Foodborne botulism: A brief review of cases transmitted by cheese products (Review).

Food safety constitutes a basic priority for public health. Foodborne botulism occurs worldwide; it is an acute paralytic disease caused by the consumption of food containing the botulinum toxin. Growing consumer demand for cheese products could result in increased exposure of the population to this toxin, and thus the risk of foodborne botulism. The majority of cases of botulism caused by dairy products are related to cheese products specifically. Epidemic outbreaks and isolated cases have been reported over time. Domestically canned foods are still among the primary causes of the disease. Cheese products are not regularly involved in botulism incidents; it is however, necessary to take control measures for manufacturing and domestic preparation due to the high risk of occurrence of this particular disease. The aim of this review is to discuss foodborne botulism caused by cheese products, providing a brief epidemiological history, and to examine certain control measures that should be taken throughout the production process to better protect public health.

Environmental Health Education: From Museum Specimens and Math Word Problems to Virtual and Augmented Reality.

Environmental degradation and its severe impact on human health has revealed the necessity for effective educational interventions. Given the importance of "Environment," "Health," and "Education," as key pillars for the achievement of sustainable development, the education for environmental health is evolving into a main component of current strategies against environmental health threats, such as climate change and urban air pollution. Environmental Health Education, which must be considered as a strategical response against environmental degradation, offers vast capacity for innovation alongside every educational stage. For instance, the application of new technologies, such as virtual and augmented reality applications, the adoption of innovative interdisciplinary educational approaches, and the incorporation of Arts are evolving into a new era's educational perspectives. All the new trends in formal, non-formal and informal Environmental Health Education should be captured and assessed, in favor of protecting both local and global natural environment, human and animal health, and promoting sustainability.

Investigation of the health effects on workers exposed to respirable crystalline silica during outdoor and underground construction projects.

Chronic exposure of workers to powder containing crystalline silica (Silicon dioxide; SiO2) can lead to chronic lung diseases (lung cancer, silicosis, etc.). Aim of this study was to evaluate the exposure of Greek construction workers to SiO2 and describe their pulmonary function. The study involved 86 outdoor and underground workers. Medical and professional history was obtained, and breath samples were collected at morning hours through a mask for the determination of SiO2 levels. Pulmonary function tests, radiological examination and evaluation of radiographs were also performed. Pulmonary function examination showed that the majority of the workers were within normal range (61.4%) while the rest were diagnosed with mild (26.5%) and more severe impairment (7.24%). Working conditions (underground-outdoor) were statistically significantly related to the categorization of pulmonary function (P=0.038). During radiological examination, the type of working activity/ conditions (underground-outdoor) were statistically significantly related to the categorization of these findings (P=0.044). Of the 69 employees, 52 did not present findings (75.4%) and 5 were diagnosed with findings specific to occupational diseases (7.23%). Environmental exposure to respirable crystalline silica (RCS) was detected at 0.0125 mg/m3 in the workplace, which is not beyond the legal limits. Underground workers with more than 15 years of exposure to SiO2 are more likely to present chronic silicosis compared to the workers of outdoor activities.

The efficacy of imiquimod on dysplastic lesions of the oral mucosa: an experimental model.

AIM: To study the potent efficacy of the immunomodulatory agent imiquimod when applied on dysplastic lesions of the oral mucosa. MATERIALS AND METHODS: Carcinogen (DMBA) was applied to the mucosa of the left buccal pouch of 26 male Wistar rats for 8 weeks, until dysplastic lesions were observed and histologically diagnosed. At the second phase of the experiment, 5% imiquimod cream was applied to these dysplastic lesions for 16 weeks. Biopsies were taken before and after treatment. RESULTS: The histological effect of imiquimod was the regression of mild dysplasia to hyperplasia for all the samples. In one case, a well-differentiated squamous cell carcinoma was converted to a papilloma-like squamous neoplasm with a benign morphology. CONCLUSION: Our results indicate that imiquimod may be effective in treatment of precancerous lesions of the oral mucosa and thus inhibit the progress of carcinogenesis.

Distant solitary skeletal muscle metastasis from papillary thyroid carcinoma.

An unusual case of isolated trapezoid muscle metastasis from a papillary carcinoma of the thyroid gland is described. Although extrathyroidal extension to the soft tissues of the neck may occur, distant metastases are rare in papillary thyroid carcinoma. Skeletal muscle metastasis from a differentiated thyroid carcinoma seems to be extremely rare, even for the follicular type of this cancer, well known for its hematogenous spread to various sites.

Relation between common polymorphisms in genes related to inflammatory response and colorectal cancer.

AIM: To investigate the association between common single nucleotide polymorphisms (SNPs) in inflammatory response-related genes such as interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNFalpha), peroxisome proliferators-activated receptor gamma (PPARgamma), intercellular adhesion molecule-1 (ICAM-1) and the risk of colorectal cancer (CRC) in a group of Greek patients. METHODS: The study group consisted of 222 CRC patients and 200 healthy controls. Genotyping was performed using allele-specific PCR of PRC-RFLP and the results were confirmed by sequencing. We studied the association of SNPs in the IL-6 (-174G>C), IL-8 (-251T>A), TNFalpha (-308G>A), ICAM-1 (R241G and K469E), and PPARgamma (Pro12Ala) genes and the risk of CRC. RESULTS: The IL-6 -174G, R241 and K469 alleles of ICAM-1 were associated with increased risk of CRC (OR = 1.77, 95% CI: 1.34-2.34; OR = 1.83, 95% CI: 1.23-2.72; and OR = 1.35, 95% CI: 1.03-1.77 respectively). The IL-8 and TNFalpha polymorphisms had no effect. Whereas the PPARgamma Pro12 genotype was associated with increased risk of disease (OR = 1.78, 95% CI: 1.25-2.49). CONCLUSION: The association between common SNPs in immunologic response-related genes and CRC is reported in the present study. Apart from shedding light on the mechanisms of malignancy initiation and progression, SNPs may improve appropriate screening for sub-populations at risk.

Assessment of JC polyoma virus in colon neoplasms.

PURPOSE: Research data have recently emphasized an intriguing association of JC polyoma virus with colon carcinogenesis. Tumorigenicity of JC virus is attributed to the T-antigen of its Mad-1 variant. Controversy arose when another research group did not confirm this association. The purpose of this study was to detect JC virus in a series of colon neoplasms from Greek patients. METHODS: A nested polymerase chain reaction assay was used to detect JC virus in 80 cancerous, 25 adenomatous specimens of large bowel, and 20 colonoscopic biopsy samples from normal patients without colorectal neoplasia. Quantitation of JC virus DNA was performed by real-time polymerase chain reaction. RESULTS: JC polyoma virus nucleotide sequence was detected in 61 percent of colon adenocarcinomas and in 60 percent of adenomas, at a viral load of 9 x 10(3) to 20 x 10(3) copies/microg DNA. Adjacent normal mucosa in 35 positive colon adenocarcinoma specimens, and normal mucosa from six patients of the control group, had low viral loads (50-450 copies/microg DNA). CONCLUSIONS: JC polyoma virus genome is present in colon neoplasms. JC virus detection in adenomas at comparable viral loads to malignant tumors suggests its implication at early steps of colonic carcinogenesis. Taking into consideration other published data, infection of colonic epithelium with JC virus might be a prime candidate for a role in chromosomal and genomic instability.

Isolated colonic leukocytoclastic vasculitis causing segmental megacolon: report of a rare case.

We report the case of a 44-year-old white man who presented with progressively worsening crampy abdominal pain and distention. Deterioration of his clinical picture along with leukocytosis and radiographic evidence of severe colonic dilation rendered exploratory laparotomy necessary. Greatly distended and inflamed transverse and descending colon were evident and an extended left colectomy was performed. Characteristic changes of leukocytoclastic vasculitis in the serosal and muscular layers of the resected colon were demonstrated at histopathologic examination. Systemic leukocytoclastic vasculitis, usually coexisting with Henoch-Schonlein purpura, commonly affects the small bowel with clinical evidence of ischemia or bleeding. Colon involvement is infrequently reported in the context of systemic disease. Isolated colonic leukocytoclastic vasculitis without extraintestinal manifestations is rare. A previously unreported case of localized leukocytoclastic vasculitis of the left colon resulting in the impressive presentation of megacolon, without the presence of any precipitating factor or associated systemic disease is presented here, with an overview of the related literature.

Hypoxia-inducible factor 1 alpha expression correlates with angiogenesis and unfavorable prognosis in bladder cancer.

INTRODUCTION AND OBJECTIVES: Hypoxia-inducible factor 1 alpha (HIF-1 alpha) is a critical regulatory protein of cellular response to hypoxia and is closely related to the triggering of the angiogenic process. We examined the relationship between hypoxia and angiogenesis, as well as their prognostic impact in patients with urothelial bladder cancer. METHODS: The immunohistochemical expression of HIF-1 alpha was evaluated in 93 formalin-fixed paraffin-embedded primary transitional cell carcinoma tissue samples. HIF-1 alpha was recognized through nuclear staining of positive cells. The angiogenic profile was individually assessed immunohistochemically using a monoclonal antibody to vascular endothelial growth factor (VEGF) and microvessel density (MVD) was calculated with immunohistochemical staining of the adhesion molecule CD31 of the endothelial cells. RESULTS: A significant positive association between HIF-1 alpha immunoreactivity and histological grade (p=0.009) was found. VEGF and MVD were closely related to tumor grade (p=0.06 and p<0.001) and clinical stage (p=0.04 and p<0.01, respectively). HIF-1 alpha was significantly correlated with VEGF expression (p=0.01) and MVD (p<0.001). Patients characterized by HIF-1 alpha overexpression had significantly worse overall (p=0.009) and disease-free survival (p=0.03). When HIF-1 alpha, histologic grade and stage were included in multivariate Cox regression analysis, HIF-1 alpha emerged as an independent prognostic factor (p=0.02) along with grade and stage, but lost its independent prognostic value after the inclusion of angiogenic factors in the multivariate model. In the subgroup of patients with T1 disease, HIF-1 alpha emerged as a significant negative predictor of the time to first recurrence. CONCLUSIONS: HIF-1 alpha and angiogenesis markers may play an important predictive and prognostic role in patients with bladder cancer. HIF-1 alpha may be of biologic and clinical value as its overexpression is related to up-regulation of VEGF, the stimulation of angiogenesis and worse prognosis.

Detection of genetic abnormalities in neoplasms from Greek patients with FAP.

AIMS: DNA microsatellite instability is a well-known feature of hereditary non-polyposis colon cancer; however, its incidence in familial adenomatous polyposis, is unclear. We report the frequency of microsatellite instability and other genetic abnormalities in a group of Greek patients with FAP, in relation to various clinicopathological variables. METHODS: Thirty-four tissue specimens from 10 patients with FAP were studied. Microsatellite instability was investigated at six loci: BAT25, BAT26, D2S123, D5S346, D17S250 and TGF-beta RII poly(A) tract. p53 and K-ras mutations were also examined. RESULTS: Microsatellite instability was detected in two FAP adenocarcinomas from different patients. Mutation percentages observed were: in K-ras 45% and 50% and in p53 14% and 58%, of FAP adenomas and adenocarcinomas, respectively. No K-ras or p53 mutations were determined in the two microsatellite instable adenocarcinomas. CONCLUSION: Microsatellite instability is detectable in a small proportion of adenocarcinomas complicating FAP. This minority of cases may constitute a distinct subgroup among FAP neoplasms.

Differential expression of bcl-2 family proteins in bladder carcinomas. Relationship with apoptotic rate and survival.

OBJECTIVE: To elucidate the role of various bcl-2 family molecules in the regulation of apoptosis and the progression of urothelial cancer, in relation to standard prognosticators. METHODS: Paraffin-embedded archival tissue from 103 N0M0 consecutive patients with invasive bladder cancer (28 T1, 57 T2, 13 T3 and 5 T4) was immunostained for bcl-2, bax, bcl-XL, bcl-Xs, p53, Ki-67 and with an anti-single stranded DNA monoclonal antibody recognizing the apoptotic cells. Survival analysis was restricted to T2-T4 tumours. Patients were followed-up until death (n = 27) or for a mean (+/- S.D.) follow-up of 37.6 (+/- 17.4) months. Within this period, 39 patients relapsed after a mean (+/- S.D.) period of 13.6 (+/- 12.3) months. RESULTS: Most tumours were immunoreactive for bax (73.1%) and bcl-XL (80.9%) whereas bcl-2 and bcl-XS expression was comparatively less common (44.4 and 28.9%, respectively). The bcl-XL and bcl-XS positivity was related to high grade (P = 0.007) and advanced stage (P = 0.010), respectively. On the contrary, bax and bcl-2 positivity was unrelated to stage or grade. Apoptotic rate was independently influenced only by p53, bcl-2 and proliferation rate. In multivariate analysis of T2-T4 urothelial carcinomas (UC)s, only bax along with T-category and age were the significant predictors of disease-free survival. Increased apoptosis and T-category were also independently related to the overall survival in T2-T4 UCs. CONCLUSIONS: The expression of bcl-2 family members appears to be differentially regulated in association with UC evolution. Most importantly, bax immunostaining offers additional information to that provided by traditional prognosticators, with regard to disease-free survival of T2-T4 UCs.

Evaluation of E-cadherin/catenin complex in primary and secondary glomerulonephritis.

Catenins (alpha-, beta-, gamma-catenin, p120(ctn)) are cytoplasmic proteins initially identified in a complex with E-cadherin (ECD). The latter belongs to a superfamily of transmembrane glycoproteins important for cell adhesion in normal and disease states. Catenins and p120(ctn), in particular, are substrates for growth factor receptor tyrosine kinases. Cell adhesive mechanisms have an impact on cell migration and proliferation and thus are potentially involved in the pathogenesis of glomerulonephritides (GNs). Using appropriate monoclonal antibodies, we investigated the immunohistochemical expression of ECD, alpha-catenin, beta-catenin, gamma-catenin, and p120(ctn) in renal biopsy specimens from 95 patients with primary GN (n = 51) and secondary lupus-associated GN (n = 44). Examined cases were divided into two groups (proliferative [n = 35] and nonproliferative [n = 60] GNs). Among examined molecules, p120(ctn), beta-catenin, and gamma-catenin were expressed more frequently in glomerular epithelial cells, mainly in parietal epithelium (76%, 48%, and 40%, respectively). p120(ctn) and gamma-catenin epithelial expression appeared to be linked closely with proliferative lupus-associated GNs (P = 0.050 and P = 0.029, respectively). Mainly in lupus GNs, with regard to cellular crescents and epithelial cells around microadhesions to Bowman's capsule, p120(ctn) (63% and 73%, respectively), beta-catenin (72% and 75%), and gamma-catenin (75% and 64%) showed the greatest frequencies of positive detection. Mesangial cells were positive only occasionally for the examined molecules. In proliferative lupus GNs, expression of beta-catenin in mesangial cells tended to be prominent (P = 0.066). ECD and alpha-catenin were not expressed in cellular crescents or microadhesions, whereas only ECD was barely detectable in glomerular epithelial cells. In conclusion, expression of beta-catenin, gamma-catenin, and p120(ctn) is focused on glomerular epithelium, as well as on such lesions deriving from it as cellular crescents. This expression probably is linked with epithelial cells' responses to various mitogens, such as growth factors.

A comparative study of the int-2 gene product in primary and secondary parathyroid lesions.

OBJECTIVE: The family of fibroblast growth factors stimulates proliferation of cells of mesenchymal, epithelial and neuroectodermal origin. One of the members of this family, the product of proto-oncogene int-2, fibroblast growth factor-3, has been found to stimulate mitosis of parathyroid cells in culture. Primary and secondary hyperparathyroidism have no clear differences with regard to the histopathological features of the diseased parathyroid glands. DESIGN: This study was undertaken in order to determine whether int-2 protein is immunohistochemically expressed in normal and abnormal parathyroid glands and to investigate whether there is a differential expression of the int-2 gene product between primary and secondary parathyroid disease. METHODS: A sheep anti-human int-2 antibody was applied to tissue sections from 37 samples of primary parathyroid disease (12 sporadic adenomas, 25 hyperplastic glands), from 30 samples of renal hyperparathyroidism, and from seven normal controls. Int-2 immunostaining was evaluated semi-quantitatively. RESULTS: None of the normal parathyroid glands stained positively. Int-2 immunopositive expression was more frequently detected in specimens of uraemic patients than in those of patients with primary parathyroid growth processes (P=0.029). The reason for this differential expression appears to be the higher proportion of oxyphilic cells growing in hyperplastic glands of patients with secondary hyperparathyroidism; the latter cells were specifically found to be int-2 immunoreactive. CONCLUSION: The int-2 gene product is likely to participate in the proliferation of this parathyroid cell subpopulation.