Sequence typing confirms that a predominant Listeria monocytogenes clone caused human listeriosis cases and outbreaks in Canada from 1988 to 2010.

Human listeriosis outbreaks in Canada have been predominantly caused by serotype 1/2a isolates with highly similar pulsed-field gel electrophoresis (PFGE) patterns. Multilocus sequence typing (MLST) and multi-virulence-locus sequence typing (MVLST) each identified a diverse population of Listeria monocytogenes isolates, and within that, both methods had congruent subtypes that substantiated a predominant clone (clonal complex 8; virulence type 59; proposed epidemic clone 5 [ECV]) that has been causing human illness across Canada for more than 2 decades.

comK prophage junction fragments as markers for Listeria monocytogenes genotypes unique to individual meat and poultry processing plants and a model for rapid niche-specific adaptation, biofilm formation, and persistence.

Different strains of Listeria monocytogenes are well known to persist in individual food processing plants and to contaminate foods for many years; however, the specific genotypic and phenotypic mechanisms responsible for persistence of these unique strains remain largely unknown. Based on sequences in comK prophage junction fragments, different strains of epidemic clones (ECs), which included ECII, ECIII, and ECV, were identified and shown to be specific to individual meat and poultry processing plants. The comK prophage-containing strains showed significantly higher cell densities after incubation at 30°C for 48 h on meat and poultry food-conditioning films than did strains lacking the comK prophage (P < 0.05). Overall, the type of strain, the type of conditioning film, and the interaction between the two were all highly significant (P < 0.001). Recombination analysis indicated that the comK prophage junction fragments in these strains had evolved due to extensive recombination. Based on the results of the present study, we propose a novel model in which the concept of defective comK prophage was replaced with the rapid adaptation island (RAI). Genes within the RAI were recharacterized as "adaptons," as these genes may allow L. monocytogenes to rapidly adapt to different food processing facilities and foods. If confirmed, the model presented would help explain Listeria's rapid niche adaptation, biofilm formation, persistence, and subsequent transmission to foods. Also, comK prophage junction fragment sequences may permit accurate tracking of persistent strains back to and within individual food processing operations and thus allow the design of more effective intervention strategies to reduce contamination and enhance food safety.

Stress urinary incontinence in younger women in primary care: prevalence and opportunistic intervention.

BACKGROUND: Stress urinary incontinence (SUI) is prevalent in females, even among young adults. Though their quality of life (QOL) is impaired and pelvic floor exercise is an effective treatment, not many affected women seek medical help. This study aimed to evaluate the feasibility of case finding and opportunistic intervention of SUI at a public Well Women Clinic in Macau, China. METHOD: A convenience sample of 408 consecutive female patients aged 30-50 years filled in the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form. They were also asked reasons for not seeking for medical help. The patients with incontinence were educated on pelvic floor muscle exercise during the gynecological examination. RESULTS: SUI was reported by 153 (37.5%) women, of whom 47 (30.7%) had impaired quality of life despite mild symptoms. Of the SUI patients, 52.9% thought that incontinence was inevitable with age, 22.2% believed that they should cope with the problem themselves, 13.7% thought that no useful treatment was available, and 3.9% had sought medical advice before. After learning pelvic floor muscle exercise for 4 to 6 months, 9.8% of SUI patients had complete relief of the symptoms, 47% partial improvement, and 17.6% no significant change. CONCLUSIONS: SUI with impaired quality of life was common before menopause. Very few affected women sought medical help. Opportunistic case finding and education about pelvic floor exercise in a Well Women Clinic were effective in the detection and treatment of the silent SUI.

Chinese men's knowledge and risk factors of osteoporosis: compared with women's.

Male osteoporosis is underappreciated. Little is known about men's knowledge of osteoporosis and how much men are at risk. This study surveyed men's knowledge of osteoporosis and their risk factors with reference to women in the primary care setting in Macau, China. A convenience sample of 302 men and 635 women aged 18 to 90 years completed questionnaires comprising the Osteoporosis Knowledge Assessment Tool and the One-Minute Osteoporosis Risk Test. Their risks of osteoporosis were assessed with the Osteoporosis Self-Assessment Screening Test. Men and women, who were aged 55 years or below, had similarly limited knowledge of osteoporosis. People aged above 55 years had significantly less knowledge; men had less knowledge than women only in this age-group. If questions specific to women or menopause were excluded, men had similar knowledge as women. A higher proportion of men than women had risk factors as more men consumed alcohol or smoked tobacco. Similar proportions of men and women reported a loss of 1 inch in body height after age 40. After age 55, 29.2% men were at medium to high risk of osteoporosis. This study concludes that health education and primary prevention of osteoporosis should be promoted to men starting in middle-age.