D; Chen, Jinding; Anany, Hany; Ackermann, Hans-W; Johnson, Roger P; Ateba, Collins N; Stanford, Kim; McAllister, Tim A

    2015-07-01

    This study aimed to isolate and characterize bacteriophages that lyse non-O157 Shiga toxin-producing Escherichia coli (STEC) from cattle feces. Of 37 non-O157 STEC-infecting phages isolated, those targeting O26 (AXO26A, AYO26A, AYO26B), O103 (AXO103A, AYO103A), O111 (AXO111A, AYO111A), O121 (AXO121A, AXO121B), and O145 (AYO145A, AYO145B) were further characterized. Transmission electron microscopy showed that the 11 isolates belonged to 3 families and 6 genera: the families Myoviridae (types rV5, T4, ViI, O1), Siphoviridae (type T5), and Podoviridae (type T7). Genome size of the phages as determined by pulsed-field gel electrophoresis ranged from 38 to 177 kb. Excluding phages AXO26A, AYO103A, AYO145A, and AYO145B, all other phages were capable of lysing more than 1 clinically important strain from serogroups of O26, O91, O103, O111, O113, O121, and O128, but none exhibited infectivity across all serogroups. Moreover, phages AYO26A, AXO121A, and AXO121B were also able to lyse 4 common phage types of STEC O157:H7. Our findings show that a diversity of non-O157 STEC-infecting phages are harbored in bovine feces. Phages AYO26A, AYO26B, AXO103A, AXO111A, AYO111A, AXO121A, and AXO121B exhibited a broad host range against a number of serogroups of STEC and have potential for the biocontrol of STEC in the environment.

  6. Colonization of the meat extracellular matrix proteins by O157 and non-O157 enterohemorrhagic Escherichia coli.

    Science.gov (United States)

    Chagnot, Caroline; Caccia, Nelly; Loukiadis, Estelle; Ganet, Sarah; Durand, Alexandra; Bertin, Yolande; Talon, Régine; Astruc, Thierry; Desvaux, Mickaël

    2014-10-01

    Enterohemorrhagic Escherichia coli (EHEC) are anthropozoonotic agents that range third among food-borne pathogens respective to their incidence and dangerousness in the European Union. EHEC are Shiga-toxin producing E. coli (STEC) responsible for foodborne poisoning mainly incriminated to the consumption of contaminated beef meat. Among the hundreds of STEC serotypes identified, EHEC mainly belong to O157:H7 but non-O157 can represent 20 to 70% of EHEC infections per year. Seven of those serogroups are especially of high-risk for human health, i.e. O26, O45, O103, O111, O121, O145 and O104. While meat can be contaminated all along the food processing chain, EHEC contamination essentially occurs at the dehiding stage of slaughtering. Investigating bacterial colonization to the skeletal-muscle extracellular matrix (ECM) proteins, it appeared that environmental factors influenced specific and non-specific bacterial adhesion of O157 and non-O157 EHEC as well as biofilm formation. Importantly, mechanical treatment (i.e. shaking, centrifugation, pipetting and vortexing) inhibited and biased the results of bacterial adhesion assay. Besides stressing the importance of the protocol to investigate bacterial adhesion to ECM proteins, this study demonstrated that the colonization abilities to ECM proteins vary among EHEC serogroups and should ultimately be taken into consideration to evaluate the risk of contamination for different types of food matrices.

  7. Latex agglutination assays for detection and of non-O157 Shiga toxin-producing E. coli serogroups O26, O45, O103, O111, O121 and O145

    Science.gov (United States)

    Latex agglutination assays were developed for the top six non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups utilizing polyclonal antibodies. Rabbit antisera were affinity purified through Protein A/G columns and the isolated immunoglobulins (IgG) were covalently immobilized onto pol...

  8. Evaluation of detection methods for non-O157 Shiga toxin-producing Escherichia coli from food.

    Science.gov (United States)

    Verhaegen, Bavo; Van Damme, Inge; Heyndrickx, Marc; Botteldoorn, Nadine; Elhadidy, Mohamed; Verstraete, Karen; Dierick, Katelijne; Denayer, Sarah; De Zutter, Lieven; De Reu, Koen

    2016-02-16

    Shiga toxin-producing Escherichia coli (STEC) remains a major foodborne pathogen of concern across the globe. Rapid detection and isolation of this pathogen is of great importance for public health reasons. In this study the detection and isolation of four non-O157 STEC strains (O26, O103, O111, O145) from different artificially contaminated matrices, namely ground (minced) beef, cattle carcass swab, lettuce mix and sprouted soy beans, were evaluated. Low amounts of STEC were used (0.25-1.40 cfu/g) to spike the samples. All samples were enriched in parallel in Buffered Peptone Water (BPW) and Brila broth. After enrichment, detection was performed using real-time PCR (qPCR), and isolation using two chromogenic agar media, CHROMagar™ STEC and ChromID™ EHEC. Inoculation on the agar media was performed either directly after enrichment or after the use of an acid treatment procedure. Furthermore, the use of this procedure was also tested on naturally contaminated food products, using 150 stx-positive samples. Although the qPCR Cycle Threshold (Ct) values were lower after enrichment in Brila broth, no significant differences in recovery were observed between both enrichment broths. Both agar media were equally suitable for the isolation of STEC, although a significantly higher recovery was obtained when using both agar media in parallel. For samples with a Ct value above 25, an acid treatment step prior to isolation ensured a significant improvement in the recovery of STEC due to the reduction in background microbiota. This acid treatment procedure proved especially useful for the isolation of STEC from sprouted soy bean samples.

  9. Biofilm formation by Shiga toxin-producing Escherichia coli O157:H7 and Non-O157 strains and their tolerance to sanitizers commonly used in the food processing environment.

    Science.gov (United States)

    Wang, Rong; Bono, James L; Kalchayanand, Norasak; Shackelford, Steven; Harhay, Dayna M

    2012-08-01

    Shiga toxin-producing Escherichia coli (STEC) strains are important foodborne pathogens. Among these, E. coli O157:H7 is the most frequently isolated STEC serotype responsible for foodborne diseases. However, the non-O157 serotypes have been associated with serious outbreaks and sporadic diseases as well. It has been shown that various STEC serotypes are capable of forming biofilms on different food or food contact surfaces that, when detached, may lead to cross-contamination. Bacterial cells at biofilm stage also are more tolerant to sanitizers compared with their planktonic counterparts, which makes STEC biofilms a serious food safety concern. In the present study, we evaluated the potency of biofilm formation by a variety of STEC strains from serotypes O157:H7, O26:H11, and O111:H8; we also compared biofilm tolerance with two types of common sanitizers, a quaternary ammonium chloride-based sanitizer and chlorine. Our results demonstrated that biofilm formation by various STEC serotypes on a polystyrene surface was highly strain-dependent, whereas the two non-O157 serotypes showed a higher potency of pellicle formation at air-liquid interfaces on a glass surface compared with serotype O157:H7. Significant reductions of viable biofilm cells were achieved with sanitizer treatments. STEC biofilm tolerance to sanitization was strain-dependent regardless of the serotypes. Curli expression appeared to play a critical role in STEC biofilm formation and tolerance to sanitizers. Our data indicated that multiple factors, including bacterial serotype and strain, surface materials, and other environmental conditions, could significantly affect STEC biofilm formation. The high potential for biofilm formation by various STEC serotypes, especially the strong potency of pellicle formation by the curli-positive non-O157 strains with high sanitization tolerance, might contribute to bacterial colonization on food contact surfaces, which may result in downstream product

  10. Behavior of non-O157 Shiga toxin-producing Escherichia coli, enteroinvasive E. coli, enteropathogenic E. coli, and enterotoxigenic E. coli strains on alfalfa sprouts.

    Science.gov (United States)

    Gómez-Aldapa, Carlos A; Rangel-Vargas, Esmeralda; Torres-Vitela, M Del Refugio; Villarruel-López, Angélica; Castro-Rosas, Javier

    2013-08-01

    Data about the behavior of non-O157 Shiga toxin-producing Escherichia coli (non-O157 STEC), enteroinvasive E. coli (EIEC), enterotoxigenic E. coli (ETEC), and enteropathogenic E. coli (EPEC) on seeds and alfalfa sprouts are not available. The behavior of STEC, EIEC, ETEC, and EPEC was determined during germination and sprouting of alfalfa seeds at 20 ± 2°C and 30 ± 2°C and on alfalfa sprouts at 3 ± 2°C. When alfalfa seeds were inoculated with STEC, EIEC, ETEC, or EPEC strains, all these diarrheagenic E. coli pathotypes (DEPs) grew during germination and sprouting of seeds, reaching counts of approximately 5 and 6 log CFU/g after 1 day at 20 ± 2°C and 30 ± 2°C, respectively. However, when the sprouts were inoculated after 1 day of seed germination and stored at 20 ± 2°C or 30 ± 2°C, no growth was observed for any DEP during sprouting at 20 ± 2°C or 30 ± 2°C for 9 days. Refrigeration reduced significantly (P < 0.0.5) the number of viable DEPs on sprouts after 20 days in storage; nevertheless, these decreases have no practical significance for the safety of the sprouts.

  11. Topological data analysis of Escherichia coli O157:H7 and non-O157 survival in soils.

    Science.gov (United States)

    Ibekwe, Abasiofiok M; Ma, Jincai; Crowley, David E; Yang, Ching-Hong; Johnson, Alexis M; Petrossian, Tanya C; Lum, Pek Y

    2014-01-01

    Shiga toxin-producing E. coli O157:H7 and non-O157 have been implicated in many foodborne illnesses caused by the consumption of contaminated fresh produce. However, data on their persistence in soils are limited due to the complexity in datasets generated from different environmental variables and bacterial taxa. There is a continuing need to distinguish the various environmental variables and different bacterial groups to understand the relationships among these factors and the pathogen survival. Using an approach called Topological Data Analysis (TDA); we reconstructed the relationship structure of E. coli O157 and non-O157 survival in 32 soils (16 organic and 16 conventionally managed soils) from California (CA) and Arizona (AZ) with a multi-resolution output. In our study, we took a community approach based on total soil microbiome to study community level survival and examining the network of the community as a whole and the relationship between its topology and biological processes. TDA produces a geometric representation of complex data sets. Network analysis showed that Shiga toxin negative strain E. coli O157:H7 4554 survived significantly longer in comparison to E. coli O157:H7 EDL 933, while the survival time of E. coli O157:NM was comparable to that of E. coli O157:H7 EDL 933 in all of the tested soils. Two non-O157 strains, E. coli O26:H11 and E. coli O103:H2 survived much longer than E. coli O91:H21 and the three strains of E. coli O157. We show that there are complex interactions between E. coli strain survival, microbial community structures, and soil parameters.

  12. Acid Resistance and Molecular Characterization of Escherichia coli O157:H7 and Different Non-O157 Shiga Toxin-Producing E. coli Serogroups.

    Science.gov (United States)

    Kim, Gwang-Hee; Breidt, Frederick; Fratamico, Pina; Oh, Deog-Hwan

    2015-10-01

    The objective of this study was to compare the acid resistance (AR) of non-O157 Shiga toxin-producing Escherichia coli (STEC) strains belonging to serogroups O26, O45, O103, O104, O111, O121, and O145 with O157:H7 STEC isolated from various sources in 400 mM acetic acid solutions (AAS) at pH 3.2 and 30 °C for 25 min with or without glutamic acid. Furthermore, the molecular subgrouping of the STEC strains was analyzed with the repetitive sequence-based PCR (rep-PCR) method using a DiversiLab(TM) system. Results for a total of 52 strains ranged from 0.31 to 5.45 log reduction CFU/mL in the absence of glutamic acid and 0.02 to 0.33 CFU/mL in the presence of glutamic acid except for B447 (O26:H11), B452 (O45:H2), and B466 (O104:H4) strains. Strains belonging to serogroups O111, O121, and O103 showed higher AR than serotype O157:H7 strains in the absence of glutamic acid. All STEC O157:H7 strains exhibited a comparable DNA pattern with more than 95% similarity in the rep-PCR results, as did the strains belonging to serogroups O111 and O121. Surprisingly, the DNA pattern of B458 (O103:H2) was similar to that of O157:H7 strains with 82% similarity, and strain B458 strain showed the highest AR to AAS among the O103 strains with 0.44 log reduction CFU/mL without glutamic acid. In conclusion, STEC serotypes isolated from different sources exhibited diverse AR and genetic subtyping patterns. Results indicated that some non-O157 STEC strains may have higher AR than STEC O157:H7 strains under specific acidic conditions, and the addition of glutamic acid provided enhanced protection against exposure to AAS.

  13. Disinfectant and Antimicrobial Susceptibility Profiles of the Big Six Non-O157 Shiga Toxin-Producing Escherichia coli Strains from Food Animals and Humans.

    Science.gov (United States)

    Beier, Ross C; Franz, Eelco; Bono, James L; Mandrell, Robert E; Fratamico, Pina M; Callaway, Todd R; Andrews, Kathleen; Poole, Toni L; Crippen, Tawni L; Sheffield, Cynthia L; Anderson, Robin C; Nisbet, David J

    2016-08-01

    The disinfectant and antimicrobial susceptibility profiles of 138 non-O157 Shiga toxin-producing Escherichia coli strains (STECs) from food animals and humans were determined. Antimicrobial resistance (AMR) was moderate (39.1% of strains) in response to 15 antimicrobial agents. Animal strains had a lower AMR prevalence (35.6%) than did human strains (43.9%) but a higher prevalence of the resistance profile GEN-KAN-TET. A decreasing prevalence of AMR was found among animal strains from serogroups O45 > O145 > O121 > O111 > O26 > O103 and among human strains from serogroups O145 > O103 > O26 > O111 > O121 > O45. One animal strain from serogroups O121 and O145 and one human strain from serogroup O26 had extensive drug resistance. A high prevalence of AMR in animal O45 and O121 strains and no resistance or a low prevalence of resistance in human strains from these serogroups suggests a source other than food animals for human exposure to these strains. Among the 24 disinfectants evaluated, all strains were susceptible to triclosan. Animal strains had a higher prevalence of resistance to chlorhexidine than did human strains. Both animal and human strains had a similar low prevalence of low-level benzalkonium chloride resistance, and animal and human strains had similar susceptibility profiles for most other disinfectants. Benzyldimethylammonium chlorides and C10AC were the primary active components in disinfectants DC&R and P-128, respectively, against non-O157 STECs. A disinfectant FS512 MIC ≥ 8 μg/ml was more prevalent among animal O121 strains (61.5%) than among human O121 strains (25%), which may also suggest a source of human exposure to STEC O121 other than food animals. Bacterial inhibition was not dependent solely on pH but was correlated with the presence of dissociated organic acid species and some undissociated acids.

  14. Survival in acidic and alcoholic medium of Shiga toxin-producing Escherichia coli O157:H7 and non-O157:H7 isolated in Argentina

    Directory of Open Access Journals (Sweden)

    Sanz Marcelo E

    2003-08-01

    Full Text Available Abstract Background In spite of Argentina having one of the highest frequencies of haemolytic uraemic syndrome (HUS, the incidence of Escherichia coli O157:H7 is low in comparison to rates registered in the US. Isolation of several non-O157 shiga toxin-producing Escherichia coli (STEC strains from cattle and foods suggests that E. coli O157:H7 is an uncommon serotype in Argentina. The present study was undertaken to compare the survival rates of selected non-O157 STEC strains under acidic and alcoholic stress conditions, using an E. coli O157:H7 strain as reference. Results Growth at 37°C of E. coli O26:H11, O88:H21, O91:H21, O111:H-, O113:H21, O116:H21, O117:H7, O157:H7, O171:H2 and OX3:H21, was found to occur at pH higher than 4.0. When the strains were challenged to acid tolerance at pH as low as 2.5, viability extended beyond 8 h, but none of the bacteria, except E. coli O91:H21, could survive longer than 24 h, the autochthonous E. coli O91:H21 being the more resistant serotype. No survival was found after 24 h in Luria Bertani broth supplemented with 12% ethanol, but all these serotypes were shown to be very resistant to 6% ethanol. E. coli O91:H21 showed the highest resistance among serotypes tested. Conclusions This information is relevant in food industry, which strongly relies on the acid or alcoholic conditions to inactivate pathogens. This study revealed that stress resistance of some STEC serotypes isolated in Argentina is higher than that for E. coli O157:H7.

  15. Comparison of eight different agars for the recovery of clinically relevant non-O157 Shiga toxin-producing Escherichia coli from baby spinach, cilantro, alfalfa sprouts and raw milk.

    Science.gov (United States)

    Kase, Julie A; Maounounen-Laasri, Anna; Son, Insook; Lin, Andrew; Hammack, Thomas S

    2015-04-01

    The FDA Bacteriological Analytical Manual (BAM) Chapter 4a recommends several agars for isolating non-O157 Shiga toxin-producing Escherichia coli (STEC); not all have been thoroughly tested for recovering STECs from food. Using E. coli strains representing ten clinically relevant O serogroups (O26, O45, O91, O103, O104, O111, O113, O121, O128, O145) in artificially-contaminated fresh produce--bagged baby spinach, alfalfa sprouts, cilantro, and raw milk--we evaluated the performance of 8 different agars. Performance was highly dependent upon strain used and the presence of inhibitors, but not necessarily dependent on food matrix. Tellurite resistant-negative strains, O91:-, O103:H6, O104:H21, O113:H21, and O128, grew poorly on CHROMagar STEC, Rainbow agar O157, and a modified Rainbow O157 (mRB) agar. Although adding washed sheep's blood to CHROMagar STEC and mRB agars improved overall performance; however, this also reversed the inhibition of non-target bacteria provided by original formulations. Variable colony coloration made selecting colonies from Rainbow agar O157 and mRB agars difficult. Study results support a strategy using inclusive agars (e.g. L-EMB, SHIBAM) in combination with selective agars (R & F E. coli O157:H7, CHROMagar STEC) to allow for recovery of the most STECs while increasing the probability of recovering STEC in high bacterial count matrices. Published by Elsevier Ltd.

  16. Latex agglutination assays for detection of non-O157 Shiga toxin-producing Escherichia coli serogroups O26, O45, O103, O111, O121, and O145.

    Science.gov (United States)

    Medina, Marjorie B; Shelver, Weilin L; Fratamico, Pina M; Fortis, Laurie; Tillman, Glenn; Narang, Neelam; Cray, William C; Esteban, Emilio; Debroy, Andchitrita

    2012-05-01

    Latex agglutination assays utilizing polyclonal antibodies were developed for the top six non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups. Rabbit antisera were affinity purified through protein A/G columns, and the isolated immunoglobulins (IgGs) were covalently immobilized onto polystyrene latex particles. The resulting latex-IgG complex had a protein (IgG) load of 0.20 to 0.28 mg/ml in a 1% latex suspension. Optimum conditions for the agglutination assay consisted of utilizing 20 μm l of latex-IgG reagent containing 2.0 to 2.8 μm g IgG in a 0.5% latex suspension. Agglutination or flocculation was observed almost instantly after mixing the colonies with the latex-IgG, indicating STEC strains. More than 100 target and nontarget strains were tested in more than 3,000 test replicates. All target organisms produced positive results, but three antisera (anti-O26, anti-O103, and anti-O145) cross-reacted with some other STECs. The anti-O103 and anti-O145 latex reagents cross-reacted with O26 strains, and the anti-O26 cross-reacted with O103 strains. The latex-IgG reagents are stable for at least 1 year and are easy to prepare. These agglutination assays can be used for identification of presumptive non-O157 STEC colonies from agar media. The techniques used to prepare the latex reagents also can be utilized for testing other STEC serogroups, other E. coli serotypes, or other pathogens to ensure safe foods to consumers.

  17. Mexican unpasteurised fresh cheeses are contaminated with Salmonella spp., non-O157 Shiga toxin producing Escherichia coli and potential uropathogenic E. coli strains: A public health risk.

    Science.gov (United States)

    Guzman-Hernandez, Rosa; Contreras-Rodriguez, Araceli; Hernandez-Velez, Rosa; Perez-Martinez, Iza; Lopez-Merino, Ahide; Zaidi, Mussaret B; Estrada-Garcia, Teresa

    2016-11-21

    Fresh cheeses are a main garnish of Mexican food. Consumption of artisanal fresh cheeses is very common and most of them are made from unpasteurised cow milk. A total of 52 fresh unpasteurised cheeses of five different types were purchased from a variety of suppliers from Tabasco, Mexico. Using the most probable number method, 67% and 63% of samples were positive for faecal coliforms and E. coli, respectively; revealing their low microbiological quality. General hygienic conditions and practices of traditional cheese manufacturers were poor; most establishments had unclean cement floors, all lacked windows and doors screens, and none of the food-handlers wore aprons, surgical masks or bouffant caps. After analysing all E. coli isolates (121 strains) for the presence of 26 virulence genes, results showed that 9 (17%) samples were contaminated with diarrheagenic E. coli strains, 8 harboured non-O157 Shiga toxin producing E. coli (STEC), and one sample contained both STEC and diffusely adherent E. coli strains. All STEC strains carried the stx1 gene. Potential uropathogenic E. coli (UPEC) strains were isolated from 15 (29%) samples; the most frequent gene combination was fimA-agn43. Two samples were contaminated with Salmonella. The results demonstrated that unpasteurised fresh cheeses produced in Tabasco are of poor microbiological quality and may frequently harbour foodborne pathogens. Food safety authorities in Mexico need to conduct more rigorous surveillance of fresh cheeses. Furthermore, simple and inexpensive measures as establishing programs emphasizing good hand milking practices and hygienic manufacturing procedures may have a major effect on improving the microbiological quality of these food items. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Evaluation of CHROMagar STEC and STEC O104 chromogenic agar media for detection of Shiga Toxin-producing Escherichia coli in stool specimens.

    Science.gov (United States)

    Gouali, Malika; Ruckly, Corinne; Carle, Isabelle; Lejay-Collin, Monique; Weill, François-Xavier

    2013-03-01

    The performance of CHROMagar STEC and CHROMagar STEC O104 (CHROMagar Microbiology, Paris, France) media for the detection of Shiga toxin-producing Escherichia coli (STEC) was assessed with 329 stool specimens collected over 14 months from patients with suspected STEC infections (June 2011 to August 2012). The CHROMagar STEC medium, after an enrichment broth step, allowed the recovery of the STEC strain from 32 of the 39 (82.1%) Shiga toxin-positive stool specimens, whereas the standard procedure involving Drigalski agar allowed the recovery of only three additional STEC strains. The isolates that grew on CHROMagar STEC medium belonged to 15 serotypes, including the prevalent non-sorbitol-fermenting (NSF) O157:H7, O26:H11, and O104:H4 serotypes. The sensitivity, specificity, and positive and negative predictive values for the CHROMagar STEC medium were between 89.1% and 91.4%, 83.7% and 86.7%, 40% and 51.3%, and 98% and 98.8%, respectively, depending on whether or not stx-negative eae-positive E. coli was considered atypical enteropathogenic E. coli (EPEC) or STEC that had lost Shiga toxin genes during infection. In conclusion, the good performance of CHROMagar STEC agar medium, in particular, the high negative predictive value, and its capacity to identify NSF O157:H7 as well as common non-O157 STEC may be useful for clinical bacteriology, public health, and reference laboratories; it could be used in addition to a method targeting Shiga toxins (detection of stx genes by PCR, immunodetection of Shiga toxins in stool specimens, or Vero cell cytotoxicity assay) as an alternative to O157 culture medium. This combined approach should allow rapid visualization of both putative O157 and non-O157 STEC colonies for subsequent characterization, essential for real-time surveillance of STEC infections and investigations of outbreaks.

  19. Fate of non O157 Shiga toxigenic Escherichia coli in composted cattle manure Eliminação de Escherichia coli Shigatoxigênica não-O157 em compostagem de esterco bovino

    Directory of Open Access Journals (Sweden)

    V.P. Gonçalves

    2007-08-01

    Full Text Available To determine the fate of Shiga toxigenic Escherichia coli (STEC non-O 157 in composted manure from naturally colonized cattle, fresh manure was obtained from three cows carrying non-O157 STEC strains possessing the stx2 gene. Two composting systems were used: a 0.6m deep cave opened in the soil and an one meter high solid manure heap in a pyramidal architecture. Every day, for the 10 first days, and every five days for a month, one manure sample from three different points in both systems was collected and cultured to determine the presence of E. coli and the presence of the stx 2 gene in the cells. The temperature was verified at each sampling. STEC non-O157 E. coli cells survived for 8, 25 and 30 days at 42, 40 and 38ºC, respectively, in the deep cave and 4, 4 and 7 days at 65, 58 and 52ºC, respectively, in the heap, during the composting manure. Temperature and indigenous microorganisms appear to contribute to pathogen disappearance in the composting system. It is concluded that both composting systems were efficient to eliminate STEC cells. Land application of composted manure should minimize environmental risk associated with the dissemination of the pathogen.Determinou-se o tempo necessário para a eliminação de Escherichia coli Shigatoxigênica (STEC não-O157 em esterco bovino composto, obtido de fezes frescas de três vacas portadoras de cepas STEC não-O157 que apresentavam o gene stx 2. Foram utilizados dois sistemas de compostagem, o primeiro foi um buraco de 0,6m escavado no solo e o segundo um monte apresentando uma arquitetura piramidal com um metro de altura. Todos os dias, durante os primeiros 10 dias e a cada cinco dias durante um mês, uma amostra de três pontos diferentes dos dois sistemas de compostagem foram coletadas e semeadas para determinar a presença de E. coli e a presença do gene stx 2 nas células, sendo que em cada coleta a temperatura do sistema de compostagem foi determinada. Células de STEC não-O157

  20. [Survival of VTEC O157 and non-O157 in water troughs and bovine feces].

    Science.gov (United States)

    Polifroni, Rosana; Etcheverría, Analía I; Arroyo, Guillermo H; Padola, Nora L

    2014-01-01

    Verotoxin-producing Escherichia coli (VTEC) is the etiologic agent of hemolytic-uremic syndrome (HUS), which typically affects children ranging in age from six months to five years old. Transmission is produced by consumption of contaminated food, by direct contact with animals or the environment and from person to person. In previous studies we determined that the environment of a dairy farm is a non-animal reservoir; thus, we proposed to study the survival of 4 VTEC isolates (O20:H19; O91:H21; O157:H7 and O178:H19) in sterile water troughs and bovine feces by viable bacteria count and detection of virulence genes by PCR. It was demonstrated that the survival of different VTEC isolates (O157 and non-O157) varied in terms of their own characteristics as well as of the environmental conditions where they were found. The main differences between isolates were their survival time and the maximal counts reached. The competitive and adaptive characteristics of some isolates increase the infection risk for people that are visiting or working on a farm, as well as the risk for reinfection of the animals and food contamination. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Evaluation of lactic acid as an initial and secondary subprimal intervention for Escherichia coli O157:H7, non-O157 Shiga toxin-producing E. coli, and a nonpathogenic E. coli surrogate for E. coli O157:H7.

    Science.gov (United States)

    Pittman, C I; Geornaras, I; Woerner, D R; Nightingale, K K; Sofos, J N; Goodridge, L; Belk, K E

    2012-09-01

    Lactic acid can reduce microbial contamination on beef carcass surfaces when used as a food safety intervention, but effectiveness when applied to the surface of chilled beef subprimal sections is not well documented. Studies characterizing bacterial reduction on subprimals after lactic acid treatment would be useful for validations of hazard analysis critical control point (HACCP) systems. The objective of this study was to validate initial use of lactic acid as a subprimal intervention during beef fabrication followed by a secondary application to vacuum-packaged product that was applied at industry operating parameters. Chilled beef subprimal sections (100 cm(2)) were either left uninoculated or were inoculated with 6 log CFU/cm(2) of a 5-strain mixture of Escherichia coli O157:H7, a 12-strain mixture of non-O157 Shiga toxin-producing E. coli (STEC), or a 5-strain mixture of nonpathogenic (biotype I) E. coli that are considered surrogates for E. coli O157:H7. Uninoculated and inoculated subprimal sections received only an initial or an initial and a second "rework" application of lactic acid in a custombuilt spray cabinet at 1 of 16 application parameters. After the initial spray, total inoculum counts were reduced from 6.0 log CFU/cm(2) to 3.6, 4.4, and 4.4 log CFU/cm(2) for the E. coli surrogates, E. coli O157:H7, and non-O157 STEC inoculation groups, respectively. After the second (rework) application, total inoculum counts were 2.6, 3.2, and 3.6 log CFU/cm(2) for the E. coli surrogates, E. coli O157:H7, and non-O157 STEC inoculation groups, respectively. Both the initial and secondary lactic acid treatments effectively reduced counts of pathogenic and nonpathogenic strains of E. coli and natural microflora on beef subprimals. These data will be useful to the meat industry as part of the HACCP validation process.

  2. Shiga toxin-producing Escherichia coli (STEC) O22:H8 isolated from cattle reduces E. coli O157:H7 adherence in vitro and in vivo.

    Science.gov (United States)

    Martorelli, L; Albanese, A; Vilte, D; Cantet, R; Bentancor, A; Zolezzi, G; Chinen, I; Ibarra, C; Rivas, M; Mercado, E C; Cataldi, A

    2017-09-01

    Shiga toxin-producing Escherichia coli (STEC) are a group of bacteria responsible for food-associated diseases. Clinical features include a wide range of symptoms such as diarrhea, hemorrhagic colitis and the hemolytic uremic syndrome (HUS), a life-threatening condition. Our group has observed that animals naturally colonized with STEC strains of unknown serotype were not efficiently colonized with E. coli O157:H7 after experimental infection. In order to assess the basis of the interference, three STEC strains were isolated from STEC persistently-colonized healthy cattle from a dairy farm in Buenos Aires, Argentina. The three isolated strains are E. coli O22:H8 and carry the stx1 and stx2d genes. The activatable activity of Stx2d was demonstrated in vitro. The three strains carry the adhesins iha, ehaA and lpfO113. E. coli O22:H8 formed stronger biofilms in abiotic surface than E. coli O157:H7 (eae+, stx2+) and displayed a more adherent phenotype in vitro towards HeLa cells. Furthermore, when both serotypes were cultured together O22:H8 could reduce O157:H7 adherence in vitro. When calves were intragastrically pre-challenged with 10(8) CFU of a mixture of the three STEC strains and two days later challenged with the same dose of the strain E. coli O157:H7 438/99, the shedding of the pathogen was significantly reduced. These results suggest that E. coli O22:H8, a serotype rarely associated with human illness, might compete with O157:H7 at the bovine recto-anal junction, making non-O157 carrying-calves less susceptible to O157:H7 colonization and shedding of the bacteria to the environment. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Development of a Robust Method for Isolation of Shiga Toxin-Positive Escherichia coli (STEC) from Fecal, Plant, Soil and Water Samples from a Leafy Greens Production Region in California

    Science.gov (United States)

    Cooley, Michael B.; Jay-Russell, Michele; Atwill, Edward R.; Carychao, Diana; Nguyen, Kimberly; Quiñones, Beatriz; Patel, Ronak; Walker, Samarpita; Swimley, Michelle; Pierre-Jerome, Edith; Gordus, Andrew G.; Mandrell, Robert E.

    2013-01-01

    During a 2.5-year survey of 33 farms and ranches in a major leafy greens production region in California, 13,650 produce, soil, livestock, wildlife, and water samples were tested for Shiga toxin (stx)-producing Escherichia coli (STEC). Overall, 357 and 1,912 samples were positive for E. coli O157:H7 (2.6%) or non-O157 STEC (14.0%), respectively. Isolates differentiated by O-typing ELISA and multilocus variable number tandem repeat analysis (MLVA) resulted in 697 O157:H7 and 3,256 non-O157 STEC isolates saved for further analysis. Cattle (7.1%), feral swine (4.7%), sediment (4.4%), and water (3.3%) samples were positive for E. coli O157:H7; 7/32 birds, 2/145 coyotes, 3/88 samples from elk also were positive. Non-O157 STEC were at approximately 5-fold higher incidence compared to O157 STEC: cattle (37.9%), feral swine (21.4%), birds (2.4%), small mammals (3.5%), deer or elk (8.3%), water (14.0%), sediment (12.3%), produce (0.3%) and soil adjacent to produce (0.6%). stx1, stx2 and stx1/stx2 genes were detected in 63%, 74% and 35% of STEC isolates, respectively. Subtilase, intimin and hemolysin genes were present in 28%, 25% and 79% of non-O157 STEC, respectively; 23% were of the “Top 6″ O-types. The initial method was modified twice during the study revealing evidence of culture bias based on differences in virulence and O-antigen profiles. MLVA typing revealed a diverse collection of O157 and non-O157 STEC strains isolated from multiple locations and sources and O157 STEC strains matching outbreak strains. These results emphasize the importance of multiple approaches for isolation of non-O157 STEC, that livestock and wildlife are common sources of potentially virulent STEC, and evidence of STEC persistence and movement in a leafy greens production environment. PMID:23762414

  4. Molecular characterization and antimicrobial resistance of STEC strains isolated from healthy cattle in 2011 and 2013 in Spain.

    Science.gov (United States)

    Cabal, A; Porrero, M C; DE LA Cruz, M L; Saez, J L; Barcena, C; Lopez, G; Gortazar, C; Dominguez, L; Alvarez, J

    2016-10-01

    Prevention of Shiga toxin-producing Escherichia coli (STEC) foodborne outbreaks is hampered by its complex epidemiology. We assessed the distribution of virulence genes (VGs), main serogroups/serotypes for public health [haemolytic uraemic syndrome (HUS)-related], antimicrobial resistance (AMR) profiles and pulsed-field gel electrophoresis (PFGE) patterns in a collection of STEC isolates obtained from cattle hide (n = 149) and faecal (n = 406) samples collected during a national survey conducted in Spain in 2011 and 2013. Isolates were cultured using McConkey and CT-SMAC agar after enrichment, and confirmed as STEC by PCR. STEC prevalence in hides (15·4%) was higher than in faeces (10·7%) and O157:H7 was more frequent in the former (2·7% vs. 0·99%). Non-O157 HUS-related serogroups were present albeit at low frequencies. The non-O157 isolates were more heterogeneous than O157:H7 in their VG patterns, with 25/64 presenting VGs from both STEC and enterotoxigenic pathotypes (hybrid isolates). Of the STEC isolates, 62·5% were resistant at least to one antimicrobial, and no differences in AMR between O157:H7 and non-O157 were detected. All isolates had different profiles by PFGE and did not form a cluster. Overall, our results demonstrated that STEC in the cattle reservoir is still a matter of concern for human health due to the presence of HUS-related serogroups, the occurrence of certain VGs, AMR and the additional risks that hybrid isolates may pose, and thus warrants further investigation.

  5. Development and validation of predictive models for growth of non-0157 shiga-toxigenic Escherichia coli (STEC) and Salmonella spp. in ground beef, lettuce, and non fat dry milk

    Science.gov (United States)

    Microbial predictive models are food safety tools that can be used to evaluate potential risk of pathogen growth in foods to facilitate effective decision-making. Research is limited regarding growth characteristics of non-O157 Shiga-toxigenic E. coli (STEC) in food and on Salmonella spp. in lettuc...

  6. Antimicrobial resistance in Escherichia coli O157 and non-O157 isolated from feces of domestic farm animals in Culiacan, Mexico

    Science.gov (United States)

    Antimicrobial resistance in E. coli O157 and non-O157 strains is a matter of increasing concern, and the association with some virulence traits in the same bacteria remains unclear. Inappropriate antimicrobial use in human and animal therapy has been associated with selective pressure in enteric mi...

  7. Purification and characterization of lipopolysaccharides from six strains of non-O157 Shiga toxin-producing Escherichia coli.

    Science.gov (United States)

    Stromberg, Loreen R; Stromberg, Zachary R; Banisadr, Afsheen; Graves, Steven W; Moxley, Rodney A; Mukundan, Harshini

    2015-09-01

    Certain Shiga toxin-producing Escherichia coli (STEC) are virulent human pathogens that are most often acquired through contaminated food. The United States Department of Agriculture, Food Safety and Inspection Service has declared several serogroups of STEC as adulterants in non-intact raw beef products. Hence, sensitive and specific tests for the detection of these STEC are a necessity for implementation in food safety programs. E. coli serogroups are identified by their respective O-antigen moiety on the lipopolysaccharide (LPS) macromolecule. We propose that the development of O-antigen-specific immunological assays can facilitate simple and rapid discriminatory detection of STEC in beef. However, the resources (antigens and antibodies) required for such development are not readily available. To overcome this, we extracted and characterized LPS and O-antigen from six STEC strains. Using hot phenol extraction, we isolated the LPS component from each strain and purified it using a series of steps to eliminate proteins, nucleic acids, and lipid A antigens. Antigens and crude LPS extracts were characterized using gel electrophoresis, immunoblotting, and modified Western blotting with commercially available antibodies, thus assessing the serogroup specificity and sensitivity of available ligands as well. The results indicate that, while many commercially available antibodies bind LPS, their activities and specificities are highly variable, and often not as specific as those required for serogroup discrimination. This variability could be minimized by the production of antibodies specific for the O-antigen. Additionally, the antigens generated from this study provide a source of characterized LPS and O-antigen standards for six serogroups of STEC. Published by Elsevier B.V.

  8. Urease genes in non-O157 Shiga toxin-producing Escherichia coli : mostly silent but valuable markers for pathogenicity

    NARCIS (Netherlands)

    Friedrich, A W; Lukas, R; Mellmann, A; Köck, R; Zhang, W; Mathys, W; Bielaszewska, M; Karch, H

    2006-01-01

    The distribution of ureC was investigated among 294 Escherichia coli isolates, comprising 72 strains from the E. coli standard reference collection (ECOR), 62 strains from the diarrhoeagenic E. coli (DEC) collection, and 160 clinical isolates of Shiga toxin-producing E. coli (STEC). The ureC gene wa

  9. Urease genes in non-O157 Shiga toxin-producing Escherichia coli : mostly silent but valuable markers for pathogenicity

    NARCIS (Netherlands)

    Friedrich, A W; Lukas, R; Mellmann, A; Köck, R; Zhang, W; Mathys, W; Bielaszewska, M; Karch, H

    2006-01-01

    The distribution of ureC was investigated among 294 Escherichia coli isolates, comprising 72 strains from the E. coli standard reference collection (ECOR), 62 strains from the diarrhoeagenic E. coli (DEC) collection, and 160 clinical isolates of Shiga toxin-producing E. coli (STEC). The ureC gene wa

  10. Variable tellurite resistance profiles of clinically-relevant Shiga toxin-producing Escherichia coli (STEC) influence their recovery from foodstuffs.

    Science.gov (United States)

    Kerangart, Stéphane; Douëllou, Thomas; Delannoy, Sabine; Fach, Patrick; Beutin, Lothar; Sergentet-Thévenot, Delphine; Cournoyer, Benoit; Loukiadis, Estelle

    2016-10-01

    Tellurite (Tel)-amended selective media and resistance (Tel-R) are widely used for detecting Shiga toxin-producing Escherichia coli (STEC) from foodstuffs. Tel-R of 81 O157 and non-O157 STEC strains isolated from animal, food and human was thus investigated. Variations of STEC tellurite minimal inhibitory concentration (MIC) values have been observed and suggest a multifactorial and variable tellurite resistome between strains. Some clinically-relevant STEC were found highly susceptible and could not be recovered using a tellurite-based detection scheme. The ter operon was highly prevalent among highly Tel-R STEC but was not always detected among intermediately-resistant strains. Many STEC serogroup strains were found to harbor sublines showing a gradient of MIC values. These Tel-R sublines showed statistically significant log negative correlations with increasing tellurite concentration. Whatever the tellurite concentration, the highest number of resistant sublines was observed for STEC belonging to the O26 serogroup. Variations in the number of these Tel-R sublines could explain the poor recovery of some STEC serogroups on tellurite-amended media especially from food products with low levels of contamination. Comparison of tellurite MIC values and distribution of virulence-related genes showed Tel-R and virulence to be related.

  11. Changes in Gene Transcription Induced by Hydrogen Peroxide Treatment of Verotoxin-Producing Escherichia coli O157:H7 and Non-O157 Serotypes on Romaine Lettuce

    Science.gov (United States)

    Mei, Gui-Ying; Tang, Joshua; Bach, Susan; Kostrzynska, Magdalena

    2017-01-01

    Disease outbreaks of verotoxin-producing Escherichia coli (VTEC) O157:H7 and non-O157 serotypes associated with leafy green vegetables are becoming a growing concern. A better understanding of the behavior of VTEC, particularly non-O157 serotypes, on lettuce under stress conditions is necessary for designing more effective control strategies. Hydrogen peroxide (H2O2) can be used as a sanitizer to reduce the microbial load in leafy green vegetables, particularly in fresh produce destined for the organic market. In this study, we tested the hypothesis that H2O2 treatment of contaminated lettuce affects in the same manner transcription of stress-associated and virulence genes in VTEC strains representing O157 and non-O157 serotypes. Six VTEC isolates representing serotypes O26:H11, O103:H2, O104:H4, O111:NM, O145:NM, and O157:H7 were included in this study. The results indicate that 50 mM H2O2 caused a population reduction of 2.4–2.8 log10 (compared to non-treated control samples) in all six VTEC strains present on romaine lettuce. Following the treatment, the transcription of genes related to oxidative stress (oxyR and sodA), general stress (uspA and rpoS), starvation (phoA), acid stress (gadA, gadB, and gadW), and virulence (stx1A, stx2A, and fliC) were dramatically downregulated in all six VTEC serotypes (P ≤ 0.05) compared to not treated control samples. Therefore, VTEC O157:H7 and non-O157 serotypes on lettuce showed similar survival rates and gene transcription profiles in response to 50 mM H2O2 treatment. Thus, the results derived from this study provide a basic understanding of the influence of H2O2 treatment on the survival and virulence of VTEC O157:H7 and non-O157 serotypes on lettuce.

  12. Validation of the Applied Biosystems RapidFinder Shiga Toxin-Producing E. coli (STEC) Detection Workflow.

    Science.gov (United States)

    Cloke, Jonathan; Matheny, Sharon; Swimley, Michelle; Tebbs, Robert; Burrell, Angelia; Flannery, Jonathan; Bastin, Benjamin; Bird, Patrick; Benzinger, M Joseph; Crowley, Erin; Agin, James; Goins, David; Salfinger, Yvonne; Brodsky, Michael; Fernandez, Maria Cristina

    2016-11-01

    The Applied Biosystems™ RapidFinder™ STEC Detection Workflow (Thermo Fisher Scientific) is a complete protocol for the rapid qualitative detection of Escherichia coli (E. coli) O157:H7 and the "Big 6" non-O157 Shiga-like toxin-producing E. coli (STEC) serotypes (defined as serogroups: O26, O45, O103, O111, O121, and O145). The RapidFinder STEC Detection Workflow makes use of either the automated preparation of PCR-ready DNA using the Applied Biosystems PrepSEQ™ Nucleic Acid Extraction Kit in conjunction with the Applied Biosystems MagMAX™ Express 96-well magnetic particle processor or the Applied Biosystems PrepSEQ Rapid Spin kit for manual preparation of PCR-ready DNA. Two separate assays comprise the RapidFinder STEC Detection Workflow, the Applied Biosystems RapidFinder STEC Screening Assay and the Applied Biosystems RapidFinder STEC Confirmation Assay. The RapidFinder STEC Screening Assay includes primers and probes to detect the presence of stx1 (Shiga toxin 1), stx2 (Shiga toxin 2), eae (intimin), and E. coli O157 gene targets. The RapidFinder STEC Confirmation Assay includes primers and probes for the "Big 6" non-O157 STEC and E. coli O157:H7. The use of these two assays in tandem allows a user to detect accurately the presence of the "Big 6" STECs and E. coli O157:H7. The performance of the RapidFinder STEC Detection Workflow was evaluated in a method comparison study, in inclusivity and exclusivity studies, and in a robustness evaluation. The assays were compared to the U.S. Department of Agriculture (USDA), Food Safety and Inspection Service (FSIS) Microbiology Laboratory Guidebook (MLG) 5.09: Detection, Isolation and Identification of Escherichia coli O157:H7 from Meat Products and Carcass and Environmental Sponges for raw ground beef (73% lean) and USDA/FSIS-MLG 5B.05: Detection, Isolation and Identification of Escherichia coli non-O157:H7 from Meat Products and Carcass and Environmental Sponges for raw beef trim. No statistically significant

  13. Growth of Escherichia coli O157:H7, Non-O157 Shiga Toxin-Producing Escherichia coli , and Salmonella in Water and Hydroponic Fertilizer Solutions.

    Science.gov (United States)

    Shaw, Angela; Helterbran, Kara; Evans, Michael R; Currey, Christopher

    2016-12-01

    The desire for local, fresh produce year round is driving the growth of hydroponic growing systems in the United States. Many food crops, such as leafy greens and culinary herbs, grown within hydroponics systems have their root systems submerged in recirculating nutrient-dense fertilizer solutions from planting through harvest. If a foodborne pathogen were introduced into this water system, the risk of contamination to the entire crop would be high. Hence, this study was designed to determine whether Escherichia coli O157:H7, non-O157 Shiga toxin-producing E. coli , and Salmonella were able to survive and reproduce in two common hydroponic fertilizer solutions and in water or whether the bacteria would be killed or suppressed by the fertilizer solutions. All the pathogens grew by 1 to 6 log CFU/ml over a 24-h period, depending on the solution. E. coli O157:H7 reached higher levels in the fertilizer solution with plants (3.12 log CFU/ml), whereas non-O157 Shiga toxin-producing E. coli and Salmonella reached higher levels in the fertilizer solution without plants (1.36 to 3.77 log CFU/ml). The foodborne pathogens evaluated here survived for 24 h in the fertilizer solution, and populations grew more rapidly in these solutions than in plain water. Therefore, human pathogens entering the fertilizer solution tanks in hydroponic systems would be expected to rapidly propagate and spread throughout the system and potentially contaminate the entire crop.

  14. Evaluation of a novel antimicrobial solution and its potential for control E. coli O157:H7, non-O157:H7 shiga toxin-producing E. coli, Salmononella spp., and Listeria monocytogenes on beef

    Science.gov (United States)

    The goal of this study was to evaluate the efficacy of a novel antimicrobial solution made with chitosan, lauric arginate ester, and organic acids on Escherichia coli O157:H7, Salmonella spp., Listeria monocytogenes, and non-O157 shiga toxin-producing E. coli cocktails and to test its potential to b...

  15. Biotinylation of environmentally isolated Shiga toxin-producing Escherichia coli (STEC) – specific bacteriophages for biosensor and biocontrol applications

    Science.gov (United States)

    Like common bacteriophages, Shiga toxin-producing Escherichia coli (STEC) bacteriophages are viruses that recognize and bind to specific bacterial host (STEC) for propagation. They co-exist with STEC hosts, which cause epidemic food and waterborne illnesses, but may act as host populations limiting ...

  16. Effect of Citrus Byproducts on Survival of O157:H7 and Non-O157 Escherichia coli Serogroups within In Vitro Bovine Ruminal Microbial Fermentations

    Directory of Open Access Journals (Sweden)

    Heather A. Duoss-Jennings

    2013-01-01

    Full Text Available Citrus byproducts (CBPs are utilized as a low cost nutritional supplement to the diets of cattle and have been suggested to inhibit the growth of both Escherichia coli O157:H7 and Salmonella. The objective of this study was to examine the effects in vitro that varying concentrations of CBP in the powdered or pelleted variety have on the survival of Shiga-toxin Escherichia coli (STEC serotypes O26:H11, O103:H8, O111:H8, O145:H28, and O157:H7 in bovine ruminal microorganism media. The O26:H11, O111:H8, O145:H28, and O157:H7 serotypes did not exhibit a change in populations in media supplemented with CBP with either variety. The O103:H8 serotype displayed a general trend for an approximate 1log10 reduction in 5% powdered CBP and 20% pelleted CBP over 6 h. There was a trend for reductions in populations of a variant form of O157:H7 mutated in the stx1 and stx2 genes in higher concentrations of CBP. These results suggest that variations exist in the survival of these serotypes of STEC within mixed ruminal microorganism fluid media when supplemented with CBP. Further research is needed to determine why CBPs affect STEC serotypes differently.

  17. Design and evaluation of two-stage multiplex real-time PCR method for detecting O157:H7 and non-O157 STEC strains from beef samples

    Science.gov (United States)

    Introduction: E. coli O157:H7 was first recognized as a human pathogen in 1982 and until recently was the only E. coli strain mandated for testing by the USDA. In June 2012, the USDA declared six additional Shiga-toxin producing E. coli serogroups (O26, O45, O103, O111, O121, and O145) as adulterant...

  18. Occurrence of non-O157 Shiga toxin-producing Escherichia coli in two commercial swine farms in the Eastern Cape Province, South Africa.

    Science.gov (United States)

    Iwu, Chinwe Juliana; Iweriebor, Benson Chuks; Obi, Larry Chikwelu; Okoh, Anthony Ifeanyi

    2016-02-01

    Shiga toxin-producing Escherichia coli (STEC) is one of the most significant causes of food-borne infections capable of causing serious health complications in humans. Even though ruminants are known to be the major reservoirs of STEC, other non-ruminant food producing animals may also harbour pathogenic E. coli strains. In this study, we investigated the prevalence of E. coli serogroups O26, O111, O121, O145, and O157 and their associated virulence genes (stx1, stx2, eae, and ehxA) in swine faecal samples obtained from the two major commercial farms located in the Nkonkobe Municipality, Eastern Cape, South Africa. The proportions of serogroups detected were O26; 35 (7%), O145; 14 (2.8%), and O157:H7; 43 (8.6%) of the total animals sampled. Out of the 500 animals sampled, 22 isolates of E. coli (1.4%) tested positive for the stx2 gene, and 7 of these isolates belonged to E. coli O26 serogroup, while the remaining 15 most likely belonged to serogroups untargeted in this study. Other virulence genes (stx1, eae, and ehxA) that we screened for were not detected. These findings reveal that pigs within the Eastern Cape Province of South Africa can harbour Shiga toxin-producing E. coli.

  19. Isolation and characterization of bacteriophages as potential agents against Shiga toxin – producing Escherichia coli (STEC) strains

    Science.gov (United States)

    Shiga – toxin producing Escherichia coli (STEC) is a significant group of foodborne pathogens that can cause mild diarrhea to serious human illnesses. The gastrointestinal tracts of cattle and other ruminants are the primary reservoirs of STEC strains and may co-harbor bacteriophages as part of its ...

  20. Risk of Escherichia coli O157:H7, Non-O157 Shiga Toxin-Producing Escherichia coli, and Campylobacter spp. in Food Animals and Their Products in Qatar.

    Science.gov (United States)

    Mohammed, Hussni O; Stipetic, Korana; Salem, Ahmed; McDonough, Patrick; Chang, Yung Fu; Sultan, Ali

    2015-10-01

    Escherichia coli O157:H7, non-O157 E. coli, and Campylobacter spp. are among the top-ranked pathogens that threaten the safety of food supply systems around the world. The associated risks and predisposing factors were investigated in a dynamic animal population using a repeat-cross-sectional study design. Animal and environmental samples were collected from dairy and camel farms, chicken processing plants, and abattoirs and analyzed for the presence of these pathogens using a combination of bacterial enrichment and real-time PCR tests without culture confirmation. Data on putative risk factors were also collected and analyzed. E. coli O157:H7 was detected by PCR at higher levels in sheep and camel feces than in cattle feces (odds ratios [OR], 6.8 and 21.1, respectively). Although the genes indicating E. coli O157:H7 were detected at a relatively higher rate (4.3%) in fecal samples from dairy cattle, they were less common in milk and udder swabs from the same animals (1 and 2%, respectively). Among the food adulterants, E. coli O103 was more common in cattle fecal samples, whereas O26 was more common in sheep feces and O45 in camel feces compared with cattle (OR, 2.6 and 3.1, respectively). The occurrence of E. coli in the targeted populations differed by the type of sample and season of the year. Campylobacter jejuni and Campylobacter coli were more common in sheep and camel feces than in cattle feces. Most of the survey and surveillance of E. coli focused on serogroup O157 as a potential foodborne hazard; however, based on the PCR results, non-O157 Shiga toxin-producing E. coli serotypes appeared to be more common, and efforts should be made to include them in food safety programs.

  1. Quantitative risk assessment of haemolytic and uremic syndrome linked to O157:H7 and non-O157:H7 Shiga-toxin producing Escherichia coli strains in raw milk soft cheeses.

    Science.gov (United States)

    Perrin, Frédérique; Tenenhaus-Aziza, Fanny; Michel, Valérie; Miszczycha, Stéphane; Bel, Nadège; Sanaa, Moez

    2015-01-01

    Shiga-toxin producing Escherichia coli (STEC) strains may cause human infections ranging from simple diarrhea to Haemolytic Uremic Syndrome (HUS). The five main pathogenic serotypes of STEC (MPS-STEC) identified thus far in Europe are O157:H7, O26:H11, O103:H2, O111:H8, and O145:H28. Because STEC strains can survive or grow during cheese making, particularly in soft cheeses, a stochastic quantitative microbial risk assessment model was developed to assess the risk of HUS associated with the five MPS-STEC in raw milk soft cheeses. A baseline scenario represents a theoretical worst-case scenario where no intervention was considered throughout the farm-to-fork continuum. The risk level assessed with this baseline scenario is the risk-based level. The impact of seven preharvest scenarios (vaccines, probiotic, milk farm sorting) on the risk-based level was expressed in terms of risk reduction. Impact of the preharvest intervention ranges from 76% to 98% of risk reduction with highest values predicted with scenarios combining a decrease of the number of cow shedding STEC and of the STEC concentration in feces. The impact of postharvest interventions on the risk-based level was also tested by applying five microbiological criteria (MC) at the end of ripening. The five MCs differ in terms of sample size, the number of samples that may yield a value larger than the microbiological limit, and the analysis methods. The risk reduction predicted varies from 25% to 96% by applying MCs without preharvest interventions and from 1% to 96% with combination of pre- and postharvest interventions.

  2. Use of lactic acid with electron beam irradiation for control of Escherichia coli O157:H7, non-O157 VTEC E. coli, and Salmonella serovars on fresh and frozen beef.

    Science.gov (United States)

    Li, Shuliu; Kundu, Devapriya; Holley, Richard A

    2015-04-01

    Lactic acid pre-treatment was examined to enhance the antimicrobial action of electron (e-) beam irradiation of beef trim. Meat samples were inoculated with Escherichia coli O157:H7, non-O157 VTEC E. coli or Salmonella cocktails and treated with 5% lactic acid at 55 °C. Samples were packaged aerobically or vacuum-packed, kept at 4 °C and treated with 1 kGy e-beam energy. Frozen samples were treated with 1, 3 or 7 kGy and stored at -20 °C for ≤ 5 d. Lactic acid enhanced the antimicrobial action of 1 kGy e-beam treatment against Salmonella by causing an additional E. coli viability by 4.5 log CFU/g, and while lactic acid did not improve the reduction, after freezing additive effects were found. After 3 kGy irradiation, Salmonella was reduced by 2 and 4 log CFU/g in the irradiated and lactic acid plus irradiated samples, respectively. Lactic acid pre-treatment was of limited value with 1 kGy treatment for improving control of toxigenic E. coli in fresh beef trim, however, it would be useful with low dose irradiation for controlling both VTEC E. coli and Salmonella in frozen product. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Top-down proteomic identification of Shiga toxin 2 variants from Shiga toxin-producing Escherichia coli (STEC) using MALDI-TOF-TOF-MS/MS-PSD

    Science.gov (United States)

    Shiga toxin-producing Escherichia coli (STEC) are increasingly linked to severe outbreaks of foodborne illness throughout the world, e.g. Germany and France in 2011. STEC infections can result in bloody diarrhea, hemolytic uremic syndrome, kidney failure and death. New analytical techniques are ne...

  4. Comparison of methods for the identification and sub-typing of O157 and non-O157 Escherichia coli serotypes and their integration into a polyphasic taxonomy approach

    Directory of Open Access Journals (Sweden)

    Prieto-Calvo M.A.

    2016-12-01

    Full Text Available Phenotypic, chemotaxonomic and genotypic data from 12 strains of Escherichia coli were collected, including carbon source utilisation profiles, ribotypes, sequencing data of the 16S–23S rRNA internal transcribed region (ITS and Fourier transform-infrared (FT-IR spectroscopic profiles. The objectives were to compare several identification systems for E. coli and to develop and test a polyphasic taxonomic approach using the four methodologies combined for the sub-typing of O157 and non-O157 E. coli. The nucleotide sequences of the 16S–23S rRNA ITS regions were amplified by polymerase chain reaction (PCR, sequenced and compared with reference data available at the GenBank database using the Basic Local Alignment Search Tool (BLAST . Additional information comprising the utilisation of carbon sources, riboprint profiles and FT-IR spectra was also collected. The capacity of the methods for the identification and typing of E. coli to species and subspecies levels was evaluated. Data were transformed and integrated to present polyphasic hierarchical clusters and relationships. The study reports the use of an integrated scheme comprising phenotypic, chemotaxonomic and genotypic information (carbon source profile, sequencing of the 16S–23S rRNA ITS, ribotyping and FT-IR spectroscopy for a more precise characterisation and identification of E. coli. The results showed that identification of E. coli strains by each individual method was limited mainly by the extension and quality of reference databases. On the contrary, the polyphasic approach, whereby heterogeneous taxonomic data were combined and weighted, improved the identification results, gave more consistency to the final clustering and provided additional information on the taxonomic structure and phenotypic behaviour of strains, as shown by the close clustering of strains with similar stress resistance patterns.

  5. Shiga toxin-producing Escherichia coli (STEC) O157 outbreak, The Netherlands, September-October 2005.

    Science.gov (United States)

    Doorduyn, Y; de Jager, C M; van der Zwaluw, W K; Friesema, I H M; Heuvelink, A E; de Boer, E; Wannet, W J B; van Duynhoven, Y T H P

    2006-07-01

    In September 2005, the first national food-related outbreak of Shiga toxin (Stx)-producing Escherichia coli (STEC) O157 was investigated in the Netherlands. A total of 21 laboratory-confirmed cases (including one secondary case), and another 11 probable cases (two primary and nine secondary cases) were reported in patients who became ill between 11 September and 10 October 2005. Preliminary investigation suggested consumption of a raw beef product, steak tartare (in the Netherlands also known as "filet americain"), and contact with other symptomatic persons as possible risk factors. A subsequent case-control study supported the hypothesis that steak tartare was the source of the outbreak (matched odds ratio (OR) 272, 95% confidence interval (CI) 3-23,211). Consumption of ready-to-eat vegetables was also associated with STEC O157 infection (matched OR 24, 95% CI 1.1-528), but was considered a less likely source, as only 40% of the cases were exposed. Samples of steak tartare collected from one chain of supermarkets where it is likely that most patients (67%) bought steak tartare, all tested negative for STEC O157. However, sampling was done three days after the date of symptom onset of the last reported case. Since 88% of the cases became ill within a two week period, point source contamination may explain these negative results. It is concluded that steak tartare was the most likely cause of the first national food-related outbreak of STEC O157 in the Netherlands.

  6. Validation of fermentation and cooking parameters for dry-fermented sausage to control Shiga toxin-producing Escherichia coli (STEC)

    Science.gov (United States)

    Shiga-toxin producing Escherichia coli (STEC) have been occasionally associated with causing illness due to under-processed and/or undercooked raw, further processed, and/or fermented meats. Regarding the latter, the United States Department of Agriculture (USDA) Food Safety and Inspection Service (...

  7. Evaluation of a multiplex real-time PCR method for detecting Shiga toxin-producing Escherichia coli in beef and comparison to the FSIS microbiology laboratory guidebook method

    Science.gov (United States)

    The “top-six” non-O157 STEC (O26, O45, O103, O111, O121, and O145) most frequently associated with outbreaks and cases of food-borne illnesses have been declared as adulterants in beef by the USDA Food Safety and Inspection Service (FSIS), and regulatory testing for these serogroups in beef began in...

  8. Characterization of enterohemorrhagic Escherichia coli on veal hides and carcasses

    Science.gov (United States)

    Enterohemorrhagic E. coli (EHEC) are Shiga toxin–producing Escherichia coli (STEC) associated with the most severe forms of foodborne illnesses. The United States Department of Agriculture (USDA) Food Safety Inspection Service (FSIS) has identified a higher percentage of non-O157 EHEC compared to E....

  9. 75 FR 81613 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Science.gov (United States)

    2010-12-28

    ... this notice. Proposed Project FoodNet Non-O157 Shiga Toxin-Producing E. coli Study: Assessment of Risk Factors for Laboratory-Confirmed Infections and Characterization of Illnesses by Microbiological... (STEC) infections occur in the United States, ranging in severity from mild diarrhea, to hemorrhagic...

  10. Revisiting the STEC testing approach: using espK and espV to make enterohemorrhagic Escherichia coli (EHEC detection more reliable in beef

    Directory of Open Access Journals (Sweden)

    Sabine eDelannoy

    2016-01-01

    Full Text Available Current methods for screening Enterohemorrhagic Escherichia coli (EHEC O157 and non-O157 in beef enrichments typically rely on the molecular detection of stx, eae, and serogroup-specific wzx or wzy gene fragments. As these genetic markers can also be found in some non-EHEC strains, a number of ‘false positive’ results are obtained. Here, we explore the suitability of five novel molecular markers, espK, espV, ureD, Z2098, and CRISPRO26:H11 as candidates for a more accurate screening of EHEC strains of greater clinical significance in industrialized countries. Of the 1,739 beef enrichments tested, 180 were positive for both stx and eae genes. Ninety (50% of these tested negative for espK, espV, ureD, and Z2098, but twelve out of these negative samples were positive for the CRISPRO26:H11 gene marker specific for a newly emerging virulent EHEC O26:H11 French clone. We show that screening for stx, eae, espK, and espV, in association with the CRISPRO26:H11 marker is a better approach to narrow down the EHEC screening step in beef enrichments. The number of potentially positive samples was reduced by 48.88% by means of this alternative strategy compared to the European and American reference methods, thus substantially improving the discriminatory power of EHEC screening systems. This approach is in line with the EFSA (European Food Safety Authority opinion on pathogenic STEC published in 2013.

  11. [Epidemiological role of pets in urban transmission cycle of STEC].

    Science.gov (United States)

    Bentancor, Adriana

    2006-01-01

    Escherichia coli is an important constitutional element of both animal's and men's microbiote. Rumiants in general and bovine in particular have been pointed out as reservoirs of shigatoxigenic (STEC) and enterohemorragic strains (EHEC). These strains are rarely reported in pets isolations and are badly documented. Revisions of the pathogenic role of E. coli in small animals, particulary based on intestinal and urogenital isolations, involve in a very low proportion the STEC strains. In dogs, ocasional isolations are reported, from feces coming from both healthy and diarreic dogs. The STEC intestinal strains prevalence in dogs and cats from urban centers, based on the habit of including regular or ocasional raw meat in their diet, should not be understimated.

  12. Differences in Shiga toxin and phage production among stx2g-positive STEC strains

    Directory of Open Access Journals (Sweden)

    Claudia Viviana Granobles Velandia

    2012-06-01

    Full Text Available Shigatoxigenic E. coli (STEC are characterized by the production of Shiga toxins (Stx encoded by temperate bacteriophages. Stx production is linked to the induction of the phage lytic cycle. Several stx variants have been described and differentially associated with the risk of developing severe illness.The variant named stx2g was first identified in a STEC strain isolated from the faeces of healthy cattle. Analysis of stx2g-positive strains isolated from humans, animals and environmental sources have shown that they have a close relationship. In this study, stx2g-positive STEC isolated from cattle were analyzed for phage and Stx production, with the aim to relate the results to differences observed in cytotoxicity.The presence of inducible phages was assessed by analyzing the bacterial growth/lysis curves and also by plaque assay. Bacterial growth curves in the absence of induction were similar for all isolates, however, notably differed among induced cultures. The two strains that clearly evidenced bacteriolysis under this condition also showed higher phage titers in plaque assays. However, only the phage plaques produced by one of these strains (FB 62 hybridized with a stx2-probe. Furthermore, the production of Stx was evaluated by EIA and Western immunoblotting in overnight supernatants. By EIA, we detected Stx only in supernatants of FB 62, with a higher signal with induced than in uninduced cultures. By immunoblotting, Stx2 could be detected after induction in all stx2g-positive isolates, but with lower amounts of Stx2B subunit in those supernatants where phages could not be detected.Taking into account all the results, several differences could be found among stx2g-positive strains. The strain with the highest cytotoxic titer showed higher levels of stx2-phages and toxin production by EIA, and the opposite was observed for strains that previously showed low cytotoxic titers, confirming that in stx2g-positive strains Stx production is

  13. Evaluation of beef trim sampling methods for detection of Shiga toxin-producing Escherichia coli (STEC)

    Science.gov (United States)

    Presence of Shiga toxin-producing Escherichia coli (STEC) is a major concern in ground beef. Several methods for sampling beef trim prior to grinding are currently used in the beef industry. The purpose of this study was to determine the efficacy of the sampling methods for detecting STEC in beef ...

  14. Comparative Genomics and Characterization of Hybrid Shigatoxigenic and Enterotoxigenic Escherichia coli (STEC/ETEC) Strains

    Science.gov (United States)

    Nyholm, Outi; Halkilahti, Jani; Wiklund, Gudrun; Okeke, Uche; Paulin, Lars; Auvinen, Petri; Haukka, Kaisa; Siitonen, Anja

    2015-01-01

    Background Shigatoxigenic Escherichia coli (STEC) and enterotoxigenic E. coli (ETEC) cause serious foodborne infections in humans. These two pathogroups are defined based on the pathogroup-associated virulence genes: stx encoding Shiga toxin (Stx) for STEC and elt encoding heat-labile and/or est encoding heat-stable enterotoxin (ST) for ETEC. The study investigated the genomics of STEC/ETEC hybrid strains to determine their phylogenetic position among E. coli and to define the virulence genes they harbor. Methods The whole genomes of three STEC/ETEC strains possessing both stx and est genes were sequenced using PacBio RS sequencer. Two of the strains were isolated from the patients, one with hemolytic uremic syndrome, and one with diarrhea. The third strain was of bovine origin. Core genome analysis of the shared chromosomal genes and comparison with E. coli and Shigella spp. reference genomes was performed to determine the phylogenetic position of the STEC/ETEC strains. In addition, a set of virulence genes and ETEC colonization factors were extracted from the genomes. The production of Stx and ST were studied. Results The human STEC/ETEC strains clustered with strains representing ETEC, STEC, enteroaggregative E. coli, and commensal and laboratory-adapted E. coli. However, the bovine STEC/ETEC strain formed a remote cluster with two STECs of bovine origin. All three STEC/ETEC strains harbored several other virulence genes, apart from stx and est, and lacked ETEC colonization factors. Two STEC/ETEC strains produced both toxins and one strain Stx only. Conclusions This study shows that pathogroup-associated virulence genes of different E. coli can co-exist in strains originating from different phylogenetic lineages. The possibility of virulence genes to be associated with several E. coli pathogroups should be taken into account in strain typing and in epidemiological surveillance. Development of novel hybrid E. coli strains may cause a new public health risk, which

  15. Comparative Genomics and Characterization of Hybrid Shigatoxigenic and Enterotoxigenic Escherichia coli (STEC/ETEC Strains.

    Directory of Open Access Journals (Sweden)

    Outi Nyholm

    Full Text Available Shigatoxigenic Escherichia coli (STEC and enterotoxigenic E. coli (ETEC cause serious foodborne infections in humans. These two pathogroups are defined based on the pathogroup-associated virulence genes: stx encoding Shiga toxin (Stx for STEC and elt encoding heat-labile and/or est encoding heat-stable enterotoxin (ST for ETEC. The study investigated the genomics of STEC/ETEC hybrid strains to determine their phylogenetic position among E. coli and to define the virulence genes they harbor.The whole genomes of three STEC/ETEC strains possessing both stx and est genes were sequenced using PacBio RS sequencer. Two of the strains were isolated from the patients, one with hemolytic uremic syndrome, and one with diarrhea. The third strain was of bovine origin. Core genome analysis of the shared chromosomal genes and comparison with E. coli and Shigella spp. reference genomes was performed to determine the phylogenetic position of the STEC/ETEC strains. In addition, a set of virulence genes and ETEC colonization factors were extracted from the genomes. The production of Stx and ST were studied.The human STEC/ETEC strains clustered with strains representing ETEC, STEC, enteroaggregative E. coli, and commensal and laboratory-adapted E. coli. However, the bovine STEC/ETEC strain formed a remote cluster with two STECs of bovine origin. All three STEC/ETEC strains harbored several other virulence genes, apart from stx and est, and lacked ETEC colonization factors. Two STEC/ETEC strains produced both toxins and one strain Stx only.This study shows that pathogroup-associated virulence genes of different E. coli can co-exist in strains originating from different phylogenetic lineages. The possibility of virulence genes to be associated with several E. coli pathogroups should be taken into account in strain typing and in epidemiological surveillance. Development of novel hybrid E. coli strains may cause a new public health risk, which challenges the

  16. A polyclonal antibody based immunoassay detects seven subtypes of Shiga toxin 2 produced by Escherichia coli in human and environmental samples.

    Directory of Open Access Journals (Sweden)

    Xiaohua He

    Full Text Available BACKGROUND: Shiga toxin-producing Escherichia coli (STEC are frequent causes of severe human diseases ranging from diarrhea to hemolytic uremic syndrome. The existing strategy for detection of STEC relies on the unique sorbitol-negative fermentation property of the O157 strains, the most commonly identified serotype has been E. coli O157. It is becoming increasingly evident, however, that numerous non-O157 STEC serotypes also cause outbreaks and severe illnesses. It is necessary to have new methods that are capable of detecting all STEC strains. METHODS AND FINDINGS: Here we describe the development of a sandwich ELISA assay for detecting both O157 and non-O157 STECs by incorporating a novel polyclonal antibody (pAb against Stx2. The newly established immunoassay was capable of detecting Stx2a spiked in environmental samples with a limit of detection between 10 and 100 pg/mL in soil and between 100 and 500 pg/mL in feces. When applied to 36 bacterial strains isolated from human and environmental samples, this assay detected Stx2 in all strains that were confirmed to be stx2-positive by real-time PCR, demonstrating a 100% sensitivity and specificity. CONCLUSIONS: The sandwich ELISA developed in this study will enable any competent laboratory to identify and characterize Stx2-producing O157 and non-O157 strains in human and environmental samples, resulting in rapid diagnosis and patient care. The results of epitope mapping from this study will be useful for further development of a peptide-based antibody and vaccine.

  17. Evaluation of the performance of the IQ-Check kits and the USDA Microbiology Laboratory Guidebook methods for detection of Shiga toxin-producing Escherichia coli (STEC) and STEC and Salmonella simultaneously in ground beef.

    Science.gov (United States)

    Baranzoni, G M; Fratamico, P M; Boccia, F; Bagi, L K; Kim, G-H; Anastasio, A; Pepe, T

    2017-03-01

    To evaluate the performance of the IQ-Check kits and the USDA Microbiology Laboratory Guidebook (MLG) methods for detection of the top seven Shiga toxin-producing Escherichia coli (STEC) (O157:H7, O26, O45, O103, O111, O121 and O145) in ground beef and both STEC and Salmonella in co-inoculated samples. Ground beef samples inoculated with ~10 CFU of STEC or both STEC and Salmonella Typhimurium were stored at 4°C for 72 h, followed by screening with the IQ-Check and BAX System kit (MLG) methods that employ different enrichment media. STEC and S. Typhimurium were detected after 12 and 18 h and their presence was confirmed by colony isolation. Both methods were able to detect STEC in ground beef after 12 h of enrichment in samples inoculated with low levels of the pathogen. STEC and S. Typhimurium can be detected and isolated in co-inoculated ground beef samples. The IQ-Check methods are comparable to the MLG methods for detection of STEC and simultaneous detection of STEC and S. Typhimurium in seeded ground beef after a short enrichment time, thus the IQ-Check method can be useful for the food industry for rapid detection of these pathogens. Published 2016. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

  18. Ionospheric tomography by gradient-enhanced kriging with STEC measurements and ionosonde characteristics

    Science.gov (United States)

    Minkwitz, David; van den Boogaart, Karl Gerald; Gerzen, Tatjana; Hoque, Mainul; Hernández-Pajares, Manuel

    2016-11-01

    The estimation of the ionospheric electron density by kriging is based on the optimization of a parametric measurement covariance model. First, the extension of kriging with slant total electron content (STEC) measurements based on a spatial covariance to kriging with a spatial-temporal covariance model, assimilating STEC data of a sliding window, is presented. Secondly, a novel tomography approach by gradient-enhanced kriging (GEK) is developed. Beyond the ingestion of STEC measurements, GEK assimilates ionosonde characteristics, providing peak electron density measurements as well as gradient information. Both approaches deploy the 3-D electron density model NeQuick as a priori information and estimate the covariance parameter vector within a maximum likelihood estimation for the dedicated tomography time stamp. The methods are validated in the European region for two periods covering quiet and active ionospheric conditions. The kriging with spatial and spatial-temporal covariance model is analysed regarding its capability to reproduce STEC, differential STEC and foF2. Therefore, the estimates are compared to the NeQuick model results, the 2-D TEC maps of the International GNSS Service and the DLR's Ionospheric Monitoring and Prediction Center, and in the case of foF2 to two independent ionosonde stations. Moreover, simulated STEC and ionosonde measurements are used to investigate the electron density profiles estimated by the GEK in comparison to a kriging with STEC only. The results indicate a crucial improvement in the initial guess by the developed methods and point out the potential compensation for a bias in the peak height hmF2 by means of GEK.

  19. Virulence Profiling of Shiga Toxin-Producing Escherichia coli Recovered from Domestic Farm Animals in Northwestern Mexico

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    Bianca Anabel Amézquita-López

    2014-01-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC is a zoonotic enteric pathogen that causes human gastrointestinal illnesses. The present study characterized the virulence profiles of O157 and non-O157 STEC strains, recovered from domestic animals in small rural farms within the agricultural Culiacan Valley in Mexico. Virulence genes coding for adhesins, cytotoxins, proteases, subtypes of Shiga toxin (Stx, and other effectors were identified in the STEC strains by PCR. The genotyping analysis revealed the presence of the effectors nleA, nleB, nleE and nleH1-2, espK, and espN in the O157:H7 and O111:H8 STEC strains. Furthermore, the genes encoding the autoagglutinating adhesin (Saa and subtilase (SubA were exclusively identified in the O8:H19 eae-negative strains. The adhesin (iha and the silent hemolysin (sheA genes were detected in 79% of the O157 and non-O157 strains. To examine the relative toxicities of the STEC strains, a fluorescent Vero cell line, Vero-d2EGFP, was employed to measure the inhibition of protein synthesis by Stx. Analysis of culture supernatants from serotype O8:H19 strains with the stx gene profile stx1a, stx2a and stx2c and serotypes O75:H8 and O146:H8 strains with the stx gene profile stx1a, stx1c and stx2b, resulted in a significant reduction in the Vero-d2EGFP fluorescent signal. These observations suggest that these non-O157 strains may have an enhanced ability to inhibit protein synthesis in Vero cells. Interestingly, analysis of the stx2c-positive O157:H7 strains resulted in a high fluorescent signal, indicating a reduced toxicity in the Vero-d2EGFP cells. These findings indicate that the O157 and non-O157 STEC strains, recovered in the Culiacan Valley, display distinct virulence profiles and relative toxicities in mammalian cells and have provided information for evaluating risks associated with zoonotic STEC in this agricultural region in Mexico.

  20. Antibiotic resistance and integrons in Shiga toxin-producing Escherichia coli (STEC).

    Science.gov (United States)

    Colello, Rocío; Etcheverría, Analía I; Di Conza, Jose A; Gutkind, Gabriel O; Padola, Nora L

    2015-03-01

    Shiga toxin-producing Escherichia coli (STEC) cause hemorrhagic colitis (HC) and hemolytic-uremic syndrome in humans (HUS). Cattle are the main reservoir of STEC and transmission to humans occurs through contaminated food and water. Antibiotics are used in pig production systems to combat disease and improve productivity and play a key role in the dissemination of antibiotic resistance genes to the bacteria. Integrons have been identified in resistant bacteria allowing for the acquisition and dissemination of antibiotic resistance genes. STEC strains isolated from humans and animals have developed antibiotic resistance. In our laboratory, 21 non-157 STEC strains isolated from pigs were analyzed to detect class 1 and 2 integrons by PCR. Eight carried integrons, 7 of them harbored intl2. In another study 545 STEC strains were also analyzed for the presence of intl1 and intl2 . Strains carrying intl1 belonged to isolates from environment (n = 1), chicken hamburger (n = 2), dairy calves (n = 4) and pigs (n = 8). Two strains isolated from pigs harbored intl2 and only one intl1 / intl2 , highlighting the presence of intl2 in pigs. The selection for multiresistant strains may contribute to the emergence of antibiotic resistant pathogens and facilitate the spreading of the mobile resistance elements to other bacteria.

  1. Antibiotic resistance and integrons in Shiga toxin-producing Escherichia coli (STEC

    Directory of Open Access Journals (Sweden)

    Rocío Colello

    2015-03-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC cause hemorrhagic colitis (HC and hemolytic-uremic syndrome in humans (HUS. Cattle are the main reservoir of STEC and transmission to humans occurs through contaminated food and water. Antibiotics are used in pig production systems to combat disease and improve productivity and play a key role in the dissemination of antibiotic resistance genes to the bacteria. Integrons have been identified in resistant bacteria allowing for the acquisition and dissemination of antibiotic resistance genes. STEC strains isolated from humans and animals have developed antibiotic resistance. In our laboratory, 21 non-157 STEC strains isolated from pigs were analyzed to detect class 1 and 2 integrons by PCR. Eight carried integrons, 7 of them harbored intl2. In another study 545 STEC strains were also analyzed for the presence of intl1 and intl2. Strains carrying intl1 belonged to isolates from environment (n = 1, chicken hamburger (n = 2, dairy calves (n = 4 and pigs (n = 8. Two strains isolated from pigs harbored intl2 and only one intl1/intl2, highlighting the presence of intl2 in pigs. The selection for multiresistant strains may contribute to the emergence of antibiotic resistant pathogens and facilitate the spreading of the mobile resistance elements to other bacteria.

  2. Antibiotic resistance and integrons in Shiga toxin-producing Escherichia coli (STEC)

    Science.gov (United States)

    Colello, Rocío; Etcheverría, Analía I.; Conza, Jose A. Di; Gutkind, Gabriel O.; Padola, Nora L.

    2015-01-01

    Shiga toxin-producing Escherichia coli (STEC) cause hemorrhagic colitis (HC) and hemolytic-uremic syndrome in humans (HUS). Cattle are the main reservoir of STEC and transmission to humans occurs through contaminated food and water. Antibiotics are used in pig production systems to combat disease and improve productivity and play a key role in the dissemination of antibiotic resistance genes to the bacteria. Integrons have been identified in resistant bacteria allowing for the acquisition and dissemination of antibiotic resistance genes. STEC strains isolated from humans and animals have developed antibiotic resistance. In our laboratory, 21 non-157 STEC strains isolated from pigs were analyzed to detect class 1 and 2 integrons by PCR. Eight carried integrons, 7 of them harbored intl2. In another study 545 STEC strains were also analyzed for the presence of intl1 and intl2 . Strains carrying intl1 belonged to isolates from environment (n = 1), chicken hamburger (n = 2), dairy calves (n = 4) and pigs (n = 8). Two strains isolated from pigs harbored intl2 and only one intl1 / intl2 , highlighting the presence of intl2 in pigs. The selection for multiresistant strains may contribute to the emergence of antibiotic resistant pathogens and facilitate the spreading of the mobile resistance elements to other bacteria. PMID:26221083

  3. Evaluation of the performance of the IQ-check kits and the USDA microbiology laboratory guidebook methods for detection of Shiga Toxin-Producing E. coli (STEC) and STEC and Salmonella simultaneously in ground beef

    Science.gov (United States)

    Aims: To evaluate the performance of the IQ-Check kits and the USDA Microbiology Laboratory Guidebook (MLG) methods for detection of the top 7 Shiga toxin-producing E. coli (STEC) (O157:H7, O26, O45, O103, O111, O121, and O145) in ground beef and both STEC and Salmonella in co-inoculated samples. M...

  4. Shiga toxin-producing Escherichia coli (STEC) from Humans in the Netherlands : Novel diagnostic approach, molecular characterization and phylogenetic background

    NARCIS (Netherlands)

    Ferdous, Mithila

    2017-01-01

    The shiga toxin-producing Escherichia coli (STEC) bacterium poses a serious public health risk as it can cause life threatening condition hemorrhagic colitis and hemolytic uremic syndrome besides diarrhea. STEC is associated with several food related outbreaks worldwide, including the famous one in

  5. Shiga toxin-producing Escherichia coli (STEC) from Humans in the Netherlands : Novel diagnostic approach, molecular characterization and phylogenetic background

    NARCIS (Netherlands)

    Ferdous, Mithila

    2017-01-01

    The shiga toxin-producing Escherichia coli (STEC) bacterium poses a serious public health risk as it can cause life threatening condition hemorrhagic colitis and hemolytic uremic syndrome besides diarrhea. STEC is associated with several food related outbreaks worldwide, including the famous one in

  6. Shiga toxin-producing Escherichia coli (STEC) O157 outbreak, The Netherlands, September - October 2005.

    NARCIS (Netherlands)

    Doorduyn, Y; Jager, C M de; Zwaluw, W K; Friesema, Ihm; Heuvelink, Ae; Boer, E de; Wannet, W J B; Duynhoven, Y T H P van

    2006-01-01

    In September 2005, the first national food-related outbreak of Shiga toxin (Stx)-producing Escherichia coli (STEC) O157 was investigated in the Netherlands. A total of 21 laboratory-confirmed cases (including one secondary case), and another 11 probable cases (two primary and nine secondary cases) w

  7. Genotypes and phenotypes of Shiga toxin-producing Escherichia coli (STEC in Abeokuta, Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    Olowe OA

    2014-10-01

    Full Text Available Olugbenga Adekunle Olowe,1 Bukola W Aboderin,1,2 Olayinka O Idris,3 Victor O Mabayoje,4 Oluyinka O Opaleye,1 O Catherine Adekunle,1 Rita Ayanbolade Olowe,1 Paul Akinniyi Akinduti,5 Olusola Ojurongbe1 1Department of Medical Microbiology and Parasitology, College of Health Sciences, Osogbo, Osun State, Nigeria; 2Medical Microbiology Unit, Pathology Department, Federal Medical Centre, Abeokuta, Nigeria; 3Department of Microbiology, College of Sciences, Afe Babalola University, Ado Ekiti, Nigeria; 4Department of Haematology, College of Health Sciences, Ladoke Akintola University, Osogbo, Osun State, Nigeria; 5Department of Medical Microbiology and Parasitology, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria Purpose: To characterize the prevalence of hemolytic Shiga toxin-producing Escherichia coli (STEC with a multidrug-resistant pattern in different age groups in Abeokuta, Nigeria. Methods: Nonrepetitive E. coli isolates were collected from 202 subjects with or without evidence of diarrhea. Each isolate was biochemically identified and antimicrobial susceptibility testing was performed using the disk diffusion method. A sorbitol fermentation test of all the E. coli isolates was done and the minimum inhibitory concentration of suspected STEC was measured by the standard broth microdilution method to determine antibiotic resistance. The genotypes of stx1, stx2, and hlyA were determined by polymerase chain reaction assay. Results: The majority of subjects were aged ≥40 years (41.6% and were female (61.9%. Of the 202 subjects, 86.1% had STEC isolates (P<0.05. A high rate of STEC isolates resistant to amoxicillin (90.6%, cefotaxime (77.7%, and cefuroxime (75.7% was observed. Resistance to amoxicillin, gentamicin, and cefotaxime was demonstrated with a minimum inhibitory concentration >16 µg/mL in 13.9%, 11.4%, and 10.4% of the isolates, respectively. The prevalence of stx1, stx2, and hlyA was 13.9%, 6.9%, and 2.0%, respectively; 5.5% of

  8. Hybrids of Shigatoxigenic and Enterotoxigenic Escherichia coli (STEC/ETEC) Among Human and Animal Isolates in Finland.

    Science.gov (United States)

    Nyholm, O; Heinikainen, S; Pelkonen, S; Hallanvuo, S; Haukka, K; Siitonen, A

    2015-11-01

    Diarrhoeagenic Escherichia coli (DEC) cause serious foodborne infections in humans. Total of 450 Shigatoxigenic E. coli (STEC) strains isolated from humans, animals and environment in Finland were examined by multiplex PCR targeting the virulence genes of various DEC pathogroups simultaneously. One per cent (3/291) of the human STEC and 14% (22/159) of the animal and environmental STEC had genes typically present in enterotoxigenic E. coli (ETEC). The strains possessed genes encoding both Shiga toxin 1 and/or 2 (stx1 and/or stx2 ) and ETEC-specific heat-stable (ST) enterotoxin Ia (estIa). The identified stx subtypes were stx1a, stx1c, stx2a, stx2d and stx2g. The three human STEC/ETEC strains were isolated from the patients with haemolytic uraemic syndrome and diarrhoea and from an asymptomatic carrier. The animal STEC/ETEC strains were isolated from cattle and moose. The human and animal STEC/ETEC strains belonged to 11 serotypes, of which O2:H27, O15:H16, O101:H-, O128:H8 and O141:H8 have previously been described to be associated with human disease. Identification of multiple virulence genes offers further information for assessing the virulence potential of STEC and other DEC. The emergence of novel hybrid pathogens should be taken into account in the patient care and epidemiological surveillance.

  9. Rapid detection of E. coli produced shiga-like toxins by lateral flow immunoassay in multiple food matrices

    Science.gov (United States)

    Shiga toxigenic E. coli (STEC) produce shiga-like toxins (Stx) that can cause human disease and death. The STEC serotype O157:H7 is a well-recognized foodborne contaminant and effective detection methods have been established. However, the emergence of non-O157 STEC strains has necessitated the deve...

  10. EFSA Panel on Biological Hazards (BIOHAZ); Scientific Opinion on the risk posed by Shiga toxinproducing Escherichia coli (STEC) and other pathogenic bacteria in seeds and sprouted seeds

    DEFF Research Database (Denmark)

    Hald, Tine

    Sprouted seeds are young seedlings obtained from the germination of seeds. They are ready-to-eat foods which have caused large outbreaks. The bacterial pathogens most frequently associated with illness due to contaminated sprouted seeds are Salmonella and to a lesser extent STEC. Bacillus cereus...... be contaminated during production, harvest, storage and transport, and there may be difficulties in traceability of seeds from production to sprouting. Bacterial pathogens on seeds may survive for long periods during seed storage. There is so far no guarantee of a bactericidal step which is able to control...... contamination of seeds with bacterial foodborne pathogens acquired prior to germination. Due to the high humidity and the favourable temperature during sprouting, bacterial pathogens present on dry seeds can multiply on the sprouts. Contamination with pathogenic bacteria must be minimized by identification...

  11. Shiga toxin-producing Escherichia coli in beef retail markets from Argentina

    Directory of Open Access Journals (Sweden)

    Victoria eBrusa

    2013-01-01

    Full Text Available Shiga toxing-producing Escherichia coli (STEC are foodborne pathogens that cause mild or serious diseases and can lead to people death. This study reports the prevalence and characteristics of STEC O157 and non-O157 in commercial ground beef and environmental samples, including meat table, knife, meat mincing machine and manipulator hands (n= 450 obtained from 90 retail markets over a nine-month period. The STEC isolates were serotyped and virulence genes as stx (Shiga toxin, rfbO157 (O157 lipopolysaccharide, fliCH7 (H7 flagellin, eae (intimin, ehxA (enterohemolysin and saa (STEC autoagglutinating adhesin, were determined. STEC O157 were identified in 23 (25.5% beef samples and 16 (4.4% environmental samples, while STEC non-O157 were present in 47 (52.2% and 182 (50.5%, respectively. Among 54 strains isolated, 17 were STEC O157:H7 and 37 were STEC non-O157. The prevalent genotype for O157 was stx2/eae/ehxA/fliCH7 (83.4%, and for STEC non-O157 the most frequent ones were stx1/stx2/saa/ehxA (29.7%; stx2 (29.7%; and stx2/saa/ehxA (27%. None of the STEC non-O157 strains were eae-positive. Besides O157:H7, other 20 different serotypes were identified, being O8:H19, O178:H19 and O174:H28 the prevalent. Strains belonging to the same serotype could be isolated from different sources of the same retail market. Also, the same serotype could be detected in different stores. In conclusion, screening techniques are increasingly sensitive, but the isolation of STEC non-O157 is still a challenge. Moreover, with the results obtained from the present work, although more studies are needed, cross-contamination between meat and the environment could be suspected.

  12. Shiga toxin-producing Escherichia coli (STEC): Zoonotic risks associated with psittacine pet birds in home environments.

    Science.gov (United States)

    Gioia-Di Chiacchio, R M; Cunha, M P V; Sturn, R M; Moreno, L Z; Moreno, A M; Pereira, C B P; Martins, F H; Franzolin, M R; Piazza, R M F; Knöbl, T

    2016-02-29

    Psittacidae are frequently bred as pets worldwide, but little is known about the zoonotic risks of these animals. The objective of this study was to investigate the presence of Shiga toxin-producing Escherichia coli (STEC) in the feces of psittacine birds housed as pets. A total of 171 fecal samples (67 cockatiels, 59 budgerigars, and 45 agapornis) were cultured. Forty-two (E. coli) strains were identified, and the presence of the eae, stx1, and stx2 genes was determined using PCR. The antimicrobial resistance profiles of the STEC strains were determined using the disk diffusion method and phylogenetic analysis according to the new Clermont phylotyping method. Using these methods, 19.4% (8/42) of the STEC strains were determined to be positive for the eae and stx2 genes. The results revealed a STEC frequency of 4.6% in the birds (8/171), with a percentage of 8.47% in budgerigars (5/59), 4.47% in cockatiels (3/67), and 0% in agapornis (0/45). None of the STEC isolates belonged to the O157 serogroup. Most of the strains were classified as sensitive to the 18 antibiotics tested. None of the strains exhibited a multiresistance profile. In the phylogenetic analysis, two strains were classified as non-typeable, three were classified as B2, two were classified as F, and one was classified as Clade I. Seven of the eight STEC strains showed a clonal profile using AFLP. E. coli strains that are stx2(+) plus eae(+) are usually associated with severe human diseases such as hemorrhagic colitis and hemolytic-uremic syndrome. The STEC-positive results indicate the zoonotic risk of breeding psittacidae in home environments.

  13. Role of verocytotoxigenic Escherichia coli in the swine production chain

    Directory of Open Access Journals (Sweden)

    Laura Ercoli

    2015-06-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC can cause severe clinical diseases in humans, such as haemorrhagic colitis (HC and haemolytic-uremic syndrome (HUS. Although ruminants, primarily cattle, have been suggested as typical reservoirs of STEC, many food products of other origins, including pork products, have been confirmed as vehicles for STEC transmission. Only in rare cases, pork consumption is associated with severe clinical symptoms caused by high pathogenic STEC strains. However, in these outbreaks, it is unknown whether the contamination of food products occurs during swine processing or via cross-contamination from foodstuffs of different sources. In swine, STEC plays an important role in the pathogenesis of oedema disease. In particular a Shiga toxin subtype, named stx2e, it is considered as a key factor involved in the damage of swine endothelial cells. On the contrary, stx2e-producing Escherichia coli has rarely been isolated in humans, and usually only from asymptomatic carriers or from patients with mild symptoms, such as uncomplicated diarrhoea. In fact, the presence of gene stx2e, encoding for stx2e, has rarely been reported in STEC strains that cause HUS. Moreover, stx2e-producing STEC isolated from humans and pigs were found to differ in serogroup, their virulence profile and interaction with intestinal epithelial cells. Because of the limited epidemiologic data of STEC in swine and the increasing role of non-O157 STEC in human illnesses, the relationship between swine STEC and human disease needs to be further investigated.

  14. Emergence of Escherichia coli encoding Shiga toxin 2f in human Shiga toxin-producing E-coli (STEC) infections in the Netherlands, January 2008 to December 2011

    NARCIS (Netherlands)

    Friesema, I.; van der Zwaluw, K.; Schuurman, T.; Kooistra-Smid, M.; Franz, E.; van Duynhoven, Y.; van Pelt, W.

    2014-01-01

    The Shiga toxins of Shiga toxin-producing Escherichia coli (STEC) can be divided into Shiga toxin 1 (Stx1) and Shiga toxin 2 (Stx2) with several sub-variants. Variant Stx(2f) is one of the latest described, but has been rarely associated with symptomatic human infections. In the enhanced STEC survei

  15. Evaluation of a multiplex real-time PCR method for detecting shiga toxin-producing Escherichia coli in beef and comparison to the U.S. Department of Agriculture Food Safety and Inspection Service Microbiology laboratory guidebook method.

    Science.gov (United States)

    Fratamico, Pina M; Wasilenko, Jamie L; Garman, Bradley; Demarco, Daniel R; Varkey, Stephen; Jensen, Mark; Rhoden, Kyle; Tice, George

    2014-02-01

    The "top-six" non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups (O26, O45, O103, O111, O121, and O145) most frequently associated with outbreaks and cases of foodborne illnesses have been declared as adulterants in beef by the U.S. Department of Agriculture Food Safety and Inspection Service (FSIS). Regulatory testing in beef began in June 2012. The purpose of this study was to evaluate the DuPont BAX System method for detecting these top six STEC strains and strains of E. coli O157:H7. For STEC, the BAX System real-time STEC suite was evaluated, including a screening assay for the stx and eae virulence genes and two panel assays to identify the target serogroups: panel 1 detects O26, O111, and O121, and panel 2 detects O45, O103, O145. For E. coli O157:H7, the BAX System real-time PCR assay for this specific serotype was used. Sensitivity of each assay for the PCR targets was ≥1.23 × 10(3) CFU/ml in pure culture. Each assay was 100% inclusive for the strains tested (20 to 50 per assay), and no cross-reactivity with closely related strains was observed in any of the assays. The performance of the BAX System methods was compared with that of the FSIS Microbiology Laboratory Guidebook (MLG) methods for detection of the top six STEC and E. coli O157:H7 strains in ground beef and beef trim. Generally, results of the BAX System method were similar to those of the MLG methods for detecting non-O157 STEC and E. coli O157:H7. Reducing or eliminating novobiocin in modified tryptic soy broth (mTSB) may improve the detection of STEC O111 strains; one beef trim sample inoculated with STEC O111 produced a negative result when enriched in mTSB with 8 mg/liter novobiocin but was positive when enriched in mTSB without novobiocin. The results of this study indicate the feasibility of deploying a panel of real-time PCR assay configurations for the detection and monitoring of the top six STEC and E. coli O157:H7 strains in beef. The approach could easily be adapted

  16. Shiga toxin-producing Escherichia coli (STEC: principal virulence factors and epidemiology Escherichia coli produtora de toxina shiga (STEC: principais fatores de virulência e dados epidemiológicos

    Directory of Open Access Journals (Sweden)

    Halha Ostrensky Saridakis

    2007-10-01

    Full Text Available Shiga toxin producing Escherichia coli is an important food borne pathogen, mainly beef products, and is associated to mild and severe bloody diarrhea. In some individuals, STEC infection can progress to hemolytic-uremic syndrome (HUS, a sequela characterized by renal failure, and thrombotic thrombocytopenic purpura (TTP, with possible central nervous system involvement. Cattle, usually healthy, is the principal reservoir of STEC, although these strains have also been isolated from other domestic animals: sheep, goats, dogs, cats and pigs. The principal virulence feature, the production of Shiga toxins, is not enough to cause diseases, and other factors are considered important, as enterohemolysin and fimbrial and afimbrial adhesions production. Although human diseases associated to STEC have not been frequently reported in Brazil, their presence is frequent in cattle, as well as the correlation between serotypes found in these animals and human patients. Escherichia coli produtora de toxina Shiga (STEC é um importante patógeno veiculado por alimentos, principalmente produtos derivados de carne bovina e está associado a quadros de diarréias leves a severas e sanguinolentas. Em alguns indivíduos, a infecção por STEC pode progredir para a síndrome hemolítico-urêmica (HUS, seqüela caracterizada pela falência renal e a púrpura trombocitopênica trombótica (TTP, com possível envolvimento do sistema nervoso central. O gado bovino, geralmente saudável, é o principal reservatório de STEC, embora estas cepas também tenham sido isoladas de outros animais domésticos: ovelhas, cabras, cães, gatos e suínos. A principal característica de virulência, a produção de toxinas Shiga, não é suficiente para causar doenças e outros fatores são considerados relevantes, como a produção de enterohemolisina e de adesinas fimbriais e afimbriais. Embora as doenças humanas associadas a STEC sejam pouco descritas no Brasil, podemos observar

  17. Molecular screening of bovine raw milk for the presence of Shiga toxin-producing Escherichia coli (STEC on dairy farms

    Directory of Open Access Journals (Sweden)

    Tatiane Vendramin

    2014-09-01

    Full Text Available Milkborne transmission of Shiga toxin- producing Escherichia coli (STEC has raised considerable concern due to recent outbreaks worldwide and poses a threat to public health. The aim of this study was to develop a sensitive and specific multiplex PCR assay to detect the presence of STEC in bovine raw milk. To identify E. coli (ATCC 25922 contamination, the gene uspA was used, and PCR sensitivity and specificity were accessed by testing diluted samples ranging from 2 to 2.0 × 10(6 CFU/mL. To detect STEC, the stx1 and stx2 genes were selected as targets. After reaction standardization, the multiplex assay was tested in raw milk collected from 101 cows on dairy farms. PCR assay for E. coli detection had a specificity of 100% and sensitivity of 79% (P<0.0001, with a lower detection limit of 2 CFU/mL. Multiplex PCR assay had 100% sensitivity for E. coli positive raw milk samples, and 31.1% were contaminated with STEC, 28.3% of stx2, and 1.9% of stx1. The multiplex PCR assay described in the present study can be employed to identify and screen E. coli harboring stx1 and stx2 genes in raw milk on dairy farms and in industries.

  18. Simultaneous direct detection of Shiga-toxin producing Escherichia coli (STEC) strains by gold nanoparticle optical sensing

    Science.gov (United States)

    Shiga-toxin producing Escherichia coli (STEC) strains (“Big Six” – O26, O45, O103, O111, O121, O145, and O157) represent significant groups of pathogens responsible for foodborne diseases. The objective of this study was to develop a colorimetric optical sensing assay that can simultaneously detect ...

  19. Factors associated with regulatory action involving investigation of illnesses associated with Shiga toxin-producing Escherichia coli in products regulated by the Food Safety and Inspection Service.

    Science.gov (United States)

    Green, Alice L; Seys, Scott; Douris, Aphrodite; Levine, Jeoff; Robertson, Kis

    2014-07-01

    We described characteristics of the Escherichia coli O157 and Escherichia coli non-O157 illness investigations conducted by the United States Department of Agriculture's Food Safety and Inspection Service (FSIS) during the 5-year period from 2006 through 2010. We created a multivariable logistic regression model to determine characteristics of these investigations that were associated with FSIS regulatory action, which was defined as having occurred if a product recall occurred or if FSIS personnel performed an environmental health assessment (Food Safety Assessment) at the implicated establishment. During this period, FSIS took regulatory action in 38 of 88 (43%) investigations. Illness investigations in which FoodNet states were involved were more likely to result in regulatory action. Illness investigations in which state and local traceback, or FSIS traceback occurred were more likely to result in regulatory action. Reasons for lack of action included evidence of cross-contamination after the product left a regulated establishment, delayed notification, lack of epidemiological information, and insufficient product information.

  20. 77 FR 9888 - Shiga Toxin-Producing Escherichia coli

    Science.gov (United States)

    2012-02-21

    ... Food Safety and Inspection Service Shiga Toxin-Producing Escherichia coli in Certain Raw Beef Products... manufacturing trimmings for six non-O157 Shiga toxin-producing Escherichia coli (STEC) serogroups (O26, O45..., non-intact product, that are contaminated with Shiga toxin-producing Escherichia coli (STEC) O26,...

  1. Cytolethal distending toxin from Shiga toxin-producing Escherichia coli O157 causes irreversible G2/M arrest, inhibition of proliferation, and death of human endothelial cells

    NARCIS (Netherlands)

    Bielaszewska, Martina; Sinha, Bhanu; Kuczius, Thorsten; Karch, Helge

    2005-01-01

    Recently, cytolethal distending toxin V (CDT-V), a new member of the CDT family, was identified in Shiga toxin-producing Escherichia coli (STEC) O157 and particular non-O157 serotypes. Here we investigated the biological effects of CDT-V from STEC O157:H(-) (strain 493/89) on human endothelial cells

  2. The long polar fimbriae of STEC O157:H7 induce expression of pro-inflammatory markers by intestinal epithelial cells.

    Science.gov (United States)

    Farfan, Mauricio J; Cantero, Lidia; Vergara, Alejandra; Vidal, Roberto; Torres, Alfredo G

    2013-03-15

    Infection with Shiga toxin-producing Escherichia coli (STEC) O157:H7 is characterized by acute inflammation of the colonic mucosa. STEC O157:H7 contains two non-identical loci encoding long polar fimbriae (Lpf), which play a role in the STEC colonization of the intestinal epithelial cells. However, no information is available regarding the involvement of Lpf in the STEC-induced host inflammatory response. Hence, in this study we assess the role of Lpf as an inducer of inflammation on intestinal epithelial cells. Secretion of pro-inflammatory cytokines in response to STEC wild type and lpf isogenic mutants was evaluated on intestinal T84 cells. Of the 27 cytokines assayed, IL-6, IL-8, IL-15, FGF, GM-CSF and IP-10 were significantly reduced, when compared to the wild-type strain, in the lpfA1 lpfA2 double mutant. Further, the host intracellular signaling pathways activated in response to Lpf were determined by using an array containing genes representative of 18 different signal transduction pathways. The analysis indicated that the NF-κB pathway is activated in response to Lpf-expressing STEC. Therefore, our study supports the role of Lpf as a STEC factor mediating intestinal inflammation.

  3. Incidencia, comportamiento y control de tipos pat??genos de "Escherichia coli" (STEC y EPEC) en leche y queso de oveja

    OpenAIRE

    Otero ??lvarez, Ver??nica

    2014-01-01

    302 p. Existen seis grupos de E. coli asociados a enfermedad intestinal en humanos. Esta tesis se ha centrado en el estudio de dos de ellos (patotipo productor de toxinas Shiga ??STEC- y enteropatog??nico ??EPEC-). Se han descrito brotes debidos a cepas STEC relacionados con leche y productos l??cteos de origen bovino y tambi??n se han aislado cepas STEC de leche y queso de oveja. Asimismo, se han aislado cepas at??picas de EPEC (aEPEC) de animales dom??sticos, entre ellos, de ganado ovino...

  4. Chromogenic agar medium for detection and isolation of Escherichia coli serogroups O26, O45, O103, O111, O121, and O145 from fresh beef and cattle feces.

    Science.gov (United States)

    Kalchayanand, Norasak; Arthur, Terrance M; Bosilevac, Joseph M; Wells, James E; Wheeler, Tommy L

    2013-02-01

    Non-O157 Shiga toxin-producing Escherichia coli (STEC) strains are clinically important foodborne pathogens. Unlike E. coli O157:H7, these foodborne pathogens have no unique biochemical characteristics to readily distinguish them from other E. coli strains growing on plating media. In this study, a chromogenic agar medium was developed in order to differentiate among non-O157 STEC strains of serogroups O26, O45, O103, O111, O121, and O145 on a single agar medium. The ability of this chromogenic agar medium to select and distinguish among these pathogens is based on a combination of utilization of carbohydrates, b -galactosidase activity, and resistance to selective agents. The agar medium in combination with immunomagnetic separation was evaluated and successfully allowed for the detection and isolation of these six serogroups from artificially contaminated fresh beef. The agar medium in combination with immunomagnetic separation also allowed successful detection and isolation of naturally occurring non-O157 STEC strains present in cattle feces. Thirty-five strains of the top six non-O157 STEC serogroups were isolated from 1,897 fecal samples collected from 271 feedlot cattle. This chromogenic agar medium could help significantly in routine screening for the top six non-O157 STEC serogroups from beef cattle and other food.

  5. Survey on the occurrence of shiga toxin producing strains of Escherichia coli (STEC) in drinking water from central Hessia

    Energy Technology Data Exchange (ETDEWEB)

    Stelz, A.; Zschoeck, M. [Untersuchungsamt Hessen, Giessen (Germany); Fels, K.; Alter, E. [Fachhochschule Giessen-Friedberg, Giessen (Germany)

    2001-07-01

    Consumption of unheated bovine food is said to be the main cause of outbreaks of enterohemorrhagic colitis (EC) and hemolytic syndrome (HUS) by E. coli O157 in man. Some cases were attributed to the ingestion of contaminated drinking water. Certain types of resources for drinking water supply are at risk of contamination with cattle faeces or sewage. In routine drinking water control E. coli is an index organism and must not be found in a sample of 100 ml. We investigated a total of 1700 drinking water samples from central Hessia (Germany) for shiga toxin producing strains of E. coli (STEC). A developed sensitive investigation scheme made it possible to detect up to 10 STEC per 100 ml water sample at least. ELISA was used for detection of shiga toxins 1 and 2, m-PCR for the genes encoding stx1, stx2, EHEC-hlyA and eaeA, plating on Enterohemolysin agar for detection of the enterohemolysin phenotype and slide agglutination technique for confirming E. coli O157. In 108 out of 1700 drinking water samples E. coli was detected, but none of the isolates belonged to serotype O157. ST1 and ST2 were not produced by the isolates. Thus, under normal circumstances drinking water in central Hessia seems to be no vehicle for STEC. (orig.)

  6. Shiga Toxin–Producing Escherichia coli Infections Associated with Hemolytic Uremic Syndrome, Italy, 1988–2000

    Science.gov (United States)

    Caprioli, Alfredo; Minelli, Fabio; Gianviti, Alessandra; De Petris, Laura; Edefonti, Alberto; Montini, Giovanni; Ferretti, Alfonso; De Palo, Tommaso; Gaido, Maurizio; Rizzoni, Gianfranco

    2003-01-01

    The mean annual incidence of hemolytic uremic syndrome in persons <15 years of age in Italy from 1988 to 2000 was 0.28 per 100,000 population. Laboratory investigations showed that Shiga toxin–producing Escherichia coli (STEC) infection occurred in 73.1% of patients. STEC O157 was the most common serotype, but a considerable number of cases were from infections by non-O157 STEC. PMID:12533290

  7. Shiga toxin-producing Escherichia coli infections associated with hemolytic uremic syndrome, Italy, 1988-2000.

    Science.gov (United States)

    Tozzi, Alberto E; Caprioli, Alfredo; Minelli, Fabio; Gianviti, Alessandra; De Petris, Laura; Edefonti, Alberto; Montini, Giovanni; Ferretti, Alfonso; De Palo, Tommaso; Gaido, Maurizio; Rizzoni, Gianfranco

    2003-01-01

    The mean annual incidence of hemolytic uremic syndrome in persons STEC) infection occurred in 73.1% of patients. STEC O157 was the most common serotype, but a considerable number of cases were from infections by non-O157 STEC.

  8. Emerging types of Shiga toxin-producing E. coli (STEC O178 present in cattle, deer and humans from Argentina and Germany

    Directory of Open Access Journals (Sweden)

    Angelika eMiko

    2014-06-01

    Full Text Available More than 400 serotypes of Shiga toxin-producing Escherichia coli (STEC have been implicated in outbreaks and sporadic human diseases. In recent years STEC strains belonging to serogroup O178 have been commonly isolated from cattle and food of bovine origin in South America and Europe. In order to explore the significance of these STEC strains as potential human pathogens, 74 German and Argentinean E. coli O178 strains from animals, food and humans were characterized phenotypically and investigated for their serotypes, stx-genotypes and forty-three virulence-associated markers by a real-time PCR-microarray. The majority (n=66 of the O178 strains belonged to serotype O178:H19. The remaining strains divided into O178:H7 (n=6, O178:H10 (n=1 and O178:H16 (n=1. STEC O178:H19 strains were mainly isolated from cattle and food of bovine origin, but one strain was from a patient with hemolytic uremic syndrome (HUS. Genotyping of the STEC O178:H19 strains by pulsed-field gel electrophoresis revealed two major clusters of genetically highly related strains which differ in their stx-genotypes and non-Stx putative virulence traits, including adhesins, toxins and serine-proteases. Cluster A-strains including the HUS-strain (n=35 carried genes associated with severe disease in humans (stx2a, stx2d, ehxA, saa, subAB1, lpfAO113, terE combined with stx1a, espP, iha. Cluster B-strains (n=26 showed a limited repertoire of virulence genes (stx2c, pagC, lpfAO113, espP, iha. Among O178:H7 strains isolated from deer meat and patients with uncomplicated disease a new STEC variant was detected that is associated with the genotype stx1c/stx2b/ehxA/subAB2/espI/[terE]/espP/iha. None of the STEC O178 strains was positive for locus of enterocyte effacement (LEE- and nle-genes. Results indicate that STEC O178:H19 strains belong to the growing group of LEE-negative STEC that should be considered with respect to their potential to cause diseases in humans.

  9. Outbreak of Non-O157 Shiga Toxin-Producing Escherichia coli Infection from Consumption of Beef Sausage

    DEFF Research Database (Denmark)

    Ethelberg, S.; Smith, B.; Torpdahl, M.;

    2009-01-01

    We describe an outbreak of Shiga toxin-producing Escherichia coli O26: H11 infection in 20 patients (median age, 2 years). The source of the infection was an organic fermented beef sausage. The source was discovered by using credit card information to obtain and compare customer transaction records...

  10. Mental Illness

    Science.gov (United States)

    ... financial problems, a loved one's death or a divorce An ongoing (chronic) medical condition, such as diabetes ... years, but most begin earlier in life. The effects of mental illness can be temporary or long ...

  11. Molecular epidemiology of a household outbreak of Shiga-toxin-producing Escherichia coli in Poland due to secondary transmission of STEC O104:H4 from Germany.

    Science.gov (United States)

    Januszkiewicz, Aleksandra; Szych, Jolanta; Rastawicki, Waldemar; Wołkowicz, Tomasz; Chróst, Anna; Leszczyńska, Beata; Kuźma, Elżbieta; Roszkowska-Blaim, Maria; Gierczyński, Rafał

    2012-04-01

    We characterized two STEC O104 : H4 clinical isolates collected in Poland from a 7-year-old boy with haemolytic uraemic syndrome (HUS) and his nanny. This household outbreak began on 29 May 2011. Because of its time-frame, the outbreak was assumed to be part of the international STEC O104 : H4 outbreak that arose in Germany in May 2011. The two Polish isolates were Shiga-toxin-producing Escherichia coli (stx2 lpf) with enteroaggregative E. coli pathotype (aggR aap aggA), thereby sharing the unique virulence properties of the epidemic STEC O104 : H4 strain from the international outbreak. The Polish isolates were multi-drug resistant and carried bla(TEM), strA, strB, tetA, sul1 and sul2 markers together with the bla(CTX-M-15) gene for CTX-M-15 extended-spectrum β-lactamase. PFGE patterns and plasmid profiles of the Polish isolates and the epidemic STEC O104 : H4 strain corresponded closely. This finding suggested an epidemiological link between the Polish STEC O104 : H4 isolates and the international outbreak. Retrospective serological investigations proved person-to-person transmission of the epidemic STEC O104 : H4 strain from a father who had visited Dortmund, Germany, to his 7-year-old son in Giżycko, Poland. To the best of our knowledge, this is the first report of household transmission of Shiga-toxin-producing E. coli in Poland.

  12. Captive wild birds as reservoirs of enteropathogenic E. coli (EPEC) and Shiga-toxin producing E. coli (STEC).

    Science.gov (United States)

    Sanches, Lilian Aparecida; Gomes, Marcelo da Silva; Teixeira, Rodrigo Hidalgo Friciello; Cunha, Marcos Paulo Vieira; Oliveira, Maria Gabriela Xavier de; Vieira, Mônica Aparecida Midolli; Gomes, Tânia Aparecida Tardelli; Knobl, Terezinha

    2017-06-02

    Psittacine birds have been identified as reservoirs of diarrheagenic Escherichia coli, a subset of pathogens associated with mortality of children in tropical countries. The role of other orders of birds as source of infection is unclear. The aim of this study was to perform the molecular diagnosis of infection with diarrheagenic E. coli in 10 different orders of captive wild birds in the state of São Paulo, Brazil. Fecal samples were analyzed from 516 birds belonging to 10 orders: Accipitriformes, Anseriformes, Columbiformes, Falconiformes, Galliformes, Passeriformes, Pelecaniformes, Piciformes, Psittaciformes and Strigiformes. After isolation, 401 E. coli strains were subjected to multiplex PCR system with amplification of genes eae and bfp (EPEC), stx1 and stx2 for STEC. The results of these tests revealed 23/401 (5.74%) positive strains for eae gene, 16/401 positive strains for the bfp gene (3.99%) and 3/401 positive for stx2 gene (0.75%) distributed among the orders of Psittaciformes, Strigiformes and Columbiformes. None of strains were positive for stx1 gene. These data reveal the infection by STEC, typical and atypical EPEC in captive birds. The frequency of these pathotypes is low and restricted to few orders, but the data suggest the potential public health risk that these birds represent as reservoirs of diarrheagenic E. coli. Copyright © 2017 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. STEC:O111-HUS complicated by acute encephalopathy in a young girl was successfully treated with a set of hemodiafiltration, steroid pulse, and soluble thrombomodulin under plasma exchange.

    Science.gov (United States)

    Yada, Noritaka; Fujioka, Masayuki; Bennett, Charles L; Inoki, Kazuya; Miki, Toyokazu; Watanabe, Akihiko; Yoshida, Toshiko; Hayakawa, Masaki; Matsumoto, Masanori; Fujimura, Yoshihiro

    2015-04-01

    We report a 14-year-old girl, who developed shigatoxin-producing E. coli (STEC)-HUS complicated by encephalopathy. She was successfully treated with hemodiafiltration, high-dose methylprednisolone pulse therapy, and soluble recombinant thrombomodulin under plasma exchange. von Willebrand factor multimers analysis provides potential insights into how the administered therapies might facilitate successful treatment of STEC-HUS.

  14. Detection of Shiga toxin-producing Escherichia coli (STEC) O157:H7, O26, O45, O103, O111, O121, and O145, and Salmonella in retail raw ground beef using the DuPont BAX system

    Science.gov (United States)

    Shiga toxin-producing Escherichia coli (STEC) and Salmonella are food-borne pathogens commonly associated with beef, and reliable methods are needed to determine their prevalence in beef and to ensure food safety. Retail ground beef was tested for the presence of E. coli O157:H7, STEC serogroups O2...

  15. Diarrheal Illness

    Centers for Disease Control (CDC) Podcasts

    2011-08-30

    Dr. Steve Monroe, director of CDC’s Division of High-Consequence Pathogens and Pathology, discusses diarrheal illness, its causes, and prevention.  Created: 8/30/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 8/31/2011.

  16. Detection of shiga-toxin producing E. coli (STEC) in leafy greens sold at local retail markets in Alexandria, Egypt.

    Science.gov (United States)

    Khalil, Rowaida K S; Gomaa, Mohamed A E; Khalil, Mahmoud I M

    2015-03-16

    Leafy green vegetables, a popular and an indispensable ingredient of the daily menus of Egyptians' diets, currently presents a great concern in terms of microbiological hazards. To the best of our knowledge, this is the first report that provides scientific evidence for prevalence of shiga-toxigenic Escherichia coli (STEC) in leafy greens sold at open air local retail markets and superstores in the Egyptian environment. A total of 486 conventional and organic leafy green samples that are eaten raw were collected from different areas in Alexandria, evaluated for total E. coli counts (ECCs), and screened for E. coli O157:H7 using conventional and molecular methods. Recovery of E. coli (≥10(2)CFU/g) from all studied types of leafy greens was indicative of fecal contamination. Total ECCs in conventional samples ranged from 5.47 to 2.56 log CFU/g. Based on their inability to ferment sorbitol on CT-SMAC media, 26 presumptive E. coli O157 isolates were detected in 71.4% (270/378) of the studied conventional samples. From all studied organic samples, only 2 types (organic cabbage and parsley, 16.7%) were contaminated with presumptive E. coli O157. All 28 isolates were further serotyped as E. coli O157 by latex agglutination test, and biochemically confirmed as E. coli. Multiplex PCR assays confirmed the ability of 21.4% (6/28) of the E. coli O157 strains to produce shiga-toxins (Stxs), and their virulence markers were as follows: stx1, 66.6% (4/6); stx2, 50% (3/6); stx1/stx2, 16.7% (1/6); eaeA, 83.3% (5/6); and hlyA, 16.7% (1/6). Only 2 strains recovered from conventional and organic parsley could possibly be classified as E. coli O157:H7 based on the presence of stx-genes (either stx1 or stx2 or both). Results of the present research highlight that high E. coli loads, together with recovery of STEC O157 isolates could pose serious health risks to the produce consumers. This emphasizes the urgent need for health authorities to value and utilize the existing knowledge to

  17. Exploiting the explosion of information associated with whole genome sequencing to tackle Shiga toxin-producing Escherichia coli (STEC) in global food production systems

    Science.gov (United States)

    The rates of foodborne disease caused by gastrointestinal pathogens continue to be a concern in both the developed and developing worlds. The growing world population, the increasing complexity of agri-food networks and the wide range of foods now associated with STEC are potential drivers for incre...

  18. Development of a High Resolution Virulence Allelic Profiling (HReVAP Approach Based on the Accessory Genome of Escherichia coli to Characterize Shiga-toxin Producing E. coli (STEC

    Directory of Open Access Journals (Sweden)

    Valeria eMichelacci

    2016-02-01

    Full Text Available Shiga-toxin producing Escherichia coli (STEC strains possess a large accessory genome composed of virulence genes existing in multiple allelic variants, which sometimes segregate with specific STEC subpopulations. We analyzed the allelic variability of 91 virulence genes of STEC by Real Time PCR followed by melting curves analysis in 713 E. coli strains including 358 STEC. The 91 genes investigated were located on the LEE, OI-57 and OI-122 pathogenicity islands and displayed a total of 476 alleles in the study population. The combinations of the 91 alleles of each strain were termed allelic signatures and used to perform cluster analyses. We termed such an approach High Resolution Virulence Allelic Profiling (HReVAP and used it to investigate the phylogeny of STEC of multiple serogroups. The dendrograms obtained identified groups of STEC segregating approximately with the serogroups and allowed the identification of subpopulations within the single groups. The study of the allelic signatures provided further evidence of the coevolution of the LEE and OI-122, reflecting the occurrence of their acquisition through a single event. The HReVAP analysis represents a sensitive tool for studying the evolution of LEE-positive STEC.

  19. Development of a High Resolution Virulence Allelic Profiling (HReVAP) Approach Based on the Accessory Genome of Escherichia coli to Characterize Shiga-Toxin Producing E. coli (STEC)

    Science.gov (United States)

    Michelacci, Valeria; Orsini, Massimiliano; Knijn, Arnold; Delannoy, Sabine; Fach, Patrick; Caprioli, Alfredo; Morabito, Stefano

    2016-01-01

    Shiga-toxin producing Escherichia coli (STEC) strains possess a large accessory genome composed of virulence genes existing in multiple allelic variants, which sometimes segregate with specific STEC subpopulations. We analyzed the allelic variability of 91 virulence genes of STEC by Real Time PCR followed by melting curves analysis in 713 E. coli strains including 358 STEC. The 91 genes investigated were located on the locus of enterocyte effacement (LEE), OI-57, and OI-122 pathogenicity islands and displayed a total of 476 alleles in the study population. The combinations of the 91 alleles of each strain were termed allelic signatures and used to perform cluster analyses. We termed such an approach High Resolution Virulence Allelic Profiling (HReVAP) and used it to investigate the phylogeny of STEC of multiple serogroups. The dendrograms obtained identified groups of STEC segregating approximately with the serogroups and allowed the identification of subpopulations within the single groups. The study of the allelic signatures provided further evidence of the coevolution of the LEE and OI-122, reflecting the occurrence of their acquisition through a single event. The HReVAP analysis represents a sensitive tool for studying the evolution of LEE-positive STEC. PMID:26941726

  20. Shiga toxin-producing Escherichia coli and rectoanal junction persistence in ruminants: a study of bacterial-epithelial interactions.

    Science.gov (United States)

    Escherichia coli O157:H7 (O157) was the first Shiga toxin-producing E. coli serotype to be associated with bloody diarrhea or hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS) in humans. It has since been implicated in several outbreaks in the U.S. and globally. Non-O157 STEC have not bee...

  1. Development and application of a green fluorescent protein (GFP) expressing E. coli O103 surrogate for tracking contamination through grinding and identifying persistent points of contamination

    Science.gov (United States)

    Objective: To 1.) develop and validate an easily trackable E. coli O157:H7/non-O157 STEC surrogate that can be detected to the same level of sensitivity as E. coli O157:H7; and 2.) apply the trackable surrogate to model contamination passage through grinding and identify points where contamination ...

  2. A simulated metagenomic approach for bacterial serotyping using shotgun genome sequences coupled with O-Antigen gene cluster analysis

    Science.gov (United States)

    Background: Accurate determination of food-borne pathogen serotype and genotype information is important for disease surveillance and outbreak source tracking. E. coli serotype O157:H7 and non-O157 of Shiga toxin-producing E. coli (STEC) serogroups, including O26, O45, O103, O111, O121, O145 (top ...

  3. Use of probiotics to reduce faecal shedding of Shiga toxin-producing Escherichia coli in sheep.

    Science.gov (United States)

    Rigobelo, E E C; Karapetkov, N; Maestá, S A; Avila, F A; McIntosh, D

    2015-03-01

    Shiga toxin-producing Escherichia coli (STEC) are zoonotic, foodborne pathogens of humans. Ruminants, including sheep, are the primary reservoirs of STEC and there is a need to develop intervention strategies to reduce the entry of STEC into the food chain. The initiation of the majority of bacterial, enteric infections involves colonisation of the gut mucosal surface by the pathogen. However, probiotic bacteria can serve to decrease the severity of infection via a number of mechanisms including competition for receptors and nutrients, and/or the synthesis of organic acids and bacteriocins that create an environment unfavourable for pathogen development. The aim of the current study was to determine whether the administration of a probiotic mixture to sheep experimentally infected with a non-O157 STEC strain, carrying stx1, stx2 and eae genes, was able to decrease faecal shedding of the pathogen. The probiotic mixture contained Lactobacillus acidophilus, Lactobacillus helveticus, Lactobacillus bulgaricus, Lactobacillus lactis, Streptococcus thermophilus and Enterococcus faecium. The numbers of non-O157 STEC in faecal samples collected from sheep receiving daily doses of the probiotic mixture were significantly lower at the 3rd, 5th and 6th week post-inoculation when compared to the levels recorded in untreated animals. It was concluded that administration of the probiotic mixture reduced faecal shedding of non-O157 STEC in sheep, and holds potential as a pre-harvest intervention method to reduce transmission to humans.

  4. Detection of Shiga toxin-producing Escherichia coli in meat marketed in Casablanca (Morocco).

    Science.gov (United States)

    Badri, S; Fassouane, A; Filliol, I; Hassar, M; Cohen, N

    2011-03-01

    The contamination of meat and meat products with Shiga toxin-producing O157:H7 and non-O157 Escherichia coli (STEC), obtained from markets in Casablanca, Morocco, was investigated. A total of 460 meat and meat products were sampled between March 2004 and July 2006 analysed and 176 strains of E. coli were isolated from these samples. The presence of the stx1, stx2, eae and ehxA genes, recognized as major virulence factors of STEC, was tested in E. coli isolates by polymerase chain reaction (PCR). STEC was detected in 4 (0.9%) samples. The result of serotyping by molecular method showed that two of these STEC isolates corresponded to the serotype O157:H7. The others Shiga toxin-producing E. coli non-O157 corresponded to O6:H21 and O76:H19. The presence of O157:H7 and non-O157 STEC in meat and meat products marketed in Casablanca, Morocco, emphasizes the importance of implementing the Hazard Analysis and Critical Control Point (HACCP) system, as well as the need for implementing, evaluating, and validating antimicrobial interventions to reduce the presence of potential pathogenic microorganisms.

  5. Contaminación de carne molida con cepas de Escherichia coli shigatoxigénico (STEC provenientes de comercios minoristas de San Martín, Buenos Aires, categorizados según nivel socioeconómico Contamination of Shiga toxin-producing Escherichia coli (STEC in fresh ground beef from butcher shops in San Martin, Buenos Aires Province, among different socioeconomic strata

    Directory of Open Access Journals (Sweden)

    L Miccio

    2011-06-01

    Full Text Available Escherichia coli shigatoxigénico (STEC produce enfermedades de transmisión alimentaria, desde diarreas leves a Síndrome Urémico Hemolítico, enfermedad de impacto en Argentina. Dentro de los alimentos implicados se destaca la carne bovina insuficientemente cocida. La contaminación de la carne molida y su relación con los estratos socioeconómicos no ha sido estudiada. El objetivo de este trabajo fue identificar en muestras de carne cepas STEC y establecer su perfil de virulencia, considerando la zona socioeconómica de procedencia y la persistencia de la contaminación en el local de venta. Se seleccionó el 30% de las bocas de expendio habilitadas en cada nivel socioeconómico. Se analizaron 72 muestras provenientes de 36 carnicerías de San Martín, Buenos Aires, en dos muestreos independientes utilizando PCR múltiple para stx1/stx2 e inmunocaptura para O157 al tamizaje. Se obtuvieron 11 cepas de 26 muestras sospechosas, 7% de los aislamientos fueron STEC O157. La proporción en la contaminación ponderada fue mayor en las zonas media y baja. No se comprobó persistencia. El grado de contaminación por STEC en carne para el área estudiada fue elevado y las cepas aisladas fueron altamente virulentas. En consideración a ello es necesario implementar programas de capacitación y control para reducir los riesgos para la salud pública.Shiga toxin-producing Escherichia coli (STEC causes foodborne diseases, from mild diarrhea to hemolytic uremic syndrome which impact in Argentina. Many human infections were acquired from eating undercooked contaminated beef. The contamination of ground beef and their relation to socio-economic strata has not been studied. The aim of this study was to identify STEC in meat samples and establish virulence profile, considering the socio-economic area of origin and persistence of contamination in local sales. It was selected 30% of the butcher shop of each socioeconomic level. It was analyzed 72 samples from 36

  6. Exploiting the explosion of information associated with whole genome sequencing to tackle Shiga toxin-producing Escherichia coli (STEC) in global food production systems.

    Science.gov (United States)

    Franz, Eelco; Delaquis, Pascal; Morabito, Stefano; Beutin, Lothar; Gobius, Kari; Rasko, David A; Bono, Jim; French, Nigel; Osek, Jacek; Lindstedt, Bjørn-Arne; Muniesa, Maite; Manning, Shannon; LeJeune, Jeff; Callaway, Todd; Beatson, Scott; Eppinger, Mark; Dallman, Tim; Forbes, Ken J; Aarts, Henk; Pearl, David L; Gannon, Victor P J; Laing, Chad R; Strachan, Norval J C

    2014-09-18

    The rates of foodborne disease caused by gastrointestinal pathogens continue to be a concern in both the developed and developing worlds. The growing world population, the increasing complexity of agri-food networks and the wide range of foods now associated with STEC are potential drivers for increased risk of human disease. It is vital that new developments in technology, such as whole genome sequencing (WGS), are effectively utilized to help address the issues associated with these pathogenic microorganisms. This position paper, arising from an OECD funded workshop, provides a brief overview of next generation sequencing technologies and software. It then uses the agent-host-environment paradigm as a basis to investigate the potential benefits and pitfalls of WGS in the examination of (1) the evolution and virulence of STEC, (2) epidemiology from bedside diagnostics to investigations of outbreaks and sporadic cases and (3) food protection from routine analysis of foodstuffs to global food networks. A number of key recommendations are made that include: validation and standardization of acquisition, processing and storage of sequence data including the development of an open access "WGSNET"; building up of sequence databases from both prospective and retrospective isolates; development of a suite of open-access software specific for STEC accessible to non-bioinformaticians that promotes understanding of both the computational and biological aspects of the problems at hand; prioritization of research funding to both produce and integrate genotypic and phenotypic information suitable for risk assessment; training to develop a supply of individuals working in bioinformatics/software development; training for clinicians, epidemiologists, the food industry and other stakeholders to ensure uptake of the technology and finally review of progress of implementation of WGS. Currently the benefits of WGS are being slowly teased out by academic, government, and industry or

  7. Detection, Characterization, and Typing of Shiga Toxin-Producing Escherichia coli.

    Science.gov (United States)

    Parsons, Brendon D; Zelyas, Nathan; Berenger, Byron M; Chui, Linda

    2016-01-01

    Shiga toxin-producing Escherichia coli (STEC) are responsible for gastrointestinal diseases reported in numerous outbreaks around the world. Given the public health importance of STEC, effective detection, characterization and typing is critical to any medical laboratory system. While non-O157 serotypes account for the majority of STEC infections, frontline microbiology laboratories may only screen for STEC using O157-specific agar-based methods. As a result, non-O157 STEC infections are significantly under-reported. This review discusses recent advances on the detection, characterization and typing of STEC with emphasis on work performed at the Alberta Provincial Laboratory for Public Health (ProvLab). Candidates for the detection of all STEC serotypes include chromogenic agars, enzyme immunoassays (EIA) and quantitative real time polymerase chain reaction (qPCR). Culture methods allow further characterization of isolates, whereas qPCR provides the greatest sensitivity and specificity, followed by EIA. The virulence gene profiles using PCR arrays and stx gene subtypes can subsequently be determined. Different non-O157 serotypes exhibit markedly different virulence gene profiles and a greater prevalence of stx1 than stx2 subtypes compared to O157:H7 isolates. Finally, recent innovations in whole genome sequencing (WGS) have allowed it to emerge as a candidate for the characterization and typing of STEC in diagnostic surveillance isolates. Methods of whole genome analysis such as single nucleotide polymorphisms and k-mer analysis are concordant with epidemiological data and standard typing methods, such as pulsed-field gel electrophoresis and multiple-locus variable number tandem repeat analysis while offering additional strain differentiation. Together these findings highlight improved strategies for STEC detection using currently available systems and the development of novel approaches for future surveillance.

  8. Molecular characterization and phylogeny of Shiga toxin-producing E. coli (STEC) from imported beef meat in Malaysia.

    Science.gov (United States)

    Abuelhassan, Nawal Nouridaim; Mutalib, Sahilah Abdul; Gimba, Fufa Ido; Yusoff, Wan Mohtar

    2016-09-01

    This study aimed at determining the presence and characterization of Escherichia coli and Shiga toxin-producing E. coli (STEC) from imported frozen beef meats. Seventy-four (74) frozen imported beef meat samples from two countries, India (42 samples) and Australia (32 samples), were collected and tested for E. coli. These samples were purchased from the frozen meat sections of five different supermarkets in different locations in Selangor, Malaysia, from April 2012 to October 2014. A total of 222 E. coli strains were isolated from the meat samples; 126 strains were isolated from country A (India), and 96 E. coli strains were from country of origin B (Australia), respectively. A total of 70 E. coli strains were identified and characterized. All E. coli strains were isolated into Fluorocult medium and identified using API 20E kit. All selected E. coli strains were characterized for Shiga toxin genes (stx1 and stx2). All biochemically identified E. coli in this study were further subjected to molecular detection through polymerase chain reaction (PCR) amplification and characterization using 16S ribosomal RNA (rRNA) gene of Shiga toxin-producing E. coli. Of the 70 E. coli strains, 11 strains were positive for both Shiga toxin genes (stx1 and stx2) and 11 (11/70) strains were positive for stx1 gene, while 25 (25/70) strains were positive for stx2 gene. The analysis of 16S rRNA gene of all the E. coli isolates in this study was successfully sequenced and analyzed, and based on sequence data obtained, a phylogenetic tree of the 16S rRNA gene was performed using Clustal W programme in MEGA 6.06 software. Phylogenetic tree showed that the E. coli isolates in our study cluster with the strain of E. coli isolated in other countries, which further confirm that the isolates of E. coli in this study are similar to those obtained in other studies. As a result, all the strains obtained in this study proved to be a strain of pathogenic E. coli, which may cause a serious outbreak

  9. Illness as Teacher: Learning from Illness

    Science.gov (United States)

    Yoo, Joanne

    2017-01-01

    This article is a conceptual exploration into the value of illness, bodies and embodied practice in teacher education. It draws on my reflections and practitioner accounts of poor health to investigate the potential to learn from illness. I position myself in this discussion as a non-tenured academic who experiences the challenges of her uncertain…

  10. Characterization of Shiga-toxin producing E.coli (STEC and enteropathogenic E.coli (EPEC using multiplex Real-Time PCR assays for stx1 , stx2 , eaeA.

    Directory of Open Access Journals (Sweden)

    Pejman Abbasi

    2014-06-01

    Full Text Available Diarrheal disease is still a major health problem, especially in developing countries, where it is considered as one of the leading causes of morbidity and mortality especially in children. Studies showed that Diarrheagenic E. coli (DEC such as STES and EPEC strains are among the most prevalent causative agents in acute diarrhea, particularly in children. Aim of the present study was to investigate the presence and the frequency of STEC and EPEC as etiologic agent of diarrhea in children less than 2 years of age with diarrhea in Shiraz.A total of 285 stool samples were collected from patients with diarrhea in Shiraz, in 2012. Diarrheagenic E. coli (DEC strains were isolated by standard biochemical analysis. In this study, we used multiplex Real time PCR and single PCR to detect the presence of indicator genes stx1 , stx2 and eaeA for STEC and EPEC strains, respectively.A total of 285 stool samples were tested in which 49 (17% were identified as contaminated with E. coli by biochemical tests. Out of total samples, 15 STEC (31% and 13 EPEC (27% were identified using multiplex Real-Time PCR assay. Among STEC isolates, 2 strains were stx1 (+, 8 isolates stx2 (+, 3 isolates were stx1 (+ , stx2 (+ and 2 isolates were stx1 (+ , stx2 (+, eaeA (+.In this study, we found rather high occurrence of STEC and EPEC virulence genes in children with diarrhea. The results of this study showed that, real time PCR can be used as a replacement for conventional PCR assay in the detecting virulence genes of STEC and EPEC strains. Real-time PCR offers the advantage of being a faster, more robust assay, because it does not require post-PCR procedures to detect amplification products.

  11. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Medicine's Front Line Observation Emergency Care Fact Sheet Health & Safety Tips Campaigns SUBSCRIBE Emergencies A-Z Share ... Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat-related illness can ...

  12. Illness anxiety disorder

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001236.htm Illness anxiety disorder To use the sharing features on this page, please enable JavaScript. Illness anxiety disorder (IAD) is a preoccupation that physical symptoms ...

  13. Coping with Chronic Illness

    Science.gov (United States)

    Having a long-term, or chronic, illness can disrupt your life in many ways. You may often be tired and in pain. Your illness might affect your ... able to work, causing financial problems. For children, chronic illnesses can be frightening, because they may not ...

  14. The epidemiology, microbiology and clinical impact of Shiga toxin-producing Escherichia coli in England, 2009-2012.

    Science.gov (United States)

    Byrne, L; Jenkins, C; Launders, N; Elson, R; Adak, G K

    2015-12-01

    Between 1 January 2009 and 31 December 2012 in England, a total of 3717 cases were reported with evidence of Shiga toxin-producing E. coli (STEC) infection, and the crude incidence of STEC infection was 1·80/100 000 person-years. Incidence was highest in children aged 1-4 years (7·63/100 000 person-years). Females had a higher incidence of STEC than males [rate ratio (RR) 1·24, P < 0·001], and white ethnic groups had a higher incidence than non-white ethnic groups (RR 1·43, P < 0·001). Progression to haemolytic uraemic syndrome (HUS) was more frequent in females and children. Non-O157 STEC strains were associated with higher hospitalization and HUS rates than O157 STEC strains. In STEC O157 cases, phage type (PT) 21/28, predominantly indigenously acquired, was also associated with more severe disease than other PTs, as were strains encoding stx2 genes. Incidence of STEC was over four times higher in people residing in rural areas than urban areas (RR 4·39, P < 0·001). Exposure to livestock and/or their faeces was reported twice as often in cases living in rural areas than urban areas (P < 0·001). Environmental/animal contact remains an important risk factor for STEC transmission and is a significant driver in the burden of sporadic STEC infection. The most commonly detected STEC serogroup in England was O157. However, a bias in testing methods results in an unquantifiable under-ascertainment of non-O157 STEC infections. Implementation of PCR-based diagnostic methods designed to detect all STEC, to address this diagnostic deficit, is therefore important.

  15. Implementation of Whole Genome Sequencing (WGS for Identification and Characterization of Shiga Toxin-Producing Escherichia coli (STEC in the United States

    Directory of Open Access Journals (Sweden)

    Rebecca L Lindsey

    2016-05-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC is an important foodborne pathogen capable of causing severe disease in humans. Rapid and accurate identification and characterization techniques are essential during outbreak investigations. Current methods for characterization of STEC are expensive and time-consuming. With the advent of rapid and cheap whole genome sequencing (WGS benchtop sequencers, the potential exists to replace traditional workflows with WGS. The aim of this study was to validate tools to do reference identification and characterization from WGS for STEC in a single workflow within an easy to use commercially available software platform. Publically available serotype, virulence, and antimicrobial resistance databases were downloaded from the Center for Genomic Epidemiology (CGE (www.genomicepidemiology.org and integrated into a genotyping plug-in with in silico PCR tools to confirm some of the virulence genes detected from WGS data. Additionally, down sampling experiments on the WGS sequence data were performed to determine a threshold for sequence coverage needed to accurately predict serotype and virulence genes using the established workflow. The serotype database was tested on a total of 228 genomes and correctly predicted from WGS for 96.1% of O serogroups and 96.5% of H serogroups identified by conventional testing techniques. A total of 59 genomes were evaluated to determine the threshold of coverage to detect the different WGS targets, 40 were evaluated for serotype and virulence gene detection and 19 for the stx gene subtypes. For serotype, 95% of the O and 100% of the H serogroups were detected at > 40x and ≥ 30x coverage, respectively. For virulence targets and stx gene subtypes, nearly all genes were detected at > 40x, though some targets were 100% detectable from genomes with coverage ≥20x. The resistance detection tool was 97% concordant with phenotypic testing results. With isolates sequenced to > 40x

  16. Growth media and temperature effects on biofilm formation by serotype O157:H7 and non-O157 Shiga toxin-producing Escherichia coli

    Science.gov (United States)

    Biofilm formation in most Escherichia coli strains is dependent on curli fimbriae and cellulose, and the expression of both varies widely among pathogenic strains. Curli and cellulose expression are often identified by their affinity for Congo red dye (CR). However, media composition and incubation ...

  17. Growth media and temperature effects on biofilm formation by serotype O157:H7 and non-O157 Shiga toxin-producing Escherichia coli.

    Science.gov (United States)

    Uhlich, Gaylen A; Chen, Chin-Yi; Cottrell, Bryan J; Nguyen, Ly-Huong

    2014-05-01

    Biofilm formation in most Escherichia coli strains is dependent on curli fimbriae and cellulose, and the production of both varies widely among pathogenic strains. Curli and cellulose production by colonies growing on agar are often identified by their affinity for Congo red dye (CR). However, media composition and incubation temperature can affect dye affinity and impose limitations on red phenotype detection by this method. In this study, we compared different Shiga toxin-producing E. coli for CR affinity and biofilm formation under different media/temperature conditions. We found strain and serotype differences in CR affinities and biofilm formation, as well as temperature and media requirements for maximum CR binding. We also constructed strains with deletions of curli and/or cellulose genes to determine their contributions to the phenotypes and identified two O45 strains with a medium-dependent induction of cellulose.

  18. Comparison of immunomagnetic separation beads for detection of six Non-O157:H7 shiga toxin-producing Escherichia coli serogroups in different matrices

    Science.gov (United States)

    A concern in public health and food safety in the United States involves the need to accurately and efficiently detect Shiga toxin producing Escherichia coli O26, O45, O103, O111, O121, and O145 which have caused outbreaks on numerous occasions. The detection of these organisms is challenging becau...

  19. Foodborne Germs and Illnesses

    Science.gov (United States)

    ... 2020 and Food Safety Food Safety Modernization Act Foodborne Germs and Illnesses Recommend on Facebook Tweet Share Compartir Foodborne Germs Botulism Campylobacter Clostridium perfringens Cyclospora E. coli ...

  20. Validation of the detection of STEC (O26, O45, O103, O111, O121, O145 and O157 in raw burgers using real-time PCR (BAX® System Q7, DuPont in “WET POOLS”

    Directory of Open Access Journals (Sweden)

    Paula Mussio

    2014-12-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC O157:H7 and no-O157:H7 have been identified as emerging foodborne pathogens responsible for an increasing number of outbreaks worldwide. Many foods have been associated to these outbreaks, mainly undercooked beef burgers. Due to the increasing production and consumption of burgers in our country, it is important to have a rapid technique to identify and isolate the most important STEC strains in foods matrixes.The objective of these investigation was to assess the sensitivity, specificity and limit detection for the screening of the most prevalent STEC in frozen raw beef burgers, using the "STEC Screening stx/eae " kit to detect the stx/eae genes and the "Panel 1 STEC E. coli O26, O111, O121" and "Panel 2 STEC E. coli O45, O103, O145" and "E. coli O157: H7 MP” (DuPont kits for the detection of the different serogroups. The use of composed samples (wet pools, the recovery of each strain from the positives samples on selective media after specified inmunoconcentration and the detection of stx/eae virulence genes in isolates by PCR were also evaluated. We validated a technique that allows the detection of the mentioned STEC strains with limits of detection between 1-5 CFU in 65 grams of raw frozen hamburgers, using wet pools. 

  1. Detection of Shiga-like toxin producing Escherichia coli from raw milk cheeses produced in Wallonia [Belgium].

    Directory of Open Access Journals (Sweden)

    El-Lioui M.

    1999-01-01

    Full Text Available Shiga-like toxin Escherichia coli (STEC implicated in aqueous diarrhoea, haemorrhagic colitis and haemolytic uraemic syndrome, has become a serious health problem in various countries. In Belgium, all cases are sporadic and no outbreak has been detected so far. Cattle are thought to be a reservoir for E. coli O157:H7, and many foodborne diseases have been associated with the consumption of minced beef, beefburgers and raw milk. Recently, foodborne outbreaks were concerned with different unusual foods such as acidic products. Although some data suggest that STEC are not prevalent within dairy products, the aim of this work was to assess the prevalence of E. coli O157 and non-O157 STEC in raw milk cheeses produced in the southern part of Belgium (Wallonia. For this purpose, 153 frozen samples of soft and semi-soft cheeses made with raw cow, ewe and goat milk were analysed for the presence of E. coli O157 and STEC. By using a dynabeads immunomagnetic separation technique (Dynabeads anti-E. coli O157, Dynal followed by streaking onto sorbitol MacConckey agar, no sample was found contaminated by E. coli O157 serotype. By using polymerase chain reaction achieved from a loopful of confluent bacterial material growing onto MacConckey agar, the use of consensus primers detected stx genes in 11.1/ of the samples but Shiga-like toxin producing strains could be isolated only in five of them (3.3/. The isolation rate seems to be optimum for samples with a thermotolerant coliform count arround or below 102 cfu per g. The five Shiga-like toxin isolates were identified as belonging to the species Hafnia alvei or Enterobacter amnigenius without any accessory virulence factors needed to cause illness. Nevertheless, because of the ability of STEC to survive adverse conditions and the possibility for commensal non-pathogenic enteric bacteria to become pathogenic, raw milk cheeses are to be considered at risk for foodborne STEC contamination.

  2. Heat Related Illnesses

    Institute of Scientific and Technical Information of China (English)

    Robert Carter III; Samuel N. Cheuvront; Michael N. Sawka

    2007-01-01

    @@ KEY POINTS · Heat illnesses range in severity from mild (heat rash, heat syncope, cramps) to serious (heat exhaustion, heat injury, heat stroke). · Although heat illness can occur in anyone, an increased risk is associated with a variety of environmental factors, personal characteristics,health conditions, and medications.

  3. Parasites and Foodborne Illness

    Science.gov (United States)

    ... called "Crypto", is a one-celled, microscopic shelled parasite and a significant cause of waterborne and foodborne illness worldwide. It is found in the intestines of many herd animals including cows, sheep, goats, deer, and elk. The illness could be intestinal, ...

  4. Critical illness myopathy.

    Science.gov (United States)

    Latronico, Nicola; Tomelleri, Giuliano; Filosto, Massimiliano

    2012-11-01

    To describe the incidence, major risk factors, and the clinical, electrophysiological, and histological features of critical illness myopathy (CIM). Major pathogenetic mechanisms and long-term consequences of CIM are also reviewed. CIM is frequently associated with critical illness polyneuropathy (CIP), and may have a relevant impact on patients' outcome. CIM has an earlier onset than CIP, and recovery is faster. Loss of myosin filaments on muscle biopsy is important to diagnose CIM, and has a good prognosis. Critical illness, use of steroids, and immobility concur in causing CIM. A rationale diagnostic approach to CIM using clinical, electrophysiological, and muscle biopsy investigations is important to plan adequate therapy and to predict recovery.

  5. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or any situation ... pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss of consciousness, vomiting or a high ...

  6. Chronic Illness & Mental Health

    Science.gov (United States)

    ... is present. For More Information Share Chronic Illness & Mental Health Download PDF Download ePub Order a free hardcopy ... For more information, see the National Institute of Mental Health (NIMH) booklet on Depression at http://www.nimh. ...

  7. Vaccines Stop Illness

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Vaccines Stop Illness Past Issues / Spring 2008 Table of ... meningitis won't infect, cripple, or kill children. Vaccine Safety In light of recent questions about vaccine ...

  8. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  9. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; vomiting; and increased body temperature of ... for symptoms that include cool, moist, pale skin, rapid pulse, elevated or lowered blood pressure, nausea, loss ...

  10. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for Disasters Communication With Your Family And Your Doctor About Your Wishes Visiting the ER Who Takes ... 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at Mercy Health System in Chesterfield, Missouri Heat- ...

  11. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  12. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... exhaustion symptoms include cool, moist, pale or flushed skin; headache; dizziness; weakness; feeling exhausted; heavy sweating; nausea; ... stage of heat illness) include flushed, hot, dry skin; fainting; a rapid, weak pulse; rapid, shallow breathing; ...

  13. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... for signs of heat stroke or exhaustion. Heat Stroke and Exhaustion Symptoms of early heat exhaustion symptoms ... heavy sweating; nausea; and giddiness. Symptoms of heat stroke (late stage of heat illness) include flushed, hot, ...

  14. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Health System in Chesterfield, Missouri Heat-related illness can be caused by overexposure to the sun or ... the elderly are most at risk, but anyone can be affected. Here you will find information about ...

  15. Heat-Related Illnesses

    Medline Plus

    Full Text Available ... Emergencies A-Z Share this! Home » Emergency 101 Heat-Related Illnesses Dr. Glenn Mitchell , Emergency physician at ... about heat cramps and heat stroke and exhaustion. Heat Cramps Symptoms include muscle spasms, usually in the ...

  16. Symptoms of Tickborne Illness

    Science.gov (United States)

    ... Removing a tick Symptoms of tickborne illness Geographic distribution of ticks that bite humans How ticks spread ... varies greatly from person to person in appearance, location, and time of onset. About 10% of people ...

  17. Sculpting the Illness Experience

    Directory of Open Access Journals (Sweden)

    Molly Bathje MS, OTR/L

    2014-10-01

    Full Text Available Otto Kamensek provided the cover art for the Fall 2014 issue of the Open Journal of Occupational Therapy. “Glimmer of Hope” is part of Otto’s collection “Shard’s, Bone Deep,” which includes hand-built ceramic sculptures that portray his experiences with a lifelong chronic illness. Engaging in ceramic sculpture helps him process the experiences associated with Juvenile Rheumatoid Arthritis and provides a means to support others experiencing chronic illness.

  18. Nonthyroidal Illness (NTIs)

    OpenAIRE

    Nanny Natalia Mulyani Soetedjo

    2009-01-01

    Nonthyroidal illness (NTIs) can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness (NTI) without preexisting hypothalamic-pituitary and thyroid gland dysfunction. After recovery from an NTI, these thyroid function test result abnormalities should be completely reversible. Multiple alterations in serum thyroid function test findings have been recognized in patients with a wide variety of NTI without evidence of preexisting thyroid or...

  19. Heat-Related Illnesses

    Science.gov (United States)

    1988-04-01

    to cold stress. Despite this ability, man has been plagued by heat illness throughout recorded history. The Old Testament describes a young man’s...encounter heat illness because of the requirement to train unacclimatized men by means of forced heavy physical cxercise. The United States Army...dyspnea, dysphagia , and urinary incontinence. 2 6 Although the muscular rigidity and hyperthermia are reminiscent of malignant hyperthermia, the putative

  20. Violence and Mental Illness

    OpenAIRE

    2008-01-01

    Violence attracts attention in the news media, in the entertainment business, in world politics, and in countless other settings. Violence in the context of mental illness can be especially sensationalized, which only deepens the stigma that already permeates our patients’ lives. Are violence and mental illness synonymous, connected, or just coincidental phenomena? This article reviews the literature available to address this fundamental question and to investigate other vital topics, includi...

  1. Prevalence of Asymptomatic Carriers of Shiga Toxin-Producing Escherichia Coli (STEC in Dairy Cattle Farms in the Governorate of Blida (Algeria

    Directory of Open Access Journals (Sweden)

    Baazize-Ammi Djamila

    2015-04-01

    Full Text Available We investigated whether dairy beef cattle raised in Algeria are Shiga toxin-producing Escherichia coli (STEC carriers. Stx1 and stx2 genes were analysed in DNA isolated from 200 faecal samples collected from adult dairy cows from 27 randomly selected farms in Blida, North Algeria, after amplification by PCR. Samples from 61 (30.5% animals out of the 200 were positive and were located in 18 farms with a prevalence of 66.7%. Interestingly, no sample from any cow was positive for only the stx2 gene, while in contrast, samples from 51 cows were positive for the stx1 gene alone (83.6% and those from 10 other cows were positive for both stx1 and stx2 genes (16.4%. It should be noted that the faecal samples infected with pathogens carrying the two genes originated from 4 out of the 18 farms that were found to be positive, with a rate of 22.2%.

  2. [Creativity and mental illness].

    Science.gov (United States)

    Rihmer, Zoltán; Gonda, Xénia; Rihmer, Annamária

    2006-01-01

    It has been known for a long time that people with salient social and artistic creativity suffer more frequently from psychiatric illnesses than the average population. In their review paper, the authors assess the Hungarian and international scientific literature regarding the association of creativity and psychopathology. They conclude that contrary to the concept prevailing in the first part of the 20th century about the strong association between schizophrenia and creativity, the results of empirical research now unambiguously suggest that prominent social and artistic creativity is associated primarily with affective, and more specifically with bipolar affective illnesses. In addition, we already know that as regards the development of creativity, it is not the given affective (depressive, manic, hypomanic) episode which is important, but the hyperthymic or cyclothymic temperament structure which also predisposes for affective illness.

  3. On being Credibly Ill

    DEFF Research Database (Denmark)

    Mik-Meyer, Nanna

    2011-01-01

    problems. The paper shows that it is predominantly poorly educated women without a bio-medical diagnosis that welfare officers describe as suffering from psychological problems despite the fact that the women themselves focus on physical ailments in their illness stories. Men and better-educated women......unexplained symptoms. The study is conducted in Denmark using qualitative interviews with welfare officers and clients. The paper's focus is on how issues of gender and class intersect in the negotiation of illness among welfare officers and clients. The particular client group in question consists...... are described by the welfare officers as tired and exhausted or truly stressed after a long working life....

  4. Mental Illness And Brain Disease.

    Science.gov (United States)

    Bedrick, Jeffrey D

    2014-01-01

    It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.

  5. Critical-Illness Polyneuropathy

    OpenAIRE

    J Gordon Millichap

    1993-01-01

    A review of the neurological complications of sepsis from the University of Western Ontario, London, and Queen’s University, Kingston, Ontario, Canada, draws attention to “critical-illness polyneuropathy” as a cause of difficulty in weaning from the ventilator.

  6. Foodborne Illness Retrospective

    Centers for Disease Control (CDC) Podcasts

    2015-05-07

    Dr. Paul Mead and Dr. Peter Drotman discuss the historic October 1999 article, Food-related Illness and Death in the United States.  Created: 5/7/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/7/2015.

  7. The nonthyroidal illness syndrome.

    Science.gov (United States)

    Adler, Suzanne Myers; Wartofsky, Leonard

    2007-09-01

    This article briefly summarizes thyroid function alterations generally seen in the euthyroid sick syndrome, provides an overview of specific thyroidal adaptations during several clinical conditions and secondary to specific pharmacologic agents, and discusses the current controversy in thyroid hormone treatment of nonthyroidal illness.

  8. HIGH-ALTITUDE ILLNESS

    Directory of Open Access Journals (Sweden)

    Dwitya Elvira

    2015-05-01

    Full Text Available AbstrakHigh-altitude illness (HAI merupakan sekumpulan gejala paru dan otak yang terjadi pada orang yang baru pertama kali mendaki ke ketinggian. HAI terdiri dari acute mountain sickness (AMS, high-altitude cerebral edema (HACE dan high-altitude pulmonary edema (HAPE. Tujuan tinjauan pustaka ini adalah agar dokter dan wisatawan memahami risiko, tanda, gejala, dan pengobatan high-altitude illness. Perhatian banyak diberikan terhadap penyakit ini seiring dengan meningkatnya popularitas olahraga ekstrim (mendaki gunung tinggi, ski dan snowboarding dan adanya kemudahan serta ketersediaan perjalanan sehingga jutaan orang dapat terpapar bahaya HAI. Di Pherice, Nepal (ketinggian 4343 m, 43% pendaki mengalami gejala AMS. Pada studi yang dilakukan pada tempat wisata di resort ski Colorado, Honigman menggambarkan kejadian AMS 22% pada ketinggian 1850 m sampai 2750 m, sementara Dean menunjukkan 42% memiliki gejala pada ketinggian 3000 m. Aklimatisasi merupakan salah satu tindakan pencegahan yang dapat dilakukan sebelum pendakian, selain beberapa pengobatan seperti asetazolamid, dexamethasone, phosopodiestrase inhibitor, dan ginko biloba.Kata kunci: high-altitude illness, acute mountain sickness, edema cerebral, pulmonary edema AbstractHigh-altitude illness (HAI is symptoms of lung and brain that occurs in people who first climb to altitude. HAI includes acute mountain sickness (AMS, high-altitude cerebral edema (HACE and high altitude pulmonary edema (HAPE. The objective of this review was to understand the risks, signs, symptoms, and treatment of high-altitude illness. The attention was given to this disease due to the rising popularity of extreme sports (high mountain climbing, skiing and snowboarding and the ease and availability of the current travelling, almost each year, millions of people could be exposed to the danger of HAI. In Pherice, Nepal (altitude 4343 m, 43% of climbers have symptoms of AMS. Furthermore, in a study conducted at sites in

  9. Comparison of Agar Media for Detection and Quantification of Shiga Toxin-Producing Escherichia coli in Cattle Feces.

    Science.gov (United States)

    Stromberg, Zachary R; Lewis, Gentry L; Moxley, Rodney A

    2016-06-01

    The isolation and quantification of non-O157 Shiga toxin-producing Escherichia coli (STEC) from cattle feces are challenging. The primary objective of this study was to evaluate the performance of selected agar media in an attempt to identify an optimal medium for the detection and quantification of non-O157 STEC in cattle feces. Comparison studies were performed using CHROMagar STEC, Possé differential agar (Possé), Possé modified by the reduction or addition of antimicrobials, STEC heart infusion washed blood agar with mitomycin C (SHIBAM), and SHIBAM modified by the addition of antimicrobials. Fourteen STEC strains, two each belonging to serogroups O26, O45, O103, O111, O121, O145, and O157, were used to test detection in inoculated fecal suspensions at concentrations of 10(2) or 10(3) CFU/g. One STEC strain from each of these seven serogroups was used to estimate the concentration of recovered STEC in feces inoculated at 10(3), 10(4), or 10(5) CFU/g. Significantly more suspensions (P < 0.05) were positive for STEC when plated on Possé containing reduced concentrations of novobiocin and potassium tellurite compared with SHIBAM, but not SHIBAM modified by containing these same antimicrobials at the same concentrations. Numerically, more suspensions were positive for STEC by using this same form of modified Possé compared with Possé, but this difference was not statistically significant. More suspensions were positive for STEC cultured on CHROMagar STEC compared with those on Possé (P < 0.05) and on modified Possé (P = 0.05). Most inoculated fecal suspensions below 10(4) CFU/g of feces were underestimated or not quantifiable for the concentration of STEC by using CHROMagar STEC or modified Possé. These results suggest that CHROMagar STEC performs better than Possé or SHIBAM for detection of STEC in bovine feces, but adjustments in the concentrations of novobiocin and potassium tellurite in the latter two media result in significant improvements in their

  10. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  11. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  12. Nonthyroidal Illness (NTIs

    Directory of Open Access Journals (Sweden)

    Nanny Natalia Mulyani Soetedjo

    2009-09-01

    Full Text Available Nonthyroidal illness (NTIs can be described as abnormal findings on thyroid function tests that occur in the setting of a nonthyroidal illness (NTI without preexisting hypothalamic-pituitary and thyroid gland dysfunction. After recovery from an NTI, these thyroid function test result abnormalities should be completely reversible. Multiple alterations in serum thyroid function test findings have been recognized in patients with a wide variety of NTI without evidence of preexisting thyroid or hypothalamic-pituitary disease. The most prominent alterations are low serum triiodothyronine (T3 and elevated reverse T3 (rT3, leading to the general term low T3 syndrome. Thyroid-stimulating hormone (TSH, thyroxine (T4, and free T4 also are affected in variable degrees based on the severity and duration of the NTI. It cannot diagnosed NTIs only by measure one thyroid hormone. As the severity of the NTI increases, both serum T3 and T4 levels drop and gradually normalize as the patient recovers. It's still be an argument for administration of replacement T3 and T4 hormone in patients with NTIS. However, it is impossible to be certain at this time that it is beneficial to replace hormone, or whether this could be harmful. Only a prospective study will be adequate to prove this point, and probably this would need to involve hundreds of patients. Ongoing studies document the beneficial effects of replacement of other hormones in these acutely and severely ill patients.

  13. Exercise Prevents Mental Illness

    Science.gov (United States)

    Purnomo, K. I.; Doewes, M.; Giri, M. K. W.; Setiawan, K. H.; Wibowo, I. P. A.

    2017-03-01

    Multiple current studies show that neuroinflammation may contribute to mental illness such as depression, anxiety, and mood disorder. Chronic inflammation in peripheral tissues is indicated by the increase of inflammatory marker like cytokine IL-6, TNF-α, and IL-1β. Pro-inflammatory cytokine in peripheral tissues can reach brain tissues and activate microglia and it causes neuroinflammation. Psychological stress may led peripheral and central inflammation. Activated microglia will produce pro-inflammatory cytokine, ROS, RNS, and tryptophan catabolizes. This neuroinflammation can promote metabolism changes of any neurotransmitter, such as serotonin, dopamine, and glutamate that will influence neurocircuit in the brain including basal ganglia and anterior cingulated cortex. It leads to mental illness. Exercise give contribution to reduce tissue inflammation. When muscle is contracting in an exercise, muscle will produce the secretion of cytokine like IL-6, IL-1ra, and IL-10. It will react as anti-inflammation and influence macrophage, T cell, monosit, protein Toll-Like Receptor (TLR), and then reduce neuroinflammation, characterised by the decrease of pro-inflammatory cytokine and prevent the activation of microglia in the brain. The objective of the present study is to review scientific articles in the literature related to the contribution of exercise to prevent and ease mental illness.

  14. Advances in understanding illness anxiety.

    Science.gov (United States)

    Harding, Kelli J; Skritskaya, Natalia; Doherty, Emily; Fallon, Brian A

    2008-08-01

    Illness anxiety, also known in its more severe form as hypochondriasis, is a debilitating and chronic condition in which normal bodily symptoms are misinterpreted as signs of serious medical illness. Patients suffer with the fear that they are ill despite reassurance to the contrary and often overuse medical services in the process. This article critically evaluates the recent literature on illness anxiety and related, medically unexplained symptoms, highlighting new and interesting findings in the areas of prevalence, classification/diagnosis, management, and evidence-based treatment and new frontiers in understanding illness anxiety, such as brain imaging, neuroimmunology, and cyberchondria.

  15. Mental Illness And Brain Disease

    Directory of Open Access Journals (Sweden)

    Bedrick Jeffrey D.

    2014-12-01

    Full Text Available It has become common to say psychiatric illnesses are brain diseases. This reflects a conception of the mental as being biologically based, though it is also thought that thinking of psychiatric illness this way will reduce the stigma attached to psychiatric illness. If psychiatric illnesses are brain diseases, however, it is not clear why psychiatry should not collapse into neurology, and some argue for this course. Others try to maintain a distinction by saying that neurology deals with abnormalities of neural structure while psychiatry deals with specific abnormalities of neural functioning. It is not clear that neurologists would accept this division, nor that they should. I argue that if we take seriously the notion that psychiatric illnesses are mental illnesses we can draw a more defensible boundary between psychiatry and neurology. As mental illnesses, psychiatric illnesses must have symptoms that affect our mental capacities and that the sufferer is capable of being aware of, even if they are not always self-consciously aware of them. Neurological illnesses, such as stroke or multiple sclerosis, may be diagnosed even if they are silent, just as the person may not be aware of having high blood pressure or may suffer a silent myocardial infarction. It does not make sense to speak of panic disorder if the person has never had a panic attack, however, or of bipolar disorder in the absence of mood swings. This does not mean psychiatric illnesses are not biologically based. Mental illnesses are illnesses of persons, whereas other illnesses are illnesses of biological individuals.

  16. Gaius Caligula's mental illness.

    Science.gov (United States)

    Sidwell, Barbara

    2010-01-01

    The strange behavior of emperor Gaius has been the subject of debate for many historians. Some charge him with madness and attribute it to his illness in A.D. 37, whereas others believe it occurred later, or else had nothing to do with his sickness.We have no real evidence to reconstruct his mental state. Therefore speculations about madness are fruitless, as they can't be proven. Also, his madness belongs to a discourse which originates mainly from the senatorial narrative that sought to discredit him through any means possible. Thus, his acts should be seen from other angles, and the search for "mad Caligula" abandoned.

  17. Attributing illness to food

    DEFF Research Database (Denmark)

    Batz, M. B.; Doyle, M. P.; Morris, J. G.

    2005-01-01

    Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other...... of a risk-based approach to improving food safety....... source responsible for illness. A wide variety of food attribution approaches and data are used around the world including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored...

  18. ILL Annual report 97

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    In 1997 the reactor operated for the planned 225 days and more than 750 experiments were carried out. Among the experimental highlights are 2 contrasting examples of the new types of experiments now possible using the new high-intensity diffractometer D2O: stroboscopic measurements of kinetic processes and rapid texture measurements of structural materials. Some early results from the new high-resolution gamma spectrometer in the study of nuclear structure are also presented. Another new facility is just coming into service: the 2{pi} image-plate detector LADI, optimised for Laue measurements on biological crystals. The contrast between biological experiments and for example those on superconductivity or neutron {beta}-decay, illustrates very well the range of scientific questions addressed through the use of ILL`s neutron beams. 30 brief accounts of research work achieved during this year are given, they are classified under 9 topics: polymers and colloids, chemistry and structure, biology, materials science, liquids and glasses, magnetism, strongly correlated electron systems, quantum systems, nuclear and fundamental physics. The scheduled new developments are described and a list of the publications is also given

  19. Role of bacteriophages in STEC infections: new implications for the design of prophylactic and treatment approaches [v2; ref status: indexed, http://f1000r.es/437

    Directory of Open Access Journals (Sweden)

    Jaime H. Amorim

    2014-08-01

    Full Text Available Shiga toxin (Stx is considered the main virulence factor in Shiga toxin-producing Escherichia coli (STEC infections. Previously we reported the expression of biologically active Stx by eukaryotic cells in vitro and in vivo following transfection with plasmids encoding Stx under control of the native bacterial promoter1,2. Since stx genes are present in the genome of lysogenic bacteriophages, here we evaluated the relevance of bacteriophages during STEC infection. We used the non-pathogenic E. coli C600 strain carrying a lysogenic 933W mutant bacteriophage in which the stx operon was replaced by a gene encoding the green fluorescent protein (GFP. Tracking GFP expression using an In Vivo Imaging System (IVIS, we detected fluorescence in liver, kidney, and intestine of mice infected with the recombinant E. coli strain after treatment with ciprofloxacin, which induces the lytic replication and release of bacteriophages. In addition, we showed that chitosan, a linear polysaccharide composed of d-glucosamine residues and with a number of commercial and biomedical uses, had strong anti-bacteriophage effects, as demonstrated at in vitro and in vivo conditions. These findings bring promising perspectives for the prevention and treatment of haemolytic uremic syndrome (HUS cases.

  20. The stigma of mental illness

    OpenAIRE

    Kordosi A; Saridi M; Souliotis K

    2015-01-01

    Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the...

  1. Subjective Illness theory and coping

    Directory of Open Access Journals (Sweden)

    Gessmann H.-W.

    2015-03-01

    Full Text Available The article presents a view of a problem of subjective illness theory in context of coping behavior. The article compiles the results of the latest studies of coping; discloses the way subjective illness theory affects the illness coping and patient's health; presents the study of differences in coping behaviour of patients at risk of heart attack and oncology. The article is recommended for specialists, concerned with psychological reasons of pathogenic processes and coping strategies of patients.

  2. Protein requirement in critical illness.

    Science.gov (United States)

    Hoffer, Leonard John

    2016-05-01

    How much protein do critically ill patients require? For the many decades that nutritional support has been used there was a broad consensus that critically ill patients need much more protein than required for normal health. Now, however, some clinical investigators recommend limiting all macronutrient provision during the early phase of critical illness. How did these conflicting recommendations emerge? Which of them is correct? This review explains the longstanding recommendation for generous protein provision in critical illness, analyzes the clinical trials now being claimed to refute it, and concludes with suggestions for clinical investigation and practice.

  3. Attributing illness to food

    DEFF Research Database (Denmark)

    Batz, M. B.; Doyle, M. P.; Morris, J. G.

    2005-01-01

    Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other s...... of a risk-based approach to improving food safety.......Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other...... source responsible for illness. A wide variety of food attribution approaches and data are used around the world including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored...

  4. Illness narratives in cancer

    DEFF Research Database (Denmark)

    Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann

    2011-01-01

    Objectives: In this paper,we investigate Danish cancer patients’ narratives on spiritual beliefs and practices and the relationship these practices may have to complementary and alternative medicine (CAM). Design: Narrative inquiry is used to uncover how spiritual beliefs and practices may...... be related to CAM. The analysis is based on empirical findings from a recent PhD project. During a two-year period first author followed 32 cancer patients, family, friends and alternative practitioners through interviews, telephone conversations, treatments and in focus groups. Results: As a general pattern......, religious and spiritual issues were not extensively unfolded in participants’ illness narratives. However, these issues were significantly elaborated on in narratives by four female participants. Conclusion: We propose that for some cancer patients CAM may function, not only or primarily as a treatment...

  5. [Nutrition in critical illness].

    Science.gov (United States)

    Ökrös, Ilona

    2014-12-21

    Critically ill patients are often unable to eat by themselves over a long period of time, sometimes for weeks. In the acute phase, serious protein-energy malnutrition may develop with progressive muscle weakness, which may result in assisted respiration of longer duration as well as longer stay in intensive care unit and hospital. In view of the metabolic processes, energy and protein intake targets should be defined and the performance of metabolism should be monitored. Enteral nutrition is primarily recommended. However, parenteral supplementation is often necessary because of the disrupted tolerance levels of the gastrointestinal system. Apparently, an early parenteral supplementation started within a week would be of no benefit. Some experts believe that muscle loss can be reduced by increased target levels of protein. Further studies are needed on the effect of immune system feeding, fatty acids and micronutrients.

  6. 肝片吸虫 Fh8明显增强 STEC 的 Stx1可溶性表达及 Stx1单克隆抗体制备%Fasciola hepatica 8 Significantly Enhances Soluble Expression of Stx1 from STEC and Stx1 Monoclonal Antibody Preparation

    Institute of Scientific and Technical Information of China (English)

    张雪寒; 张碧成; 张强; 汪伟; 何孔旺

    2016-01-01

    Shiga toxin 1 (Stx1 ),AB5 pentamers protein,is one of major virulent factors of Shiga Toxin-produ-cing Escherichia coli (STEC).The N-terminal fragment of Stx1 A subunit encodes a signal peptide,and its C-termi-nal amino acid sequences presents high hydrophobicity and low immunogenicity by bioinformatics software analysis, and these features lead to expression failure and inclusion of target protein.In this study,our aim is to clone stx1 gene and express soluble protein for development of monoclonal antibodies against Stx1 A.The 21 0 bp of Fh8 gene from Fasciola hepatica was cloned into pCold Ⅰ with Nde Ⅰ and Xho Ⅰ,and the middle fragment between 73 -759 ntof stx1A subunit was amplified,fused with Fh8 gene to construct recombinant strain of BL21 (DE3)/pColdⅠ-Fh8-stx1.His-Fh8-stx1A was immunized Balb /c mice to prepare positive hybridomas and monoclonal antibodies by Sp2 /0 cell fusion screening.We successfully constructed a recombinant plasmid pCold Ⅰ-Fh8-stx1a,expressed His-Fh8-Stx1 A in prokaryotic cells in soluble form.Three stably secreting anti-Stx1 A monoclonal antibodies (McAb)of hybridoma cell lines were developed,one of them was used to prepare high titer ascites.Western Blot assay showed ascites after purified are able to react with recombinant His-Fh8-Stx1 A and Shiga toxin 1 crude ex-tract.We successfully prepared soluble Stx1 A protein with good antigenicity,and three monoclonal antibodies with high titers,these will lay substantial foundation for future study,i.e.developing sandwich ELISA and colloidal gold test strip to detect STEC.%志贺毒素1(Shiga toxin 1,Stx1),系五聚体蛋白,是产志贺毒素性大肠杆菌(Shiga Toxin-producing Escherichia coli,STEC)主要的毒素因子,但 Stx1体外极不易可溶性表达,旨在克隆和表达志贺毒素1(Shiga toxin 1,Stx1)A 亚基,体外获得可溶性表达的 Stx1,以研制单克隆抗体。生物信息学软件分析 Stx1 A 亚基氨基酸序列,Stx1 A1

  7. Aspects of spirituality concerning illness

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Jochemasen, Henk; Post, Doeke

    2007-01-01

    The spiritual dimension of illness, health and care may be seen as a unique aspect in addition to the physical, mental and social dimension. This contribution describes experiences of patients, nurses and hospital chaplains in relation to the spiritual aspects of being ill. Qualitative research was

  8. Water Recreation and Illness Severity

    Science.gov (United States)

    Abstract Background: The health endpoint of prior studies of water recreation has been the occurrence gastrointestinal (GI) of illness. The use of this dichotomous health outcome fails to take into account the range of symptom severity among those with GI illness, as well as thos...

  9. Aspects of spirituality concerning illness

    NARCIS (Netherlands)

    van Leeuwen, Rene; Tiesinga, Lucas J.; Jochemasen, Henk; Post, Doeke

    2007-01-01

    The spiritual dimension of illness, health and care may be seen as a unique aspect in addition to the physical, mental and social dimension. This contribution describes experiences of patients, nurses and hospital chaplains in relation to the spiritual aspects of being ill. Qualitative research was

  10. Staging of unipolar affective illness

    Directory of Open Access Journals (Sweden)

    Ewa Ferensztajn

    2014-12-01

    Full Text Available In this article, a concept of staging of unipolar affective illness (recurrent depression is presented. In respective subchapters, three most important aspects of this issue have been discussed: 1 staging of unipolar affective illness; 2 staging of treatment-resistant depression; and 3 conversion of unipolar into bipolar affective illness. The evidence for so called neuroprogression of the illness, accumulated in recent years, has allowed for a classification of staging based on a concept of allostasis and allostatic load. In the course of illness, changes in neuroendocrine system (mainly hypothalamic pituitary-adrenal (HPA axis, immunological system, mechanisms of oxidative stress, neurotransmitters, neurotrophic factors as well as structural and functional changes of the brain occur. In their paper of 2007, Fava and Tossani elaborated a concept of staging of unipolar affective illness presenting a continuum model of five consecutive stages with specific clinical features. In the present paper, a concept of treatment-resistant depression and staging of treatment resistance is presented in the context of several models. An important determinant of treatment-resistant depression is so called subthreshold bipolarity which is connected with worse efficacy of antidepressant drugs. In the course of illness, there is a possibility of changing diagnosis from recurrent depression into bipolar affective illness. The studies on this issue show that frequency of such diagnostic conversion is 1,5% of depressed patients per year.

  11. Role conflict, uncertainty in illness, and illness-related communication avoidance: College students facing familial chronic illness

    OpenAIRE

    Suchak, Meghana

    2014-01-01

    The focus of the current study was on examining possible differences in college students' adjustment based on residency status (i.e., international Asian vs. domestic students) and illness status (i.e., having a family member with a chronic illness vs. not having a family member with a chronic illness). The study also examined the associations between overall college student adjustment and the family and illness-related factors of role conflict, uncertainty in illness, and illness-related com...

  12. Youth blogging and serious illness.

    Science.gov (United States)

    Nesby, Linda; Salamonsen, Anita

    2016-03-01

    In recent years, a growing number of young people who experience illness tend to blog about it. In this paper, we question whether and how illness blogs illustrate the intercommunicative aspect of blogging by bringing forth both the literary concept of the implied reader and the sociological concepts of empowerment and agency in the analysis. We argue that young people blogging about serious illness demonstrate the inherent intercommunicative potential of blogging. We also argue that youth blogging about serious illness may represent a fruitful strategy for ill young people to create meaning, stay front-stage in youth communities and build self-esteem and confidence out of chaos. Furthermore, we argue that these blogs may contribute rather unique experience-based knowledge and reflections about existential issues to other young blog readers, who may otherwise not get access to this aspect of life. Youth blogging about serious illness thereby reflects a patient group so far not very visible and through the genre youth stand out as more competent when it comes to illness and healthcare issues than what is often presumed.

  13. The role of extraintestinal foodborne pathogens in human illness

    Science.gov (United States)

    In recent years understanding the role of foodborne pathogens in human disease has evolved to include conditions outside the gastrointestinal diseases typically associated with bacteria such as Salmonella, Shiga toxin-producing Escherichia coli (STEC), Listeria monocytogenes, etc. Other human pathog...

  14. Parvovirus B19 and Other Illnesses

    Science.gov (United States)

    ... Cheek Rash Parvovirus B19 and Other Illnesses References Parvovirus B19 and Other Illnesses Recommend on Facebook Tweet ... disease is the most common illness caused by parvovirus B19 infection. Learn More Parvovirus B19 infection can ...

  15. [Non thyroidal illnesses (NTIS)].

    Science.gov (United States)

    Luca, F; Goichot, B; Brue, T

    2010-09-01

    Abnormalities in the circulating levels of thyroid hormones, without evidence of coexisting thyroid or pituitary gland disease can be observed in all general diseases. These nonthyroidal illnesses (NTIS) are the result of complex mechanisms that combine the effect of some drugs, cytokines, nutritional and endocrine factors at all levels of the thyrotropic axis, from the hypothalamus to the cellular transporters and nuclear receptors of thyroid hormones. The patterns of NTIS depend on the underlying disease and its severity. Thirtyfive years after the initial description, the pathophysiological significance of these anomalies remains controversial. One of the dilemma of NTIS is whether the hormone responses represent an adaptive and normal, physiologic response to conserve energy and protect against hypercatabolism in case of aggression, or whether it is a maladaptive response contributing to a worsening of the disease. This debate is not just a theoretical question, because in the first case the process must be respected, in the other case a vigorous treatment to restore circulating thyroid hormone levels is justified. There have been very few clinical studies designed to address whether the substitution with thyroid hormone is advantageous, and there is at current time no permissive evidence for the use of thyroid hormone replacement in patients with NTIS. But the clinical context, the choice of the molecule or of the dose and the way of administration were not necessarily the most relevant. Theoretically, stimulation of thyreotrope axis used a continuous infusion of TRH seems to provide clinical benefit. With the expectation that randomized clinical trials will provide demonstration of NTIS treatment efficiency, the question might remain unanswered for several more years.

  16. Ionizing radiation injuries and illnesses.

    Science.gov (United States)

    Christensen, Doran M; Iddins, Carol J; Sugarman, Stephen L

    2014-02-01

    Although the spectrum of information related to diagnosis and management of radiation injuries and illnesses is vast and as radiation contamination incidents are rare, most emergency practitioners have had little to no practical experience with such cases. Exposures to ionizing radiation and internal contamination with radioactive materials can cause significant tissue damage and conditions. Emergency practitioners unaware of ionizing radiation as the cause of a condition may miss the diagnosis of radiation-induced injury or illness. This article reviews the pertinent terms, physics, radiobiology, and medical management of radiation injuries and illnesses that may confront the emergency practitioner. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Microbiological water quality of Igapó Lake Londrina - PR and genotypic characterization of virulence factors associated with enteropathogenic Escherichia coli (EPEC and Shiga toxin-producing E. coli (STEC

    Directory of Open Access Journals (Sweden)

    Paulo Alfonso Schuroff

    2014-12-01

    Full Text Available This work aimed at the detection and quantification of Total Coliforms and Escherichia coli in Igapó Lake, in order to evaluate the quality of these waters as proper or unfit for recreation, in addition to the genotypic characterization of virulence factors associated with EPEC and STEC by PCR. The study area was the Igapó Lake I, II, III and IV. Samples were collected monthly from March 2011 to February 2012. The technique used for the detection and quantification of Total Coliforms and E. coli was the Colilert chromogenic substrate. In the technique of PCR, the eae and bfp genes were tested to characterize the typical EPEC pathotype; stx1, stx2, eae and hlyA the STEC pathotype and the samples that presented only the eae gene were characterized as atypical EPEC. According to CONAMA Resolution 357/2005, it has been observed that only Igapó Lake III was rated inappropriate for primary contact recreation, while for secondary contact recreation, all lakes were considered appropriate. Moreover, a strong relationship between rainfall and E. coli indices in Igapó Lake can be observed, which in dry months the quantity drastically decreases, while in rainy months the opposite relationship was observed. Of the 97 strains of E. coli isolated, two had the eae gene (atypical EPEC. None of the isolates contained genes stx1, stx2, bfp and hlyA. Thus, we hope to educate the population and public agencies of the importance of microbiological monitoring of recreational waters to prevent outbreaks of waterborne infections.

  18. Improving Communication About Serious Illness

    Science.gov (United States)

    2017-01-07

    Critical Illness; Chronic Disease; Terminal Care; Palliative Care; Communication; Advance Care Planning; Neoplasm Metastasis; Lung Neoplasms; Pulmonary Disease, Chronic Obstructive; Heart Failure; End Stage Liver Disease; Kidney Failure, Chronic

  19. Student Attitudes Toward Mental Illness

    Science.gov (United States)

    Hare-Mustin, Rachel T.; Garvine, Richard

    1974-01-01

    Inquiry into the initial attitudes toward mental illness of students taking an abnormal psychology class indicates students' concerns and preconceptions and provides a basis for shaping the course to respond to student needs. (JH)

  20. Living with Mentally Ill Parent

    Directory of Open Access Journals (Sweden)

    Kadriye Buldukoglu

    2011-12-01

    Full Text Available The present review seeks to identify and analyze qualitative studies that examined experiences of children whose parents have a mental illness. This study reported that children whose parents have a mental illness had some common experiences. These experiences may have negative effects on children’s coping skills, resilience to tough living conditions and ability to maintain their mental health. In spite of these negative conditions, some of these children have much more self-confidence, resilience and independence because of inner development and early maturation. Some effective intervention programs are needed to promote information to children and other family members about mental illness, coping behaviors. Availability of such psychiatric services and nation-wide programs with professionals to deal with these problems should be organized properly to increase quality of life of these children. Furthermore, qualitative researches that explore the experiences of children whose parents with mental illness should also be conducted in our country.

  1. The Ubiquity of Chronic Illness.

    Science.gov (United States)

    Fonseca, Claudia; Fleischer, Soraya; Rui, Taniele

    2016-01-01

    This is a review of five different books dealing with some aspect of what might be termed a "chronic illness" - Alzheimer's disease, lupus, addiction, erectile dysfunction, and leprosy. The array of different subjects examined in these books points to the negotiable limits of this hugely open category. What exactly constitutes an "illness"? Why not use a less biomedical term instead: "disturbance", "problem", or simply "condition"? And how are we to understand "chronic" - simply as the flipside of "acute" or "curable"?

  2. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  3. Dependency in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Rumei Yang

    2016-03-01

    Full Text Available By necessity, critically ill patients admitted to intensive care units (ICUs have a high level of dependency, which is linked to a variety of negative feelings, such as powerlessness. However, the term dependency is not well defined in the critically ill patients. The concept of “dependency” in critically ill patients was analyzed using a meta-synthesis approach. An inductive process described by Deborah Finfgeld-Connett was used to analyze the data. Overarching themes emerged that reflected critically ill patients’ experience and meaning of being in dependency were (a antecedents: dependency in critically ill patients was a powerless and vulnerable state, triggered by a life-threatening crisis; (b attributes: the characteristic of losing “self” was featured by dehumanization and disembodiment, which can be alleviated by a “self”-restoring process; and (c outcomes: living with dependency and coping with dependency. The conceptual model explicated here may provide a framework for understanding dependency in critically ill patients.

  4. Prevalence and Characterization of Shiga Toxin-Producing Escherichia coli Isolated from Slaughtered Qurban Animal in Jakarta Province

    Directory of Open Access Journals (Sweden)

    Siti Gusti Ningrum

    2016-08-01

    Full Text Available This study was conducted to investigate the presence of shiga toxin producing Escherichia coli (STEC and the possibility of carrying rfbE gene and H7 flagellar on meat, liver, and stool samples collected from Jakarta Province of Indonesia. A total of 51 samples collected from meat, liver, and stool of slaughtered cattle from qurban festival were tested using conventional culture and multiplex PCR methods. STEC non O157 were detected in meat (5.3% and stool (8.3% with one isolate from stool carried H7 flagellar. However, all isolates were lacking of rfbE gene. In antimicrobial susceptibility tests, the STEC isolates showed antibiotic resistance to erythromycin and oxacillin. Overall, the result shows that meat and liver of this origin activity represents a potential risk to human health.

  5. [Gustave Flaubert's illness].

    Science.gov (United States)

    Gastaut, H; Gastaut, Y

    1982-01-01

    All those interested in Gustave Flaubert's illness, during his lifetime as well as after his death, have agreed that he had epilepsy. The one important exception is Jean-Paul Sartre, who, in the 2800 pages of his "Idiot de la famille" claimed that Flaubert was a hysteric with very moderate intelligence who somatized his neurosis in the form of seizures. These, in Sartre's views, were moreover probably hysterical, but possibly epileptic resulting from the existence of a psychogenic epilepsy bred from the neurosis. The basis for this neurosis could have originated at the time of Gustave's birth, as this occurred between those of two brothers who both died young, and as his mother had wished for a daughter. Further development of the neurosis might have taken place during a temporary phase of learning difficulties, exaggerated and exploited by his father to make his youngest son the idiot of a family in which the eldest son was the dauphin. Destroyed in this way, Gustave would have sought refuge in passivity and could have developed a hatred for his father and for his elder brother, who he would have liked to kill before killing himself. But, unable to carry out his wishes and desiring both to die and to survive, Gustave, adolescent, might have chosen the pathway of "false deaths", as exemplified by the seizures. Modern epileptology data enables not only to confirm the epileptic etiology and to discount the hysterical nature of the fits, but also: 1. to establish precise details of the site and nature of the cerebral lesions responsible for the attacks: neonatal atrophy or vascular malformation of the occipitotemporal cortex of the left hemisphere, the only lesion capable of provoking: a) the phosphenes marking the onset of the seizures; b) the intellectual manifestations (forced thoughts or flight of ideas), affective features (panic terror), and psychosensory (ecmnesic hallucinations) or psychomotor (confusional automatism) symptoms accompanying some attacks; c) the

  6. The stigma of mental illness

    Directory of Open Access Journals (Sweden)

    Kordosi A

    2015-10-01

    Full Text Available Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the individual. The search for sources of this review was made through books on the topic and articles of the last twenty years, from online internet sources (pubmed, scopus, google scholar. Literature Review:Stigma brought about by illness from mental illness, is a complex process and concept, located in social interaction and the dynamics of social relations. The social stigma borne by mental illness in general, as well as the lack of information, ignorance, stereotypes, myths and prejudices, are the main reasons that characterize, even today, depression as a taboo subject. The stigma of mental illness is indeliblyimprinted in the identity of human suffering. In any case, the impact of stigma is critical for people who are sick. The psychological stress and difficult conditions that shape their daily lives aggravate their already compromised mental health, having a significant impact on the course and outcome of the disease itself. Key strategies to address stigma are protest, education and contact. Conclusions:A significant step in combating the stigma is to raise public awareness on the issues of mental health and their inclusion in society.

  7. Illness in the Returned International Traveler.

    Science.gov (United States)

    Sanford, Christopher A; Fung, Claire

    2016-03-01

    Familiarity with the distribution, mode of transmission, and risk factors for acquisition of illnesses commonly transmitted to travelers to low-income nations can help guide clinicians in their work-up of an ill returned traveler. The 3 most common categories of illness in returned international travelers are gastrointestinal illness, fever, and dermatoses. Diarrhea is the most common illness reported in returned international travelers. Fever is a marker of a potentially significant illness; work-up of the ill febrile returned traveler should be conducted promptly. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Psychodynamics in medically ill patients.

    Science.gov (United States)

    Nash, Sara Siris; Kent, Laura K; Muskin, Philip R

    2009-01-01

    This article explores the role of psychodynamics as it applies to the understanding and treatment of medically ill patients in the consultation-liaison psychiatry setting. It provides historical background that spans the eras from Antiquity (Hippocrates and Galen) to nineteenth-century studies of hysteria (Charcot, Janet, and Freud) and into the twentieth century (Flanders Dunbar, Alexander, Engle, and the DSM). The article then discusses the effects of personality on medical illness, treatment, and patients' ability to cope by reviewing the works of Bibring, Kahana, and others. The important contribution of attachment theory is reviewed as it pertains the patient-physician relationship and the health behavior of physically ill patients. A discussion of conversion disorder is offered as an example of psychodynamics in action. This article highlights the important impact of countertransference, especially in terms of how it relates to patients who are extremely difficult and "hateful," and explores the dynamics surrounding the topic of physician-assisted suicide, as it pertains to the understanding of a patient's request to die. Some attention is also given to the challenges surrounding the unique experience of residents learning how to treat medically ill patients on the consultation-liaison service. Ultimately, this article concludes that the use and understanding of psychodynamics and psychodynamic theory allows consultation-liaison psychiatrists the opportunity to interpret the life narratives of medically ill patients in a meaningful way that contributes importantly to treatment.

  9. Somali Refugees' Perceptions of Mental Illness.

    Science.gov (United States)

    Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie

    2015-01-01

    Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.

  10. National Survey of Shiga Toxin-Producing Escherichia coli Serotypes O26, O45, O103, O111, O121, O145, and O157 in Australian Beef Cattle Feces.

    Science.gov (United States)

    Mellor, Glen E; Fegan, Narelle; Duffy, Lesley L; McMILLAN, Kate E; Jordan, David; Barlow, Robert S

    2016-11-01

    Escherichia coli O157 and six non-O157 Shiga toxin-producing E. coli (STEC) serotypes (O26, O45, O103, O111, O121, and O145, colloquially referred to as the "big 6") have been classified as adulterants of raw nonintact beef products in the United States. While beef cattle are a known reservoir for the prototype STEC serotype, E. coli O157, less is known about the dissemination of non-O157 STEC serotypes in Australian cattle. In the present study, 1,500 fecal samples were collected at slaughter from adult (n =628) and young (n =286) beef cattle, adult (n =128) and young (n =143) dairy cattle, and veal calves (n = 315) across 31 Australian export-registered processing establishments. Fecal samples were enriched and tested for E. coli O157 and the big 6 STEC serotypes using BAX System PCR and immunomagnetic separation methods. Pathogenic STEC (pSTEC; isolates that possess stx, eae, and an O antigen marker for O157 or a big 6 serotype) were isolated from 115 samples (7.7%), of which 100 (6.7%) contained E. coli O157 and 19 (1.3%) contained a big 6 serotype. Four of the 115 samples contained multiple pSTEC serotypes. Among samples confirmed for big 6 pSTEC, 15 (1%) contained E. coli O26 and 4 (0.3%) contained E. coli O111. pSTEC of serotypes O45, O103, O121, and O145 were not isolated from any sample, even though genes indicative of E. coli belonging to these serotypes were detected by PCR. Analysis of animal classes revealed a higher pSTEC prevalence in younger animals, including veal (12.7%), young beef (9.8%), and young dairy (7.0%), than in adult animals, including adult beef (5.1%) and adult dairy (3.9%). This study is the largest of its kind undertaken in Australia. In contrast to E. coli O157 and consistent with previous findings, this study reports a relatively low prevalence of big 6 pSTEC serotypes in Australian cattle populations.

  11. Presence of faecal coliforms, Escherichia coli and diarrheagenic E. coli pathotypes in ready-to-eat salads, from an area where crops are irrigated with untreated sewage water.

    Science.gov (United States)

    Castro-Rosas, Javier; Cerna-Cortés, Jorge F; Méndez-Reyes, Eligio; Lopez-Hernandez, Daniel; Gómez-Aldapa, Carlos A; Estrada-Garcia, Teresa

    2012-05-15

    from restaurant A(2) and 3 were (Mixed salad) samples from each C restaurant. Three samples harboured non-O157 STEC strains, 2 EIEC, 1 ETEC and 2 samples had non-O157 STEC and EIEC strains, simultaneously. A significant difference (p=0.008) between the prevalence of E. coli vs. DEPs was observed. Independently of the restaurants' overall hygienic status, most RTE-salads had a poor microbiological quality and some harboured DEPs that have been associated with illness in Mexico. Health authorities should focus on implementing DEPs screening in raw vegetables and enforcing the legislation that forbids irrigation with untreated sewage water of both root and leafy vegetables. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. Carrion's disease: an eradicable illness?

    Science.gov (United States)

    Gomes, Cláudia; Pons, Maria J; Del Valle Mendoza, Juana; Ruiz, Joaquim

    2016-12-01

    Carrion's disease is a neglected tropical disease caused by Bartonella bacilliformis, a vector-borne pathogen restricted to the Andean valleys of Peru, Ecuador and Colombia. Carrion's disease is a biphasic illness; in the acute phase the case-fatality rate can be as high as 88 %, related to high parasitemia, arriving to almost all erythrocytes, and secondary bacterial infections close related with the development of transient immunosuppression in the earlier illness phases. In addition, there are an undefined number of asymptomatic carriers that are reservoirs of the etiological agent of Carrion's disease in endemic areas, they make take into account due to they are the perpetuators of this disease. The actual scenario of Carrion's disease, in which the illness is arriving to new areas, due to the expansion of the vector's distribution, suggests that now may be a crucial time to design a strategy focusing on its elimination.

  13. [Illness behavior in chronic pain].

    Science.gov (United States)

    Lavielle, Pilar; Clark, Patricia; Martínez, Homero; Mercado, Francisco; Ryan, Gery

    2008-01-01

    To describe the illness behaviour in patients with chronic pain. We conducted semi-structured interviews to 53 patients during 2000, in a tertiary care center. We explored their initial interpretations, responses and subsequent practices to chronic pain, until they received a diagnosis that satisfied them. Illness behaviour was determined by pain intensity and disability; beliefs regarding pain causes, trust in social networks, and quality and satisfaction with the health care systems. In terms of the decision to seek care, the first option was to go to the popular sector, followed by consulting a general physician, and as last resort, to go to a tertiary care center ("with a specialist"). Illness behaviour should be conceptualized as a process, which combines the use of different health care sectors by the same subjects, as a result of care provided sequentially by each previous sector.

  14. Serious Illness Conversations in ESRD.

    Science.gov (United States)

    Mandel, Ernest I; Bernacki, Rachelle E; Block, Susan D

    2017-05-08

    Dialysis-dependent ESRD is a serious illness with high disease burden, morbidity, and mortality. Mortality in the first year on dialysis for individuals over age 75 years old approaches 40%, and even those with better prognoses face multiple hospitalizations and declining functional status. In the last month of life, patients on dialysis over age 65 years old experience higher rates of hospitalization, intensive care unit admission, procedures, and death in hospital than patients with cancer or heart failure, while using hospice services less. This high intensity of care is often inconsistent with the wishes of patients on dialysis but persists due to failure to explore or discuss patient goals, values, and preferences in the context of their serious illness. Fewer than 10% of patients on dialysis report having had a conversation about goals, values, and preferences with their nephrologist, although nearly 90% report wanting this conversation. Many nephrologists shy away from these conversations, because they do not wish to upset their patients, feel that there is too much uncertainty in their ability to predict prognosis, are insecure in their skills at broaching the topic, or have difficulty incorporating the conversations into their clinical workflow. In multiple studies, timely discussions about serious illness care goals, however, have been associated with enhanced goal-consistent care, improved quality of life, and positive family outcomes without an increase in patient distress or anxiety. In this special feature article, we will (1) identify the barriers to serious illness conversations in the dialysis population, (2) review best practices in and specific approaches to conducting serious illness conversations, and (3) offer solutions to overcome barriers as well as practical advice, including specific language and tools, to implement serious illness conversations in the dialysis population. Copyright © 2017 by the American Society of Nephrology.

  15. Cost of illness and illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    Vervoort, V.M.C.; Vriezekolk, J.E.; Olde Hartman, T.C.; Cats, H.A.; van Helmond, T.; Van der Laan, W.H.; Geenen, R.; Van den Ende, C.H.M.

    2016-01-01

    OBJECTIVES: The disease impact and economic burden of fibromyalgia (FM) are high for patients and society at large. Knowing potential determinants of economic costs may help in reducing this burden. Cognitive appraisals (perceptions) of the illness could affect costs. The present study estimated

  16. Assessment of virulence factors characteristic of human Escherichia coli pathotypes and antimicrobial resistance in O157:H7 and non-O157:H7 isolates from livestock in Spain.

    Science.gov (United States)

    Cabal, A; Gómez-Barrero, S; Porrero, C; Bárcena, C; López, G; Cantón, R; Gortázar, C; Domínguez, L; Álvarez, J

    2013-07-01

    The distribution of virulence factors (VFs) typical of diarrheagenic Escherichia coli and the antimicrobial resistance (AMR) profiles were assessed in 780 isolates from healthy pigs, broilers, and cattle from Spain. VF distribution was broader than expected, although at low prevalence for most genes, with AMR being linked mainly to host species.

  17. Assessment of Virulence Factors Characteristic of Human Escherichia coli Pathotypes and Antimicrobial Resistance in O157:H7 and Non-O157:H7 Isolates from Livestock in Spain

    OpenAIRE

    2013-01-01

    The distribution of virulence factors (VFs) typical of diarrheagenic Escherichia coli and the antimicrobial resistance (AMR) profiles were assessed in 780 isolates from healthy pigs, broilers, and cattle from Spain. VF distribution was broader than expected, although at low prevalence for most genes, with AMR being linked mainly to host species.

  18. Assessing illness- and non-illness-based motivations for violence in persons with major mental illness.

    Science.gov (United States)

    Penney, Stephanie R; Morgan, Andrew; Simpson, Alexander I F

    2016-02-01

    Research on violence perpetrated by individuals with major mental illness (MMI) typically focuses on the presence of specific psychotic symptoms near the time of the violent act. This approach does not distinguish whether symptoms actually motivate the violence or were merely present at the material time. It also does not consider the possibility that non-illness-related factors (e.g., anger, substance use), or multiple motivations, may have been operative in driving violence. The failure to make these distinctions clouds our ability to understand the origins of violence in people with MMI, to accurately assess risk and criminal responsibility, and to appropriately target interventions to reduce and manage risk. This study describes the development of a new coding instrument designed to assess motivations for violence and offending among individuals with MMI, and reports on the scheme's interrater reliability. Using 72 psychiatric reports which had been submitted to the court to assist in determining criminal responsibility, we found that independent raters were able to assess different motivational influences for violence with a satisfactory degree of consistency. More than three-quarters (79.2%) of the sample were judged to have committed an act of violence as a primary result of illness, whereas 20.8% were deemed to have offended as a result of illness in conjunction with other non-illness-based motivating influences. Current findings have relevance for clarifying the rate of illness-driven violence among psychiatric patients, as well as legal and clinical issues related to violence risk and criminal responsibility more broadly.

  19. Estimates of Foodborne Illness in the United States -- Burden of Foodborne Illness: Findings

    Science.gov (United States)

    ... Illness Trends Foodborne Outbreaks Foodsafety.gov Burden of Foodborne Illness: Findings Recommend on Facebook Tweet Share Compartir ... CDC provides estimates for two major groups of foodborne illnesses Known foodborne pathogens — 31 pathogens known ...

  20. Nonthyroidal illness syndrome in children.

    Science.gov (United States)

    Marks, Seth D

    2009-12-01

    Neuroendocrine changes in the hypothalamic-pituitary-thyroid axis during critical illness result in nonthyroidal illness syndrome (NTIS) characterized by abnormal thyrotropin (TSH) and thyroid hormone levels. Studies looking at the natural history of neuroendocrine changes during critical illness have revealed the presence of NTIS. NTIS has been described in a variety of patient settings. Many studies have tried to uncover the pathophysiology behind NTIS and several theories are proposed. Whether NTIS requires treatment or intervention is still controversial and the results of the treatment studies are arguably mixed. Whether implicitly stated or not, the underlying purpose of all the natural history, pathophysiology, or treatment studies is to determine whether NTIS is adaptive or maladaptive. Some studies have illustrated a correlation between illness severity and the degree of NTIS but a cause and effect relationship is still elusive. The human studies can be divided between those with either adult or pediatric subjects, with much less data available in the latter. This review examines the available literature on NTIS with an emphasis on the pediatric literature.

  1. New chopper control at ILL

    Energy Technology Data Exchange (ETDEWEB)

    Descamps, F. [Institut Max von Laue - Paul Langevin (ILL), 38 - Grenoble (France)

    1997-04-01

    Proper phasing is an essential characteristic of the chopper systems used at ILL. A wide variety of choppers and selectors differing in weight, speed and bearing types are controlled by a unique electronic card performing digital adaptative filtering. The chopper regulation system is described. (author).

  2. Transfusion in critically ill children

    DEFF Research Database (Denmark)

    Secher, E L; Stensballe, J; Afshari, A

    2013-01-01

    Transfusion of blood products is a cornerstone in managing many critically ill children. Major improvements in blood product safety have not diminished the need for caution in transfusion practice. In this review, we aim to discuss the interplay between benefits and potential adverse effects of t...

  3. Delirium in critically ill patients

    NARCIS (Netherlands)

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and

  4. Gulf War Illness Research Program

    Science.gov (United States)

    2010-01-01

    neurofibromato- sis; autism ; and other areas with military health interests including psychological health, traumatic brain injury, and Gulf War Illness (GWI...the national news headlines, it has not dimmed our hope that treatments and cures for GWI are waiting to be discovered and brought to bear against

  5. Communication About Chronic Critical Illness

    Science.gov (United States)

    Nelson, Judith E.; Mercado, Alice F.; Camhi, Sharon L.; Tandon, Nidhi; Wallenstein, Sylvan; August, Gary I.; Morrison, R. Sean

    2008-01-01

    Background Despite poor outcomes, life-sustaining treatments including mechanical ventilation are continued for a large and growing population of patients with chronic critical illness. This may be owing in part to a lack of understanding resulting from inadequate communication between clinicians and patients and families. Our objective was to investigate the informational needs of patients with chronic critical illness and their families and the extent to which these needs are met. Methods In this prospective observational study conducted at 5 adult intensive care units in a large, university-affiliated hospital in New York, New York, 100 patients with chronic critical illness (within 3–7 days of elective tracheotomy for prolonged mechanical ventilation) or surrogates for incapacitated patients were surveyed using an 18-item questionnaire addressing communication about chronic critical illness. Main outcome measures included ratings of importance and reports of whether information was received about questionnaire items. Results Among 125 consecutive, eligible patients, 100 (80%) were enrolled; questionnaire respondents included 2 patients and 98 surrogates. For all items, more than 78% of respondents rated the information as important for decision making (>98% for 16 of 18 items). Respondents reported receiving no information for a mean (SD) of 9.0 (3.3) of 18 items, with 95% of respondents reporting not receiving information for approximately one-quarter of the items. Of the subjects rating the item as important, 77 of 96 (80%) and 69 of 74 (93%) reported receiving no information about expected functional status at hospital discharge and prognosis for 1-year survival, respectively. Conclusions Many patients and their families may lack important information for decision making about continuation of treatment in the chronic phase of critical illness. Strategies for effective communication in this clinical context should be investigated and implemented. PMID

  6. Mouldy feed, mycotoxins and Shiga toxin - producing Escherichia coli colonization associated with Jejunal Hemorrhage Syndrome in beef cattle

    Directory of Open Access Journals (Sweden)

    Masson Luke

    2011-06-01

    Full Text Available Abstract Background Both O157 and non-O157 Shiga toxin - producing Escherichia coli (STECs cause serious human disease outbreaks through the consumption of contaminated foods. Cattle are considered the main reservoir but it is unclear how STECs affect mature animals. Neonatal calves are the susceptible age class for STEC infections causing severe enteritis. In an earlier study, we determined that mycotoxins and STECs were part of the disease complex for dairy cattle with Jejunal Hemorrhage Syndrome (JHS. For STECs to play a role in the development of JHS, we hypothesized that STEC colonization should also be evident in beef cattle with JHS. Aggressive medical and surgical therapies are effective for JHS, but rely on early recognition of clinical signs for optimal outcomes suggesting that novel approaches must be developed for managing this disease. The main objective of this study was to confirm that mouldy feeds, mycotoxins and STEC colonization were associated with the development of JHS in beef cattle. Results Beef cattle developed JHS after consuming feed containing several types of mycotoxigenic fungi including Fusarium poae, F. verticillioides, F. sporotrichioides, Penicillium roqueforti and Aspergillus fumigatus. Mixtures of STECs colonized the mucosa in the hemorrhaged tissues of the cattle and no other pathogen was identified. The STECs expressed Stx1 and Stx2, but more significantly, Stxs were also present in the blood collected from the lumen of the hemorrhaged jejunum. Feed extracts containing mycotoxins were toxic to enterocytes and 0.1% of a prebiotic, Celmanax Trademark, removed the cytotoxicity in vitro. The inclusion of a prebiotic in the care program for symptomatic beef calves was associated with 69% recovery. Conclusions The current study confirmed that STECs and mycotoxins are part of the disease complex for JHS in beef cattle. Mycotoxigenic fungi are only relevant in that they produce the mycotoxins deposited in the feed. A

  7. Vitamin D deficiency in pediatric critical illness

    Directory of Open Access Journals (Sweden)

    Kiran B. Hebbar, MD, FCCM

    2014-12-01

    Conclusions: Vitamin D deficiency is common in the pediatric critical care population. Significant seasonal differences were noted even in the critically ill. The role of vitamin D in certain diseases like asthma in critically ill children merit further study.

  8. Correlates of Illness Severity in Infectious Mononucleosis

    Directory of Open Access Journals (Sweden)

    John Odame

    2014-01-01

    Full Text Available INTRODUCTION: Understanding the spectrum and frequencies of Epstein-Barr virus (EBV complications and markers of illness severity in immunocompetent patients with primary EBV infection will inform management of patients with EBV-related illnesses.

  9. How to Report a Foodborne Illness

    Science.gov (United States)

    ... Inspection Service Food Safety How to Report a Foodborne Illness - General Public Recommend on Facebook Tweet Share ... of foodborne disease outbreaks. Contact CDC about a Foodborne Illness: Please call CDC INFO at 1-800- ...

  10. Helping a Child Manage a Chronic Illness

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160011.html Helping a Child Manage a Chronic Illness Feeling they have control over their ... News) -- Children and teens who feel confident handling a chronic illness on their own appear better able ...

  11. Illness causal beliefs in Turkish immigrants

    OpenAIRE

    Klimidis Steven; Minas Harry; Tuncer Can

    2007-01-01

    Abstract Background People hold a wide variety of beliefs concerning the causes of illness. Such beliefs vary across cultures and, among immigrants, may be influenced by many factors, including level of acculturation, gender, level of education, and experience of illness and treatment. This study examines illness causal beliefs in Turkish-immigrants in Australia. Methods Causal beliefs about somatic and mental illness were examined in a sample of 444 members of the Turkish population of Melbo...

  12. Bipolar illness, creativity, and treatment.

    Science.gov (United States)

    Rothenberg, A

    2001-01-01

    There have been in recent years increasing claims in both popular and professional literature for a connection between bipolar illness and creativity. A review of studies supporting this claim reveals serious flaws in sampling, methodology, presentation of results, and conclusions. Although there is therefore no evidence for etiological or genetic linkages, it is still necessary to explain interrelationships in those creative persons suffering from the illness. Examples of the work in progress of artists with bipolar disorder, Jackson Pollock and Edvard Munch, illustrate the use of healthy and adaptive creative cognition--janusian and homospatial processes--in the former's breakthrough conception during an improvement phase in treatment leading to the development of the Abstract Expressionist Movement and in the latter's transformation of an hallucination into his famous artwork "The Scream." Treatment options that do not produce cognitive effects are important for creative persons with bipolar disorder.

  13. Hinduism, marriage and mental illness.

    Science.gov (United States)

    Sharma, Indira; Pandit, Balram; Pathak, Abhishek; Sharma, Reet

    2013-01-01

    For Hindus, marriage is a sacrosanct union. It is also an important social institution. Marriages in India are between two families, rather two individuals, arranged marriages and dowry are customary. The society as well as the Indian legislation attempt to protect marriage. Indian society is predominantly patriarchal. There are stringent gender roles, with women having a passive role and husband an active dominating role. Marriage and motherhood are the primary status roles for women. When afflicted mental illness married women are discriminated against married men. In the setting of mental illness many of the social values take their ugly forms in the form of domestic violence, dowry harassment, abuse of dowry law, dowry death, separation, and divorce. Societal norms are powerful and often override the legislative provisions in real life situations.

  14. Delirium in critically ill patients.

    Science.gov (United States)

    Slooter, A J C; Van De Leur, R R; Zaal, I J

    2017-01-01

    Delirium is common in critically ill patients and associated with increased length of stay in the intensive care unit (ICU) and long-term cognitive impairment. The pathophysiology of delirium has been explained by neuroinflammation, an aberrant stress response, neurotransmitter imbalances, and neuronal network alterations. Delirium develops mostly in vulnerable patients (e.g., elderly and cognitively impaired) in the throes of a critical illness. Delirium is by definition due to an underlying condition and can be identified at ICU admission using prediction models. Treatment of delirium can be improved with frequent monitoring, as early detection and subsequent treatment of the underlying condition can improve outcome. Cautious use or avoidance of benzodiazepines may reduce the likelihood of developing delirium. Nonpharmacologic strategies with early mobilization, reducing causes for sleep deprivation, and reorientation measures may be effective in the prevention of delirium. Antipsychotics are effective in treating hallucinations and agitation, but do not reduce the duration of delirium. Combined pain, agitation, and delirium protocols seem to improve the outcome of critically ill patients and may reduce delirium incidence. © 2017 Elsevier B.V. All rights reserved.

  15. Meditation's impact on chronic illness.

    Science.gov (United States)

    Bonadonna, Ramita

    2003-01-01

    Meditation is becoming widely popular as an adjunct to conventional medical therapies. This article reviews the literature regarding the experience of chronic illness, theories about meditation, and clinical effects of this self-care practice. Eastern theories of meditation include Buddhist psychology. The word Buddha means the awakened one, and Buddhist meditators have been called the first scientists, alluding to more than 2500 years of precise, detailed observation of inner experience. The knowledge that comprises Buddhist psychology was derived inductively from the historical figure's (Prince Siddhartha Gautama) diligent self-inquiry. Western theories of meditation include Jungian, Benson's relaxation response, and transpersonal psychology. Clinical effects of meditation impact a broad spectrum of physical and psychological symptoms and syndromes, including reduced anxiety, pain, and depression, enhanced mood and self-esteem, and decreased stress. Meditation has been studied in populations with fibromyalgia, cancer, hypertension, and psoriasis. While earlier studies were small and lacked experimental controls, the quality and quantity of valid research is growing. Meditation practice can positively influence the experience of chronic illness and can serve as a primary, secondary, and/or tertiary prevention strategy. Health professionals demonstrate commitment to holistic practice by asking patients about use of meditation, and can encourage this self-care activity. Simple techniques for mindfulness can be taught in the clinical setting. Living mindfully with chronic illness is a fruitful area for research, and it can be predicted that evidence will grow to support the role of consciousness in the human experience of disease.

  16. Illness perceptions of cancer patients: relationships with illness characteristics and effects on coping.

    NARCIS (Netherlands)

    Hopman, E.P.C.; Rijken, P.M.

    2013-01-01

    Background: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. Insights into illness perceptions of cancer patients are however scarce. The purpose of the present study was to explore how people with cancer perceive their illness. Moreover, we

  17. Breastfeeding during maternal or infant illness.

    Science.gov (United States)

    Coates, M M; Riordan, J

    1992-01-01

    The continuation of breastfeeding during a hospital stay is not only possible, it can be beneficial for both the mother and the infant. The ill mother avoids breast engorgement and possible mastitis; the infant of an ill mother continues to receive, in breast milk, antibodies to the mother's illness. Through breast milk, an ill infant receives antibodies to his illness, liquids, and an easily digested, nourishing food. In addition, the physical and emotional comfort the mother and infant give each other eases the job of the nurse who cares for them. Hospital policies that take a woman's lactational status into account and encourage breastfeeding should be the accepted standard.

  18. Aspects of spirituality concerning illness.

    Science.gov (United States)

    van Leeuwen, René; Tiesinga, Lucas J; Jochemsen, Henk; Jochemasen, Henk; Post, Doeke

    2007-12-01

    The spiritual dimension of illness, health and care may be seen as a unique aspect in addition to the physical, mental and social dimension. This contribution describes experiences of patients, nurses and hospital chaplains in relation to the spiritual aspects of being ill. Qualitative research was performed with the design of a focus group study, consisting of 13 focus groups with a total of 67 participants. A purposive sample was used comprising patients, nurses and hospital chaplains working in oncology, cardiology and neurology in different institutions and regions in the Netherlands. The qualitative analysis consisted of open coding and the determining of topics, followed by the subsequent attachment of substantial dimensions and characteristic fragments. Data were analysed by using the computer program KWALITAN. Spirituality play various roles in patients lives during their illness. There is a wide range of topics that may have an individual effect on patients. Despite differences in emphasis, the topics play a role in different patient categories. Although the spiritual topics seem to manifest themselves more clearly in long-term care relationships, they may also play a role during brief admittance periods (such as treatment decisions). The spiritual topics that arise from this study offer caregivers a framework for signalling the spiritual needs of patients. The question is not whether spirituality is a relevant focus area in care, but how and to what degree it plays a role with individual patients. Follow up research should aim at further exploration of spiritual aspects in care, the relationship between spirituality and health and at effective training of caregivers.

  19. Characterization of the Shiga toxin-producing Escherichia coli O26 isolated from human in Poland between 1996 and 2014.

    Science.gov (United States)

    Januszkiewicz, A; Wołkowicz, T; Chróst, A; Szych, J

    2015-06-01

    Shiga toxin-producing Escherichia coli (STEC) O26 infections can be comparable with STEC O157 infections in severity of the acute haemolytic-uremic syndrome HUS and long-term sequelae. Among O26 STEC isolates, highly virulent clone O26:H11/H- Sequence Type 29 (ST 29) emerged in Germany in mid-1990s and spread to European countries. However, up to date, no STEC O26:H11/H- belonging to ST29 has been documented in Poland. In this study, we determined the relationship and clonal structure, stx genotypes, plasmid gene profiles and antimicrobial resistance of nine human STEC O26:H11/H- strains from human patients in Poland between 1996 and 2014. Of the 9 human STEC O26:H11/H- strains, two belonged to ST29 and were isolated from two children with HUS and renal failure with sepsis respectively. These strains showed the molecular characteristics of the emerging human-pathogenic ST29 clone (stx1-, stx2a+, eae+, ehxA+, etpD+, katP-, espP-). The remaining STEC O26:H11/H- strains examined in this study, belonged to ST21, with plasmid genes profiles frequently reported in ST21 strains in Europe. STEC O26 infections with serious human health consequences highlight the need of continuous surveillance of non-O157 STEC and implementation of the diagnostic approaches focused on their detection. Significance and impact of the study: These study provides the first data on the occurrence of emerging Shiga toxin-producing Escherichia coli O26:H11 ST 29 clone in human patients in Poland. Those strains show the molecular characteristics of highly virulent new ST29 pathotype (stx1-, stx2a+, eae+ ehxA+, etpD+, katP-, espP-). These results demonstrated prompt efforts to implement diagnostic approaches detection of those pathogen in the European countries.

  20. Post orgasmic illness syndrome (POIS)

    Science.gov (United States)

    2016-01-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS “attacks” that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man’s seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur—although rarely—in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina. PMID:27652231

  1. Post orgasmic illness syndrome (POIS).

    Science.gov (United States)

    Waldinger, Marcel D

    2016-08-01

    Men with post orgasmic illness syndrome (POIS) become ill rather immediately after ejaculation, whether spontaneously at night, during sexual intercourse or masturbation. Two subtypes are distinguished: primary and secondary POIS. It also occurs before or after a man has been sterilized. POIS is an invalidating most probably auto-immune disease leading to much distress in males and their partners. It is characterized by five criteria. Its symptoms are described by seven clusters. However, the manifestation of these symptoms varies from one male to the other but is relatively constant in the person himself. Among men the symptoms vary in intensity, durations and sort of symptoms. POIS is a chronic disorder that manifests itself in POIS "attacks" that occur within a few minutes to a few hours after ejaculation, and disappear spontaneously after 3 to 7 days. POIS is not associated with increased total serum IgE concentrations. On the contrary, there are indications that POIS is triggered by specific cytokines that are released by an auto-immune reaction to the man's seminal fluid. Indirect clinical evidence suggests that the antigen (Ag) triggering the POIS systemic reaction is not bound to spermatozoa but to seminal fluid produced by prostatic tissue. In addition, POIS may also occur-although rarely-in females. In those cases, it is hypothesized that the Ag is associated with female prostatic tissue around the vagina.

  2. Nutrition in chronic critical illness.

    Science.gov (United States)

    Pingleton, S K

    2001-03-01

    Nutritional management of patients with respiratory failure can be a model of nutritional management in chronically critically ill patients. This model requires recognition of the differing metabolic states of starvation and hypermetabolism. Starvation can result in malnutrition, with adverse effect on respiratory muscle strength, ventilatory drive, and immune defense mechanisms. General nutritional goals include preservation of lean body mass by providing adequate energy and positive nitrogen balance. General nutritional prescriptions for both states include a substrate mix of 20% protein, 60% to 70% carbohydrates, and 20% to 30% fat. Positive nitrogen balance is difficult to attain in hypermetabolic patients and energy requirements are increased compared with starved patients. Enteral nutrition should be the mode of initial nutrient delivery unless the gastrointestinal tract is nonfunctional. Monitoring of nutritional support is essential. Complications of nutritional support are multiple. Nutritional hypercapnia is an important complication in a chronically critically ill patient. Outcomes of selected long-term acute patients are poor, with only 8% of patients fully functional 1 year after discharge. Appropriate nutritional therapy is one aspect of management of these patients that has the possibility of optimizing function and survival.

  3. Seizures in the critically ill.

    Science.gov (United States)

    Ch'ang, J; Claassen, J

    2017-01-01

    Critically ill patients with seizures are either admitted to the intensive care unit because of uncontrolled seizures requiring aggressive treatment or are admitted for other reasons and develop seizures secondarily. These patients may have multiorgan failure and severe metabolic and electrolyte disarrangements, and may require complex medication regimens and interventions. Seizures can be seen as a result of an acute systemic illness, a primary neurologic pathology, or a medication side-effect and can present in a wide array of symptoms from convulsive activity, subtle twitching, to lethargy. In this population, untreated isolated seizures can quickly escalate to generalized convulsive status epilepticus or, more frequently, nonconvulsive status epileptics, which is associated with a high morbidity and mortality. Status epilepticus (SE) arises from a failure of inhibitory mechanisms and an enhancement of excitatory pathways causing permanent neuronal injury and other systemic sequelae. Carrying a high 30-day mortality rate, SE can be very difficult to treat in this complex setting, and a portion of these patients will become refractory, requiring narcotics and anesthetic medications. The most significant factor in successfully treating status epilepticus is initiating antiepileptic drugs as soon as possible, thus attentiveness and recognition of this disease are critical.

  4. Illness Insight and Recovery: How Important is Illness Insight in Peoples’ Recovery Process?

    DEFF Research Database (Denmark)

    Korsbek, Lisa

    2013-01-01

    Topic: This account reflects on the topic of illness insight and recovery. Purpose: The purpose of the account is to clarify our understanding about the importance of illness insight in peoples’ recovery process, especially when relating the question of illness insight to the question of identity....... Sources Used:The writing is based on research literature related to illness insight and on personal recovery experiences.Conclusions and Implications for Practice: It is helpful to consider the integration of the issue of illness insight when addressing the questions and consequences of diagnosis...... in relation to the importance of illness insight in the recovery process....

  5. Media and mental illness: relevance to India.

    Science.gov (United States)

    Padhy, S K; Khatana, S; Sarkar, S

    2014-01-01

    Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.

  6. The labor market consequences of family illness.

    Science.gov (United States)

    Roberts, Allison A.

    1999-12-01

    BACKGROUND: This study examines the impact of mental illness on the labor market performance of family members of afflicted individuals. Numerous research projects have attempted to measure the impact of mental illness and related disorders on the ill individual, yet have traditionally neglected estimating potential costs accruing to family members of the ill. AIMS OF THE STUDY: Previous research estimating the impact of illness on the time allocation decisions of family caregivers has been limited in scope. I obtain estimates of the impact of mental illness on the probability of labor force participation and hours of work of all family members. The general analysis used in this study will pave the way for more accurate assessments of the costs of all types of illness and the estimates obtained will provide policy makers with a much more complete picture of the costs of mental illness. METHODS: The main empirical work in this study includes a probit estimation of labor force participation and a tobit regression of hours worked (including sample selection correction). The data sample, taken from the 1987 National Medical Expenditure Survey, is also partitioned by gender to clarify effects of family illness on labor supply for both females and males. RESULTS: Adult males are found to increase their probability of labor force participation in the presence of mental illness in the family (all else equal) when the mental illness is accompanied by a chronic physical illness. However, females are surprisingly found to have no significant impact on their probability of being a member of the labor market when a family member is afflicted with mental illness. On the other hand, hours of work are significantly reduced for both females and males when the mentally ill family member is afflicted with additional illnesses (physical and/or mental). DISCUSSION: Previous studies have traditionally not considered the effects of family illness on males because females are typically

  7. Evolving definitions of mental illness and wellness.

    Science.gov (United States)

    Manderscheid, Ronald W; Ryff, Carol D; Freeman, Elsie J; McKnight-Eily, Lela R; Dhingra, Satvinder; Strine, Tara W

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  8. Glycemic control in critically ill patients

    OpenAIRE

    2012-01-01

    Hyperglycemia is common in critically ill patients and can be caused by various mechanisms, including nutrition, medications, and insufficient insulin. In the past, hyperglycemia was thought to be an adaptive response to stress, but hyperglycemia is no longer considered a benign condition in patients with critical illnesses. Indeed, hyperglycemia can increase morbidity and mortality in critically ill patients. Correction of hyperglycemia may improve clinical outcomes. To date, a definite answ...

  9. The Fight against Stigma toward Mental Illness

    Directory of Open Access Journals (Sweden)

    Olcay Cam

    2010-02-01

    Full Text Available In many health conditions, stigma is receiving increasing attention. Public stigmatization toward mental illness can affect particularly the patients and family memberships to help seeking behavior and treatment. These stigmatized persons in the society are deprived of rights and benefits. In this paper, reasons and consequences of stigma associated with mental illness are reviewed and combat against mental illnesses originated stigma are discussed. [TAF Prev Med Bull 2010; 9(1.000: 71-78

  10. Violence and mental illness: an overview

    OpenAIRE

    Stuart, Heather

    2003-01-01

    This paper evaluates the relationship of mental illness and violence by asking three questions: Are the mentally ill violent? Are the mentally ill at increased risk of violence? Are the public at risk? Mental disorders are neither necessary nor sufficient causes of violence. Major determinants of violence continue to be socio-demographic and economic factors. Substance abuse is a major determinant of violence and this is true whether it occurs in the context of a concurrent ...

  11. Evolving Definitions of Mental Illness and Wellness

    OpenAIRE

    Tara W. Strine, MPH; Satvinder Dhingra, MPH; Lela R. McKnight-Eily, PhD; Carol D. Ryff, PhD; Elsie J. Freeman, MD, MPH; Ronald W. Manderscheid, PhD

    2010-01-01

    Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an "absence of disease" model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to ph...

  12. Behavior of shiga toxin-producing Escherichia coli, enteroinvasive E. coli, enteropathogenic E. coli and enterotoxigenic E. coli strains on whole and sliced jalapeño and serrano peppers.

    Science.gov (United States)

    Gómez-Aldapa, Carlos A; Rangel-Vargas, Esmeralda; Gordillo-Martínez, Alberto J; Castro-Rosas, Javier

    2014-06-01

    The behavior of enterotoxigenic Escherichia coli (ETEC), enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC) and non-O157 shiga toxin-producing E. coli (non-O157-STEC) on whole and slices of jalapeño and serrano peppers as well as in blended sauce at 25 ± 2 °C and 3 ± 2 °C was investigated. Chili peppers were collected from markets of Pachuca city, Hidalgo, Mexico. On whole serrano and jalapeño stored at 25 ± 2 °C or 3 ± 2 °C, no growth was observed for EPEC, ETEC, EIEC and non-O157-STEC rifampicin resistant strains. After twelve days at 25 ± 2 °C, on serrano peppers all diarrheagenic E. coli pathotypes (DEP) strains had decreased by a total of approximately 3.7 log, whereas on jalapeño peppers the strains had decreased by approximately 2.8 log, and at 3 ± 2 °C they decreased to approximately 2.5 and 2.2 log respectively, on serrano and jalapeño. All E. coli pathotypes grew onto sliced chili peppers and in blended sauce: after 24 h at 25 ± 2 °C, all pathotypes had grown to approximately 3 and 4 log CFU on pepper slices and sauce, respectively. At 3 ± 2 °C the bacterial growth was inhibited. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Hazard detection by illness pattern similarities.

    Science.gov (United States)

    Stille, W T

    1980-01-01

    Health hazard detection was investigated by using cluster analysis of illness patterns of occupational groups. This approach was expected to avoid the bias problems of simple illness rates and to detect hazards by their effects on illness severity. The practical use of this approach lead to the following criterion: an environmental exposure of people associated with an illness pattern typical of a more advanced age is a health hazard. The use of this criterion and methodology is widely applicable in industry and the prospect for further improvement in detection methods is good.

  14. Inequality in the social consequences of illness

    DEFF Research Database (Denmark)

    Burström, B; Whitehead, M; Lindholm, C

    2000-01-01

    those people with chronic illness. The study tests two opposing hypotheses: (1) the increasingly flexible, deregulated labor market in Britain would result in an increased number of new jobs, and thus better employment opportunities for unskilled workers, including those with chronic illness; (2......) the more regulated labor market in Sweden, with the associated health and social policies, would provide greater opportunities for jobs and job security for workers with chronic illness. Analysis of data on men from the British General Household Survey and the Swedish Survey of Living Conditions, 1979...... that active labor market policies and employment protection may increase the opportunities for people with chronic illness to remain in work....

  15. Looking after chronically ill dogs

    DEFF Research Database (Denmark)

    Christiansen, Stine B.; Kristensen, Annemarie Thuri; Sandøe, Peter

    2013-01-01

    thus face similar challenges when caring for their animals. This qualitative study uncovers impacts on an owner's life, when attending to the care of an aged or chronically ill dog and reflects on the differing roles of caregivers with animal and human patients. Twelve dog owners were selected for in......-depth interviews based on the dogs' diagnoses, and the choice of treatments and care expected to affect the owner's life. Interviews were recorded, transcribed, and analyzed qualitatively. The dog owners reported several changes in their lives due to their dog's condition: practicalities like extra care, changes...... in use of the home, and restrictions relating to work, social life, and finances. These were time-consuming, tough, and annoying, but could often be dealt with through planning and prioritizing. Changes in the human–dog relationship and activities caused sadness and frustration, which in turn led...

  16. HYPOPHOSPHATAEMIA IN CRITICALLY ILL CHILDREN

    Directory of Open Access Journals (Sweden)

    Poornima Shankar

    2016-07-01

    Full Text Available BACKGROUND To estimate the prevalence of hypophosphataemia and outcome associated with this disturbance in children admitted to PICU. METHOD In this prospective cohort study, 102 children admitted consecutively to a paediatric intensive care unit (PICU were monitored regarding their phosphorus serum levels during the first 7 days of admission. Age, gender, diagnosis at admission, malnutrition, starvation period, length of stay, and outcome were analysed as independent variables for hypophosphataemia. RESULTS Most of our patients (56% developed hypophosphataemia during their PICU stay. The number of starvation days, days on mechanical ventilation, and survival to discharge were significantly associated with hypophosphataemia. The worst outcomes correlated well with this abnormality. CONCLUSION Hypophosphataemia was commonly observed in our PICU and was associated with the presence of respiratory diseases, infections, and increased starvation days and ventilation days. These factors might be considered as risk factors for hypophosphataemia in critically ill children

  17. Strategies for On-Line Decontamination of Carcasses

    Science.gov (United States)

    Byelashov, Oleksandr A.; Sofos, John N.

    Microbial food safety has been one of the most important challenges for the meat industry during the last two decades due to important foodborne outbreaks traced to contaminated products and associated costly product recalls from the market. Escherichia coli O157:H7 and other non-O157 Shiga toxin-producing (STEC) strains, as well as Salmonella serotypes, Campylobacter jejuni, Clostridium perfringens, Clostridium botulinum, Listeria monocytogenes, Staphylococcus aureus, Yersinia enterocolitica, Aeromonas hydrophila, and Bacillus cereusare important pathogenic contaminants of meat and poultry products (Sofos, 2004a). STEC, especially, have been of major concern for the beef industry for a number of years, since for almost two decades contaminated beef products have been major sources of foodborne E. coli O157:H7 infection (Rangel, Sparling, Crowe, Griffin, & Swerdlow, 2005).

  18. World survey of mental illness stigma.

    Science.gov (United States)

    Seeman, Neil; Tang, Sabrina; Brown, Adalsteinn D; Ing, Alton

    2016-01-15

    To obtain rapid and reproducible opinions that address mental illness stigma around the world. Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome. Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1 ± 0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response. This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured. The method engages English speakers only, mainly young, educated males. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Illness narratives of people who are homeless

    Directory of Open Access Journals (Sweden)

    Cecilia Håkanson

    2016-11-01

    Full Text Available Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and “freedom” in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony. The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  20. Random Assignment to Illness: Teaching Illness and Disease in the Introductory Health Communication Course

    Science.gov (United States)

    Gray, Jennifer B.; Riley, Sarah

    2011-01-01

    A key concept in health communication is the difference between disease and illness: disease refers to the physical manifestations of a condition, while illness encompasses the physical, emotional, social, communicative, and psychological experience of living with a condition. The individual illness experience takes into account the full story of…

  1. Illness perceptions of cancer patients: relationships with illness characteristics and coping.

    NARCIS (Netherlands)

    Hopman, P.; Rijken, M.

    2015-01-01

    Objective: Illness perceptions have proven to be predictive of coping and adjustment in many chronically ill patients. However, insights into illness perceptions of cancer patients are scarce. The purpose of the present study was to explore how a heterogeneous sample of cancer patients perceive thei

  2. Random Assignment to Illness: Teaching Illness and Disease in the Introductory Health Communication Course

    Science.gov (United States)

    Gray, Jennifer B.; Riley, Sarah

    2011-01-01

    A key concept in health communication is the difference between disease and illness: disease refers to the physical manifestations of a condition, while illness encompasses the physical, emotional, social, communicative, and psychological experience of living with a condition. The individual illness experience takes into account the full story of…

  3. Illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    van Ittersum, M.W.; van Wilgen, C.P.; Hilberdink, W.K.; Groothoff, J.W.; van der Schans, C.P.

    2009-01-01

    OBJECTIVE: Former studies in chronic diseases showed the importance of patients' beliefs and perceptions. The Revised Illness Perception Questionnaire was developed to assess these illness perceptions. Our goal was to investigate psychometric properties of the IPQ-R for Fibromyalgia Dutch language v

  4. Illness perceptions in patients with fibromyalgia

    NARCIS (Netherlands)

    Van Ittersum, M. W.; van Wilgen, C. P.; Hilberdink, W. K. H. A.; Groothoff, J. W.; van der Schans, C. P.

    2009-01-01

    Objective: Former studies in chronic diseases showed the importance of patients' beliefs and perceptions. The Revised Illness Perception Questionnaire was developed to assess these illness perceptions. Our goal was to investigate psychometric properties of the IPQ-R for Fibromyalgia Dutch language v

  5. Mental Illness in the Peripartum Period

    Science.gov (United States)

    Ostler, Teresa

    2009-01-01

    Women are particularly vulnerable in the peripartum period for either developing a mental illness or suffering symptom exacerbation. These illnesses are often experienced covertly, however, and women may not seek out professional help, even though their symptoms may be seriously affecting their well-being and parenting. This article provides an…

  6. Illness representations in patients with hand injury.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2009-07-01

    Differences in illness perception about hand injury may partly explain the variation in health behaviours such as adherence to post-operative therapy, coping strategy, emotional response and eventual clinical outcome. This study examined the illness perception of patients with hand injuries in the acute trauma setting.

  7. Attitudes of psychiatry residents toward mental illness

    Directory of Open Access Journals (Sweden)

    Pejović-Milovančević Milica

    2007-01-01

    Full Text Available Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI and personality traits were examined using the Eysenck Personality Questionnaire (EPQ. Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill. .

  8. Delirium in the Critically Ill Child.

    Science.gov (United States)

    Norman, Sharon; Taha, Asma A; Turner, Helen N

    The purposes of this article are to describe the scientific literature on assessment, prevention, and management of delirium in critically ill children and to articulate the implications for clinical nurse specialists, in translating the evidence into practice. A literature search was conducted in 4 databases-OvidMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Web of Science-using the terms "delirium," "child," and "critically ill" for the period of 2006 to 2016. The scientific literature included articles on diagnosis, prevalence, risk factors, adverse outcomes, screening tools, prevention, and management. The prevalence of delirium in critically ill children is up to 30%. Risk factors include age, developmental delay, severity of illness, and mechanical ventilation. Adverse outcomes include increased mortality, hospital length of stay, and cost for the critically ill child with delirium. Valid and reliable delirium screening tools are available for critically ill children. Prevention and management strategies include interventions to address environmental triggers, sleep disruption, integrated family care, and mobilization. Delirium is a common occurrence for the critically ill child. The clinical nurse specialist is accountable for leading the implementation of practice changes that are based on evidence to improve patient outcomes. Screening and early intervention for delirium are key to mitigating adverse outcomes for critically ill children.

  9. Illness in Children and Parental Response

    NARCIS (Netherlands)

    M.A. Bruijnzeels (Marc)

    1997-01-01

    textabstractMost children suffer from illnesses from time to time. In only a small part of these ill children parents decide to seek professional help. So, most child health care is carried out by parents. In general, this phenomenon is called the iceberg of symptoms. The part of the iceberg under t

  10. Reducing the Stigma of Mental Illness.

    Science.gov (United States)

    Brown, Kaylene; Bradley, Loretta J.

    2002-01-01

    Each year, an estimated 50 million Americans will experience a mental disorder while only one fourth of them will seek mental health services. Contends that this disparity results from the stigma attached to mental illness. Proposes that counselors must educate the general public about the misconceptions of mental illness and advocate for parity…

  11. Social Work Faculty and Mental Illness Stigma

    Science.gov (United States)

    Watson, Amy C.; Fulambarker, Anjali; Kondrat, David C.; Holley, Lynn C.; Kranke, Derrick; Wilkins, Brittany T.; Stromwall, Layne K.; Eack, Shaun M.

    2017-01-01

    Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice…

  12. Outbreak of Mysterious Illness Among Hospital Staff

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Ebbehøj, Niels Erik

    2016-01-01

    BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency depa....... Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention.......BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...... the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged...

  13. Characterization of Shiga Toxin-Producing Escherichia coli Isolated from Ground Beef Collected in Different Socioeconomic Strata Markets in Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Patricia Llorente

    2014-01-01

    Full Text Available Consumption of raw/undercooked ground beef is the most common route of transmission of Shiga toxin-producing E. coli (STEC. The aim of the study was to determine the STEC contamination level of the ground beef samples collected in 36 markets of different socioeconomic strata in Buenos Aires, Argentina, and the characterization of the isolated strains. Ninety-one out of 252 (36.1% samples were stx+. Fifty-seven STEC strains were recovered. Eleven STEC strains belonged to O157 serogroup, and 46 to non-O157 serogroups. Virulence markers of the 57 STEC were stx1, 5.3% (3/57; stx2, 86.0% (49/57; stx1/stx2, 8.8% (5/57; ehxA, 61.4% (35/57; eae, 26.3% (15/57; saa, 24.6% (14/57. Shiga toxin subtypes were stx2, 31.5% (17/54; stx2c-vhb, 24.1% (13/54; stx2c-vha, 20.4% (11/54; stx2/stx2c-vha, 14.8% (8/54; stx2/stx2c-vhb, 5.6% (3/54; stx2c-vha/vhb, 3.7% (2/54. Serotypes O178:H19 and O157:H7 were prevalent. Contamination rate of STEC in all strata was high, and the highest O157 contamination was observed at low strata at several sampling rounds. Persistence of STEC was not detected. Sixteen strains (28.1% were resistant to ampicillin, streptomycin, amikacin, or tetracycline. The STEC contamination level of ground beef could vary according to the sociocultural characteristics of the population.

  14. Evaluation of eight agar media for the isolation of shiga toxin-Producing Escherichia coli.

    Science.gov (United States)

    Gill, Alexander; Huszczynski, George; Gauthier, Martine; Blais, Burton

    2014-01-01

    The growth characteristics of 96 shiga toxin-producing Escherichia coli (STEC) strains representing 36 different O-types (including priority O types O26, O45, O103, O111, O121, O145 and O157) on commercial and in-house agar media were studied. The ability of the strains to grow on agar media with varying selective supplement formulations was evaluated using MacConkey Agar (MAC); Rainbow® Agar O157 (RBA); Rainbow® Agar O157 with manufacturer-recommended selective supplements (RBA-NT); Rainbow® Agar O157 with USDA-recommended selective supplements (RBA-USDA); CHROMagar STEC™ (CH STEC); Tryptone Bile agar containing cefixime and tellurite (TBA-CT); Tryptone Bile agar containing cefixime, tellurite, eosin and methylene blue (TBA-EM); and VTEC agar. All of the strains were able to grow on MAC, RBA and VTEC agar, whereas a number of strains (including some non-O157 priority O types) were unable to grow on the highly selective media CH STEC, RBA-NT, RBA-USDA, TBA-EM and TBA-CT. Only RBA-NT and CH STEC exhibited significant inhibition of background flora from ground beef enrichment. Significant inhibition of background flora from beef trim enrichment was observed with RBA-NT, RBA-USDA, CH STEC, TBA-EM and VTEC agar. With exception of E. coli O157, several different colony morphologies were observed on the differential plating media among strains of the same O type, indicating that this colony morphology is not a reliable means of identifying target STEC. These results suggest that an approach to maximize the recovery of target STEC from beef enrichment cultures is dual plating on lesser (RBA, MAC, VTEC agar) and more highly (RBA-NT, CH STEC) selective agars.

  15. Molecular genetics in affective illness

    Energy Technology Data Exchange (ETDEWEB)

    Mendlewicz, J.; Sevy, S.; Mendelbaum, K. (Erasme Univ. Hospital, Brussels (Belgium))

    1993-01-01

    Genetic transmission in manic depressive illness (MDI) has been explored in twins, adoption, association, and linkage studies. The X-linked transmission hypothesis has been tested by using several markers on chromosome X: Xg blood group, color blindness, glucose-6-phosphate dehydrogenase (G6PD), factor IX (hemophilia B), and DNA probes such as DXS15, DXS52, F8C, ST14. The hypothesis of autosomal transmission has been tested by association studies with the O blood group located on chromosome 9, as well as linkage studies on chromosome 6 with the Human Leucocyte Antigens (HLA) haplotypes and on Chromosome 11 with DNA markers for the following genes: D2 dopamine receptor, tyrosinase, C-Harvey-Ras-A (HRAS) oncogene, insuline (ins), and tyrosine hydroxylase (TH). Although linkage studies support the hypothesis of a major locus for the transmission of MDI in the Xq27-28 region, several factors are limiting the results, and are discussed in the present review. 105 refs., 1 fig., 2 tabs.

  16. Critically ill Guillain Barre' syndrome.

    Science.gov (United States)

    Taly, A B; Gupta, S K; Vasanth, A; Suresh, T G; Rao, U; Nagaraja, D; Swamy, H S; Rao, S; Subbakrishna, D K

    1994-11-01

    Among the 153 patients fulfilling NINDS criteria for Guillain Barre' Syndrome (GBS) seen over 5.5 yrs, there were 47 (M:F 38.9) critically ill patients (age range 4 to 60 years). Antecedent event was recorded in 25 patients and the peak deficit was attained over a mean period of 9.5 days. Besides severe motor paralysis other salient features were: bulbar paralysis--42, sensory symptoms or signs--21, dysautonomia 31 and requirement for ventilatory assistance 45. CSF protein was raised in 63% cases. All the 17 patients who underwent electromyography had abnormalities of nerve conduction paramentes. Mean stay on the ventilator was 29.6 days and was not influenced by corticosteroid. Complications were frequent: pulmonary and urinary tract infection, dysautonomia, electrolyte disturbances, haemetmesis, bleeding from tracheostomy site and hepatic and renal failure. Mortality in steroids treated group (13/27) and the conservatively managed group (5/20) did not differ significantly. No discriminant factor emerged between survivors and non-survivors. Age and sex of the patients, presence of antecedent event, onset to peak interval and CSF protein level did not predict the need for ventilatory assistance, although these patients at admission had more frequent weakness of facial, bulbar, trunk, neck and proximal muscles of upper limbs and autonomic disturbances. Course of GBS remains unpredictable at the onset of the disease, warrants close supervision and meticulous supportive care and remains a therapeutic challenge.

  17. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire.

    Science.gov (United States)

    Nowicka-Sauer, Katarzyna; Banaszkiewicz, Dorota; Staśkiewicz, Izabela; Kopczyński, Piotr; Hajduk, Adam; Czuszyńska, Zenobia; Ejdys, Mariola; Szostakiewicz, Małgorzata; Sablińska, Agnieszka; Kałużna, Anna; Tomaszewska, Magda; Siebert, Janusz

    2016-08-01

    The study evaluates the psychometric properties of a Polish translation of the Brief Illness Perception Questionnaire. A total of 276 patients with chronic conditions (58.7% women) completed the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. The internal consistency of the Polish Brief Illness Perception Questionnaire measured with Cronbach's alpha was satisfactory (α = 0.74). Structural validity was demonstrated by significant inter-correlations between the Brief Illness Perception Questionnaire components. Discriminant validity was supported by the fact that the Brief Illness Perception Questionnaire enables patients with various conditions to be differentiated. Significant correlations were found between Brief Illness Perception Questionnaire and depression and anxiety levels. The Polish Brief Illness Perception Questionnaire thus evaluated is a reliable and valid tool.

  18. The Impact of Illness Identity on Recovery from Severe Mental Illness.

    Science.gov (United States)

    Yanos, Philip T; Roe, David; Lysaker, Paul H

    2010-04-01

    The impact of the experience and diagnosis of mental illness on one's identity has long been recognized; however, little is known about the impact of illness identity, which we define as the set of roles and attitudes that a person has developed in relation to his or her understanding of having a mental illness. The present article proposes a theoretically driven model of the impact of illness identity on the course and recovery from severe mental illness and reviews relevant research. We propose that accepting a definition of oneself as mentally ill and assuming that mental illness means incompetence and inadequacy impact hope and self-esteem, which further impact suicide risk, coping, social interaction, vocational functioning, and symptom severity. Evidence supports most of the predictions made by the model. Implications for psychiatric rehabilitation services are discussed.

  19. New pharmaceuticals reduce cost of illness.

    Science.gov (United States)

    Hansen, R W

    1986-06-01

    The cost of illness includes not only the funds required to treat illness, but also the effect on the patient's quality of life. Recent concern about rising health costs have focused on the direct expenditures without noting that the cost of illness in terms of mortality and morbidity has declined significantly. Pharmaceuticals have played a major role in reducing the total cost of illness. Several studies of the cost-effectiveness of past introductions of vaccines and pharmaceuticals reveal large cost savings. Although the focus of most studies has been on major advances, the continuing process of less dramatic therapeutic improvements has significantly trimmed the cost of illness. Cost-benefit studies of new drugs or changes in drug use, while more difficult to perform, make it possible to influence the selection of therapy. Since pharmaceuticals represent less than 10% of total treatment costs, reduction in the cost of pharmaceutical products can only have a minor impact on the total cost of illness. Pharmaceuticals can reduce the cost of illness by providing alternative therapies that reduce direct treatment cost or improve the public health.

  20. Illness Perceptions and Fatigue in Systemic Vasculitis

    Science.gov (United States)

    Grayson, Peter C.; Amudala, Naomi A.; McAlear, Carol A.; Leduc, Renée L.; Shereff, Denise; Richesson, Rachel; Fraenkel, Liana; Merkel, Peter A.

    2014-01-01

    Objective To compare illness perceptions among patients with different forms of vasculitis, identify risk factors for negative illness perceptions, and determine the association between illness perceptions and fatigue. Methods Participants were recruited from an online registry in vasculitis to complete the revised Illness Perception Questionnaire (IPQ-R). Mean scores on each IPQ-R dimension were compared across types of vasculitis. Cluster analysis and stepwise regression identified predictors of negative illness perception. Fatigue was measured using the general subscale of the Multidimensional Fatigue Inventory (MFI). Patient-reported measures of disease activity and IPQ-R dimensions were assessed in relation to MFI scores using linear regression in sequential, additive models with model-fit comparisons. Results 692 participants with 9 forms of vasculitis completed the IPQ-R. For 6 out of 8 IPQ-R dimensions, there were no significant differences in mean scores between the different vasculitides. Scores in identity and cyclical dimensions were significantly higher in Behçet’s disease compared to other types of vasculitis (13.5 vs 10.7; 4.0 vs 3.2, pvasculitis, and younger age is a risk factor for negative illness perceptions. Illness perceptions explain differences in fatigue scores beyond what can be explained by measures of disease activity. PMID:23861259

  1. Hypophosphatemia in critically ill children.

    Directory of Open Access Journals (Sweden)

    Kavous Shahsavari Nia

    2016-08-01

    Full Text Available Introduction: Hypophosphatemia is a common disorder in critically ill patients, and is associated with myasthenia, especially in respiratory muscles, and respiratory infections. This study was conducted to describe the prevalence of hypophosphatemia in children hospitalized in the pediatric intensive care unit (PICU of Children’s Hospital in Tabriz, Iran, in 2014-2015. Methods: In this descriptive study, medical records of all children admitted to the PICU of the children’s university hospital affiliated to Tabriz University of Medical Sciences were collected from archives of the hospital from 2014-2015 upon adopting permission. The medical records were examined in terms of demographic information, clinical diagnosis of the disease, serum phosphate level, nutritional status, therapeutic interventions, and other underlying specifications. The data were analyzed using SPSS software and descriptive tests. Results: Of the 83 eligible medical records, 45 records belonged to boys, and 38 records belonged to girls. The most prevalent and the least prevalent diseases in these children were acute pulmonary disease (57.8% and septic shock (1.2% respectively. Regarding the nutritional status, 38.6% of the children suffered malnutrition. Phosphorus deficiency was prevalent in the first day in 10.8% of the children, and abnormal levels of phosphorus were observed from the fourth to the sixth day in 26.5% of the children, which increased to 34.9% from the seventh to the tenth day. Conclusion: This study showed no statistically significant correlation between sex and prevalence of hypophosphatemia. Type of disease was not significantly associated with the level of phosphorus. Moreover, the patients’ nutritional status was not significantly associated with the prevalence of hypophosphatemia.

  2. Electrotherapy and mental illness: then and now.

    Science.gov (United States)

    Gilman, Sander L

    2008-09-01

    Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrotherapy is exemplary for a shift in attitude and the decline of electrotherapy. With the re-somaticization of mental illness over the past decades has come the reappearance of somatic therapies such as electrotherapy.

  3. Chronic illness in adolescents: a sociological perspective.

    Science.gov (United States)

    Silber, T J

    1983-01-01

    This article relates chronic illness in adolescents to a sociological model of deviance. This is an area of controversy: the views of Freidson, Lorber and Robinson are presented as being representative of the dispute. Four situations are discussed in which the issues of prognosis, responsibility and stigma elicit societal response. The usefulness of a sociological model consists in making vague societal perception and rules explicit. The concept of the chronically ill adolescent as deviant is descriptive and devoid of value judgment. Only through such rigorous assessment is it possible to gain a realistic understanding of the societal role in the life of the chronically ill adolescent.

  4. Youth adjustment to parental illness or disability: the role of illness characteristics, caregiving, and attachment.

    Science.gov (United States)

    Ireland, Michael J; Pakenham, Kenneth I

    2010-12-01

    This study aimed to (1) examine relations between youth adjustment and three sets of predictors: parental illness/disability characteristics, caregiving, and parent-child attachment, and (2) explore differences on these variables between youths of parental physical illness/disability and youths of parental mental illness. Eighty-one youths between 10 and 25 years of a parent with a physical illness/disability (35%) or a mental illness (43%) completed a series of self-report measures assessing perceived characteristics of the parent's illness/disability, caregiving experiences, and adjustment outcomes. Results revealed a set of predictors of poorer youth adjustment: gradual illness/disability onset, being male, isolation, lower perceived maturity, and less choice in caregiving. Youths of parental mental illness differed from youths of parental physical illness/disability on emotional distress (worry and discomfort) dimensions of caregiving. Youth-parent attachment security was associated with youth caregiving and there was a trend for attachment to vary according to parental illness/disability type. Findings highlight young caregiving as an important target for service and policy planning.

  5. Many Chronic Illnesses Linked to Suicide Risk

    Science.gov (United States)

    ... fullstory_166776.html Many Chronic Illnesses Linked to Suicide Risk Odds 9 times higher for people with ... problems seem to have a higher risk of suicide, a new study suggests. And, for certain conditions -- ...

  6. Concept Analysis of Illness Engulfment in Schizophrenia.

    Science.gov (United States)

    Vining, Danny; Robinson, Jennifer C

    2016-06-01

    Schizophrenia has a significant risk of damaging an individual's self-concept. Through the process of illness engulfment an individual's self-concept becomes reorganized entirely around the experience of having schizophrenia. The purpose of this manuscript is to clarify the structure and function of the concept of illness engulfment in schizophrenia using Walker and Avant's (2011) method of concept analysis. Data came from a review of scholarly literature, as well as contemporary and historical art, literature, music, and other media forms. The analysis discussed two defining attributes of experience of illness and impact on self-concept with a total of seven indicators. The article listed antecedents, consequences, and discussed the Modified Engulfment Scale as empirical referents. Fictional cases were developed to illustrate the concept. Finally, the concept of illness engulfment was discussed within the framework of the Roy Adaptation Model.

  7. Why critically ill patients are protein deprived.

    Science.gov (United States)

    Hoffer, L John; Bistrian, Bruce R

    2013-01-01

    Critical illness dramatically increases muscle proteolysis and more than doubles the dietary protein requirement. Yet surprisingly, most critically ill patients receive less than half the recommended amount of protein during their stay in a modern intensive care unit. What could explain the wide gap between the recommendations in clinical care guidelines and actual clinical practice? We suggest that an important aspect of the problem is the failure of guidelines to explain the pathophysiology of protein-energy malnutrition and the ways critical illness modifies protein metabolism. The difficulty created by the lack of a framework for reasoning about appropriate protein provision in critical illness is compounded by the many ambiguous and often contradictory ways the word malnutrition is used in the critical care literature. Failing to elucidate these matters, the recommendations for protein provision in the guidelines are incoherent, unconvincing, and easy to ignore.

  8. Seniors' life histories and perceptions of illness.

    Science.gov (United States)

    Montbriand, Muriel J

    2004-03-01

    This life history research examined seniors' life experiences and perceived connections to illnesses. From a randomly selected sample of 190 seniors'interviews, 107 deemed to be the most expressive life stories were selected as the focus for this analysis. All seniors lived independently in a Canadian prairie city, were 60 years of age or older, Caucasian, European decent, had a chronic illness, and told of lives touched by the Great Depression and World War II. Given the paucity of research exploring seniors' life histories, these findings increase understanding of how life experiences shape seniors' identities. Four main themes emerged to describe seniors' lives: chaos, tragedy, quest, and romance. Findings reported here show that seniors with optimistic perceptions do not connect their life experiences with illnesses. Seniors with pessimistic perceptions frequently connect their life experiences with present illnesses and are most likely to remember past abuse and coping with abuse.

  9. Probiotic (VSL#3) for Gulf War Illness

    Science.gov (United States)

    2012-10-01

    are relevant to GW Veterans. Altered gut flora may be the etiological factor for IBS and GW Illness. Probiotics are living organisms that improve... health by re-establishing a normal gut flora. The overall objective of the study was to determine whether Bifidobacterium infantis 35624 (Align...W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness. PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D. M.P.H

  10. Electrotherapy and mental illness: then and now

    OpenAIRE

    Sander L. Gilman

    2008-01-01

    Abstract Today electrotherapy has reappeared as a therapy of choice for the treatment of depression and other forms of mental illness. It had de facto vanished from allopathic medicine from the 1920s to the end of the century. The debates about electrotherapy mirror the question of whether mental illness was somatic and to be treated by somatic means or psychological to be treated with psychotherapy. Sigmund Freud's move from an advocate to an opponent of electrothera...

  11. Gulf War Illness Inflammation Reduction Trial

    Science.gov (United States)

    2015-10-01

    1 AWARD NUMBER: W81XWH-14-1-0477 TITLE: Gulf War Illness Inflammation Reduction Trial PRINCIPAL INVESTIGATOR: Ronald R. Bach, Ph.D...5a. CONTRACT NUMBER Gulf War Illness Inflammation Reduction Trial 5b. GRANT NUMBER W81XWH-14-1-0477 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...GWI). Elevated biomarkers of inflammation were observed in our pilot observational study of GWI. Thus, chronic inflammation appears to be part of

  12. Illness Behavior and Anomie In Family Practice

    Science.gov (United States)

    Ramesar, Simon

    1985-01-01

    Patients who present with physical complaints that have a psychosocial source are often dissatisfied with reassurance that nothing is physically wrong. This is frustrating to the physician, who may elect to refer the patient, do nothing further—or address the issue of illness behavior. This article analyzes the effects of the physician's response on the doctor/patient relationship, and outlines several methods of psychotherapy which can be used to change illness behavior. PMID:21274170

  13. Coping mediates the relationship between disease severity and illness intrusiveness among chronically ill patients.

    Science.gov (United States)

    Hundt, Natalie E; Bensadon, Benjamin A; Stanley, Melinda A; Petersen, Nancy J; Kunik, Mark E; Kauth, Michael R; Cully, Jeffrey A

    2015-09-01

    Reducing perceptions of illness intrusiveness may improve quality of life and mental health among patients with cardiopulmonary disease. To better understand relationships between coping style, locus of control, perceived illness intrusiveness, and disease severity, we analyzed data from 227 older Veterans with chronic obstructive pulmonary disease or congestive heart failure. Regressions revealed illness intrusiveness to be associated with younger age and greater disease severity, less internal locus of control, and avoidant/emotion-focused coping. Avoidant/emotion-focused coping but not active coping mediated the relationship between illness severity and illness intrusiveness. Findings suggest that supportive psychological interventions may reduce illness intrusiveness by targeting an avoidant/emotion-focused coping style and associated behaviors. © The Author(s) 2013.

  14. Nutritional support of the critically ill child.

    Science.gov (United States)

    Huddleston, K C; Ferraro-McDuffie, A; Wolff-Small, T

    1993-03-01

    There is a growing awareness that the nutrition an individual receives as a child may exert significant consequences later in life. The successful treatment of critically ill children influences their potential for full recovery and optimal outcome. This requires an understanding of how the child responds to stress and starvation. Daily energy needs of the child in the intensive care unit are highly variable. Specific knowledge of the nutritional assessment of these children, whether sustaining an acute or chronic illness, is required, as is an understanding of how the disease process affects the child. Further work needs to be done to evaluate how chronic illness affects the growth, development, and maturation of the child. Assessment parameters remain somewhat controversial, and recent studies indicate that, indeed, critically ill children may be overfed if standard equations are used to calculate needs. Poor clinical outcomes can occur if the child is underfed or overfed. The long-term results of specific diets, micronutrients, glutamine, and new access routes into the infant are not yet known. Research in these areas is rapidly growing, and the new knowledge will provide a greater ability to meet the individual needs of the critically ill child. Perhaps in the future the treatment of choice in patients with organ failure will involve specific micronutrients that influence the immune status and cellular degradation. In the meantime, critically ill children deserve to have their basic nutritional needs met, and nurses can do much to individualize the nutritional support required to produce optimal patient outcomes.

  15. Media and mental illness: Relevance to India

    Directory of Open Access Journals (Sweden)

    S K Padhy

    2014-01-01

    Full Text Available Media has a complex interrelationship with mental illnesses. This narrative review takes a look at the various ways in which media and mental illnesses interact. Relevant scientific literature and electronic databases were searched, including Pubmed and GoogleScholar, to identify studies, viewpoints and recommendations using keywords related to media and mental illnesses. This review discusses both the positive and the negative portrayals of mental illnesses through the media. The portrayal of mental health professionals and psychiatric treatment is also discussed. The theories explaining the relationship of how media influences the attitudes and behavior are discussed. Media has also been suggested to be a risk factor for the genesis or exacerbation of mental illnesses like eating disorders and substance use disorders. The potential use of media to understand the psychopathology and plight of those with psychiatric disorders is referred to. The manner in which media can be used as a tool for change to reduce the stigma surrounding mental illnesses is explored.

  16. Evolving Definitions of Mental Illness and Wellness

    Directory of Open Access Journals (Sweden)

    Tara W. Strine, MPH

    2010-01-01

    Full Text Available Understanding of the definitions of wellness and illness has changed from the mid-20th century to modern times, moving from a diagnosis-focused to a person-focused definition of mental illnesses, and from an “absence of disease” model to one that stresses positive psychological function for mental health. Currently, wellness refers to the degree to which one feels positive and enthusiastic about oneself and life, whereas illness refers to the presence of disease. These definitions apply to physical as well as mental illness and wellness. In this article, we build on the essential concepts of wellness and illness, discuss how these definitions have changed over time, and discuss their importance in the context of health reform and health care reform. Health reform refers to efforts focused on health, such as health promotion and the development of positive well-being. Health care reform refers to efforts focused on illness, such as treatment of disease and related rehabilitation efforts.

  17. Beliefs regarding diet during childhood illness

    Directory of Open Access Journals (Sweden)

    Asha D Benakappa

    2012-01-01

    Full Text Available Background: Fifty percent to 70% of the burden of childhood diarrhea and respiratory infections is attributable to undernutrition. It is compounded by food restriction during illness due to false beliefs, leading to a vicious cycle of malnutrition and infection. In the long run, it decreases the child′s productivity, which is an obstacle to sustainable socioeconomic development. Objectives: To assess the dietary practices during different illnesses, to study the role of education, culture and religion in feeding an ill child and to create awareness against detrimental practices. Materials and Methods: A cross-sectional study was undertaken among 126 caregivers of ill children using an open-ended pretested questionnaire. Statistical package for social sciences software was used for data analysis. Simple proportions, percentages and Chi-square were used. Results: Caregivers believed that a child must be fed less during illness. Educational status did not play a role in maintaining beliefs, but elders and religion did. Doctors too were responsible for unwanted dietary restrictions. Media did not have an impact in spreading nutrition messages. Decreased breast feeds, initiating bottle feeds, feeding diluted milk and reducing complementary feeds during illness was widely practiced. Calorie intake during illness was very less and statistically significant. Firmly rooted beliefs about "hot" and "cold" foods lead to restriction of food available at home. Conclusions: Healthy feeding practices were few, and inappropriate ones predominant. Dietary education was overlooked. While planning community-based nutrition programs, firmly rooted beliefs should be kept in mind. Involving the elderly caregivers and mothers actively along with the health workers is the need of the hour.

  18. Perceived illness intrusion among patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Bapat Usha

    2009-01-01

    Full Text Available Dialysis therapy is extremely stressful as it interferes with all spheres of daily acti-vities of the patients. This study is aimed at understanding the perceived illness intrusion among pa-tients on hemodialysis (HD and to find the association between illness intrusion and patient demo-graphics as well as duration of dialysis. A cross sectional study involving 90 patients with chronic kidney disease (CKD stage V, on HD was performed during the period from 2005 to 2006. The subjects included were above 18 years of age, willing, stable and on dialysis for at least two months. Patients with psychiatric co-morbidity were excluded. A semi-structured interview schedule covering socio-demographics and a 13 item illness intrusion checklist covering the various aspects of life was ca-rried out. The study patients were asked to rate the illness intrusion and the extent. The data were ana-lyzed statistically. The mean age of the subjects was 50.28 ± 13.69 years, males were predominant (85%, 73% were married, 50% belonged to Hindu religion, 25% had pre-degree education, 25% were employed and 22% were housewives. About 40% and 38% of the study patients belonged to middle and upper socio-economic strata respectively; 86% had urban background and lived in nuclear fami-lies. The mean duration on dialysis was 24 ± 29.6 months. All the subjects reported illness intrusion to a lesser or greater extent in various areas including: health (44%, work (70% finance (55%, diet (50% sexual life (38% and psychological status (25%. Illness had not intruded in areas of rela-tionship with spouse (67%, friends (76%, family (79%, social (40% and religious functions (72%. Statistically significant association was noted between illness intrusion and occupation (P= 0.02.

  19. How the Media Cover Mental Illnesses: A Review

    Science.gov (United States)

    Ma, Zexin

    2017-01-01

    Purpose: Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies…

  20. Life satisfaction post stroke : The role of illness cognitions

    NARCIS (Netherlands)

    van Mierlo, M. L.; van Heugten, C. M.; Post, M. W M; de Kort, P. L M; Visser-Meily, J.M.A.

    2015-01-01

    OBJECTIVE: To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness

  1. Life satisfaction post stroke : The role of illness cognitions

    NARCIS (Netherlands)

    van Mierlo, M. L.; van Heugten, C. M.; Post, M. W. M.; de Kort, P. L. M.; Visser-Meily, J. M. A.

    2015-01-01

    Objective: To describe illness cognitions two months and two years post stroke and to investigate changes in illness cognitions over time. We also examined the associations between illness cognitions and life satisfaction at two months and two years post stroke and investigated if changes in illness

  2. How the Media Cover Mental Illnesses: A Review

    Science.gov (United States)

    Ma, Zexin

    2017-01-01

    Purpose: Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies…

  3. Perceived Mental Illness Stigma, Intimate Relationships, and Sexual Risk Behavior in Youth with Mental Illness

    Science.gov (United States)

    Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2013-01-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…

  4. Adults' Explanations and Children's Understanding of Contagious Illnesses, Non-Contagious Illnesses, and Injuries

    Science.gov (United States)

    Toyama, Noriko

    2016-01-01

    The present study examined (1) whether children notice different causes for contagious illnesses, non-contagious illnesses, and injuries and (2) what information adults provide to children and to what extent this information is related to children's causal awareness. Studies 1 and 2 explored preschool teachers' and mothers' explanations of…

  5. The Chronic Illness Initiative: Supporting College Students with Chronic Illness Needs at DePaul University

    Science.gov (United States)

    Royster, Lynn; Marshall, Olena

    2008-01-01

    College students with chronic illness find it difficult to succeed in traditional degree programs due to disruptions caused by relapses and unpredictable waxing and waning symptoms. College disability offices are often unable to help, both because their standard supports are not appropriate and because students with chronic illness frequently do…

  6. Making sense of different illness realities: restructuring of illness meaning among Swedish-born women.

    Science.gov (United States)

    Bäärnhielm, Sofie

    2005-01-01

    This study explores restructuring of illness meaning among eight Swedish-born female patients, assessed as somatizing, encountering caregivers imposing a "psychological language" of distress. Data were collected 1997-2001 from 32 interviews and analysed with a Grounded Theory approach. Two major trends were identified in the participants' process of restructuring illness meaning: first, a trend of accepting a "psychological language" of understanding distress and then of paying attention to stress and demanding work conditions. The term "burnout" was introduced. For participants, giving meaning to illness had been a continuous and interactive process in which new meanings had been integrated within a framework of both constancy and change. Restructuring illness meaning had not been uncomplicated. Participants tried to bridge illness perspectives and treatment strategies within their daily life situations of handling distress. The social context had been important for bridging gaps in illness perspectives and in creating coherence between frames of meanings. The results support the view that Antonovsky's concept of Sense of Coherence (SOC) may have relevance when considering the process of restructuring illness meaning, and that constructing coherence between experience, expression, past and new meanings given to illness, may be significant for patients' recovery. The results stress the importance of research exploring the interaction between individuals and social and cultural groups in multicultural milieus in order to obtain insights as to how people make sense of their clinical encounter.

  7. Perceived Mental Illness Stigma, Intimate Relationships, and Sexual Risk Behavior in Youth with Mental Illness

    Science.gov (United States)

    Elkington, Katherine S.; Hackler, Dusty; Walsh, Tracy A.; Latack, Jessica A.; McKinnon, Karen; Borges, Cristiane; Wright, Eric R.; Wainberg, Milton L.

    2013-01-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted…

  8. Mental Illness among Us: A New Curriculum to Reduce Mental Illness Stigma among Medical Students

    Science.gov (United States)

    Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.

    2013-01-01

    Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…

  9. Mental Illness among Us: A New Curriculum to Reduce Mental Illness Stigma among Medical Students

    Science.gov (United States)

    Aggarwal, Anuj K.; Thompson, Maxwell; Falik, Rebecca; Shaw, Amy; O'Sullivan, Patricia; Lowenstein, Daniel H.

    2013-01-01

    Objectives: Medical students have been shown to have high levels of psychological distress, including self-stigmatization and unwillingness to seek care. The authors hypothesized that a student-led curriculum involving personal mental illness experience, given during the first-year neuroscience course, and titled "Mental Illness Among Us…

  10. Life threatening illness and hospice care.

    Science.gov (United States)

    Stein, A; Forrest, G C; Woolley, H; Baum, J D

    1989-01-01

    A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening illness. Eighteen (72%) of the families felt they had been well supported by the hospice and valued the family like atmosphere, perceiving the staff to be friendly, approachable, and helpful. The actual nature of hospice care, in an environment with other terminally ill children, was, however, considered a drawback for a few families. A number of families still had unmet needs, notably appropriate child minding when away from the hospice. The impact of chronic life threatening illness on the families was substantial. The parents (particularly the mothers), the index children, and their siblings all experienced much higher levels of psychological symptomatology than would have been expected from normal samples. While families felt greatly helped over symptom control, a proportion remained very worried about certain symptoms, particularly breathlessness, seizures, and pain. A high proportion of families were experiencing financial and employment difficulties as a result of their children's illnesses. PMID:2730123

  11. Illness as a condition of our existence in the world: on illness and pathic existence.

    Science.gov (United States)

    Martinsen, Elin Håkonsen; Solbakk, Jan Helge

    2012-06-01

    This paper seeks to find different ways of addressing illness as an experience essential to the understanding of being a human being. As a conceptual point of departure, we suggest the notion of 'pathic existence' as developed by the German physician and philosopher Viktor von Weizsäcker (1886-1957). Through an analysis of his conceptualisation of the pathic and of pathic categories, we demonstrate how this auxiliary typology may be of help in unveiling different modes of ill-being, or Kranksein. Furthermore, we show how illness plays a paradigmatic role in this type of existence. We discuss how von Weizsäcker's claim of illness as "a way of being human" indicates how such a view of the illness existence both differs from and touches upon other streams of thought within the philosophy of medicine and medical ethics. Finally, we highlight some of the normative implications emerging from this perspective of relevance in today's medicine.

  12. The detection and treatment of depression in the physically ill

    OpenAIRE

    2010-01-01

    Depression and chronic physical illness are in reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses. Depression associated with physical illness is less well detected than depression occurring on its own, and various ways of improving both the detection and treatment of depression accompanying physical illness are described. This paper is in fou...

  13. Brainstorm: occupational choice, bipolar illness and creativity.

    Science.gov (United States)

    Tremblay, Carol Horton; Grosskopf, Shawna; Yang, Ke

    2010-07-01

    Although economists have analyzed earnings, unemployment, and labor force participation for those with bipolar illness, occupational choice has yet to be explored. Psychological and medical studies often suggest an association between bipolar illness and creative achievement, but they tend to focus on eminent figures, case studies, or small samples. We seek to examine occupational creativity of non-eminent individuals with bipolar disorder. We use Epidemiologic Catchment Area data to estimate a multinomial logit model matched to an index of occupational creativity. Those with bipolar illness appear to be disproportionately concentrated in the most creative occupational category. Nonparametric kernel density estimates reveal that the densities of the occupational creativity variable for the bipolar and non-bipolar individuals significantly differ in the ECA data, and suggest that the probability of engaging in creative activities on the job is higher for bipolar than non-bipolar workers.

  14. Nutrition, illness, and injury in aquatic sports.

    Science.gov (United States)

    Pyne, David B; Verhagen, Evert A; Mountjoy, Margo

    2014-08-01

    In this review, we outline key principles for prevention of injury and illness in aquatic sports, detail the epidemiology of injury and illness in aquatic athletes at major international competitions and in training, and examine the relevant scientific evidence on nutrients for reducing the risk of illness and injury. Aquatic athletes are encouraged to consume a well-planned diet with sufficient calories, macronutrients (particularly carbohydrate and protein), and micronutrients (particularly iron, zinc, and vitamins A, D, E, B6, and B12) to maintain health and performance. Ingesting carbohydrate via sports drinks, gels, or sports foods during prolonged training sessions is beneficial in maintaining energy availability. Studies of foods or supplements containing plant polyphenols and selected strains of probiotic species are promising, but further research is required. In terms of injury, intake of vitamin D, protein, and total caloric intake, in combination with treatment and resistance training, promotes recovery back to full health and training.

  15. Diagnostic Categories in Autobiographical Accounts of Illness.

    Science.gov (United States)

    Kelly, Michael P

    2015-01-01

    Working within frameworks drawn from the writings of Immanuel Kant, Alfred Schutz, and Kenneth Burke, this article examines the role that diagnostic categories play in autobiographical accounts of illness, with a special focus on chronic disease. Four lay diagnostic categories, each with different connections to formal medical diagnostic categories, serve as typifications to make sense of the way the lifeworld changes over the course of chronic illness. These diagnostic categories are used in conjunction with another set of typifications: lay epidemiologies, lay etiologies, lay prognostics, and lay therapeutics. Together these serve to construct and reconstruct the self at the center of the lifeworld. Embedded within the lay diagnostic categories are narratives of progression, regression, or stability, forms of typification derived from literary and storytelling genres. These narratives are developed by the self in autobiographical accounts of illness.

  16. [Health education: knowledge, social representation, and illness].

    Science.gov (United States)

    Gazzinelli, Maria Flávia; Gazzinelli, Andréa; Reis, Dener Carlos dos; Penna, Cláudia Maria de Mattos

    2005-01-01

    This article discusses the theory and practice of health and education, beginning with the notion of the hegemony (in health education practice) of strategies linked to the notion that to grasp established knowledge always leads to the acquisition of new behaviors and practices. Five different axioms have oriented education and health practices, either juxtaposed or at different moments: (1) the notion of overcoming the determination of knowledge over practices; (2) the determination of representations over practices; (3) the analysis of representations within the traditional framework of right and wrong; (4) reciprocity between representations and practices; and (5) the importance of considering practices amenable to re-elaboration through representations, thus situating experience in understanding subjects' illness processes, as well as the way subjects culturally construct illness. The article highlights the need for a link between social representations and illness-as-experience in health education practices.

  17. Protein and energy provision in critical illness.

    Science.gov (United States)

    Hoffer, L John

    2003-11-01

    It has recently been recommended that parenterally fed, critically ill patients should receive considerably less energy than the 36 kcal.kg(-1).d(-1) customarily received in earlier years and that mixed amino acid infusions not exceed 1.5 g.kg(-1).d(-1). The implications of these recommendations should be considered carefully, especially for patients with low body weight. Any sizeable reduction in energy provision will lead to negative energy balance in at least some patients, and negative energy balance is known to increase protein requirements. The optimal rate of amino acid delivery for underfed, critically ill patients is not well defined and could well exceed 1.5 g.kg(-1).d(-1). In addition, there are good reasons to suspect that the safe protein requirement of severely underweight, critically ill patients is >1.5 g.kg(-1).d(-1), even when adequate energy is provided.

  18. Morgellons: contested illness, diagnostic compromise and medicalisation.

    Science.gov (United States)

    Fair, Brian

    2010-05-01

    The case of Morgellons illustrates how the emergence of a new medically contested illness intersected with and impacted on the diagnostic processes of an existing uncontested psychiatric condition, Delusional Parasitosis (DP). More specifically, the sociopolitical processes at play in the contested illness, Morgellons, dubiously reflect patient empowerment, as well the resilience and power of medical jurisdiction. This research offers insights into the contested illness and medicalisation literatures, and aims to bridge these two approaches towards the relationship between patient empowerment and medical authority, which I do through the notion of doctor-patient compromise. The data for this research come from a comprehensive qualitative analysis of Morgellons discourse through four key sources: the pro-Morgellons website Morgellons.org; the anti-Morgellons website Morgellonswatch.com; the popular media's portrayal of Morgellons; and the DP and Morgellons articles published in peer-reviewed medical journals, as made available on PubMed.

  19. Diastolic dysfunction in the critically ill patient.

    Science.gov (United States)

    Suárez, J C; López, P; Mancebo, J; Zapata, L

    2016-11-01

    Left ventricular diastolic dysfunction is a common finding in critically ill patients. It is characterized by a progressive deterioration of the relaxation and the compliance of the left ventricle. Two-dimensional and Doppler echocardiography is a cornerstone in its diagnosis. Acute pulmonary edema associated with hypertensive crisis is the most frequent presentation of diastolic dysfunction critically ill patients. Myocardial ischemia, sepsis and weaning failure from mechanical ventilation also may be associated with diastolic dysfunction. The treatment is based on the reduction of pulmonary congestion and left ventricular filling pressures. Some studies have found a prognostic role of diastolic dysfunction in some diseases such as sepsis. The present review aims to analyze thoroughly the echocardiographic diagnosis and the most frequent scenarios in critically ill patients in whom diastolic dysfunction plays a key role. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. The neurological illness of Friedrich Nietzsche.

    Science.gov (United States)

    Hemelsoet, D; Hemelsoet, K; Devreese, D

    2008-03-01

    Friedrich Nietzsche (1844-1900), one of the most profound and influential modern philosophers, suffered since his very childhood from severe migraine. At 44 he had a mental breakdown ending in a dementia with total physical dependence due to stroke. From the very beginning, Nietzsche's dementia was attributed to a neurosyphilitic infection. Recently, this tentative diagnosis has become controversial. To use historical accounts and original materials including correspondence, biographical data and medical papers to document the clinical characteristics of Nietzsche's illness and, by using this pathography, to discuss formerly proposed diagnoses and to provide and support a new diagnostic hypothesis. Original letters from Friedrich Nietzsche, descriptions by relatives and friends, and medical descriptions. Original German sources were investigated. Biographical papers published in medical journals were also consulted. Nietzsche suffered from migraine without aura which started in his childhood. In the second half of his life he suffered from a psychiatric illness with depression. During his last years, a progressive cognitive decline evolved and ended in a profound dementia with stroke. He died from pneumonia in 1900. The family history includes a possible vascular-related mental illness in his father who died from stroke at 36. Friedrich Nietzsche's disease consisted of migraine, psychiatric disturbances, cognitive decline with dementia, and stroke. Despite the prevalent opinion that neurosyphilis caused Nietzsche's illness, there is lack of evidence to support this diagnosis. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) accounts for all the signs and symptoms of Nietzsche's illness. This study adds new elements to the debate and controversy about Nietzsche's illness. We discuss former diagnoses, comment on the history of a diagnostic mistake, and integrate for the first time Nietzsche's medical problems.

  1. Illness perception in Chinese adults with epilepsy.

    Science.gov (United States)

    Ji, Haixia; Zhang, Lei; Li, Lunlan; Gong, Guiping; Cao, Zhaolun; Zhang, Jianfeng; Zhou, Nong; Wang, Yu; Tu, Houmian; Wang, Kai

    2016-12-01

    Epilepsy is among the most common neurological disorders worldwide. Understanding the patient's subjective experience plays an important role in the treatment and rehabilitation of the patient. However, few studies are concerned about the illness perception of Chinese adults with epilepsy. 117 Chinese adults with epilepsy and 87 Chinese adults with chronic liver disease completed the Chinese version of the Revised Illness Perception Questionnaire (CIPQ-R). The Chinese epilepsy patients also completed the Social Support Rating Scale (SSRS) and Simplified Coping Style Questionnaire (SCSQ). A comparison about CIPQ-R score between the epilepsy group and chronic liver group was conducted using the independent sample t test. Partial correlation coefficients were calculated among the eight subscales of the CIPQ-R and its associated factors. Results for the CIPQ-R indicated that both the epilepsy patients and the chronic liver disease patients had a moderate belief in their personal control and treatment control over their disorder. Consistent with our hypothesis, patients with epilepsy and those with chronic liver disease perceived their respective disease similarly in terms of timeline and illness coherence. However, epilepsy patients had a higher negative emotional representations level than that we expected when compared to those of the patients suffering from chronic liver disease. Partial correlation analysis in Chinese epilepsy patients showed that the timeline acute/chronic dimension and emotional representations dimension were closely related to the other dimensions of illness perception. Moreover, the illness perception of the patients was significantly associated with social support, coping style, duration of epilepsy, seizure frequency, and the number of antiepileptic drugs. Chinese patients with epilepsy had limited understanding of the illness, and poor belief in personal control and treatment control. They had a negative emotional response to their illness

  2. New U.S. Foodborne Illness Estimate

    Centers for Disease Control (CDC) Podcasts

    2010-12-13

    This podcast discusses CDC's report on new estimates of illnesses due to eating contaminated food in the United States. Dr. Elaine Scallan, assistant professor at the University of Colorado and former lead of the CDCs FoodNet surveillance system, shares the details from the first new comprehensive estimates of foodborne illness in the U.S. since 1999.  Created: 12/13/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID); National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 12/15/2010.

  3. Probiotic (VSL 3) for Gulf War Illness

    Science.gov (United States)

    2015-10-01

    AD_________________ Award Number: W81XWH-10-1-0593 TITLE: Probiotic (VSL#3) for Gulf War Illness PRINCIPAL INVESTIGATOR: Ashok Tuteja, M.D...2015 5a. CONTRACT NUMBER Probiotic (VSL#3) for Gulf War Illness 5b. GRANT NUMBER W81XWH-10-1-0593 5c. PROGRAM ELEMENT NUMBER 6 . AUTHOR(S) 5d...ABSTRACT The overall objective of the study is to determine whether probiotic VSL#3® will improve 1) intestinal symptoms of Irritable Bowel Syndrome

  4. Bipolar illness: factors in drinking behavior.

    Science.gov (United States)

    Dunner, D L; Hensel, B M; Fieve, R R

    1979-04-01

    Alcohol use and abuse was investigated in 73 patients with bipolar I manic-depressive illness who were attending a lithium clinic. Alcohol-related problems were identified in 7 of the male and none of the female patients. Family data revealed a higher morbid risk for alcoholism among relatives of patients with drinking problems than among relatives of patients without drinking problems. Morbid risks for affective disorder for these two groups of relatives were similar, suggesting that alcoholism among relatives of patients with bipolar illness is not solely "genotypically" related to the affective disorder.

  5. Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

    Directory of Open Access Journals (Sweden)

    Gustavo Varela

    2015-01-01

    Full Text Available Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC, viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC. Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

  6. Behavior of Different Shiga Toxin-Producing Escherichia coli Serotypes in Various Experimentally Contaminated Raw-Milk Cheeses

    OpenAIRE

    Miszczycha, Stéphane D.; Perrin, Frédérique; Ganet, Sarah; Jamet, Emmanuel; TENENHAUS-AZIZA, Fanny; Montel, Marie-Christine; Thevenot-Sergentet, Delphine

    2013-01-01

    Shiga toxin-producing Escherichia coli (STEC) is an important cause of food-borne illness. The public health implication of the presence of STEC in dairy products remains unclear. Knowledge of STEC behavior in cheeses would help to evaluate the human health risk. The aim of our study was to observe the growth and survival of experimentally inoculated STEC strains in raw-milk cheeses manufactured and ripened according to five technological schemes: blue-type cheese, uncooked pressed cheese wit...

  7. The stigma of mental illness in the labor market.

    Science.gov (United States)

    Hipes, Crosby; Lucas, Jeffrey; Phelan, Jo C; White, Richard C

    2016-03-01

    Mental illness labels are accompanied by devaluation and discrimination. We extend research on reactions to mental illness by utilizing a field experiment (N = 635) to test effects of mental illness labels on labor market discrimination. This study involved sending fictitious applications to job listings, some applications indicating a history of mental illness and some indicating a history of physical injury. In line with research indicating that mental illness leads to stigma, we predicted fewer callbacks to candidates with mental illness. We also predicted relatively fewer callbacks for applicants with mental illness when the jobs involved a greater likelihood for interpersonal contact with the employer. Results showed significant discrimination against applicants with mental illness, but did not indicate an effect of potential proximity to the employer. This contributes a valuable finding in a natural setting to research on labor market discrimination towards people with mental illness. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Predicting wellbeing among people with epilepsy using illness cognitions.

    Science.gov (United States)

    Salter, Kirstie A; Prior, Kirsty N; Bond, Malcolm J

    2017-06-01

    This study sought to examine the synergistic contribution of illness-related perceptions (stigma, severity, and threat) and illness behavior to wellbeing among people with epilepsy. Poorer wellbeing was expected among those who perceived greater stigma, illness severity, and threat and had more extreme illness behavior. Individuals with a diagnosis of epilepsy (N=210), recruited through local and online support groups, completed a questionnaire comprising demographic and epilepsy-specific information, and validated measures of illness perceptions and behavior, epilepsy-related quality of life, and general psychological health. Bivariate associations among illness cognition, illness behavior, and wellbeing were all as expected. Structural equation modeling highlighted the strong, direct effect of illness threat on quality of life, with other contributions from perceived stigma and an abnormal illness behavior syndrome (i.e., maladaptive illness responses). Significant variance was accounted for in both quality of life (64%) and psychological health (34%). Preliminary evidence of the contributions of illness threat and maladaptive illness responses to wellbeing highlights the need for longitudinal research to examine the dynamic nature of such findings. Clinicians are encouraged to consider the potential value of screening for both illness threat and abnormal illness behavior to facilitate interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Doing gender, doing away with illness

    DEFF Research Database (Denmark)

    Kolling, Marie

    2012-01-01

    It is well documented in biomedical literature that impotence is a common complication of diabetes. What has received much less attention is how diabetes challenges male gender identity and how the illness interferes in intimate matters. Drawing on empirical findings from an anthropological field...

  10. [Medicines reconciliation in critically ill patients].

    Science.gov (United States)

    Lopez-Martin, C; Aquerreta, I; Faus, V; Idoate, A

    2014-01-01

    Medicines reconciliation plays a key role in patient safety. However, there is limited data available on how this process affects critically ill patients. In this study, we evaluate a program of reconciliation in critically ill patients conducted by the Intensive Care Unit's (ICU) pharmacist. Prospective study about reconciliation medication errors observed in 50 patients. All ICU patients, excluding patients without regular treatment. Reconciliation process was carried out in the first 24h after ICU admission. Discrepancies were clarified with the doctor in charge of the patient. We analyzed the incidence of reconciliation errors, their characteristics and gravity, the interventions made by the pharmacist and their acceptance by physicians. A total of 48% of patients showed at least one reconciliation error. Omission of drugs accounted for 74% of the reconciliation errors, mainly involving antihypertensive drugs (33%). An amount of 58% of reconciliation errors detected corresponded to severity category D. Pharmacist made interventions in the 98% of patients with discrepancies. A total of 81% of interventions were accepted. The incidence and characteristics of reconciliation errors in ICU are similar to those published in non-critically ill patients, and they affect drugs with high clinical significance. Our data support the importance of the stablishment of medication reconciliation proceedings in critically ill patients. The ICU's pharmacist could carry out this procedure adequately. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  11. Illness behavior in patients with musculoskeletal disease

    NARCIS (Netherlands)

    Bot, A.G.J.

    2013-01-01

    This PhD thesis studies the influence of psychological factors in illness behavior in different hand and upper extremity conditions encountered in the practice of a hand surgeon. The importance of the language used by the patient and the amount of shared decision making in an orthopaedic practice is

  12. Mental illness in Saudi Arabia: an overview

    Directory of Open Access Journals (Sweden)

    Almutairi AF

    2015-01-01

    Full Text Available Adel F Almutairi Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC, Riyadh, Kingdom of Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaWhile I was reading on this topic, I came across an online article attributed to a Saudi psychologist that contained information about mental illness among the Saudi population. What really struck me right away was the estimate that was given for the number of mentally ill people in the country. It was claimed that about half of the Saudi population is suffering from mental illness.1 This made me wonder on what grounds the psychologist was basing the claim and how she came up with this scary statistic. If the figure was based on an empirical study, what was the sample size and how robust was the research? Unfortunately, no details were given to answer these questions. Nevertheless, such an alarming figure was the main impetus and driving force for me to write this article and provide readers with an overview of the magnitude of mental illness in the world, and more specifically, in the kingdom of Saudi Arabia, based on recent literature. This article also provides perspectives of scientists working at King Abdullah International Medical Research Center, on how we intend to tackle this issue.  

  13. Blood-Injury-Illness Phobia: A Review.

    Science.gov (United States)

    Thyer, Bruce A.; And Others

    1985-01-01

    Surveys empirical literature pertaining to phobias of blood, injury, or illness (BII); defines BII phobia as selectively associated with vasovagal fainting response upon exposure to phobic stimuli. Presents clinical, demographic, and etiological information from 15 BII phobics and suggests that BII phobia warrants diagnostic category separate from…

  14. Mental Illness in Children: Know the Signs

    Science.gov (United States)

    ... Autism spectrum disorder: Signs and symptoms. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/autism/signs.html. Accessed Dec. 8, 2014. Feb. 11, 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/childrens-health/in-depth/mental-illness-in-children/ ...

  15. On a Monotone Ill-posed Problem

    Institute of Scientific and Technical Information of China (English)

    Nguyen BUONG

    2005-01-01

    A class of a posteriori parameter choice strategies for the operator version of Tikhonovregularization (including variants of Morozov's and Arcangeli's methods) is proposed and used in investigating the rate of convergence of the regularized solution for ill-posed nonlinear equation involving a monotone operator in Banach space.

  16. Development of neutron optical components at ILL

    CERN Document Server

    Courtois, P; Humblot, H; Alianelli, L; Pfeiffer, F O

    2002-01-01

    The neutron optics laboratory at ILL carries out an innovative research program in various fields of neutron optics with the aim of developing new and improved tools for neutron instrumentation. An overview of some recent highlights is presented, indicating the breadth of the potential applications. (orig.)

  17. Work adjustments among the chronically ill.

    NARCIS (Netherlands)

    Baanders, A.N.; Andries, F.; Rijken, P.M.; Dekker, J.

    2001-01-01

    Work(place) adjustments can help the work capacity of persons with a chronic disease. This study aims to to quantify the presence of work adjustments among chronically ill workers in the Netherlands, and to investigate the extent to which the presence of work adjustments are related to the

  18. Wellness within illness: happiness in schizophrenia.

    Science.gov (United States)

    Palmer, Barton W; Martin, Averria Sirkin; Depp, Colin A; Glorioso, Danielle K; Jeste, Dilip V

    2014-10-01

    Schizophrenia is typically a chronic disorder and among the most severe forms of serious mental illnesses in terms of adverse impact on quality of life. Yet, there have been suggestions that some people with schizophrenia can experience an overall sense of happiness in their lives. We investigated happiness among 72 outpatients with non-remitted chronic schizophrenia with a mean duration of illness of 24.4 years, and 64 healthy comparison subjects (HCs). Despite continued treatment with antipsychotic medications, the individuals with schizophrenia manifested a mild to moderate level of psychopathology. People with schizophrenia reported lower mean levels of happiness than HCs, but there was substantial heterogeneity within the schizophrenia group. Level of happiness in persons with schizophrenia was significantly correlated with higher mental health-related quality of life, and several positive psychosocial factors (lower perceived stress, and higher levels of resilience, optimism, and personal mastery). However, level of happiness was not related to sociodemographic characteristics, duration of illness, severity of positive or negative symptoms, physical function, medical comorbidity, or cognitive functioning. Except for an absence of an association with resilience, the pattern of correlations of happiness with other variables seen among HCs was similar to that in individuals with schizophrenia. Although happiness may be harder to achieve in the context of a serious mental illness, it nonetheless appears to be a viable treatment goal in schizophrenia. Psychotherapies targeting positive coping factors such as resilience, optimism, and personal mastery warrant further investigation. Copyright © 2014. Published by Elsevier B.V.

  19. New European policy toward chronically ill employees

    NARCIS (Netherlands)

    Kopnina, H.; Haafkens, J.; Elling, L.R.

    2009-01-01

    This article provides an overview of current policies related to the chronically ill employees in the Netherlands. Different levels of policy are discussed: those formulated at the European, Dutch and organizational levels. A significantg percentage of Dutch employees suffer from longstanding diseas

  20. Acronyms Gone Wild! ILL Flirts with NCIP

    Science.gov (United States)

    Carlson, Al

    2008-01-01

    While the traditional uses of InterLibrary Loan (ILL) can be cumbersome, much of the work is now done electronically. Google and WorldCat can tell patrons which libraries in their areas owns the the titles they want, but they cannot always tell patrons whether there is a copy on the shelf available for loan. Several ILS vendors and OCLC are…

  1. Diagnosing Febrile Illness in a Returned Traveler

    Centers for Disease Control (CDC) Podcasts

    2012-03-01

    This podcast will assist health care providers in diagnosing febrile illness in patients returning from a tropical or developing country.  Created: 3/1/2012 by National Center for Enteric, Zoonotic, and Infectious Diseases (NCEZID).   Date Released: 3/1/2012.

  2. Communication with older, seriously ill patients.

    NARCIS (Netherlands)

    Vliet, L.M. van; Lindenberger, E.; Weert, J.C.M. van

    2015-01-01

    This article aims to provide more insight into effective communication with older people with serious illness and their surrogates/caregivers. To do so, if focusses on specific skills in three core functions of communication (i) empathic behavior, (ii) information provision and (iii) enabling decisi

  3. Pancreatic Involvement in Critically ill Patients

    Directory of Open Access Journals (Sweden)

    Abhinav Agrawal

    2015-07-01

    Full Text Available Elevation of pancreatic enzymes is often observed in patients admitted to intensive care units in the United States. Elevated pancreatic enzymes can occur due to acute pancreatitis or numerous non-specific reasons. Non-specific enzyme elevation can be seen in patients with head injury, acute renal failure, diabetic ketoacidosis or patients on hemodialysis. Patients with severe acute pancreatitis can be admitted to the intensive care units for intensive care or patients admitted to the intensive care units for other critical illness can develop acute pancreatitis due to a variety of reasons like ischemia, hypoperfusion, drugs or hypercalcemia. It can be a challenging task to distinguish between acute pancreatitis and non-specific enzyme elevation, especially in critically ill patients with multiple co-morbidities admitted to the intensive care units in whom historical information may not be always available. In addition, the clinical consequences of pancreatic enzyme elevation in the critically ill patients are also not very clear. This review attempts to describe the complex interplay of various factors that can lead to either pancreatic inflammation and/or pancreatic enzyme elevation in the critically ill patients along with the clinical consequences and approach to patient with pancreatic enzyme elevation in the intensive care units.

  4. Gendering psychosis: the illness of Zelda Fitzgerald.

    Science.gov (United States)

    Seeman, Mary V

    2016-03-01

    Psychiatric textbooks tend to describe psychosis as it is experienced by men. The well-documented illness of Zelda Fitzgerald illustrates the feminine side of psychosis. The distinctive features of Zelda's illness--its specific precipitants, the timing of its onset, the discontinuities in its course, the pronounced mood swings, the preservation of intellect and of agency, the maintenance of human ties, the association of flare-ups with immune and hormonal changes, the responsiveness to treatment, the lifelong creativity and productivity--show the female side of psychotic illness, one that is rarely described in diagnostic manuals. This paper relies on Nancy Milford's biography of Zelda, as well as on several other biographical sources and, using Zelda's own words and the words of her husband and friends, allows entry into a feminine world of psychosis, not encountered in textbooks. The expression of psychotic illness varies from person to person, its exact shape depending on many factors, most of them still undetermined, but gender is a critically important core component of variance.

  5. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  6. Barbecue Basics: Tips to Prevent Foodborne Illness

    Medline Plus

    Full Text Available ... from becoming ill,” says Marjorie Davidson, Ph.D., education team leader in FDA’s Center for Food Safety ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  7. Barbecue Basics: Tips to Prevent Foodborne Illness

    Medline Plus

    Full Text Available ... to Prevent Foodborne Illness Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Get Consumer Updates by email. En Español It’s the season for picnics, cookouts, and other outdoor ...

  8. Cardiac troponin elevations among critically ill patients.

    NARCIS (Netherlands)

    Klein Gunnewiek, J.M.T.; Hoeven, J.G. van der

    2004-01-01

    PURPOSE OF THE REVIEW: Elevated levels of cardiac troponins, indicative of the presence of cardiac injury, have been reported in critically ill patients. In this review, the incidence, significance, and clinical relevance of elevated troponin levels among this group of patients will be discussed. RE

  9. Smoking, Mental Illness, and Public Health.

    Science.gov (United States)

    Prochaska, Judith J; Das, Smita; Young-Wolff, Kelly C

    2016-12-16

    Tobacco remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of "the host" (e.g., tobacco user characteristics), the "agent" (e.g., nicotine product characteristics), the "vector" (e.g., tobacco industry), and the "environment" (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness. Expected final online publication date for the Annual Review of Public Health Volume 38 is March 20, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

  10. About the right to be ill.

    Science.gov (United States)

    Halasz, Jacek

    2017-07-14

    The article raises the issue of 'the right to be ill', formulated by Tadeusz Kielanowski, a Polish physician and humanist. According to him, the right to health should be supplemented by the principle which would serve the protection of people with diseases or disabilities. One-sided interpretation of 'the right to health' may result in various forms of intolerance and discrimination. This paper presents what dangers Kielanowski recognized and explains why his approach was considered to be a novelty; what the idea of 'the right to be ill' is, how the need for it is substantiated. This idea is considered in the context of human rights and it constitutes a starting point for the reflection on social phenomena connected with medicine. Taking into account the changes in medical ethics and culture which have taken place in the recent decades the question has been asked-is it worth talking about the right to be ill these days? Giving positive answers to this question, the spheres and issues that have been presented can be analyzed and assessed from the perspective of the right to be ill.

  11. Attitudes toward patient expertise in chronic illness.

    Science.gov (United States)

    Thorne, S E; Ternulf Nyhlin, K; Paterson, B L

    2000-08-01

    Although it has become an accepted standard to acknowledge the patient as a full partner in health care decisions, replacing traditional authoritative relationships with those based on an emancipatory model, the experiences of persons living with chronic illness confirm that this paradigm shift is not yet apparent in many health care relationships. In this paper, the authors present a qualitative secondary analysis of combined data sets from their research into chronic illness experience with two quite different chronic diseases - Type I Diabetes (a socially legitimized chronic disease) and Environmental Sensitivities (a disease which is currently treated with considerable scepticism). Comparing the experiences of individuals with diseases that are quite differently socially constructed, it becomes possible to detect common underlying health professional values and attitudes that powerfully influence the experience of living with and negotiating health care for a chronic illness. In the discussion of findings from this study, the authors examine the implications of the spiral of behaviors that fuels mutual alienation in chronic illness care relationships if professionals are unable to value patient expertise.

  12. Acute Stress Response in Critically Ill Children

    NARCIS (Netherlands)

    M. den Brinker (Marieke)

    2006-01-01

    textabstractThe understanding of the endocrine changes in critically ill children is important, as it provides insights in the pathophysiology of the acute stress in children and its differences compared with adults. Furthermore, it delineates prognostic factors for survival and supports the rati

  13. Doing gender, doing away with illness

    DEFF Research Database (Denmark)

    Kolling, Marie

    2012-01-01

    fieldwork conducted among men and women who are living with type 2 diabetes in conditions of urban poverty in Northeast Brazil, this article examines how the men’s illness experiences are interwoven with the changes they concomitantly experienced in their sexuality. By examining the disruptiveness...

  14. Needs of people with severe mental illness

    NARCIS (Netherlands)

    Wiersma, D

    2006-01-01

    Objective: This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care. Method: Focus is on the definition of the concept of need as what people can b

  15. Resisting the Stigma of Mental Illness

    Science.gov (United States)

    Thoits, Peggy A.

    2011-01-01

    The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…

  16. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  17. Pressure sore prevention in acutely ill patients.

    Science.gov (United States)

    James, H

    1997-03-01

    A wide range of factors affect the skin's ability to withstand pressure, friction and shear. Clinically validated pressure-relieving equipment is essential to prevent pressure sores in acutely ill patients. A successful pressure sore prevention strategy depends on sufficient resource allocation, appropriate levels and types of preventive equipment and evaluation.

  18. Needs of people with severe mental illness

    NARCIS (Netherlands)

    Wiersma, D

    2006-01-01

    Objective: This study reviews conceptual and methodological issues of needs for care among people with severe mental illness (SMI) and presents data on their prevalence, correlates and consequences for mental health care. Method: Focus is on the definition of the concept of need as what people can

  19. Ministry to the Chronically Ill Child.

    Science.gov (United States)

    Spinetta, Pat Deasy; Collins, Denis E.

    1993-01-01

    Reports growth in the number of chronically ill children attending Catholic schools. Describes the separate roles of home, school, and hospital in children's long-term care. Urges educators to obtain necessary information on children's attendance, peer interaction, education, and medical compliance. Reviews issues specific to chronically ill…

  20. Resisting the Stigma of Mental Illness

    Science.gov (United States)

    Thoits, Peggy A.

    2011-01-01

    The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…

  1. Personality and illness adaptation in adults with type 1 diabetes: the intervening role of illness coping and perceptions.

    Science.gov (United States)

    Rassart, Jessica; Luyckx, Koen; Klimstra, Theo A; Moons, Philip; Groven, Chris; Weets, Ilse

    2014-03-01

    Inspired by the common sense model, the present cross-sectional study examined illness perceptions and coping as intervening mechanisms in the relationship between Big Five personality traits and illness adaptation in adults with Type 1 diabetes. A total of 368 individuals with Type 1 diabetes (18-35 years old) completed questionnaires on personality, diabetes-related problems, illness perceptions, and illness coping. First, Neuroticism, Agreeableness, and Conscientiousness predicted patients' illness adaptation, above and beyond the effects of sex, age, and illness duration. Second, illness coping was found to be an important mediating mechanism in the relationship between the Big Five and illness adaptation. Finally, perceived consequences and perceived personal control partially mediated the relationship between the Big Five and illness coping. These findings underscore the importance of examining patients' personality to shed light on their daily functioning and, hence, call for tailored intervention programs which take into account the personality of the individual patient.

  2. Endocrine and metabolic considerations in critically ill patients 4: Thyroid function in critically ill patients

    OpenAIRE

    Fliers, Eric; Bianco, Antonio C.; Langouche, Lies; Boelen, Anita

    2015-01-01

    Patients in the intensive care unit (ICU) typically present with decreased concentrations of plasma tri-iodothyronine, low thyroxine, and normal range or slightly decreased concentration of thyroid-stimulating hormone. This ensemble of changes is collectively known as non-thyroidal illness syndrome (NTIS). The extent of NTIS is associated with prognosis, but no proof exists for causality of this association. Initially, NTIS is a consequence of the acute phase response to systemic illness and ...

  3. Psychiatric aspec ts of chronic physical illness in adolescence

    African Journals Online (AJOL)

    2008-05-18

    May 18, 2008 ... Survival rates for children who suffer chronic physical illnesses have increased ... and adjust to the stress and limitations imposed by the illness. For a ... presents unique challenges for the adolescent, his/her family, and.

  4. History of febrile illness and variation in semen quality

    DEFF Research Database (Denmark)

    Carlsen, Elisabeth; Andersson, Anna-Maria; Petersen, Jørgen Holm

    2003-01-01

    The purpose of this study was to analyse the effect of a history of febrile illness on semen quality.......The purpose of this study was to analyse the effect of a history of febrile illness on semen quality....

  5. Clinical use of lactate monitoring in critically ill patients

    NARCIS (Netherlands)

    J. Bakker (Jan); M.W.N. Nijsten (Maarten); T.C. Jansen (Tim)

    2013-01-01

    textabstractIncreased blood lactate levels (hyperlactataemia) are common in critically ill patients. Although frequently used to diagnose inadequate tissue oxygenation, other processes not related to tissue oxygenation may increase lactate levels. Especially in critically ill patients, increased gly

  6. Mental illness in the nursing workplace: a collective autoethnography.

    Science.gov (United States)

    Kidd, Jacquie Dianne; Finlayson, Mary P

    2010-01-01

    Many nurses are burned out, exhausted and have a high intent to leave their jobs. These factors, when experienced over a period of time, are consistent with the development of mental illness. This study takes a collective autoethnographical approach to mental illness in the nursing workplace by focusing on the stories of nurses who have experienced mental illness in clinical practice. It highlights three ways in which nursing and mental illness are connected; the nurse who is vulnerable to mental illness prior to entering the profession, the nurse who develops mental illness that is independent of her work but is nevertheless impacted by it, and the nurse who develops mental illness as a result of her work and/or role. This paper explores the hyphenated lives and bullying these nurses experience, and recommends strategies that the profession, employing organisations, and individuals can adopt to reduce nurses' progression from stress to distress and mental illness.

  7. Should we mobilise critically ill patients? A review.

    LENUS (Irish Health Repository)

    O'Connor, Enda D

    2009-12-01

    Neuromuscular weakness, a frequent complication of prolonged bed rest and critical illness, is associated with morbidity and mortality. Mobilisation physiotherapy has widespread application in patients hospitalised with non-critical illness.

  8. The prediction of different experiences of longterm illness

    DEFF Research Database (Denmark)

    Blank, N; Diderichsen, Finn

    1996-01-01

    To analyse the role played by socioeconomic factors and self rated general health in the prediction of the reporting of severe longterm illness, and the extent to which these factors explain social class differences in the reporting of such illness.......To analyse the role played by socioeconomic factors and self rated general health in the prediction of the reporting of severe longterm illness, and the extent to which these factors explain social class differences in the reporting of such illness....

  9. 2006 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-05-14

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  10. 2006 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-06-13

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  11. 2006 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-03-06

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  12. 2007 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-07-31

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  13. 2010 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-06-20

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  14. 2010 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-09-26

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  15. 2007 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-07-16

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  16. 2010 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-08-16

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  17. 2007 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety, and Security

    2009-05-04

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  18. 2003 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

    2007-05-23

    Annual Illness and Injury Surveillance Program report for 2003 for the Nevada Test Site. The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  19. 2007 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety, and Security

    2009-07-16

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  20. 2007 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-07-31

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  1. 2010 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-10-05

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  2. 2006 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-08-20

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  3. Mental Illness In Nursing Homes: Variations Across States

    OpenAIRE

    Grabowski, David C.; Aschbrenner, Kelly A.; Feng, Zhanlian; Mor, Vincent

    2009-01-01

    The institutionalization of individuals with mental illness in nursing homes is an important policy concern. Using nursing home Minimum Data Set assessments from 2005, we found large cross-state variation in both the rates of mental illness among nursing home admissions and the estimated rates of nursing home admissions among persons with mental illness. We also found that newly admitted individuals with mental illness were younger and more likely to become long-stay residents. Taken together...

  4. 2006 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-05-19

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  5. 2006 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2008-04-24

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  6. 2010 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-10-26

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  7. 2010 Pantex Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-06-29

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  8. 2010 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2011-09-12

    The U.S. Department of Energy's (DOE) commitment to assuring the health and safety of its workers includes the conduct of illness and injury surveillance activities that provide an early warning system to detect health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence, occupational injuries and illnesses, and disabilities and deaths among current workers.

  9. The illness of Vincent van Gogh.

    Science.gov (United States)

    Arnold, Wilfred Niels

    2004-03-01

    Vincent van Gogh (1853-1890) was a wonderfully accomplished artist whose work is now widely appreciated. He created a great number of masterpiece paintings and drawings in just one decade devoted to art. His productivity is even more remarkable when considered in the context of his debilitating illness. He suffered from medical crises that were devastating, but in the intervening periods he was both lucid and creative. He left a profound, soul-searching description of his jagged life in his correspondence, which provides the basis for the present analysis. An inherited metabolic disease, acute intermittent porphyria, accounts for all of the signs and symptoms of van Gogh's underlying illness. On this 150th anniversary of the birth of Vincent van Gogh it is appropriate to revisit the subject and to analyze the lack of organized skepticism in the popular media about other diagnoses.

  10. Heat Illness in Football: Current Concepts.

    Science.gov (United States)

    Krohn, Austin R; Sikka, Robby; Olson, David E

    2015-01-01

    Despite growing health and safety concerns, American football remains a vastly popular sport in the United States. Unfortunately, even with increased efforts in promoting education and hydration, the incidence of death from exertional heat stroke continues to rise. General risk factors such as hydration status, obesity, fitness level, and football-specific risk factors such as timing of training camp and equipment all contribute to the development of heat illness. At the professional level, changes have been made to effectively reduce mortality from heat stroke with no deaths since August 2001. However, there have been at least 33 total deaths at the high school and collegiate levels since this time. More efforts need to be focused at these levels to mandate exertional heat illness prevention guidelines in order to reverse this trend of mortality in our younger athletes.

  11. The discovery of drug-induced illness.

    Science.gov (United States)

    Jick, H

    1977-03-01

    The increased use of drugs (and the concurrent increased risks of drug-induced illness) require definition of relevant research areas and strategy. For established marketed drugs, research needs depend on the magnitudes of risk of an illness from a drug and the base-line risk. With the drug risk high and the base-line risk low, the problem surfaces in premarketing studies or through the epidemic that develops after marketing. If the drug adds slightly to a high base-line risk, the effect is undetectable. When both risks are low, adverse effects can be discovered by chance, but systematic case-referent studies can speed discovery. If both risks are high, clinical trials and nonexperimental studies may be used. With both risks intermediate, systematic evaluations, especially case-referent studies are needed. Newly marketed drugs should be routinely evaluated through compulsory registration and follow-up study of the earliest users.

  12. The interfacility transport of critically ill newborns.

    Science.gov (United States)

    Whyte, Hilary Ea; Jefferies, Ann L

    2015-01-01

    The practice of paediatric/neonatal interfacility transport continues to expand. Transport teams have evolved into mobile intensive care units capable of delivering state-of-the-art critical care during paediatric and neonatal transport. While outcomes are best for high-risk infants born in a tertiary care setting, high-risk mothers often cannot be safely transferred. Their newborns may then have to be transported to a higher level of care following birth. The present statement reviews issues relating to transport of the critically ill newborn population, including personnel, team competencies, skills, equipment, systems and processes. Six recommendations for improving interfacility transport of critically ill newborns are highlighted, emphasizing the importance of regionalized care for newborns.

  13. Early nutritional depletion in critically ill children.

    Science.gov (United States)

    Pollack, M M; Wiley, J S; Holbrook, P R

    1981-08-01

    Nutritional status was evaluated in 50 medical admissions to a pediatric ICU. All patients were evaluated within 48 h of admission; none had chronic organ failure or malignancies. Nutritional assessment included weight/50th percentile weight for length, length/50th percentile length for age, triceps skinfold thickness, and midarm muscle circumference. Acute protein-energy malnutrition (PEM) occurred in 16% of all children. Chronic PEM also occurred in 16%. The nutrient stores of fat and somatic protein were deficient in 18 and 20% of all children. Acute PEM and deficient somatic protein stores were more frequent in children less than 2 years (p less than 0.05). These findings indicate that malnutrition and nutrient store deficiencies are common early in the course of critical illnesses in children, especially in those less than 2 years of age. However, the findings do not indicate if the severity of illness was the cause or effect of poor nutritional status.

  14. Melatonin Secretion Pattern in Critically Ill Patients

    DEFF Research Database (Denmark)

    Boyko, Yuliya; Holst, René; Jennum, Poul

    2017-01-01

    Critically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin...... secretion and sleep patterns differed in these patients with and without remifentanil infusion. Eight patients were included. Blood-melatonin was taken every 4th hour, and polysomnography was carried out continually during a 48-hour period. American Academy of Sleep Medicine criteria were used for sleep...... scoring if sleep patterns were identified; otherwise, Watson's classification was applied. As remifentanil was periodically administered during the study, its effect on melatonin and sleep was assessed. Melatonin secretion in these patients followed a phase-delayed diurnal curve. We did not observe any...

  15. Poliomyelitis-like illness associated with asthma.

    OpenAIRE

    Blomquist, H K; Björkstén, B

    1980-01-01

    A 10-year-old girl with a combination of paralytic disease, resembling poliomyelitis, and asthma is described. The girl developed neurological symptoms 5 days after a severe attack of asthma. No aetiology to the flaccid paralysis could be demonstrated although Coxsackie B5 virus was isolated from a stool. A similar poliomyelitis-like illness associated with asthma has previously been reported in 13 cases from Australia and the UK.

  16. Ill-Posedness of sublinear minimization problems

    Directory of Open Access Journals (Sweden)

    S. Issa

    2011-04-01

    Full Text Available It is well known that minimization problems involving sublinear regularization terms are ill-posed, in Sobolev spaces. Extended results to spaces of bounded variation functions BV were recently showed in the special case of bounded regularization terms. In this note, a generalization to sublinear regularization is presented in BV spaces. Notice that our results are optimal in the sense that linear regularization leads to well-posed minimization problems in BV spaces.

  17. Mental illness in Saudi Arabia: an overview

    OpenAIRE

    Almutairi AF

    2015-01-01

    Adel F Almutairi Population Health Research Section, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Kingdom of Saudi Arabia; King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi ArabiaWhile I was reading on this topic, I came across an online article attributed to a Saudi psychologist that contained information about mental illness among the Saudi population. What really struck me right away was the estimate that was given for the number of m...

  18. Reduced Cortisol Metabolism during Critical Illness

    Science.gov (United States)

    Boonen, Eva; Vervenne, Hilke; Meersseman, Philippe; Andrew, Ruth; Mortier, Leen; Declercq, Peter E.; Vanwijngaerden, Yoo-Mee; Spriet, Isabel; Wouters, Pieter J.; Perre, Sarah Vander; Langouche, Lies; Vanhorebeek, Ilse; Walker, Brian R.; Van den Berghe, Greet

    2015-01-01

    BACKGROUND Critical illness is often accompanied by hypercortisolemia, which has been attributed to stress-induced activation of the hypothalamic–pituitary–adrenal axis. However, low corticotropin levels have also been reported in critically ill patients, which may be due to reduced cortisol metabolism. METHODS In a total of 158 patients in the intensive care unit and 64 matched controls, we tested five aspects of cortisol metabolism: daily levels of corticotropin and cortisol; plasma cortisol clearance, metabolism, and production during infusion of deuterium-labeled steroid hormones as tracers; plasma clearance of 100 mg of hydrocortisone; levels of urinary cortisol metabolites; and levels of messenger RNA and protein in liver and adipose tissue, to assess major cortisol-metabolizing enzymes. RESULTS Total and free circulating cortisol levels were consistently higher in the patients than in controls, whereas corticotropin levels were lower (PCortisol production was 83% higher in the patients (P=0.02). There was a reduction of more than 50% in cortisol clearance during tracer infusion and after the administration of 100 mg of hydrocortisone in the patients (P≤0.03 for both comparisons). All these factors accounted for an increase by a factor of 3.5 in plasma cortisol levels in the patients, as compared with controls (Pcortisol clearance also correlated with a lower cortisol response to corticotropin stimulation. Reduced cortisol metabolism was associated with reduced inactivation of cortisol in the liver and kidney, as suggested by urinary steroid ratios, tracer kinetics, and assessment of liver-biopsy samples (P≤0.004 for all comparisons). CONCLUSIONS During critical illness, reduced cortisol breakdown, related to suppressed expression and activity of cortisol-metabolizing enzymes, contributed to hypercortisolemia and hence corticotropin suppression. The diagnostic and therapeutic implications for critically ill patients are unknown. (Funded by the Belgian

  19. DISC1 genetics, biology and psychiatric illness

    OpenAIRE

    2013-01-01

    Psychiatric disorders are highly heritable, and in many individuals likely arise from the combined effects of genes and the environment. A substantial body of evidence points towards DISC1 being one of the genes that influence risk of schizophrenia, bipolar disorder and depression, and functional studies of DISC1 consequently have the potential to reveal much about the pathways that lead to major mental illness. Here, we review the evidence that DISC1 influences disease risk through effects u...

  20. Parents, Teachers, and Medical Personnel: Helping Children with Chronic Illness.

    Science.gov (United States)

    Mescon, Joan A. W.; Honig, Alice S.

    1995-01-01

    Reviews how chronic illness affects the psychosocial and cognitive development of ill children, using both Eriksonian and Piagetian theoretical rubrics. Explores family and child stress and coping with medical crises and manifestations of illness. Provides recommendations for enhancing parent and professional communication and educational…

  1. Death Education and Attitudes toward Euthanasia and Terminal Illness.

    Science.gov (United States)

    Nagi, Mostafa H.; Lazerine, Neil G.

    1982-01-01

    Analyzed attitudes of 614 Protestant and Catholic Cleveland clergy toward terminal illness and euthanasia. Clergy responses revealed that, although eager to prolong life, terminally ill patients feared prolonged illness more than death. The controversial nature of euthanasia became more apparent with clergy who had more training in death…

  2. Concepts, Structures, and Goals: Redefining Ill-Definedness

    Science.gov (United States)

    Lynch, Collin; Ashley, Kevin D.; Pinkwart, Niels; Aleven, Vincent

    2009-01-01

    In this paper we consider prior definitions of the terms "ill-defined domain" and "ill-defined problem". We then present alternate definitions that better support research at the intersection of Artificial Intelligence and Education. In our view both problems and domains are ill-defined when essential concepts, relations, or criteria are un- or…

  3. Behavior of Man in Health and Illness, Nursing 103A.

    Science.gov (United States)

    Bakke, Sandra I.

    A description is provided of a course, "Behavior of Man in Health and Illness," designed to introduce first-year undergraduate nursing students to the theories and concepts related to the health-illness continuum, the stress of illness, and coping theory. The description begins with an overview of course content, followed by information on the…

  4. Travel-associated Illness Trends and Clusters, 2000-2010

    NARCIS (Netherlands)

    Leder, Karin; Torresi, Joseph; Brownstein, John S.; Wilson, Mary E.; Keystone, Jay S.; Barnett, Elizabeth; Schwartz, Eli; Schlagenhauf, Patricia; Wilder-Smith, Annelies; Castelli, Francesco; von Sonnenburg, Frank; Freedman, David O.; Cheng, Allen C.

    2013-01-01

    Longitudinal data examining travel-associated illness patterns are lacking. To address this need and determine trends and clusters in travel-related illness, we examined data for 2000-2010, prospectively collected for 42,223 ill travelers by 18 GeoSentinel sites. The most common destinations from wh

  5. Resolving mental illness stigma: should we seek normalcy or solidarity?

    Science.gov (United States)

    Corrigan, Patrick W

    2016-04-01

    Two approaches have emerged to deal with the stigma of mental illness: normalcy, where people with mental illness are framed as 'just like everyone else'; and solidarity, where the public agrees to stand with those with mental illness regardless of their symptoms. Pros and cons of each approach are considered.

  6. Children's Conceptions of Mental Illness: A Naive Theory Approach

    Science.gov (United States)

    Fox, Claudine; Buchanan-Barrow, Eithne; Barrett, Martyn

    2010-01-01

    This paper reports two studies that investigated children's conceptions of mental illness using a naive theory approach, drawing upon a conceptual framework for analysing illness representations which distinguishes between the identity, causes, consequences, curability, and timeline of an illness. The studies utilized semi-structured interviewing…

  7. 78 FR 28292 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2013-05-14

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... War Veterans' Illnesses Task Force Draft Written Report is now complete. VA is inviting...

  8. 76 FR 65321 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2011-10-20

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... War Veterans' Illnesses Task Force Draft Written Report is now complete. VA is inviting...

  9. 75 FR 16577 - Gulf War Veterans' Illnesses Task Force

    Science.gov (United States)

    2010-04-01

    ... AFFAIRS Gulf War Veterans' Illnesses Task Force AGENCY: Department of Veterans Affairs (VA). ACTION... the Gulf War Veterans' Illnesses Task Force (GWVI-TF) in August 2009 to conduct a comprehensive review... Veterans' Illnesses Task Force Draft Written Report is now complete. The VA is inviting public comments...

  10. Intravenous levetiracetam in critically ill children

    Directory of Open Access Journals (Sweden)

    Faruk Incecik

    2016-01-01

    Full Text Available Background: To report the effectiveness and safety of intravenous (IV levetiracetam (LEV in the treatment of critically ill children with acute repetitive seizures and status epilepticus (SE in a children′s hospital. Materials and Methods: We retrospectively analyzed data from children treated with IV LEV. Results: The mean age of the 108 children was 69.39 ± 46.14 months (1-192 months. There were 58 (53.1% males and 50 (46.8% females. LEV load dose was 28.33 ± 4.60 mg/kg/dose (10-40 mg/kg. Out of these 108 patients, LEV terminated seizures in 79 (73.1%. No serious adverse effects were observed but agitation and aggression were developed in two patients, and mild erythematous rash and urticaria developed in one patient. Conclusion: Antiepileptic treatment of critically ill children with IV LEV seems to be effective and safe. Further study is needed to elucidate the role of IV LEV in critically ill children.

  11. Energy expenditure of acutely ill hospitalised patients

    Directory of Open Access Journals (Sweden)

    Gariballa Salah

    2006-03-01

    Full Text Available Abstract Objective To measure energy expenditure of acutely ill elderly patients in hospital and following discharge in the community. Design Sixty-three consecutive hospitalised acutely ill elderly patients were recruited. Eight patients were studied to assess the reliability of the Delta Tract Machine as a measure of energy expenditure; 35 patients had their energy expenditure studied in hospital on two occasions and 20 patients had their energy expenditure measured in hospital and at 6 weeks in the community Results Men had higher basal energy expenditure (BMR values compared to women however the difference was not statistically significant [Men, mean (SD 1405 (321 Kcal, women 1238 (322 kcal; mean difference (95% CI 166 kcal (-17 to 531, p = 0.075]. After adjusting for age, gender and body mass index both medication and C-reactive protein (CRP, concentrations showed significant correlation with measured energy expenditure in hospital, (r = -0.36, "p Conclusion Tissue inflammation and medications were associated with change in measured energy expenditure in acutely ill patients.

  12. Thrombo-prophylaxis in acutely ill medical and critically ill patients

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2014-01-01

    Full Text Available Thrombo-prophylaxis has been shown to reduce the incidence of pulmonary embolism (PE and mortality in surgical patients. The purpose of this review is to find out the evidence-based clinical practice criteria of deep vein thrombosis (DVT prophylaxis in acutely ill medical and critically ill patients. English-language randomized controlled trials, systematic reviews, and meta-analysis were included if they provided clinical outcomes and evaluated therapy with low-dose heparin or related agents compared with placebo, no treatment, or other active prophylaxis in the critically ill and medically ill population. For the same, we searched MEDLINE, PUBMED, Cochrane Library, and Google Scholar. In acutely ill medical patients on the basis of meta-analysis by Lederle et al. (40 trials and LIFENOX study, heparin prophylaxis had no significant effect on mortality. The prophylaxis may have reduced PE in acutely ill medical patients, but led to more bleeding events, thus resulting in no net benefit. In critically ill patients, results of meta-analysis by Alhazzani et al. and PROTECT Trial indicate that any heparin prophylaxis compared with placebo reduces the rate of DVT and PE, but not symptomatic DVT. Major bleeding risk and mortality rates were similar. On the basis of MAGELLAN trial and EINSTEIN program, rivaroxaban offers a single-drug approach to the short-term and continued treatment of venous thrombosis. Aspirin has been used as antiplatelet agent, but when the data from two trials the ASPIRE and WARFASA study were pooled, there was a 32% reduction in the rate of recurrence of venous thrombo-embolism and a 34% reduction in the rate of major vascular events.

  13. The occurrence of Shiga toxin-producing Escherichia coli in bathing water of the Sierra de la Ventana region, Buenos Aires Province, Argentina.

    Science.gov (United States)

    Marucci, Patricia L; Olivera, Nelda L; Brugnoni, Lorena I; Sica, Maria G; Cubitto, Maria Amelia

    2011-04-01

    The region of Sierra de la Ventana is located in the southwest of Buenos Aires Province, Argentina. Traditionally, this area has been devoted to livestock and agriculture, but tourism has had a significant development in recent years. In the region, there are many rivers and streams that are used for swimming and bathing. A survey of the occurrence of Shiga toxin-producing Escherichia coli (STEC) in these waters was conducted, and the microbiological quality of rivers and streams was investigated. No E. coli O157 was recovered by immunomagnetic separation. Nevertheless, the Shiga toxin gene, exclusively stx2 genotype, was detected in four non-O157 E. coli strains. Two STEC strains carried eae factor, but none of them harbored the EHEC-hlyA gene. Three of the STEC isolates belonged to samples obtained in the warm months, and one to the winter sampling. In the sample sites where STEC strains were isolated the counts of E. coli/100 ml exceeded or were close to the limit recommended by the United States Environmental Protection Agency for bathing water. The relationship observed between the rainy season and E. coli counts suggests that among the main causes for the hygienic indicator increase is the runoff of manure deposited on soils that may also induce the entrance of pathogens into the aquatic environment. This research, the first reporting STEC isolation from recreational waters in this area, revealed that streams and rivers from a beef-producing area of Argentina are a reservoir of STEC strains.

  14. [Serotype identification and antibiotic susceptibility of Shiga toxin-producing Escherichia coli in the Weishan area in Shandong Province, China].

    Science.gov (United States)

    Shao, C C; Hu, B; Bi, Z W; Kou, Z Q; Fang, M; Chen, B L; Bi, Z Q

    2017-01-06

    Objective: To determine the serotypes and drug resistance profiles of Shiga toxin-producing Escherichia coli (STEC) in animal stools from the Weishan area in Shandong Province, China. To provide the basis for further study. Methods: Five hundred animal stool samples (from pigs, cattle, sheep, dogs and birds) were collected from the Weishan area and STEC strains were isolated from these samples. Strains were serotyped by a serum agglutination test, and their drug resistance profiles were determined through antimicrobial sensitivity experiments. In this study, PCR was used to detect tetracycline resistance genes (tetA, tetB, tetC, tetD) and beta-lactam resistance genes (blaSHV-1, blaCTX-M, blaTEM). Results: Sixteen strains of STEC were isolated from animal stool samples. Thirteen strains were isolated from pig stool samples, two from bovine stool samples and one from a sheep stool sample. Two of the strains were identified as E. coli O157:H7, and other 14 strains were non-O157 STEC of different serotypes. Antimicrobial sensitivity experiments showed that 15 of the strains were multidrug resistant. The rates of resistance were as follows: nalidixic acid (12/16 strains), sulfisoxazole (11/16), trimethoprim and sulphame-thoxazole (11/16), doxycycline (9/16), azithromycin (9/16), tetracycline (9/16), chloramphenicol (8/16) and streptomycin (8/16). Therefore, nalidixic acid showed the highest rate of resistance among the strains, followed by trimethoprim and sulphame-thoxazole, and sulfisoxazole. Resistance to cefepime or imipenem was not detected. In total, three types of drug resistance genes (tetA, tetB and tetC) were detected among the 16 strains. Conclusion: The results showed that STEC strains isolated from animals in the Weishan area were of a range of serotypes. The 16 strains of STEC isolated from animal stools in this area were resistant to a number of antibiotics, with many strains displaying multidrug resistance.

  15. Life skills programmes for chronic mental illnesses

    Science.gov (United States)

    Tungpunkom, Patraporn; Maayan, Nicola; Soares-Weiser, Karla

    2014-01-01

    Background Most people with schizophrenia have a cyclical pattern of illness characterised by remission and relapses. The illness can reduce the ability of self-care and functioning and can lead to the illness becoming disabling. Life skills programmes, emphasising the needs associated with independent functioning, are often a part of the rehabilitation process. These programmes have been developed to enhance independent living and quality of life for people with schizophrenia. Objectives To review the effects of life skills programmes compared with standard care or other comparable therapies for people with chronic mental health problems. Search methods We searched the Cochrane Schizophrenia Group Trials Register (June 2010). We supplemented this process with handsearching and scrutiny of references. We inspected references of all included studies for further trials. Selection criteria We included all relevant randomised or quasi-randomised controlled trials for life skills programmes versus other comparable therapies or standard care involving people with serious mental illnesses. Data collection and analysis We extracted data independently. For dichotomous data we calculated relative risks (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis, based on a random-effects model. For continuous data, we calculated mean differences (MD), again based on a random-effects model. Main results We included seven randomised controlled trials with a total of 483 participants. These evaluated life skills programmes versus standard care, or support group. We found no significant difference in life skills performance between people given life skills training and standard care (1 RCT, n = 32, MD −1.10; 95% CI −7.82 to 5.62). Life skills training did not improve or worsen study retention (5 RCTs, n = 345, RR 1.16; 95% CI 0.40 to 3.36). We found no significant difference in PANSS positive, negative or total scores between life skills intervention and

  16. Fathers with mental illness: implications for clinicians and health services.

    Science.gov (United States)

    Fletcher, Richard J; Maharaj, O'Neil N; Fletcher Watson, Chloe H; May, Chris; Skeates, Nigel; Gruenert, Stefan

    2013-08-05

    A significant proportion of fathers living with their natural, adopted, step or foster children experience mental illness. Psychiatric illness among fathers can have a devastating impact on children's wellbeing, and even milder forms of paternal mental illness can have serious developmental effects on children. While several pathways linking paternal mental illness with poor child outcomes have been identified, fathers' impaired parenting is an important, potentially malleable factor. Clinicians can assist fathers with mental illness and their families by proactively inquiring about children and by exploring fathering-focused psychological support.

  17. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma.

    Science.gov (United States)

    Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

    2005-12-01

    Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.

  18. Women’s Perception of Reproductive Illness in Manipur, India

    Directory of Open Access Journals (Sweden)

    Pebam Krishnakumari

    2014-01-01

    Full Text Available Perception of reproductive illness by the women themselves is important in understanding the women's reproductive health in a particular society. It also indicates the possibility of taking perception as a tool for measuring reproductive illness. Though women do not have a “germ theory” to explain their reproductive illness they have a sense of illness pathology. Reproductive illness perceived by women is related to physical symptoms and situations in a network of meanings and different meanings are socially generated to articulate their experiences.

  19. Moving towards effective chronic illness management: asthma as an exemplar.

    Science.gov (United States)

    Estes, Tracy S

    2011-01-01

    The United States health care system is at a pivotal point in its ability to manage chronic illness. The demands and philosophical differences between the management of acute and chronic illnesses suggest the need for different strategies for effective and efficient management of chronic illness. The purpose of this article is to discuss the Chronic Care Model and the collaborative approach to managing chronic illnesses. Asthma, as an exemplar, will be used to illustrate the need for the development of new models of collaborative care for the treatment of chronic illnesses.

  20. Social inequalities in the experience of illness in Sweden

    DEFF Research Database (Denmark)

    Blank, N; Diderichsen, Finn

    1996-01-01

    daily, weak social network) in the case of men, and virtually entirely in the case of women. Other ill-health dimensions, such as self-rated general health and impaired working capacity, prove to be related to severity of illness, the latter being more strongly associated with experience of severe...... illness than the former irrespective of social class. The results lend support to the hypothesis that manual classes are subjected to what might be called "double suffering"; they have more long-term illnesses and also experience these illnesses with greater intensity and frequency....

  1. Critical illness polyneuropathy and myopathy: a systematic review.

    Science.gov (United States)

    Zhou, Chunkui; Wu, Limin; Ni, Fengming; Ji, Wei; Wu, Jiang; Zhang, Hongliang

    2014-01-01

    Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles, respectively. Clinically, they manifest as limb and respiratory muscle weakness. Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation. Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event. Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy. Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population. The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical, diagnostic, differentiating, and treatment information for this debilitating neurological disease.

  2. The social construction of illness: key insights and policy implications.

    Science.gov (United States)

    Conrad, Peter; Barker, Kristin K

    2010-01-01

    The social construction of illness is a major research perspective in medical sociology. This article traces the roots of this perspective and presents three overarching constructionist findings. First, some illnesses are particularly embedded with cultural meaning--which is not directly derived from the nature of the condition--that shapes how society responds to those afflicted and influences the experience of that illness. Second, all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness. Third, medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. We address central policy implications of each of these findings and discuss fruitful directions for policy-relevant research in a social constructionist tradition. Social constructionism provides an important counterpoint to medicine's largely deterministic approaches to disease and illness, and it can help us broaden policy deliberations and decisions.

  3. Clinical characteristics associated with illness perception in psoriasis.

    Science.gov (United States)

    Wahl, Astrid K; Robinson, Hilde S; Langeland, Eva; Larsen, Marie H; Krogstad, Anne-Lene; Moum, Torbjørn

    2014-05-01

    Knowledge of illness perception may aid the identification of groups of patients with a higher risk of coping poorly with the demands of their illness. This study aims to investigate associations between illness perception, clinical characteristics, patient knowledge, quality of life and subjective health in persons with psoriasis. The present study was based on cross-sectional data from patients awaiting climate therapy in Gran Canaria. We included 254 eligible patients (74%) who completed a questionnaire including the revised Illness Perception Questionnaire, the Psoriasis Knowledge Questionnaire, and the Dermatological Life Quality Index. Disease severity was measured using the Psoriasis Area and Severity Index. Several statistically significant associations between clinical characteristics, knowledge and various illness perception dimensions were found. Illness perception was also significantly related to disease-specific quality of life and subjective health. These findings contradict previous findings, which suggested that objective disease factors are not relevant to illness perception in psoriasis.

  4. Construction of the XZ113 △ eaeA, XZ113 △stx2 and XZ113 △ ehxA mutants of STEC O18 XZ113 and their pathogenicity in mice%产志贺毒素大肠杆菌O18XZ113株主要毒力基因eaeA、stx2、ehxA突变株的构建及其对小鼠的致病作用

    Institute of Scientific and Technical Information of China (English)

    薛涛; 陈先亮; 高崧; 刘秀梵

    2011-01-01

    [目的]探讨毒力基因eaeA、stx2、ehxA与产志贺毒素大肠杆菌O18致病力的关系.[方法]利用λ-Red重组系统,构建STEC XZ113株eaeA、stx2、ehxA基因缺失突变株并进行一系列生物学特性的研究.[结果]细胞粘附试验表明突变株XZ113△eaeA对HEp-2细胞的粘附能力明显降低;Vero细胞毒素试验表明突变株XZ113 △stx2失去了使Vero细胞发生病变的能力;溶血活性试验表明突变株XZ113△ehxA无法在血平板上产生溶血圈,丢失了溶血能力.回复株在以上表型方面与野生株XZ113一致;与亲本株的体外竞争试验结果表明,突变株竞争力减弱,体内竞争结果表明突变株XZ1 13△eaeA被中度致弱;突变株XZ113 △stx2和突变株XZ113△ehxA被高度致弱.[结论]stx2、ehxA基因在STEC O18 XZ113株的致病过程中发挥着更为重要的作用.%[Objective] To study the contribution of virulence genes of STEC 018 XZ113 isolate to the pathogenicity in mice. [Methods] The eaeA, stx2 and ehxA knock-out mutants of STEC strain XZ113 were generated using λ-Red recombination system. [ Results] Bacterial adherence test showed that the eaeA mutant adhered to Hep-2 cells in a diffuse manner with no microcolony formation. Vero cells assay showed that the stx mutant had no cytotoxicity to Vero cells. Enterohemolytic activity test showed that the ehxA mutant lost the ability to express the enterohemolytic activity. Competition assay between the wild-type strain XZ113 and its mutants in vivo and in vitro showed that all mutants were mildly attenuated in vitro, but in vivo, XZ113△eaeA was moderate attenuated, XZ113 △stx2 and XZ11△ehxA were all highly attenuated. [Conclusions] These results indicate that the virulence factors encoded by the stx2 and ehxA genes were important for the pathogenesis of STEC O18 in mice.

  5. Role of lactate in critically ill children

    Directory of Open Access Journals (Sweden)

    Chugh Krishan

    2004-01-01

    Full Text Available Lactic acidosis is a common finding in critically ill patients. It has been used as a prognostic marker of the outcome in Pediatric Intensive Care Unit patients. Lactic acid is produced as a product of anaerobic glycolysis and is reversibly converted to pyruvate in the presence of favorable metabolic environment. All the body tissues can produce and consume lactate with few having predominant function of production and others of consumption. Liver is a major organ for lactate consumption and it is the liver, which metabolizes the increased lactic acid produced in regional tissue beds. The lactate levels can be done on arterial, venous, or mixed venous blood and can be measured by various methods. Serial lactate concentrations and the difference in arterial and mixed venous lactate levels or between the arterial and regional blood lactate levels like jugular venous lactate levels have been shown to have better correlation with the outcome. High initial blood lactate levels and persistently high lactate levels have been correlated with poor outcome. There are various causes of lactic acid overproduction, which may produce either hyperlactatemia or lactic acidosis. High blood lactate levels are found in critically ill patients with shock of any etiology and sepsis due to various reasons, which include increased catecholamine induced glucose flux apart from the tissue hypoperfusion and hypoxia. Various other illnesses can cause an increase in blood lactate levels like acute lung/liver injury, severe asthma, poisoning, post cardiac surgery etc. Treating the underlying disease leading to lactic acidosis is the best measure to control lactic acidosis. Some therapeutic choices are available to neutralize the effect of lactic acid on cell function, but none has stood the test of time and are tried only in desperate situations.

  6. Febrile illness experience among Nigerian nomads

    Directory of Open Access Journals (Sweden)

    Akogun Oladele B

    2012-01-01

    Full Text Available Abstract Background An understanding of the febrile illness experience of Nigerian nomadic Fulani is necessary for developing an appropriate strategy for extending malaria intervention services to them. An exploratory study of their malaria illness experience was carried out in Northern Nigeria preparatory to promoting malaria intervention among them. Methods Ethnographic tools including interviews, group discussions, informal conversations and living-in-camp observations were used for collecting information on local knowledge, perceived cause, severity and health seeking behaviour of nomadic Fulani in their dry season camps at the Gongola-Benue valley in Northeastern Nigeria. Results Nomadic Fulani regarded pabboje (a type of "fever" that is distinct from other fevers because it "comes today, goes tomorrow, returns the next" as their commonest health problem. Pabboje is associated with early rains, ripening corn and brightly coloured flora. Pabboje is inherent in all nomadic Fulani for which treatment is therefore unnecessary despite its interference with performance of duty such as herding. Traditional medicines are used to reduce the severity, and rituals carried out to make it permanently inactive or to divert its recurrence. Although modern antimalaria may make the severity of subsequent pabboje episodes worse, nomads seek treatment in private health facilities against fevers that are persistent using antimalarial medicines. The consent of the household head was essential for a sick child to be treated outside the camp. The most important issues in health service utilization among nomads are the belief that fever is a Fulani illness that needs no cure until a particular period, preference for private medicine vendors and the avoidance of health facilities. Conclusions Understanding nomadic Fulani beliefs about pabboje is useful for planning an acceptable community participatory fever management among them.

  7. Arranged matches and mental illness: therapists' dilemmas.

    Science.gov (United States)

    Greenberg, David; Buchbinder, Jacob Tuvia; Witztum, Eliezer

    2012-01-01

    Traditional societies place especial value on marriage and having children, and marriages are often arranged. A series of situations and dilemmas associated with arranged matches and their consequences are described in the course of mental health work with ultra-orthodox Jewish people with severe mental illness. Issues of confidentiality may arise with parents and matchmakers; on the other hand, respectful cooperation with religious authorities, counselors in the community, and family members is important. Information on genetic counseling, contraception, medication during pregnancy, and breastfeeding are considered and interact with communal structures and practices. There is a need for close support and evaluation during the process of marriage, childbearing, and parenthood.

  8. Glucose metabolism in critically ill patients

    DEFF Research Database (Denmark)

    Nielsen, Signe Tellerup; Krogh-Madsen, Rikke; Møller, Kirsten

    2015-01-01

    , stimulates insulin secretion and inhibits glucagon release both in healthy individuals and in patients with type 2 diabetes (T2DM). Compared to insulin, GLP-1 appears to be associated with a lower risk of severe hypoglycemia, probably because the magnitude of its insulinotropic action is dependent on blood...... characteristics and are, among other things, both characterized by different grades of systemic inflammation and insulin resistance. The GLP-1 might be a potential new treatment target in critically ill patients with stress-induced hyperglycemia....

  9. Mental illness-related stigma in healthcare

    Science.gov (United States)

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

  10. How to diagnose a foodborne illness.

    Science.gov (United States)

    Donnenberg, Michael S; Narayanan, Shivakumar

    2013-09-01

    Timely diagnosis of foodborne infection can be critical not only for the patient, but also for the larger community because of the potential to interrupt further spread. This article presents the diagnostic approach to patients with foodborne illness, discussing epidemiologic clues of various foodborne pathogens and their distinguishing clinical features of diagnostic importance. Also discussed are situations whereby stool cultures should be ordered; other helpful stool tests; nonculture methods of identifying organisms and their applicability in clinical settings; the role of pulsed-field gel electrophoresis in typing organisms; and large-scale sharing of data to aid in identification of large outbreaks.

  11. Illness denial questionnaire for patients and caregivers

    Directory of Open Access Journals (Sweden)

    Rossi Ferrario S

    2017-03-01

    Full Text Available Silvia Rossi Ferrario,1 Ines Giorgi,2 Paola Baiardi,3 Laura Giuntoli,4 Gianluigi Balestroni,1 Paola Cerutti,1 Marina Manera,2 Paola Gabanelli,2 Valentina Solara,5 Roberta Fornara,6 Michela Luisetti,1 Pierangela Omarini,1 Giovanna Omarini,1 Giulio Vidotto4 1Psychology Unit, Istituti Clinici Scientifici Maugeri SpA SB, Veruno, NO, Italy; 2Psychology Unit, 3Scientific Direction, Istituti Clinici Scientifici Maugeri SpA SB, Pavia, Italy; 4Department of General Psychology, University of Padova, Padova, Italy; 5Department of Neurology, ALS Centre, “Maggiore della Carita`” University Hospital, Novara, Italy; 6Psychology Unit, SS Trinità Hospital, Borgomanero, NO, Italy Purpose: Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial Questionnaire, IDQ assessing patients’ and caregivers’ denial in relation to their illness/disturbance. Patients and methods: After a preliminary study, a final version of 24 dichotomous items (true/false was selected. We hypothesized a theoretical model with three dimensions: denial of negative emotions, resistance to change, and conscious avoidance, the first two composing the actual Denial and the last representing an independent component of the illness denial behavior. The IDQ was administered to 400 subjects (219 patients and 181 caregivers together with the Anxiety–Depression Questionnaire – Reduced form (AD-R, in order to assess concurrent validity. Confirmatory factor analysis (CFA, internal consistency indices (Cronbach’s α and McDonald’s ω, and test–retest analysis were performed. Results: CFA and internal consistency indices (Cronbach’s α: 0.87–0.96 indicated a clear and meaningful three-factor structure of IDQ, for both patients and caregivers. Further analyses showed good concurrent validity, with Denial and its subscale negatively associated with anxiety and depression and

  12. Was Maurice Ravel's illness a corticobasal degeneration?

    Science.gov (United States)

    Baeck, E

    1996-02-01

    The French composer Maurice Ravel (1875-1937) was struck down at the peak of his career by an aphasia and apraxia that destroyed his artistic realization but preserved his musical sensibility and judgment. He died after craniotomy. Multiple hypotheses have been formulated to explain the exact nature of his illness, probably corticobasal degeneration. However, in the absence of a post-mortem examination, the diagnosis must remain speculative despite the accurate descriptions of the symptoms in numerous biographies, the neuro-psychological notes of Théophile Alajouanine and the operative findings of Clovis Vincent.

  13. The rights of americans with mental illness.

    Science.gov (United States)

    Talbott, John A

    2011-08-01

    This contribution to the literature starts by summarizing the history of psychiatric services in America from the time of our colonization to the present. It then discusses the Bill of Rights and the subsequent "rights" gained by the mentally ill, largely through state legislative or legal actions. Finally, it concludes with a discussion of how the entire area of rights has been swept up in a larger attempt to achieve a federal Bill of Patients' Rights and then a Health Reform Act in 2010.

  14. Myopathies in critical illness: characterization and nutritional aspects.

    Science.gov (United States)

    Burnham, Ellen L; Moss, Marc; Ziegler, Thomas R

    2005-07-01

    Myopathies related to critical illness have received increasing recognition over the past decade and are common in patients even after a brief period in the intensive care unit. Recent studies have revealed that myopathies in the critically ill may in fact be more prevalent than neuropathies and that morbidity and mortality may be greater. Protein catabolism, an increase in urinary nitrogen loss, and muscle wasting are observed in critical illness myopathy. Muscle biopsies in critically ill patients demonstrate low glutamine levels, low protein/DNA levels, and high concentrations of extracellular water. The increased flux of glutamine in muscle in these patients is thought to be insufficient to meet the body's requirement for glutamine, and thus in critical illness this amino acid may be classified as "conditionally essential." Three subtypes of critical illness myopathy have been described that are often grouped together as acute quadriplegic myopathy: thick-filament myopathy, critical illness myopathy, and necrotizing myopathy. These can be differentiated based on clinical features and muscle biopsy. Treatments for critical illness myopathies range from primary prevention, i.e., avoiding myopathy-inducing drugs, to novel nutritional therapies, such as glutamine and glutathione supplementation. One should be particularly vigilant for the development of myopathies in critically ill alcoholic patients, who may have a chronic alcoholic myopathy at baseline. In the past decade, advances have been made in characterizing and identifying patients with myopathies due to critical illness. However, additional studies must be performed in order to develop appropriate therapies for this potentially devastating disorder.

  15. Disparities in oral cancer survival among mentally ill patients.

    Directory of Open Access Journals (Sweden)

    Ting-Shou Chang

    Full Text Available BACKGROUND: Many studies have reported excess cancer mortality in patients with mental illness. However, scant studies evaluated the differences in cancer treatment and its impact on survival rates among mentally ill patients. Oral cancer is one of the ten most common cancers in the world. We investigated differences in treatment type and survival rates between oral cancer patients with mental illness and without mental illness. METHODS: Using the National Health Insurance (NHI database, we compared the type of treatment and survival rates in 16687 oral cancer patients from 2002 to 2006. The utilization rate of surgery for oral cancer was compared between patients with mental illness and without mental illness using logistic regression. The Cox proportional hazards model was used for survival analysis. RESULTS: Oral cancer patients with mental disorder conferred a grave prognosis, compared with patients without mental illness (hazard ratios [HR] = 1.58; 95% confidence interval [CI] = 1.30-1.93; P<0.001. After adjusting for patients' characteristics and hospital characteristics, patients with mental illness were less likely to receive surgery with or without adjuvant therapy (odds ratio [OR] = 0.47; 95% CI = 0.34-0.65; P<0.001. In multivariate analysis, oral cancer patients with mental illness carried a 1.58-times risk of death (95% CI = 1.30-1.93; P<0.001. CONCLUSIONS: Oral cancer patients with mental illness were less likely to undergo surgery with or without adjuvant therapy than those without mental illness. Patients with mental illness have a poor prognosis compared to those without mental illness. To reduce disparities in physical health, public health strategies and welfare policies must continue to focus on this vulnerable group.

  16. Positive feelings among terminally ill cancer patients.

    Science.gov (United States)

    Van der Lee, M L; Swarte, N B; Van der Bom, J G; Van den Bout, J; Heintz, A P M

    2006-03-01

    For a realistic perspective on what it is like to have cancer and be in the last months of life, it is necessary to also study the positive feelings people may still experience. We set out to describe positive feelings experienced by terminally ill patients. The Depression Adjective Checklist was completed by 96 cancer patients with an estimated life expectancy of less than 3 months. On average patients endorsed 30% (3.6/12) of the positive mood items, and 25% (5.4/22) of the negative mood items. The larger part of terminally ill cancer patients with an estimated life expectancy of less than 3 months reported one or more positive mood states. A positive mood state such as 'being interested' was endorsed by more than half (65%) of the patients, other positive feelings were endorsed by a substantial proportion of patients, for example: 38% of patients endorsed feeling 'jovial' and 35% reported being 'optimistic'. Although having incurable cancer often leads to feelings of depression, mood is variable and many patients experience at least some positive feelings.

  17. Stress causing psychosomatic illness among nurses

    Directory of Open Access Journals (Sweden)

    Kane Pratibha

    2009-01-01

    Full Text Available Stress in nurses is an endemic problem. It contributes to health problems in nurses and decreases their efficiency. Documenting the causes and extent of stress in any healthcare unit is essential for successful interventions . Aim : Establishing the existence and extent of work stress in nurses in a hospital setting, identifying the major sources of stress, and finding the incidence of psychosomatic illness related to stress. Materials and Methods: This study used a questionnaire relating to stressors and a list of psychosomatic ailments. One hundred and six nurses responded and they were all included in the study. Stressors were based on four main factors: work related, work interactions, job satisfaction, and home stress. The factors relating to stress were given weights according to the severity. The total score of 50 was divided into mild, moderate, severe, and burnout. Results: Most important causes of stress were jobs not finishing in time because of shortage of staff, conflict with patient relatives, overtime, and insufficient pay. Psychosomatic disorders like acidity, back pain, stiffness in neck and shoulders, forgetfulness, anger, and worry significantly increased in nurses having higher stress scores. Increase in age or seniority did not significantly decrease stress. Conclusion: Moderate levels of stress are seen in a majority of the nurses. Incidence of psychosomatic illness increases with the level of stress. Healthcare organizations need to urgently take preemptive steps to counter this problem.

  18. Costs of Illness Due to Endemic Cholera

    Science.gov (United States)

    Poulos, C.; Riewpaiboon, A.; Stewart, J.F.; Clemens, J.; Guh, S.; Agtini, M.; Sur, D.; Islam, Z.; Lucas, M.; Whittington, D.

    2013-01-01

    Summary Economic analyses of cholera immunization programmes require estimates of the costs of cholera. The Diseases of the Most Impoverished programme measured the public, provider, and patient costs of culture-confirmed cholera in four study sites with endemic cholera using a combination of hospital- and community-based studies. Families with culture-proven cases were surveyed at home 7 and 14 days after confirmation of illness. Public costs were measured at local health facilities using a micro-costing methodology. Hospital-based studies found that the costs of severe cholera were USD 32 and 47 in Matlab and Beira. Community-based studies in North Jakarta and Kolkata found that cholera cases cost between USD 28 and USD 206, depending on hospitalization. Patient costs of illness as a percentage of average monthly income were 21% and 65% for hospitalized cases in Kolkata and North Jakarta, respectively. This burden on families is not captured by studies that adopt a provider perspective. PMID:21554781

  19. Enhancement Approach in Well&Illness Tourism

    Directory of Open Access Journals (Sweden)

    Ruhet Genç

    2015-04-01

    Full Text Available The component of tourism preparatory parties is to make tourists, whether they are medical or companion, feel more comfortable and bring back home good health attached to good memories. In order to lead a satisfactory discussion primarily wellness and illness tourism concepts are properly described. After explaining their dynamics, factors which are constitutive in these kind of touristic activities, mainly tourists‟ motivations are mentioned. As being a new era of medical tourism, it is shown that facilitators are of great significance. They offer medical value tourism by eliminating too many unknowns for the tourist. Not only empathy but queries also enable highlighting the tourists‟ expectations, experiences and showing the ways of understanding their situation better. New medical hubs and the future ones have to take into account, promote consumer researches that they can advance themselves in the light of new information. The best way to develop well&illness tourism is to make tourist, patient and their companion satisfied with their activities and/or treatment.

  20. Illness beliefs in African Americans with hypertension.

    Science.gov (United States)

    Pickett, Stephanie; Allen, Wilfred; Franklin, Mary; Peters, Rosalind M

    2014-02-01

    Guided by Leventhal's common sense model of illness representations, this study examined the relationship between hypertension beliefs and self-care behaviors necessary for blood pressure (BP) control in a sample of 111 community-dwelling African Americans with hypertension. Participants completed the revised Illness Perception Questionnaire, BP Self-Care Scale, and a demographic data sheet, and had BP measured. Analyses revealed that beliefs about the causes of hypertension differed by gender and educational level. Stress-related causal attributions accounted for 34.7% of the variance in hypertension beliefs. Participants who believed stress or external factors caused hypertension were less likely to engage in healthy self-care behaviors (e.g., keeping doctor visits, eating low-salt, low-fat diets). Results suggest that patients who are nonadherent with hypertension self-care recommendations may hold hypertension beliefs that are not consistent with the medically endorsed views of this disease. To more effectively treat and control BP, providers should assess patients' hypertension beliefs.

  1. Picturing Illness: History, Poetics, and Graphic Medicine

    Directory of Open Access Journals (Sweden)

    Raghavi Ravi Kasthuri

    2015-05-01

    Full Text Available Comics have often been treated as a juvenile and sub-literary art form; however, taking cues from the new-found cultural acceptance of comics, particularly with the publication of Art Spiegelman’s Maus (1986, Chris Ware’s Jimmy Corrigan: The Smartest Kid on Earth (2000, and Alison Bechdel’s Fun Home: A Family Tragedy (2006, there have emerged, over the past decade, a new breed of comics dealing with the patient/caregivers’ experiences, perspectives and identities. Christened as graphic medicine, these illness narratives use comics as a medium to address wide ranging disease/illness related issues. The present review examines the following issues: What is graphic medicine? Is there a tangible relationship between underground comics and graphic medicine? If so, can we regard underground comics as historical precedent to graphic medicine? What are the uses of comics in medicine? Broadly put, drawing examples from various graphic medical narratives, the paper seeks to trace the history and poetics of graphic medicine.

  2. Antibiotic dose optimization in critically ill patients.

    Science.gov (United States)

    Cotta, M O; Roberts, J A; Lipman, J

    2015-12-01

    The judicious use of existing antibiotics is essential for preserving their activity against infections. In the era of multi-drug resistance, this is of particular importance in clinical areas characterized by high antibiotic use, such as the ICU. Antibiotic dose optimization in critically ill patients requires sound knowledge not only of the altered physiology in serious infections - including severe sepsis, septic shock and ventilator-associated pneumonia - but also of the pathogen-drug exposure relationship (i.e. pharmacokinetic/pharmacodynamic index). An important consideration is the fact that extreme shifts in organ function, such as those seen in hyperdynamic patients or those with multiple organ dysfunction syndrome, can have an impact upon drug exposure, and constant vigilance is required when reviewing antibiotic dosing regimens in the critically ill. The use of continuous renal replacement therapy and extracorporeal membrane oxygenation remain important interventions in these patients; however, both of these treatments can have a profound effect on antibiotic exposure. We suggest placing emphasis on the use of therapeutic drug monitoring and dose individualization when optimizing therapy in these settings. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  3. Birds of ill omen in Slavic beliefs

    Directory of Open Access Journals (Sweden)

    Aksić Nina V.

    2015-01-01

    Full Text Available This paper deals with birds of ill omen and beliefs related to their cries and calls. According to the presence of the ill omen attribute, these birds are sorted into three groups. The paper describes various divination types according to the calls of so-called unclean birds, as well as various prophecies, i.e. their ominous „weight“, on the basis of numerous examples from the Slavic cultural sphere, with additional, more recent examples from the Serbian space. The final remarks are related to four segments: the type of the listed birds’ bad omen (death, disease / year of famine, fire, bad weather; prophecy of evil or merely information, i.e. warning about a possible bad event; the manner of the bird’s prophecy or report of misfortune (a call, a manner of flight etc.; existence of undesirable actions related to certain birds (actions that could result in negative consequences for the person who performs them. [Projekat Ministarstva nauke Republike Srbije, br. 47016: Interdisciplinarno istraživanje kulturnog i jezičkog nasleđa Srbije i izrada multimedijalnog internet portala „Pojmovnik srpske kulture

  4. Supporting Muslim Patients During Advanced Illness.

    Science.gov (United States)

    Boucher, Nathan A; Siddiqui, Ejaz A; Koenig, Harold G

    2017-01-01

    Religion is an important part of many patients' cultural perspectives and value systems that influence them during advanced illness and toward the end of life when they directly face mortality. Worldwide violence perpetrated by people identifying as Muslim has been a growing fear for people living in the US and elsewhere. This fear has further increased by the tense rhetoric heard from the recent US presidential campaign and the new presidential administration. For many, this includes fear of all Muslims, the second-largest religious group in the world with 1.6 billion adherents and approximately 3.5 million in the US alone. Patient-centered care requires health professionals to look past news headlines and unchecked social media so they can deliver high-quality care to all patients. This article explores areas of importance in the context of advanced illness for practitioners of Islam. These include the conditions needed for prayer, the roles of medical treatment and religious authority, the importance of modesty, the religious concordance of clinicians, the role of family in medical decision making, advance care planning, and pain and symptom management. Initial recommendations to optimize care for Muslim patients and their families, informed by the described tenets of Muslim faith, are provided for clinicians and health systems administrators. These include Islamic cultural awareness training for staff, assessment of patients and families to determine needs, health education and decision-making outreach, and community health partnerships with local Islamic institutions.

  5. Music as Illness; Music as Healing.

    Science.gov (United States)

    Pritchard, Maureen

    2015-09-01

    Throughout the Soviet Union, the arts became tied to ethnicity through the project of Socialist Realism. When, in 1991, the Kyrgyz Republic became independent from the Soviet Union, its national narrative continued to be built upon tropes of Kyrgyz ethnicity. Through their engagement with images of the ethno-national self, the arts provide a great source of beauty. Defining beauty as a representation of the self that is pure whole, and stable, Julia Kristeva asserts that beauty and suffering are part of the same phenomena. Arthur Kleinman argues that suffering is best understood as existing within the triangulated relationship of cultural representation, collective experience, and subjectivity. Music too is part of this triangulated relationship, and therefore, a part of suffering. Drawing upon ten months of ethnographic fieldwork in Kyrgyzstan, this article explores the illness experience of a single Kyrgyz musician. In doing so, it illustrates music's role in self-formation and the development of social, economic, and political ties and the shifts that occur in these during illness. In drawing forth the role of music in the construction of racialized ethnicities, this article demonstrates how the experience of transformative beauty can coexist with turmoil, marginalization, and violence.

  6. Illness perceptions in coronary heart disease: sociodemographic, illness-related, and psychosocial correlates.

    NARCIS (Netherlands)

    Aalto, A.M.; Heijmans, M.; Weinman, J.; Aro, A.R.

    2005-01-01

    OBJECTIVES: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD). METHODS: The sample of the questionnaire study (n=3130 at baseline and n=2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons

  7. Approaching the concept of self-managing illness in long term illness. A review of literature.

    Directory of Open Access Journals (Sweden)

    Stavrou V

    2014-04-01

    Full Text Available Abstract: The management of long term illness is globally challenging and the common concerns are mainly found in developed, developing and transitory countries as the increase in the ageing of the population deteriorates the problems. For patients who are suffering from long term illnesses, there is an interest for programs of self managing the disease, which highlight the core essence of educating patients on managing the disease. Purpose: The purpose of the current study is to a present the basic definitions of self managing the disease, b identify the current situation and c discuss and support nursing staff in educating the patient on self managing the illness. Materials- Methods: A review of relevant articles was conducted on the electronic database Medline/ Pubmed as well as through Scholar Google search engine and a secondary search on the references found on the articles. This occurred irrespective of the publication time.Conclusions The role of the nurse as a member of the interdisciplinary group is important because it helps the patient to develop skills of self care. Complete programs of self-managing the illness with the participation of the nurses in the planning, application and evaluation of the results, will contribute significantly to the patient, notwithstanding the professional benefit for the nurses.

  8. The role of illness perceptions in labour participation of the chronically ill.

    NARCIS (Netherlands)

    Boot, C.R.L.; Heijmans, M.; Gulden, J.W.J. van der; Rijken, M.

    2008-01-01

    OBJECTIVE: We aimed to investigate associations between work disability and illness perceptions, over and above medical assessment and self-reported health. METHODS: A representative sample of people aged 15-64 years with various chronic physical diseases was derived from the Panel of Patients with

  9. Illness perceptions in coronary heart disease: sociodemographic, illness-related, and psychosocial correlates.

    NARCIS (Netherlands)

    Aalto, A.M.; Heijmans, M.; Weinman, J.; Aro, A.R.

    2005-01-01

    OBJECTIVES: This study examined illness perceptions (IP) and their correlates in coronary heart disease (CHD). METHODS: The sample of the questionnaire study (n=3130 at baseline and n=2745 at 1-year follow-up, aged 45-74 years) was drawn from the drug reimbursement register, which covers persons wit

  10. Illness perceptions, adjustment to illness, and depression in a palliative care population.

    Science.gov (United States)

    Price, Annabel; Goodwin, Laura; Rayner, Lauren; Shaw, Emma; Hansford, Penny; Sykes, Nigel; Monroe, Barbara; Higginson, Irene; Hotopf, Matthew; Lee, William

    2012-05-01

    Representations of illness have been studied in several populations, but research is limited in palliative care. To describe illness representations in a population with advanced disease receiving palliative care and to examine the relationship between illness perceptions, adaptive coping, and depression. A cross-sectional survey of 301 consecutive eligible patients recruited from a palliative care service in south London, U.K. Measures used included the Brief Illness Perception Questionnaire (Brief IPQ), the Mental Adjustment to Cancer (MAC) Scale, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9. Scores were not normally distributed for most questions on the Brief IPQ. The correlations found between items on the Brief IPQ were understandable in the context of advanced disease. MAC helplessness-hopelessness and fighting spirit were highly correlated with items on the Brief IPQ in opposite directions. The Brief IPQ domains of consequences, identity, concern, personal control, and emotion were associated with depression, a relationship that was not explained by adaptive coping. Seven causal attribution themes were identified: don't know, personal responsibility, exposure, pathological process, intrinsic personal factors, chance, fate or luck, and other. Both lung cancer diagnosis and gender were found to be independently associated with personal responsibility attribution. None of the attribution themes were associated with the presence of depression. Assessment of illness perceptions in palliative care is likely to yield important information about risk of depression and will help clinicians to personalize management of advanced disease. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  11. Nitrogen Balance and Protein Requirements for Critically Ill Older Patients

    Directory of Open Access Journals (Sweden)

    Roland N. Dickerson

    2016-04-01

    Full Text Available Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.

  12. Graphic Depictions: Portrayals of Mental Illness in Video Games.

    Science.gov (United States)

    Shapiro, Samuel; Rotter, Merrill

    2016-11-01

    Although studies have examined portrayals of mental illness in the mass media, little attention has been paid to such portrayals in video games. In this descriptive study, the fifty highest-selling video games in each year from 2011 to 2013 were surveyed through application of search terms to the Wikia search engine, with subsequent review of relevant footage on YouTube. Depiction categories were then assigned based on the extent of portrayal and qualitative characteristics compared against mental illness stereotypes in cinema. Twenty-three of the 96 surveyed games depicted at least one character with mental illness. Forty-two characters were identified as portraying mental illness, with most characters classified under a "homicidal maniac" stereotype, although many characters did not clearly reflect cinema stereotypes and were subcategorized based on the shared traits. Video games contain frequent and varied portrayals of mental illness, with depictions most commonly linking mental illness to dangerous and violent behaviors.

  13. Nitrogen Balance and Protein Requirements for Critically Ill Older Patients.

    Science.gov (United States)

    Dickerson, Roland N

    2016-04-18

    Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.

  14. Constructs and concepts comprising the stigma of mental illness

    OpenAIRE

    2012-01-01

    People with mental illness frequently confront public stigma andmay experience self-stigma. This review discusses the concepts of mental illness stigma and its consequences for those with mental illness. After a conceptual overview of stigma prominent consequences pertaining to public stigma (i.e.,employment, health care quality) and self-stigma (i.e., self-confidence, quality of life, “why try” effect) are reviewed. We discuss the three main public stigma change strategies - protest, educati...

  15. 2009 Argonne National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-08-19

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  16. 2007 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-06-30

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  17. 2008 Nevada Test Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-10-05

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  18. 2007 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-07-13

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  19. 2008 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-09-17

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  20. 2007 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-05-05

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  1. 2007 Sandia National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-02-04

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  2. 2009 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-11-24

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  3. 2008 Kansas City Plant Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-09-22

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  4. 2008 Brookhaven National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-12-10

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  5. 2008 Idaho National Laboratory Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-11-23

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  6. 2008 Savannah River Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Health, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2009-09-29

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  7. Influenza-like illness and presenteeism among school employees.

    Science.gov (United States)

    de Perio, Marie A; Wiegand, Douglas M; Brueck, Scott E

    2014-04-01

    We determined the prevalence of influenza-like illness (ILI) among employees of a suburban Ohio school district. In a survey of 412 of 841 employees (49%), 120 (29%) reported ILI symptoms during the school year, and 92 (77%) reported working while ill. Age ≥50 years and asthma were significantly associated with reporting of ILI symptoms. Encouraging school employees to receive the seasonal influenza vaccine and to stay home when ill should be part of a comprehensive influenza prevention strategy.

  8. Burden of Self-reported Acute Gastrointestinal Illness in Cuba

    OpenAIRE

    Prieto, Pablo Aguiar; Finley, Rita L; Muchaal, P.K.; Guerin, Michele T; Isaacs, Sandy; Domínguez, Arnaldo Castro; Marie, Gisele Coutín; Perez, Enrique

    2009-01-01

    Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a ...

  9. 2009 Pantex Plant Annual Illness and Injury Surveillance

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-12-15

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  10. 2009 Hanford Site Annual Illness and Injury Surveillance Report

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, Office of Health, Safety and Security, Office of Health and Safety, Office of Illness and Injury Prevention Programs

    2010-12-01

    The U.S. Department of Energy’s (DOE) commitment to assuring the health and safety of its workers includes the conduct of epidemiologic surveillance activities that provide an early warning system for health problems among workers. The Illness and Injury Surveillance Program monitors illnesses and health conditions that result in an absence of workdays, occupational injuries and illnesses, and disabilities and deaths among current workers.

  11. RISK FACTORS OF MORTALITY IN NEONATAL ILLNESS

    Directory of Open Access Journals (Sweden)

    Jeyanthi

    2016-03-01

    Full Text Available BACKGROUND Infant Mortality Rate (IMR is high in India. Identification of risk factors of mortality in neonatal illness is essential to reduce Neonatal Mortality Rate (NMR and ultimately the IMR. AIM To identify the risk factors of mortality in neonatal illness. SETTING AND DESIGN It was a nested case control study done at the sick neonatal unit of urban tertiary referral centre. METHODS AND MATERIALS After obtaining ethical committee approval, retrospective analysis of 150 out born neonatal case records of babies admitted during the period from October 2015 to December 2015 was done. Data such as demographic features, maternal details, referral details, perinatal events, clinical features, laboratory reports and outcome were recorded. STATISTICAL ANALYSIS These risk factors were subjected to univariate and multivariate logistic regression analysis and P value calculated for the same to find out significant risk factors of mortality in neonatal illness. RESULTS Neonatal mortality rate was 22%. Male-to-female ratio was 2:1, death occurred more commonly in female neonates (23.1%. Home deliveries carried more risk of mortality. Birth order 4 and above had 25% mortality. Neonates of mother who had primary education and below had higher mortality. Perinatal asphyxia and sepsis were the most common causes of neonatal mortality. By univariate analysis, preterms had 4.9 times increased risk of mortality than term babies. Apnoeic spells, chest retractions and shock had 8 times, 3 times and 3.6 times increased risk of mortality respectively. By multivariate analysis, birth weight below 2 kilograms (kg carried 11.8 times more risk of mortality with a p value 0.00 (95% C.I 3.2, 30.4 and poor maternal intake of iron and folic acid tablets was 3.9 times more risk p value 0.003 (95% C.I 1.6, 9.6, apnoeic spells were 5.8 times more risk of mortality with p value 0.02 (95% C.I 1.3, 26.2. CONCLUSION Birth weight below 2 kg, poor maternal intake of iron and folic

  12. Illness beliefs and psychological outcome in people with Parkinson's disease.

    Science.gov (United States)

    Simpson, Jane; Lekwuwa, Godwin; Crawford, Trevor

    2013-06-01

    Illness beliefs are important predictors of psychological outcome in people with chronic illness and evidence suggests these could also be significant in furthering our understanding of psychological functioning in people with Parkinson's disease. Illness beliefs are specific, dynamic representations of an illness and cover dimensions such as cause, identity, consequences and controllability. Eighty-one people with Parkinson's disease completed a series of questionnaires to provide demographic, clinical and psychosocial data, which were then used to assess the relative impact of illness beliefs on their psychological functioning. Psychological functioning was assessed by measuring levels of depression, anxiety, stress, positive affect and emotional well-being. Hierarchical block regression indicated that illness beliefs were important independent predictors across some but not all outcomes and the results emphasised the importance of testing new predictors against more established predictors of outcome such as physical functioning and self-esteem. The illness beliefs most important in psychological outcome in people with PD were causal beliefs (particularly in psychosocial causes) and illness coherence (the level of understanding of the illness). The therapeutic potential of psychosocial variables was discussed given that these can be modified during therapy and this change can positively influence psychological outcome.

  13. Functional illness in primary care: dysfunction versus disease.

    Science.gov (United States)

    Williams, Nefyn; Wilkinson, Clare; Stott, Nigel; Menkes, David B

    2008-05-15

    The Biopsychosocial Model aims to integrate the biological, psychological and social components of illness, but integration is difficult in practice, particularly when patients consult with medically unexplained physical symptoms or functional illness. This Biopsychosocial Model was developed from General Systems Theory, which describes nature as a dynamic order of interacting parts and processes, from molecular to societal. Despite such conceptual progress, the biological, psychological, social and spiritual components of illness are seldom managed as an integrated whole in conventional medical practice. This is because the biomedical model can be easier to use, clinicians often have difficulty relinquishing a disease-centred approach to diagnosis, and either dismiss illness when pathology has been excluded, or explain all undifferentiated illness in terms of psychosocial factors. By contrast, traditional and complementary treatment systems describe reversible functional disturbances, and appear better at integrating the different components of illness. Conventional medicine retains the advantage of scientific method and an expanding evidence base, but needs to more effectively integrate psychosocial factors into assessment and management, notably of 'functional' illness. As an aid to integration, pathology characterised by structural change in tissues and organs is contrasted with dysfunction arising from disordered physiology or psychology that may occur independent of pathological change. We propose a classification of illness that includes orthogonal dimensions of pathology and dysfunction to support a broadly based clinical approach to patients; adoption of which may lead to fewer inappropriate investigations and secondary care referrals and greater use of cognitive behavioural techniques, particularly when managing functional illness.

  14. [Mental disorder and suicide prevention in patients with physical illness].

    Science.gov (United States)

    Inagaki, Masatoshi; Ohtsuki, Tsuyuka

    2012-01-01

    Suicide rate in Japan is 25/100,000 in a year. The rate is higher than those in other developed countries. Physical illness is a risk factor for suicide. To prevent suicide in patients with physical illness, identification of mental illness, such as depression, is important. In addition, palliative care for distressing physical and psychological symptoms is also important. In process of identification of mental illness and distressing physical symptoms, communications between medical staff and patients are essential. Enhancing communication skills of medical staff may be a key point to prevent suicide.

  15. Impact of childhood chronic illnesses on siblings: a literature review.

    LENUS (Irish Health Repository)

    O' Brien, Irene

    2012-02-01

    BACKGROUND: Childhood illness can have a significant impact on families, particularly on the ill child\\'s siblings. There is a dearth of published literature focusing on the needs of siblings of ill children. AIM: This literature review aims to provide an overview of the current healthcare literature in relation to the impact of childhood chronic illness or disability on siblings. METHOD: A literature review was undertaken by searching the databases CINAHL, PsycINFO, ProQuest and Cochrane Library for relevant articles in English using the search terms: \\'siblings\\

  16. Heat illness--a review of military experience (Part 1).

    Science.gov (United States)

    Bricknell, M C

    1995-10-01

    This paper is the first part of a two part review of the published literature reporting the military experience of heat illness. It summarises current concepts of the mechanisms for the development of heat illness. The reports of heat illness in the military medical literature from pre-World War 1 to the end of World War 2 are discussed. The second part will consider reports from the end of the Second World War to the present day. Epidemiological evidence for the factors causing heat illness will be summarised and finally the current areas of uncertainty will be identified with proposals for future research.

  17. Allergic to life: Psychological factors in environmental illness

    Energy Technology Data Exchange (ETDEWEB)

    Simon, G.E.; Katon, W.J.; Sparks, P.J. (Robert Wood Johnson Clinical Scholars Program, Seattle, WA (USA))

    1990-07-01

    Environmental illness is an increasingly frequent and medically unexplained syndrome of allergy to common environmental agents. A recent outbreak of chemical-induced illness allowed study of psychological factors in environmental illness. Thirty-seven symptomatic plastics workers completed structured diagnostic interviews and self-report measures of somatization and psychopathology. The 13 subjects who developed environmental illness scored higher on all measures than those who did not. The greatest differences were in prior history of anxiety or depressive disorder (54% versus 4%) and number of medically unexplained physical symptoms before exposure (6.2 versus 2.9). These findings suggest that psychological vulnerability strongly influences chemical sensitivity following chemical exposure.

  18. Monocyte Profiles in Critically Ill Patients With Pseudomonas Aeruginosa Sepsis

    Science.gov (United States)

    2017-02-02

    Pseudomonas Infections; Pseudomonas Septicemia; Pseudomonas; Pneumonia; Pseudomonal Bacteraemia; Pseudomonas Urinary Tract Infection; Pseudomonas Gastrointestinal Tract Infection; Sepsis; Sepsis, Severe; Critically Ill

  19. Anemia and Blood Transfusions in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    M. Kamran Athar

    2012-01-01

    Full Text Available Anemia is common in critically ill patients. As a consequence packed red blood cell (PRBC transfusions are frequent in the critically ill. Over the past two decades a growing body of literature has emerged, linking PRBC transfusion to infections, immunosuppression, organ dysfunction, and a higher mortality rate. However, despite growing evidence that risk of PRBC transfusion outweighs its benefit, significant numbers of critically ill patients still receive PRBC transfusion during their intensive care unit (ICU stay. In this paper, we summarize the current literature concerning the impact of anemia on outcomes in critically ill patients and the potential complications of PRBC transfusions.

  20. Prevalence of diarrhea-associated virulence genes and genetic diversity in Escherichia coli isolates from fecal material of various animal hosts.

    Science.gov (United States)

    Chandran, Abhirosh; Mazumder, Asit

    2013-12-01

    In order to assess the health risk associated with a given source of fecal contamination using bacterial source tracking (BST), it is important to know the occurrence of potential pathogens as a function of host. Escherichia coli isolates (n=593) from the feces of diverse animals were screened for various virulence genes: stx1 and stx2 (Shiga toxin-producing E. coli [STEC]), eae and EAF (enteropathogenic E. coli [EPEC]), STh, STp, and LT (enterotoxigenic E. coli [ETEC]), and ipaH (enteroinvasive E. coli [EIEC]). Eleven hosts were positive for only the eae (10.11%) gene, representing atypical EPEC, while two hosts were positive for both eae and EAF (1.3%), representing typical EPEC. stx1, stx2, or both stx1 and stx2 were present in 1 (0.1%,) 10 (5.56%), and 2 (1.51%) hosts, respectively, and confirmed as non-O157 by using a E. coli O157 rfb (rfbO157) TaqMan assay. STh and STp were carried by 2 hosts (2.33%) and 1 host (0.33%), respectively, while none of the hosts were positive for LT and ipaH. The repetitive element palindromic PCR (rep-PCR) fingerprint analysis identified 221 unique fingerprints with a Shannon diversity index of 2.67. Multivariate analysis of variance revealed that majority of the isolates clustered according to the year of sampling. The higher prevalence of atypical EPEC and non-O157 STEC observed in different animal hosts indicates that they can be a reservoir of these pathogens with the potential to contaminate surface water and impact human health. Therefore, we suggest that E. coli from these sources must be included while constructing known source fingerprint libraries for tracking purposes. However, the observed genetic diversity and temporal variation need to be considered since these factors can influence the accuracy of BST results.

  1. Witchcraft and Biopsychosocial Causes of Mental Illness: Attitudes and Beliefs About Mental Illness Among Health Professionals in Five Countries.

    Science.gov (United States)

    Stefanovics, Elina A; He, Hongbo; Cavalcanti, Maria; Neto, Helio; Ofori-Atta, Angelo; Leddy, Meaghan; Ighodaro, Adesuwa; Rosenheck, Robert

    2016-03-01

    This study examines the intercorrelation of measures reflecting beliefs about and attitudes toward people with mental illness in a sample of health professionals (N = 902) from five countries: Brazil, China, Ghana, Nigeria, and the United States, and, more specifically, the association of beliefs in supernatural as contrasted with biopsychosocial causes of mental illness. Factor analysis of a 43-item questionnaire identified four factors favoring a) socializing with people with mental illness; b) normalizing their roles in society; c) belief in supernatural causes of mental illness (e.g., witchcraft, curses); and d) belief in biopsychosocial causes of mental illness. Unexpectedly, a hypothesized negative association between belief in supernatural and biopsychosocial causation of mental illness was not found. Belief in the biopsychosocial causation was weakly associated with less stigmatized attitudes towards socializing and normalized roles.

  2. [Illness behavior and depression in tinnitus patients].

    Science.gov (United States)

    Schönweiler, R; Neuschulte, C; Paar, G H

    1989-05-01

    Tinnitus patients often complain of psychosomatic disorders and of problems in social life. We intended to prove the modulation of tinnitus perception by psychosocial factors. We examined 48 tinnitus patients, 35 with and 13 without hearing loss. A control group of 48 patients without tinnitus, without hearing disorder and without tumor disease was adapted to correspond to the tinnitus group in respect of age, sex and social factors. A quantitative assessment of complaints as well as of the intensity of depression was made via questionaires (Giessener Beschwerdebogen and Beck Depression Inventory). In tinnitus patients, we found a statistically significantly higher degree of complaints even for non-otological symptoms. They were statistically more depressive than the controls, but less than patients with endogenic depression usually are. Nevertheless, in tinnitus patients it seems to be reasonable to inquire after general symptoms of illness to assess whether cooperation with a psychiatrist is required before initiating somatic treatment.

  3. in Critically Ill Patients: Success and Limits

    Directory of Open Access Journals (Sweden)

    Filippo Mariano

    2011-01-01

    Full Text Available Citrate anticoagulation has risen in interest so it is now a real alternative to heparin in the ICUs practice. Citrate provides a regional anticoagulation virtually restricted to extracorporeal circuit, where it acts by chelating ionized calcium. This issue is particularly true in patients ongoing CRRT, when the “continuous” systemic anticoagulation treatment is per se a relevant risk of bleeding. When compared with heparin most of studies with citrate reported a longer circuit survival, a lower rate of bleeding complications, and transfused packed red cell requirements. As anticoagulant for CRRT, the infusion of citrate is prolonged and it could potentially have some adverse effects. When citrate is metabolized to bicarbonate, metabolic alkalosis may occur, or for impaired metabolism citrate accumulation leads to acidosis. However, large studies with dedicated machines have indeed demonstrated that citrate anticoagulation is well tolerated, safe, and an easy to handle even in septic shock critically ill patients.

  4. Selenium supplementation for critically ill adults

    DEFF Research Database (Denmark)

    Allingstrup, Mikkel; Afshari, Arash

    2015-01-01

    BACKGROUND: Selenium is a trace mineral essential to health and has an important role in immunity, defence against tissue damage and thyroid function. Improving selenium status could help protect against overwhelming tissue damage and infection in critically ill adults. This Cochrane review......, to May 20, 2014), EMBASE (Ovid SP, to May 20, 2014), CAB, BIOSIS and CINAHL. We handsearched the reference lists of the newest reviews and cross-checked with our search in MEDLINE. We contacted the main authors of included studies to request any missed, unreported or ongoing studies. The latest search...... in order to retrieve relevant and missing data. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and we resolved any disagreements by discussion. Our primary outcome measure was all-cause mortality. We performed several subgroup and sensitivity analyses to assess the effects...

  5. Remote psychotherapy for terminally ill cancer patients.

    Science.gov (United States)

    Cluver, Jeffrey S; Schuyler, Dean; Frueh, B Christopher; Brescia, Frank; Arana, George W

    2005-01-01

    We conducted a feasibility study of remote psychotherapy in 10 terminally ill cancer patients with diagnoses of adjustment disorder or major depression. Subjects received six sessions of individual cognitive therapy with the same therapist. Sessions alternated between face-to-face sessions and remote sessions delivered by analogue videophone. After each therapy session, a brief questionnaire was used to evaluate the subjects' level of satisfaction with the session, sense of connectedness to the therapist and overall progress being made in the therapy. Nine patients completed the study. Of 53 completed therapy sessions, 21 were by videophone and 32 were conducted face to face. Participants reported strong positive perceptions and acceptance after almost all therapy sessions, regardless of service delivery mode. The study suggests that there may be a role for the delivery of psychotherapy using low-bandwidth videophones.

  6. Children of Parents With Serious Mental Illness

    DEFF Research Database (Denmark)

    Ranning, Anne; Munk Laursen, Thomas; Thorup, Anne

    2016-01-01

    with a single mother with SMI. Conjugal families were dissolved at higher rates if a parent had SMI, especially if the mother (incidence rate ratio 2.98; 95% CI 2.80–3.17) or the father (incidence rate ratio 2.60; 95% CI 2.47–2.74) had schizophrenia. Risks for family dissolution varied greatly with parents...... analyses were performed assessing the risk of dissolution of the conjugal family. Results Children's living arrangements were characterized by fewer nuclear families and more single-parent–headed households when parents had serious mental illness (SMI). From birth, 15% to 20% of children lived......’ socioeconomic position in all diagnostic groups. Conclusion Parents’ SMI affects children's family living arrangements because fewer children live with both parents and more children live with a single parent or are separated from both parents. Family cohesion seems especially difficult to maintain when parents...

  7. Nutritional Assessment in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Najmeh Hejazi

    2016-05-01

    Full Text Available Background: Malnutrition is an important factor in the survival of critically ill patients. The purpose of the present study was to assess the nutritional status of patients in the intensive care unit (ICU on the days of admission and discharge via a detailed nutritional assessment. Methods: Totally, 125 patients were followed up from admission to discharge at 8ICUs in Shiraz, Iran. The patients’ nutritional status was assessed using subjective global assessment (SGA, anthropometric measurements, biochemical indices, and body composition indicators. Diet prescription and intake was also evaluated. Results: Malnutrition prevalence significantly increased on the day of discharge (58.62% compared to the day of admission (28.8% according to SGA (P<0.001. The patients’ weight, mid-upper-arm circumference, mid-arm muscle circumference, triceps skinfold thickness, and calf circumference decreased significantly as well (P<0.001. Lean mass weight and body cell mass also decreased significantly (P<0.001. Biochemical indices showed no notable changes except for magnesium, which decreased significantly (P=0.013. A negative significant correlation was observed between malnutrition on discharge day and anthropometric measurements. Positive and significant correlations were observed between the number of days without enteral feeding, days delayed from ICU admission to the commencement of enteral feeding, and the length of ICU stay and malnutrition on discharge day. Energy and protein intakes were significantly less than the prescribed diet (26.26% and 26.48%, respectively. Conclusion: Malnutrition on discharge day increased in the patients in the ICU according to SGA. Anthropometric measurements were better predictors of the nutritional outcome of our critically ill patients than were biochemical tests.

  8. Nutritional requirements of the critically ill patient.

    Science.gov (United States)

    Costa, Nuno André de Almeida; Marinho, Aníbal Defensor; Cançado, Luciana Ribeiro

    2012-09-01

    Given the inaccessibility of indirect calorimetry, intensive care units generally use predictive equations or recommendations that are established by international societies to determine energy expenditure. The aim of the present study was to compare the energy expenditure of critically ill patients, as determined using indirect calorimetry, to the values obtained using the Harris-Benedict equation. A retrospective observational study was conducted at the Intensive Care Unit 1 of the Centro Hospitalar do Porto. The energy requirements of hospitalized critically ill patients as determined using indirect calorimetry were assessed between January 2003 and April 2012. The accuracy (± 10% difference between the measured and estimated values), the mean differences and the limits of agreement were determined for the studied equations. Eighty-five patients were assessed using 288 indirect calorimetry measurements. The following energy requirement values were obtained for the different methods: 1,753.98±391.13 kcal/day (24.48 ± 5.95 kcal/kg/day) for indirect calorimetry and 1,504.11 ± 266.99 kcal/day (20.72±2.43 kcal/kg/day) for the Harris-Benedict equation. The equation had a precision of 31.76% with a mean difference of -259.86 kcal/day and limits of agreement between -858.84 and 339.12 kcal/day. Sex (p=0.023), temperature (p=0.009) and body mass index (p<0.001) were found to significantly affect energy expenditure. The Harris-Benedict equation is inaccurate and tends to underestimate energy expenditure. In addition, the Harris-Benedict equation is associated with significant differences between the predicted and true energy expenditure at an individual level.

  9. Optimizing antimicrobial therapy in critically ill patients

    Directory of Open Access Journals (Sweden)

    Vitrat V

    2014-10-01

    Full Text Available Virginie Vitrat,1 Serge Hautefeuille,2 Cécile Janssen,1 David Bougon,2 Michel Sirodot,2 Leonardo Pagani1,3 1Antimicrobial Stewardship Program, Infectious Diseases Unit, 2Intensive Care Unit, Annecy-Genevois Hospital Center (CHANGE, Annecy, France; 3Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy Abstract: Critically ill patients with infection in the intensive care unit (ICU would certainly benefit from timely bacterial identification and effective antimicrobial treatment. Diagnostic techniques have clearly improved in the last years and allow earlier identification of bacterial strains in some cases, but these techniques are still quite expensive and not readily available in all institutions. Moreover, the ever increasing rates of resistance to antimicrobials, especially in Gram-negative pathogens, are threatening the outcome for such patients because of the lack of effective medical treatment; ICU physicians are therefore resorting to combination therapies to overcome resistance, with the direct consequence of promoting further resistance. A more appropriate use of available antimicrobials in the ICU should be pursued, and adjustments in doses and dosing through pharmacokinetics and pharmacodynamics have recently shown promising results in improving outcomes and reducing antimicrobial resistance. The aim of multidisciplinary antimicrobial stewardship programs is to improve antimicrobial prescription, and in this review we analyze the available experiences of such programs carried out in ICUs, with emphasis on results, challenges, and pitfalls. Any effective intervention aimed at improving antibiotic usage in ICUs must be brought about at the present time; otherwise, we will face the challenge of intractable infections in critically ill patients in the near future. Keywords: ICU, antimicrobial therapies, antimicrobial stewardship, pharmacokinetics, pharmacodynamics, antimicrobial resistance, early diagnosis

  10. A pilot study of transformation, attributed meanings to the illness, and spiritual well-being for terminally ill cancer patients.

    Science.gov (United States)

    Ando, Michiyo; Morita, Tatsuya; Lee, Virginia; Okamoto, Takuya

    2008-12-01

    The present study investigated what types of transformation terminally ill cancer patients experienced from diagnosis until the terminal stage, what meanings terminally ill cancer patients attributed to their illness, and whether or not those who attributed positive meaning to their illness achieved high levels of spiritual well-being as a preliminary study. Ten terminally ill cancer patients in the hospice wards of two general hospitals participated. A clinical psychologist conducted a semistructured interview with the patients individually for about 60 min. Patients completed the FACIT-Sp and HADS before the interview and talked about the meanings of cancer experience. The contents of the interviews were analyzed qualitatively. Patients were separated into high and low levels of spiritual-well being by the median of FACIT-Sp scores. Three types of transformation were extracted: "group with peaceful mind," "group with both positive attitude and uneasy feeling," and "groups with uneasy feeling." As attributed meanings to the illness, five categories were extracted: "positive meaning," "natural acceptance," "negative acceptance," "search for meaning," and "regret and sorrow." Patients in the high level spiritual well-being group attributed the meaning of illness to "positive meaning" and "natural acceptance," and those in the low level spiritual well-being group attributed it to "regret and sorrow" and "search for meaning." Some Japanese terminally ill cancer patients experienced positive transformation, and patients who attributed "positive meaning" and "natural acceptance" to their illness experience achieved high levels of spiritual well-being.

  11. Detection of Shiga Toxin-Producing Escherichia coli in Ground Beef Using the GeneDisc Real-Time PCR System

    Directory of Open Access Journals (Sweden)

    Pina eFratamico

    2012-12-01

    Full Text Available Escherichia coli O157:H7 and certain non-O157 Shiga toxin-producing Escherichia coli (STEC serogroups have emerged as important public health threats. The development of methods for rapid and reliable detection of this heterogeneous group of pathogens has been challenging. GeneDisc real-time PCR assays were evaluated for detection of the stx1, stx2, eae, and ehx genes and a gene that identifies the O157 serogroup followed by a second GeneDisc assay targeting serogroup-specific genes of STEC O26, O45, O91, O103, O111, O113, O121, O145, and O157. The ability to detect the STEC serogroups in ground beef samples artificially inoculated at a level of ca. 2-20 CFU/25 g and subjected to enrichment in mTSB or BPW was similar. Following enrichment, all inoculated ground beef samples showed amplification of the correct set of target genes carried by each strain. Samples inoculated with STEC serogroups O26, O45, O103, O111, O121, O145, and O157 were subjected to immunomagnetic separation, and isolation was achieved by plating onto Rainbow agar O157. Colonies were confirmed by PCR assays targeting stx1, stx2, eae, and serogroup-specific genes. Thus, this work demonstrated that GeneDisc assays are rapid, sensitive, and reliable and can be used for screening ground beef and potentially other foods for STEC serogroups that are important food-borne pathogens worldwide.

  12. Perceived mental illness stigma, intimate relationships and sexual risk behavior in youth with mental illness.

    Science.gov (United States)

    Elkington, Katherine S; Hackler, Dusty; Walsh, Tracy A; Latack, Jessica A; McKinnon, Karen; Borges, Cristiane; Wright, Eric R; Wainberg, Milton L

    2013-05-01

    The current study examines the role of mental illness-related stigma on romantic or sexual relationships and sexual behavior among youth with mental illness (MI), including youths' experiences of stigma, the internalization of these experiences, and the behavior associated with managing stigma within romantic and sexual relationships. We conducted in-depth interviews with N=20 youth with mental illness (MI) (55% male, 16-24 years, 75% Latino) from 4 psychiatric outpatient clinics in New York City. We conducted a thematic analysis to investigate shared experiences of MI stigma and its impact on youth's sexual or romantic relationships and associated behaviors. Our analysis revealed four main themes: 1) societal perceptions of those with MI as partners (societal stigma); 2) individual experiences of stigma within relationships (individual level); 3) internalized stigma of self as a partner (social-psychological processes); and 4) managing a stigmatized identity, of which some of the behaviors directly placed them at increased risk for HIV. We found that just under half of the sample (n=9/20) endorsed all themes, including engaging in HIV/STI sexual risk behaviors as a method to manage a stigmatize identity, which suggests that MI stigma and sexual risk may be linked. We discuss differences by gender and diagnosis. Findings provide new information for providers and researchers to address on the role of stigma experiences in the romantic and sexual behavior of youth in psychiatric treatment. Implications for stigma and HIV/STI prevention interventions are discussed.

  13. Older men and older women remand prisoners: mental illness, physical illness, offending patterns and needs.

    Science.gov (United States)

    Davoren, Mary; Fitzpatrick, Mary; Caddow, Fintan; Caddow, Martin; O'Neill, Conor; O'Neill, Helen; Kennedy, Harry G

    2015-05-01

    Older prisoners are the fastest growing group of prisoners in most countries. They have high rates of physical and psychiatric co-morbidity, compared to community dwelling older persons and also compared with other prisoner groups. Very high rates of mental illness have been found in remand (pre-trial) prisoners when compared with other prisoner groups; however to date there have been no studies examining older male and female remand prisoners. A retrospective chart review was conducted of all remands, to a male and a female prison, over a six and half-year period. Demographic data were collected pertaining to psychiatric and medical diagnoses and seriousness of offending. We found rising numbers of older prisoners amongst male remand prisoners. Older remand prisoners had very high rates of affective disorder and alcohol misuse. They had rates of psychotic illnesses and deliberate self-harm comparable to younger remand prisoners. High rates of vulnerability were found among older prisoners and older prisoners had a greater need for general medical and psychiatric services than younger prisoners. We also found comparable offending patterns with younger prisoners and high rates of sexual offending among the older male prisoner group. Given the ageing population of many countries it is likely the numbers of older prisoners will continue to grow and given their high levels of both physical and psychiatric illness this will have implications for future service delivery.

  14. Gender Differences in Anxiety Disorders: Prevalence, Course of Illness, Comorbidity and Burden of Illness

    Science.gov (United States)

    McLean, Carmen P.; Asnaani, Anu; Litz, Brett T.; Hofmann, Stefan G.

    2011-01-01

    Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N = 20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men. PMID:21439576

  15. Self-management and support needs of chronically ill people

    NARCIS (Netherlands)

    van Houtum, L.

    2016-01-01

    Over the past decade, self-management by patients has been recognized an important aspect of chronic illness care, as it can help avoid preventable mortality and morbidity and improve the quality of life of patients and their families. However, not all people with a chronic illness are able to

  16. "Rationality" as a Moderator Between Life Events and Illness.

    Science.gov (United States)

    Pekarik, Gene

    1986-01-01

    The author examined the theory of rational beliefs as a moderator between life events and illness using a sample of 283 college students. Results suggested that rationality functioned to prevent stress and illness when there were few stressors, but did not reduce the effect of high levels of life events. (Author/MT)

  17. On the downplay of suffering in Nordenfelt's theory of illness.

    Science.gov (United States)

    Hofmann, Bjørn

    2013-12-01

    In his influential theory of health Nordenfelt bases the concepts of health and illness on the notions of ability and disability. A premise for this is that ability and disability provide a more promising, adequate, and useful basis than well-being and suffering. Nordenfelt uses coma and manic episodes as paradigm cases to show that this is so. Do these paradigm cases (and thus the premise) hold? What consequences does it have for the theory of health and illness if it they do not? These are the key questions in this article, which first presents the relationship between pain and disability in Nordenfelt's theory and the paradigm cases he uses to argue for the primacy of disability over pain. Then, Nordenfelt's concepts of illness are outlined, highlighting its presumptions and arguments. The main point is that if you do not have an action-theoretical perspective, it is not obvious that disability is the core concept for illness. The compelling effect of the paradigm cases presupposes that you see ability as the primary issue. To those who do not share this presumption, people in coma may not be ill. There are alternative well founded arguments for the primacy of first person experiences for the concept of illness. Hence, we need better arguments for the primacy of disability over first person experiences in illness, or first-person experience should be more primarily included in the concept of illness.

  18. The challenge of unravelling family resemblance related to illness behaviour.

    NARCIS (Netherlands)

    Cardol, M.; Groenewegen, P.P.; Spreeuwenberg, P.; Dijk, L. van; Bosch, W. van den; Bakker, D.H. de

    2005-01-01

    Background: Efforts to promote health or prevent disease may conflict with patients’ habits at home. Irrespective of the national setting, families are important social contexts in which illness occurs and resolves. Family members resemble each other in their illness behaviour, even across generatio

  19. Art Education and Disability Studies Perspectives on Mental Illness Discourses

    Science.gov (United States)

    Derby, John K.

    2009-01-01

    This dissertation critically examines mental illness discourses through the intersecting disciplinary lenses of art education and disability studies. Research from multiple disciplines is compared and theorized to uncover the ways in which discourses, or language systems, have oppressively constructed and represented "mental illness." To establish…

  20. Mayaro Virus in Child with Acute Febrile Illness, Haiti, 2015.

    Science.gov (United States)

    Lednicky, John; De Rochars, Valery Madsen Beau; Elbadry, Maha; Loeb, Julia; Telisma, Taina; Chavannes, Sonese; Anilis, Gina; Cella, Eleonora; Ciccozzi, Massinno; Okech, Bernard; Salemi, Marco; Morris, J Glenn

    2016-11-01

    Mayaro virus has been associated with small outbreaks in northern South America. We isolated this virus from a child with acute febrile illness in rural Haiti, confirming its role as a cause of mosquitoborne illness in the Caribbean region. The clinical presentation can mimic that of chikungunya, dengue, and Zika virus infections.