Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 160
Filtrar
1.
Toxins (Basel) ; 14(1)2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-35051006

RESUMO

Staphylococcal enterotoxin A (SEA), the toxin protein secreted by Staphylococcus aureus, can cause staphylococcal food poisoning outbreaks and seriously threaten global public health. However, little is known about the pathogenesis of SEA in staphylococcal foodborne diseases. In this study, the effect of SEA on intestinal barrier injury and NLRP3 inflammasome activation was investigated by exposing BALB/c mice to SEA with increasing doses and a potential toxic mechanism was elucidated. Our findings suggested that SEA exposure provoked villi injury and suppressed the expression of ZO-1 and occludin proteins, thereby inducing intestinal barrier dysfunction and small intestinal injury in mice. Concurrently, SEA significantly up-regulated the expression of NLRP3 inflammasome-associated proteins and triggered the mitogen-activated protein kinase (MAPK) and nuclear factor kappa-B (NF-κB) signaling pathways in jejunum tissues. Notably, selective inhibitors of MAPKs and NF-κB p65 ameliorated the activation of NLRP3 inflammasome stimulated by SEA, which further indicated that SEA could activate NLRP3 inflammasome through NF-κB/MAPK pathways. In summary, SEA was first confirmed to induce intestinal barrier dysfunction and activate NLRP3 inflammasome via NF-κB/MAPK signaling pathways. These findings will contribute to a more comprehensive understanding of the pathogenesis of SEA and related drug-screening for the treatment and prevention of bacteriotoxin-caused foodborne diseases via targeting specific pathways.


Assuntos
Enterotoxinas/toxicidade , Contaminação de Alimentos , Inflamassomos/metabolismo , Enteropatias/fisiopatologia , Mucosa Intestinal/efeitos dos fármacos , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Transdução de Sinais/efeitos dos fármacos , Staphylococcus/química , Animais , Modelos Animais de Doenças , Doenças Transmitidas por Alimentos/fisiopatologia , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , NF-kappa B/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo
2.
PLoS One ; 16(12): e0262032, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34972156

RESUMO

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients' time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.


Assuntos
Doenças Transmitidas por Alimentos/fisiopatologia , Zoonoses/fisiopatologia , Adolescente , Adulto , Idoso , Animais , Criança , Efeitos Psicossociais da Doença , Estudos Transversais , Demografia , Diarreia/epidemiologia , Diarreia/fisiopatologia , Anos de Vida Ajustados por Deficiência , Etiópia/epidemiologia , Características da Família , Comportamento Alimentar , Feminino , Estresse Financeiro , Alimentos , Doenças Transmitidas por Alimentos/economia , Doenças Transmitidas por Alimentos/prevenção & controle , Custos de Cuidados de Saúde , Humanos , Expectativa de Vida , Masculino , Carne , Pessoa de Meia-Idade , Modelos Econômicos , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem , Zoonoses/economia , Zoonoses/prevenção & controle
3.
Muscle Nerve ; 64(4): 435-444, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34255868

RESUMO

INTRODUCTION/AIMS: Neurophysiological patterns in patients with foodborne botulism are rarely described after the acute phase. We report data from a large Italian outbreak of botulism, with patients evaluated at different timepoints after poisoning. METHODS: Eighteen male patients (mean age 47 ± 8.4 y) underwent 22 clinical and neurophysiological evaluations (4 patients were re-evaluated). The resting compound muscle action potential (CMAP) amplitude, postexercise CMAP amplitude, CMAP change after high-frequency (50 Hz) repetitive nerve stimulation (HFRNS), and motor unit action potentials (MUAPs) were assessed in the acute (4-8 days after poisoning; 5 patients), early post-acute (32-39 days after poisoning; 5 patients), and late post-acute (66-80 days after poisoning; 12 patients) phases. RESULTS: In the acute, early post-acute, and late post-acute phases, respectively, reduced CMAP amplitudes were found in 100%, 20%, and 17% of patients; abnormal postexercise CMAP facilitation was observed in 100%, 40%, and 0% of patients; and pathological incremental responses to HFRNS were found in 80%, 50%, and 8% of patients. Baseline CMAP amplitudes, postexercise CMAP facilitation, and CMAP increases in response to HFRNS differed significantly between the acute and post-acute phases. Small MUAPs were found in 100% of patients in the acute and early post-acute phases and in 50% of patients in the late post-acute phase. DISCUSSION: The neurophysiological findings of foodborne botulism vary considerably according to the evaluation time point. In the post-acute phase, different neurophysiological techniques must be applied to support a diagnosis of botulism.


Assuntos
Potenciais de Ação/fisiologia , Botulismo/fisiopatologia , Eletrodiagnóstico , Eletromiografia , Condução Nervosa/fisiologia , Doença Aguda , Adulto , Botulismo/complicações , Botulismo/epidemiologia , Eletrodiagnóstico/tendências , Eletromiografia/tendências , Seguimentos , Doenças Transmitidas por Alimentos/complicações , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade
4.
Cardiovasc Toxicol ; 21(9): 772-780, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34125412

RESUMO

Mad honey intoxication (MHI) is a food-induced clinical condition that usually presents with cardiovascular symptoms and can lead to life-threatening arrhythmias if not diagnosed and treated early. No data exist in the literature on the presence of interatrial block (IAB) after food intoxication. In our study, we sought to investigate atrioventricular electrocardiography (ECG) parameters and determine the frequency of IAB in patients with MHI. In total, 76 patients diagnosed with MHI were included in our retrospective study. Twelve-lead ECGs were performed and participants were divided into two groups according to the presence of IAB in the reference ECG. The P maximum (Pmax), P minimum (Pmin), P dispersion (Pdisp), T peak to T end (Tp-Te) interval and QT dispersion (QTdisp) values were compared between the two groups. IAB was detected in 28 (35.5%) of 76 MHI patients included in the final analysis. Pmax duration (122 ± 8; p < 0.001) and PD (69 ± 11; p < 0.001) were significantly higher in the IAB ( +) group. During regression analysis, Pmax [odds ratio (OR) 1.158, 95% confidence interval (CI) 1.036-1.294; p = 0.010] and Pd (OR 1.086, 95% CI 1.001-1.017; p = 0.046) were independently associated with IAB. Pmax and Pd area under the receiver operating characteristic curve values for IAB prediction were 0.926 (95% CI 0.841-1,000; p < 0.001) and 0.872 (95% CI 0.765-0.974; p < 0.001), respectively. ECG changes are common in patients presenting with MHI. These patients need to be followed up clinically in terms of progression to arrhythmic events that may occur in the future.


Assuntos
Potenciais de Ação , Eletrocardiografia , Doenças Transmitidas por Alimentos/diagnóstico , Frequência Cardíaca , Mel/intoxicação , Bloqueio Interatrial/diagnóstico , Bloqueio Interatrial/fisiopatologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Bloqueio Interatrial/etiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Adulto Jovem
6.
Am J Trop Med Hyg ; 104(5): 1889-1894, 2021 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-33684061

RESUMO

Lathyrism is an incurable neurological disorder, resulting from excessive consumption of grass pea (Lathyrus sativus), which clinically manifests as paralysis of lower limbs. Because of the high production of grass peas, a large number of people are expected to be affected by the disease in Northeast Ethiopia. However, there is no comprehensive study that quantified the magnitude of the problem. Therefore, in this study, we determined the prevalence of lathyrism and socioeconomic disparities in Northeast Ethiopia. A community-based cross-sectional study was used which used a quantitative method of data collection from January to February 2019. Data were collected from a total of 2,307 inhabitants in the study area using structured questionnaires. Lathyrism cases were identified using a case definition of symmetrical spastic leg weakness, and subacute or insidious onset, with no sensory deficit, and with a history of grass pea consumption before and at the onset of paralysis. The majority (56.8%) of participants were male, and 34.7% were aged 45 years or older. Overall, the prevalence of lathyrism was 5.5%, and it was higher in males (7.9%) than in females (2.5%). Moreover, the prevalence was higher among farmers (7.0%) than merchants (0.3%), very poor economic status (7.2%) than very rich (1.1%), who produced (9.6%) grass pea than not produced (0.9%), and those who used clay pottery (6.2%) than metal (4.8%) for cooking. The prevalence of lathyrism in Northeast Ethiopia is remarkably high. Therefore, we recommend lathyrism to be among the list of reportable health problems and incorporated in the national routine surveillance system.


Assuntos
Doenças Transmitidas por Alimentos/epidemiologia , Latirismo/epidemiologia , Lathyrus/intoxicação , Paralisia/epidemiologia , Culinária/métodos , Estudos Transversais , Etiópia/epidemiologia , Feminino , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/patologia , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Latirismo/etiologia , Latirismo/patologia , Latirismo/fisiopatologia , Extremidade Inferior/patologia , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Paralisia/etiologia , Paralisia/patologia , Paralisia/fisiopatologia , Prevalência , Saúde Pública , Fatores Socioeconômicos , Inquéritos e Questionários
7.
Toxins (Basel) ; 13(2)2021 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-33525722

RESUMO

Bacillus cereus is a ubiquitous soil bacterium responsible for two types of food-associated gastrointestinal diseases. While the emetic type, a food intoxication, manifests in nausea and vomiting, food infections with enteropathogenic strains cause diarrhea and abdominal pain. Causative toxins are the cyclic dodecadepsipeptide cereulide, and the proteinaceous enterotoxins hemolysin BL (Hbl), nonhemolytic enterotoxin (Nhe) and cytotoxin K (CytK), respectively. This review covers the current knowledge on distribution and genetic organization of the toxin genes, as well as mechanisms of enterotoxin gene regulation and toxin secretion. In this context, the exceptionally high variability of toxin production between single strains is highlighted. In addition, the mode of action of the pore-forming enterotoxins and their effect on target cells is described in detail. The main focus of this review are the two tripartite enterotoxin complexes Hbl and Nhe, but the latest findings on cereulide and CytK are also presented, as well as methods for toxin detection, and the contribution of further putative virulence factors to the diarrheal disease.


Assuntos
Bacillus cereus/metabolismo , Proteínas de Bactérias/metabolismo , Diarreia/microbiologia , Enterotoxinas/metabolismo , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Proteínas Hemolisinas/metabolismo , Vômito/microbiologia , Animais , Bacillus cereus/genética , Bacillus cereus/patogenicidade , Proteínas de Bactérias/genética , Depsipeptídeos/genética , Depsipeptídeos/metabolismo , Diarreia/diagnóstico , Diarreia/fisiopatologia , Enterotoxinas/genética , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/fisiopatologia , Regulação Bacteriana da Expressão Gênica , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/fisiopatologia , Proteínas Hemolisinas/genética , Interações Hospedeiro-Patógeno , Humanos , Virulência , Vômito/diagnóstico , Vômito/fisiopatologia
8.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462030

RESUMO

This case represents a rare fulminant course of fried-rice associated food poisoning in an immunocompetent person due to pre-formed exotoxin produced by Bacillus cereus, with severe manifestations of sepsis, including multi-organ (hepatic, renal, cardiac, respiratory and neurological) failure, shock, metabolic acidosis, rhabdomyolysis and coagulopathy. Despite maximal supportive measures (continuous renal replacement therapy, plasmapheresis, N-acetylcysteine infusion and blood products, and broad-spectrum antimicrobials) and input from a multidisciplinary team (consisting of infectious diseases, intensive care, gastroenterology, surgery, toxicology, immunology and haematology), mortality resulted. This case is the first to use whole genome sequencing techniques to confirm the toxigenic potential of B. cereus It has important implications for food preparation and storage, particularly given its occurrence in home isolation during the COVID-19 pandemic.


Assuntos
Bacillus cereus/genética , Exotoxinas/genética , Doenças Transmitidas por Alimentos/diagnóstico , Acetilcisteína/uso terapêutico , Acidose/fisiopatologia , Acidose/terapia , Adulto , Antiarrítmicos/uso terapêutico , Antibacterianos/uso terapêutico , Arritmias Cardíacas/fisiopatologia , Arritmias Cardíacas/terapia , Bacillus cereus/isolamento & purificação , Transtornos da Coagulação Sanguínea/fisiopatologia , Transtornos da Coagulação Sanguínea/terapia , Transfusão de Sangue , Encefalopatias , Terapia de Substituição Renal Contínua , Evolução Fatal , Feminino , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Doenças Transmitidas por Alimentos/terapia , Sequestradores de Radicais Livres/uso terapêutico , Humanos , Imunocompetência , Falência Hepática/fisiopatologia , Falência Hepática/terapia , Insuficiência de Múltiplos Órgãos/fisiopatologia , Insuficiência de Múltiplos Órgãos/terapia , Plasmaferese , Insuficiência Renal/fisiopatologia , Insuficiência Renal/terapia , Rabdomiólise/fisiopatologia , Rabdomiólise/terapia , Sepse/fisiopatologia , Sepse/terapia , Choque/fisiopatologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Sequenciamento Completo do Genoma
9.
Ned Tijdschr Geneeskd ; 1642020 05 20.
Artigo em Holandês | MEDLINE | ID: mdl-32613785

RESUMO

BACKGROUND: Scombroid food poisoning is caused by eating fish with a high concentration of histamine. Histamine is converted from histidine in fish of the Scombroidea family if it is not stored at a sufficiently low temperature. The clinical picture resembles an allergic reaction. CASE DESCRIPTION: Twenty-one of our hospital personnel went to the ER, mostly reporting flushing, headache, palpitations and gastro-intestinal symptoms. They had all eaten tuna salad in the staff canteen. The symptoms appeared to be caused by scombroid food poisoning. CONCLUSION: As a result of early recognition of the clinical picture and prompt crisis management we were able to prevent the outbreak spreading further.


Assuntos
Surtos de Doenças/prevenção & controle , Conservação de Alimentos , Doenças Transmitidas por Alimentos , Gastroenteropatias , Histamina/intoxicação , Toxinas Marinhas/intoxicação , Atum , Animais , Serviços Médicos de Emergência , Rubor/diagnóstico , Rubor/etiologia , Conservação de Alimentos/métodos , Conservação de Alimentos/normas , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/etiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Cefaleia/diagnóstico , Cefaleia/etiologia , Humanos , Recursos Humanos em Hospital
10.
PLoS Pathog ; 14(9): e1007279, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30180210

RESUMO

The digestive tract is the first organ affected by the ingestion of foodborne bacteria. While commensal bacteria become resident, opportunistic or virulent bacteria are eliminated from the gut by the local innate immune system. Here we characterize a new mechanism of defense, independent of the immune system, in Drosophila melanogaster. We observed strong contractions of longitudinal visceral muscle fibers for the first 2 hours following bacterial ingestion. We showed that these visceral muscle contractions are induced by immune reactive oxygen species (ROS) that accumulate in the lumen and depend on the ROS-sensing TRPA1 receptor. We then demonstrate that both ROS and TRPA1 are required in a subset of anterior enteroendocrine cells for the release of the DH31 neuropeptide which activates its receptor in the neighboring visceral muscles. The resulting contractions of the visceral muscles favors quick expulsion of the bacteria, limiting their presence in the gut. Our results unveil a precocious mechanism of defense against ingested opportunistic bacteria, whether they are Gram-positive like Bacillus thuringiensis or Gram-negative like Erwinia carotovora carotovora. Finally, we found that the human homolog of DH31, CGRP, has a conserved function in Drosophila.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina/fisiologia , Proteínas de Drosophila/fisiologia , Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/fisiologia , Hormônios de Inseto/fisiologia , Animais , Animais Geneticamente Modificados , Bacillus thuringiensis/patogenicidade , Drosophila melanogaster/genética , Drosophila melanogaster/microbiologia , Drosophila melanogaster/fisiologia , Feminino , Microbiologia de Alimentos , Doenças Transmitidas por Alimentos/microbiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Imunidade Inata , Canais Iônicos , Lactobacillus plantarum/patogenicidade , Contração Muscular/fisiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/fisiopatologia , Infecções Oportunistas/prevenção & controle , Pectobacterium carotovorum/patogenicidade , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais , Canal de Cátion TRPA1/fisiologia
11.
Sheng Wu Gong Cheng Xue Bao ; 34(6): 839-851, 2018 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-29943530

RESUMO

We evaluated the tolerance and pathogenesis of foodborne pathogens with a simulated gastro-intestinal tract model that simulates the chemical, physical and biological effects of human digestion process under laboratory conditions. This could be used to study the tolerance, pathogenesis, gut microbiota interaction and vaccine development of foodborne pathogens, so as to contribute to control and treatment of foodborne pathogens. This review introduces the applications of simulated gastro-intestinal tract model tp evaluate foodborne pathogens, which includes in-vitro static gastro-intestinal model, in-vitro dynamic gastro-intestinal model, conventional animal model and humanized animal model. And the concepts and characteristics of all models are described in detail. Also, the shortcomings of existing models are analyzed, and improvements of artificial gastro-intestinal tract model are prospected. In conclusion, this review could provide comprehensive data for promoting the progress of studying tolerance and pathogenesis of foodborne pathogens.


Assuntos
Doenças Transmitidas por Alimentos/fisiopatologia , Trato Gastrointestinal/microbiologia , Animais , Modelos Animais de Doenças , Microbioma Gastrointestinal , Humanos , Modelos Biológicos
12.
Toxicol Mech Methods ; 28(3): 195-204, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28980857

RESUMO

Experimental induction of hyperoxaluria by ethylene glycol (EG) administration is disapproved as it causes metabolic acidosis while the oral administration of chemically synthesized potassium oxalate (KOx) diet does not mimic our natural system. Since existing models comprise limitations, this study is aimed to develop an improved model for the induction of dietary hyperoxaluria, and nephrocalcinosis in experimental rats by administration of naturally available oxalate rich diet. Male albino Wistar rats were divided into five groups. Group I, control; group II rats received 0.75% EG, group III rats fed with 5% KOx diet and group IV and V rats were administered with spinach extract of 250 and 500 mg soluble oxalate/day respectively, for 28 d. Urine and serum biochemistry were analyzed. After the experimental period, rats were sacrificed, liver and kidney tissue homogenates were used for antioxidant and lipid peroxidation assay. Relative change in expression of kidney injury molecule-1 (KIM-1) and crystal modulators genes in kidney tissues were evaluated. Tissue damage was assessed by histology studies of liver and kidney. Experimental group rats developed hyperoxaluria and crystalluria. Urine parameters, serum biochemistry, antioxidant profile, lipid peroxidation levels and gene expression analysis of experimental group II and III rats reflected acute kidney damage compared to group V rats. Histopathology results showed moderate hyperplasia in liver and severe interstitial inflammation in kidneys of group II and III than group V rats. Ingestion of naturally available oxalate enriched spinach extract successfully induced dietary hyperoxaluria and nephrocalcinosis in rats with minimal kidney damage.


Assuntos
Modelos Animais de Doenças , Doenças Transmitidas por Alimentos/etiologia , Hiperoxalúria/etiologia , Nefrocalcinose/etiologia , Ácido Oxálico/intoxicação , Folhas de Planta/efeitos adversos , Spinacia oleracea/efeitos adversos , Administração Oral , Animais , Biomarcadores/sangue , Biomarcadores/metabolismo , Biomarcadores/urina , Cristalização , Etilenoglicol/toxicidade , Doenças Transmitidas por Alimentos/metabolismo , Doenças Transmitidas por Alimentos/patologia , Doenças Transmitidas por Alimentos/fisiopatologia , Regulação da Expressão Gênica/efeitos dos fármacos , Hiperoxalúria/metabolismo , Hiperoxalúria/patologia , Hiperoxalúria/fisiopatologia , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/patologia , Peroxidação de Lipídeos/efeitos dos fármacos , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Nefrocalcinose/metabolismo , Nefrocalcinose/patologia , Nefrocalcinose/fisiopatologia , Ácido Oxálico/administração & dosagem , Ácido Oxálico/química , Ácido Oxálico/metabolismo , Extratos Vegetais/efeitos adversos , Extratos Vegetais/química , Folhas de Planta/química , Ratos Wistar , Insuficiência Renal/etiologia , Spinacia oleracea/química
13.
Endocr Metab Immune Disord Drug Targets ; 18(2): 155-162, 2018 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-28982343

RESUMO

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide that causes a spectrum of diseases including neonatal hyperbilirubinemia, acute and chronic hemolysis after exposure to oxidative stress. AIM OF THE WORK: This five years retrospective study was carried out to study the demographic, clinical and laboratory data of 1000 patients with G6PD deficiency anemia registered in Hematology Unit, Pediatric Department, Tanta University Hospital. PATIENTS AND METHODS: Data were collected from patient's files, from November 2011 to November 2016, using the pre-designed questionnaires to obtain the complete history, clinical presentation and laboratory investigations including the complete blood count, red blood cells morphology, liver and renal functions and quantitative assay of G6PD enzyme activity by spectrophotometric method. RESULTS: Males were more commonly affected than females (932 males versus 68 females). The highest prevalence of hemolytic crisis in G6PD deficiency patients was found within the age group of 1-3 years (920 patients; 92%) with mean age of the first presentation of 22.8±15.54 months. Patients presented mainly with pallor (1000 patients; 100%), dark red urine (896 patients; 89.6%) and jaundice (878 patients; 87.8%) after 24-72 hours of exposure to the precipitating factors (mean: 36±17.73 hours). Diets were the most common precipitating factor of hemolysis in patients with G6PD deficiency (834 patients; 83.4% of studied cases) especially fava beans (326 patients; 32.6%) and falafel (194 patients; 19.4%) which were the most common precipitating food products causing hemolysis followed by chick pea (108 patients; 10.8%), broad bean (76 patients; 7.6%), green pea (44 patients; 4.4%), pea nuts (38 patients; 3.8%), lentil (28 patients; 2.8%), and lastly black eyed peas (20 patients; 2 %). Infections were the 2nd most common cause of hemolysis (124 patients; 12.4%) including pneumonia (34 patients; 3.4%), tonsillitis (32 patients; 3.2%), typhoid fever (28 patients; 2.8%), hepatitis A (18 patients; 1.8%) and urinary tract infection (12 patients; 1.2%). Drugs were the least common cause of hemolysis (42 patients; 4.2%) including diclofenac sodium (24 patients; 2.4%), ibuprofen (8 patients; 0.8%), acetylsalicylic acid (4 patients; 0.4%), co-trimoxazole (4 patients; 0.4%) and nitrofurantion (2 patients; 0.2%). There was normocytic normochromic anemia with reticulocytosis and Heinz bodies in pre-transfusion complete blood picture in all studied cases. G6PD assay show marked decrease in enzyme level at time of presentation in all cases with the commonest G6PD enzyme level of 3-4 U/gm Hb (592 patients; 59.2%). CONCLUSION AND RECOMMENDATIONS: G6PD deficiency anemia presented mainly with pallor, dark red urine and jaundice after exposure to certain diets, drugs and diseases and therefore patients with G6PD deficiency should avoid exposure to these precipitating factors of hemolysis. We can also recommend large neonatal screening programs to detect cases of G6PD deficiency before the occurrence of acute hemolysis and molecular studies to detect G6PD enzyme variant in Egypt.


Assuntos
Anemia Hemolítica/etiologia , Doenças Transmitidas por Alimentos/etiologia , Deficiência de Glucosefosfato Desidrogenase/fisiopatologia , Insuficiência Hepática/etiologia , Insuficiência Renal/etiologia , Adolescente , Adulto , Fatores Etários , Anemia Hemolítica/epidemiologia , Anemia Hemolítica/fisiopatologia , Criança , Cicer/efeitos adversos , Egito/epidemiologia , Saúde da Família , Feminino , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Deficiência de Glucosefosfato Desidrogenase/sangue , Insuficiência Hepática/fisiopatologia , Hospitais Universitários , Humanos , Rim/fisiopatologia , Fígado/fisiopatologia , Masculino , Prevalência , Insuficiência Renal/fisiopatologia , Estudos Retrospectivos , Sementes/efeitos adversos , Índice de Gravidade de Doença , Fatores Sexuais , Vicia faba/efeitos adversos
14.
JNMA J Nepal Med Assoc ; 56(206): 268-270, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28746328

RESUMO

Paragonimiasis is a zoonosis caused by many species of Paragonimus commonly P. westermani. Human get infected by eating raw, salted, pickled, smoked, partially cooked crustaceans (crayfish or crabs). Clinical manifestations ranges from non-specific symptoms like pain abdomen, diarrhea, urticarial rashes, fever to pleuropulmonary symptoms like cough, hemoptysis, chest pain and dyspnea. A 48 years, female presented at TUTH emergency with fever on and off for nine months, cough and shortness of breath for three months, lethargy, malaise and urticaria with history of raw crab intake one month prior to the onset of symptoms. Blood and pleural fluid analysis revealed raised total counts with eosinophilia and x-ray showed bilateral infiltration of lower lobes with pleural effusion. Diagnosis was confirmed by microscopic examination of sputum for Paragonimus. She responded well to Praziquantel. Pulmonary paragonimiasis must be considered in the differential diagnosis of unresolving pneumonia and unexplained hypereosinophilia.


Assuntos
Eosinofilia , Paragonimíase , Paragonimus westermani/isolamento & purificação , Derrame Pleural , Pneumonia , Praziquantel/administração & dosagem , Frutos do Mar , Animais , Anti-Helmínticos/administração & dosagem , Diagnóstico Diferencial , Eosinofilia/diagnóstico , Eosinofilia/etiologia , Feminino , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/tratamento farmacológico , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos , Pessoa de Meia-Idade , Paragonimíase/diagnóstico , Paragonimíase/etiologia , Paragonimíase/fisiopatologia , Paragonimíase/terapia , Derrame Pleural/sangue , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Derrame Pleural/terapia , Pneumonia/sangue , Pneumonia/diagnóstico , Pneumonia/tratamento farmacológico , Pneumonia/etiologia , Escarro/microbiologia , Avaliação de Sintomas/métodos , Resultado do Tratamento
15.
Clin Toxicol (Phila) ; 55(7): 624-628, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28443386

RESUMO

BACKGROUND: Star fruit (SF) is a commonly available fruit produced and eaten in tropical and subtropical countries. Since 1993, various reports have described neurotoxicity after eating SF, but this clinical condition remains unfamiliar. We aimed to describe this clinical entity, the role of renal dysfunction in this disorder, treatment strategies, and prognosis of patients with SF intoxication. METHODS: We conducted a search of PubMed and Google Scholar databases from 1993 to 2016. We included reports describing patients with a clear history of SF ingestion with acute symptoms. We described the demographic characteristics, reported SF intake, treatments used, and outcomes. RESULTS: We reviewed totally 126 patients (male:female = 1.5:1) from 33 articles with mean age 54.4 ± 11 (range: 30-84). The most common symptom was hiccups (65%), whereas confusion and seizure were the most common symptoms associated with mortality (42% and 61%, respectively). Pre-intoxication renal function also affected mortality. While there was no mortality in patients with normal renal function (NRF), the mortality of patients among reported cases with chronic renal insufficiency and end-stage renal disease undergoing dialysis were 36% and 27%, respectively. With the inclusion of patients reported to have NRF, the overall mortality was 24%. Consistently, the number of SF consumed was substantially higher in the patients with NRF than those with renal functional impairment. The most common treatment strategy was hemodialysis (59%). CONCLUSIONS: Patients with impaired renal function were at higher risks of SF intoxication. Severe neurologic symptoms mandate immediate medical intervention because of the association between their occurrence and high mortalities. Toxin removal through dialysis, rather than symptomatic relief, seems to be beneficial to patient survival. Early and continuous dialysis appears to alleviate severe symptoms and prevent symptom rebounds.


Assuntos
Averrhoa/intoxicação , Doenças Transmitidas por Alimentos/etiologia , Frutas/intoxicação , Falência Renal Crônica/complicações , Rim/fisiopatologia , Síndromes Neurotóxicas/etiologia , Insuficiência Renal Crônica/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Doenças Transmitidas por Alimentos/mortalidade , Doenças Transmitidas por Alimentos/fisiopatologia , Doenças Transmitidas por Alimentos/terapia , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/fisiopatologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Síndromes Neurotóxicas/mortalidade , Síndromes Neurotóxicas/fisiopatologia , Síndromes Neurotóxicas/terapia , Diálise Renal , Insuficiência Renal Crônica/mortalidade , Insuficiência Renal Crônica/fisiopatologia , Insuficiência Renal Crônica/terapia , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
16.
Aliment Pharmacol Ther ; 46(2): 126-141, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28449246

RESUMO

BACKGROUND: Hepatitis E virus (HEV) is a leading cause of acute icteric hepatitis and acute liver failure in the developing world. During the last decade, there has been increasing recognition of autochthonous (locally acquired) HEV infection in developed countries. Chronic HEV infection is now recognised, and in transplant recipients this may lead to cirrhosis and organ failure. AIM: To detail current understanding of the molecular biology of HEV, diagnostic and therapeutic strategies and propose future directions for basic science and clinical research. METHODS: PubMed was searched for English language articles using the key words "hepatitis E", "viral hepatitis", "autochthonous infection", "antiviral therapy", "liver transplantation", "acute", "chronic", "HEV", "genotype", "transmission" "food-borne", "transfusion". Additional relevant publications were identified from article reference lists. RESULTS: There has been increasing recognition of autochthonous HEV infection in Western countries, mainly associated with genotype 3. Chronic HEV infection has been recognised since 2008, and in transplant recipients this may lead to cirrhosis and organ failure. Modes of transmission include food-borne transmission, transfusion of blood products and solid organ transplantation. Ribavirin therapy is used to treat patients with chronic HEV infection, but new therapies are required as there have been reports of treatment failure with ribavirin. CONCLUSIONS: Autochthonous HEV infection is a clinical issue with increasing burden. Future work should focus on increasing awareness of HEV infection in the developed world, emphasising the need for clinicians to have a low threshold for HEV testing, particularly in immunosuppressed patients. Patients at potential risk of chronic HEV infection must also be educated and given advice regarding prevention of infection.


Assuntos
Hepatite E/epidemiologia , Hepatite E/fisiopatologia , Doença Aguda , Transfusão de Sangue , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Genótipo , Hepatite E/tratamento farmacológico , Hepatite E/virologia , Vírus da Hepatite E/genética , Humanos , Hospedeiro Imunocomprometido , Ribavirina/uso terapêutico , Falha de Tratamento
17.
Curr Opin Infect Dis ; 29(5): 495-501, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27454403

RESUMO

PURPOSE OF REVIEW: The aim of the study was to provide an update on foodborne viral infections describing illness burden, the main aetiological agents (enteric viruses, hepatitis viruses and emerging and zoonotic viruses) and advances in virus detection in foods. RECENT FINDINGS: Norovirus (NoV) is the most common viral foodborne pathogen globally (125 million cases and 35 000 deaths). The role of the asymptomatic food handlers in contributing to NoV outbreaks is becoming increasingly clear, with up to one-quarter of outbreaks attributable to them. Handwashing with soap and water remains the best method for removing NoV from fingers. Risk assessment for transmission of emerging viruses through the food chain should include consideration of all means by which food could post a hazard, that is not just consumption. New technologies have demonstrated the widespread nature of viral contamination in the food chain, but this does not necessarily correlate with the risk of disease. Finally, understanding people's knowledge and behaviour is just as important as understanding virus characteristics and epidemiology when assessing risks of foodborne transmission. SUMMARY: The predominant viruses transmitted through food tend to be those for which humans are the natural hosts, so that effective control measures need to prevent exposure of foods to human faeces.


Assuntos
Doenças Transmitidas por Alimentos , Viroses , Infecções por Caliciviridae , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Doenças Transmitidas por Alimentos/virologia , Gastroenterite , Humanos , Norovirus , Medição de Risco
18.
Ann N Y Acad Sci ; 1378(1): 50-57, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27450775

RESUMO

Threats by fundamentalist leaders to use chemical weapons have resulted in renewed interest in cyanide toxicity. Relevant insights may be gained from studies on cyanide mass intoxication in populations relying on cyanogenic cassava as the main source of food. In these populations, sublethal concentrations (up to 80 µmol/l) of cyanide in the blood are commonplace and lead to signs of acute toxicity. Long-term toxicity signs include a distinct and irreversible spastic paralysis, known as konzo, and cognition deficits, mainly in sequential processing (visual-spatial analysis) domains. Toxic culprits include cyanide (mitochondrial toxicant), thiocyanate (AMPA-receptor chaotropic cyanide metabolite), cyanate (protein-carbamoylating cyanide metabolite), and 2-iminothiazolidine-4-carboxylic acid (seizure inducer). Factors of susceptibility include younger age, female gender, protein-deficient diet, and, possibly, the gut functional metagenome. The existence of uniquely exposed and neurologically affected populations offers invaluable research opportunities to develop a comprehensive understanding of cyanide toxicity and test or validate point-of-care diagnostic tools and treatment options to be included in preparedness kits in response to cyanide-related threats.


Assuntos
Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Cianetos/intoxicação , Doenças Transmitidas por Alimentos/diagnóstico , Manihot/intoxicação , Encéfalo/fisiopatologia , Cianetos/sangue , Doenças Transmitidas por Alimentos/sangue , Doenças Transmitidas por Alimentos/fisiopatologia , Humanos
20.
Toxicon ; 118: 61-3, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27103071

RESUMO

Chelonitoxism is a type of seafood poisoning which usually occurs due to consumption of certain marine turtle flesh. As the pharmacology or chemistry of the toxin is still unknown, antidote or treatment to chelonitoxism is unavailable. The symptoms can vary from common gastro-intestinal symptoms to neurological manifestations and even death. This case report of community poisoning following consumption of turtle meat includes the death of an adult male (56 yrs.) being reported for the first time in the Great Nicobar Island, Andaman and Nicobar (A&N) Islands, India in August 2012. The patient encountered common gastrointestinal symptoms after one day of ingestion of green turtle flesh and later, he developed neurological symptoms and did not respond to symptomatic treatment and expired after four days after the consumption. However, out of 30 villagers who took the same food, six others developed symptoms and recovered within a period of 3-7 days while two pets (a dog and a cat) died within 24 hours as they were fed with the same food. In spite of several existing wildlife protection acts, catching a turtle and making them a source of food-celebration is quite common in coastal areas of the Indian Ocean and the Bay of Bengal which includes A&N Islands. A proper monitoring and follow-up of the food-borne diseases along with a wide range of explorative health education protocol should be implemented especially for the people who are not reachable via media to avoid such incidents in future.


Assuntos
Surtos de Doenças , Contaminação de Alimentos , Doenças Transmitidas por Alimentos/etiologia , Toxinas Marinhas/toxicidade , Carne/efeitos adversos , Tartarugas , Dor Abdominal/etiologia , Adolescente , Adulto , Animais , Síndrome da Ardência Bucal/etiologia , Gatos , Surtos de Doenças/veterinária , Cães , Evolução Fatal , Feminino , Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/fisiopatologia , Doenças Transmitidas por Alimentos/veterinária , Humanos , Índia/epidemiologia , Ilhas do Oceano Índico/epidemiologia , Masculino , Pessoa de Meia-Idade , Animais de Estimação , Resultado do Tratamento , Vômito/etiologia , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA