Large Outbreak of Botulism Associated with a Church Potluck Meal--Ohio, 2015.

On April 21, 2015, the Fairfield Medical Center (FMC) and Fairfield Department of Health contacted the Ohio Department of Health (ODH) about a patient suspected of having botulism in Fairfield County, Ohio. Botulism is a severe, potentially fatal neuroparalytic illness.* A single case is a public health emergency, because it can signal an outbreak. Within 2 hours of health department notification, four more patients with similar clinical features arrived at FMC's emergency department. Later that afternoon, one patient died of respiratory failure shortly after arriving at the emergency department. All affected persons had eaten at the same widely attended church potluck meal on April 19. CDC's Strategic National Stockpile sent 50 doses of botulinum antitoxin to Ohio. FMC, the Fairfield Department of Health, ODH, and CDC rapidly responded to confirm the diagnosis, identify and treat additional patients, and determine the source.

Hormonal adaptation and the stress of exercise training: the role of glucocorticoids.

Glucocorticoids, such as cortisol, are steroid hormones produced by the zona fasciculata of the adrenal cortex in the adrenal gland. These hormones play vital roles in the body's defense mechanisms when dealing with stress, as well as being important in blood glucose regulation. Regrettably, misconceptions regarding the physiological actions of these hormones (in particular relative to the catabolism) have been created within the areas of sports and exercise. For example, cortisol most often is viewed as having a counter-productive role in exercise that can lead to a mal-adaptation to the exercise training process, due to the catabolic nature of this hormone relative to protein turnover. Therefore, the intent of this article is to present an overview and to offer remarks on the necessary and critically important functions of glucocorticoids during exercise, and in the adaptation process associated with exercise training. The emphasis is specifically to correct several of the misconceptions and misunderstandings that are portrayed within some research and popular literature regarding endocrine responses to exercise and exercise training.

Cryptogenic stroke in relation to genetic variation in clotting factors and other genetic polymorphisms among young men and women.

BACKGROUND AND PURPOSE: The purpose of the present study was to compare the prevalences of genetic polymorphisms in persons with cryptogenic stroke with those among stroke patients with evidence of large-artery occlusive disease or an unequivocal cardioembolic source (noncryptogenic stroke). METHODS: We compared the prevalences of genetic polymorphisms thought to be related to thrombi formation in young stroke patients with evidence of large-artery occlusive disease or an unequivocal cardioembolic source (noncryptogenic stroke; controls; n=79) with those in young stroke patients without such sources (cryptogenic stroke; cases; n=67). Common variations in the genes encoding factor V, prothrombin, angiotensin I-converting enzyme, 5,10-methylenetetrahydrofolate reductase, endothelial cell nitric oxide synthase, tissue plasminogen activator, plasminogen activator inhibitor-1, and fibrinogen were evaluated. We also compared the allele prevalence of these genes among all stroke patients with those among a large pool of historical controls assayed for these genes. RESULTS: None of these genetic polymorphisms was statistically significantly related to cryptogenic stroke. With respect to a comparison of all ischemic stroke with historical controls, only the prevalence of tissue plasminogen activator D allele among stroke subjects was statistically significantly higher than that of the historical controls (P=0.0014). CONCLUSIONS: These findings generally do not support the hypothesis that genes associated with a prothrombotic state are risk factors among a subgroup of young people with stroke of undetermined cause. Except for the D tissue plasminogen activator allele, the findings also indicated that these genetic factors are unrelated, or only weakly related, to all ischemic stroke.