Investigations of disease outbreaks linked to shellfish consumption have been reported in the scientific literature; however, only few countries systematically collate and report such data through a ...disease surveillance system. We conducted a systematic review to investigate shellfish-borne viral outbreaks and to explore their distribution in different countries, and to determine if different types of shellfish and viruses are implicated. Six databases (Medline, Embase, Scopus, PubMed, Eurosurveillance Journal and Spingerlink electronic Journal) and a global electronic reporting system (ProMED) were searched from 1980 to July 2012. About 359 shellfish-borne viral outbreaks, alongside with nine ProMED reports, involving shellfish consumption, were identified. The majority of the reported outbreaks were located in East Asia, followed by Europe, America, Oceania, Australia and Africa. More than half of the outbreaks (63.6 %) were reported from Japan. The most common viral pathogens involved were norovirus (83.7 %) and hepatitis A virus (12.8 %). The most frequent type of consumed shellfish which was involved in outbreaks was oysters (58.4 %). Outbreaks following shellfish consumption were often attributed to water contamination by sewage and/or undercooking. Differences in reporting of outbreaks were seen between the scientific literature and ProMED. Consumption of contaminated shellfish represents a risk to public health in both developed and developing countries, but impact will be disproportionate and likely to compound existing health disparities.
Background Prehypertension is associated with increased risk for mortality, a fact that generated a debate regarding the use of antihypertensive therapy in prehypertensives. Increased exercise ...capacity is associated with lower mortality risk, but little is known about its effects in prehypertensives. Thus, we evaluated the association between exercise capacity and all-cause mortality in prehypertensives. Methods A graded exercise test was performed in 4,478 prehypertensive men at the Veterans Affairs Medical Centers in Washington, DC and Palo Alto, CA. Four fitness categories (quartiles) were defined based on peak metabolic equivalents (METs) achieved. All-cause mortality was assessed for both younger (≤60 years) and older individuals. The mean follow-up period was 9.0 ± 6.0 years. Results Exercise capacity was a strong predictor of all-cause mortality, independent of traditional risk factors. The adjusted risk for all-cause mortality was reduced by 15% for every 1-MET increase in exercise capacity in the entire cohort, 18% for younger and 12% for older individuals. Compared to the Very-Low-Fit individuals (≤6 METs) the adjusted mortality risk was 40% lower in Low-Fit (6.1–8.0 METs); 58% lower in Moderate-Fit (8.1–10 METs), and 73% lower in High-Fit individuals (>10 METs). The trends were similar but more pronounced among younger than older individuals. Conclusions A strong, inverse and graded association between exercise capacity and all-cause mortality was observed in prehypertensive individuals. The protective effects of increased fitness were more pronounced in younger than older individuals, suggesting that age should be more closely considered when assessing fitness and mortality relationships.
Aims
To investigate the renal effects of fitness in people with diabetes with mild renal dysfunction.
Methods
The effect of a 12‐week exercise programme on estimated GFR in 128 people with diabetes ...was evaluated.
Results
All cardiometabolic variables improved after 12 weeks of supervised exercise. Although there was a modest 3.9% increase in estimated GFR from baseline in the 128 people who completed the study, those with baseline chronic kidney disease stages 2 and 3 were found to have significant (6 and 12%, respectively; p < 0.01) improvements in post‐exercise estimated GFR. Moreover, 42% of the people with chronic kidney disease stage 3 improved to chronic kidney disease stage 2 after the intervention.
Conclusion
Short‐term exercise improves renal function in those with more moderate baseline chronic kidney disease. Thus, renal function appears to be responsive to enhanced physical fitness. Being a strong and modifiable risk factor, enhanced fitness should be considered a non‐pharmacological adjunct in the management of diabetic kidney disease.
Core optical networks using reconfigurable optical switches and tunable lasers appear to be on the road towards widespread deployment and could evolve to all-optical mesh networks in the coming ...future. Considering the impact of physical layer impairments in the planning and operation of all-optical (and translucent) networks is the main focus of the Dynamic Impairment Constraint Optical Networking (DICONET) project. The impairment aware network planning and operation tool (NPOT) is the main outcome of DICONET project, which is explained in detail in this paper. The key building blocks of the NPOT, consisting of network description repositories, the physical layer performance evaluator, the impairment aware routing and wavelength assignment engines, the component placement modules, failure handling, and the integration of NPOT in the control plane are the main contributions of this study. Besides, the experimental result of DICONET proposal for centralized and distributed control plane integration schemes and the performance of the failure handling in terms of restoration time is presented in this study.
The objective of the study was to investigate the impact on the quality of life of people living close to a municipal wastewater treatment plant. A case control study, including 235 inhabitants ...living within a 500 m radius by a municipal wastewater treatment plant (cases) and 97 inhabitants living in a different area (controls), was conducted. A standardized questionnaire was self-completed by the participants which examined the general health perception and the overall life satisfaction. Also, the concentration of airborne pathogenic microorganisms in aerosol samples collected around the wastewater treatment plant was investigated. Significant risk for symptoms such as headache, unusual tiredness, and concentration difficulties was recorded and an increased possibility for respiratory and skin diseases was reported. A high rate of the cases being irritable and moody was noticed. Significantly higher gastrointestinal symptoms were also reported among the cases in relation to the controls. The prevalence of pathogenic airborne microorganisms originating from the wastewater treatment plant was reported in high numbers in sampling points close to the wastewater treatment plant. More analytical epidemiological investigations are needed to determine the cause as well as the burden of the diseases to inhabitants living surrounding the wastewater treatment plant.
In March 2012, there was an unusual increase of gastroenteritis cases in a district with 37 264 inhabitants in central Greece. It was estimated that more than 3600 people developed symptoms. A 1:1 ...case-control study showed that consumption of tap water was a risk factor for acquiring infection odds ratio (OR) 2·18, 95% confidence interval (CI) 1·11–4·28. Descriptive data, low gastroenteritis incidence in adjacent areas with different water supply systems, and water-quality data further supported the hypothesis of a waterborne outbreak. Thirty-eight stool samples were positive for rotavirus. Bacterial indicators of recent faecal contamination were detected in samples from the water source and ice cubes from a local production enterprise. Molecular epidemiology of rotavirus strains, apart from the common strain, G3P8, identified the unusual G/P combination G2P8. Water sanitation measures contributed to the control of the outbreak. This outbreak demonstrated the need for the cooperation of laboratories with different expertise and the importance of early notification of waterborne gastroenteritis outbreaks.
The purpose of this study is to assess the overall impact of different anthropogenic activities in the Vouraikos River basin (southwestern Greece, Natura 2000 area). Virological quality of river ...water samples was investigated. Positive samples for human adenoviruses were found occasionally, while porcine adenoviruses and bovine polyoma viruses were not detected. It is the first time that virological data are collected in the study area.
Fruit juices are an important part of the modern diet in many countries. However, few data are available concerning the microbiological quality of the fruit juices sold in Greece. Using standard ...microbiological procedures, we conducted a bacteriological survey of commercially sold, pasteurized, shelf-stable fruit juices from retail markets. A total of 120 samples of fruit juices sold in various retail markets were examined for their bacteriological quality. The pH of the tested juices was 2.4–4.8. Bacteria were isolated from 51 samples (42.5%) and fungi from 78 samples (65%).
Escherichia coli O157:H7 was detected in four of the analyzed samples (3.34%), and
Staphylococcus aureus was detected in four different samples (3.34%). In 11 samples (9.1%), the total number of microorganisms detected was as high as 125 colony-forming units (CFU). Acidophilic microorganisms were isolated from 26 samples (21.7%) and
Blastomyces was detected in 46 samples (38.3%). All samples were negative for
Lactobacillus,
Clostridium perfrigens,
Salmonella spp.,
Bacillus cereus, total coliforms,
E. coli, and
Listeria monocytogenes.
Many of the microorganisms detected may cause disease in humans; thus, a number of the tested samples did not meet the Greek guidelines for the microbiological quality of juices. Use of a Hazard Analysis Critical Control Point (HACCP) system should be generally introduced into the juice industry sector to improve the quality of fruit juices, as well as other manufactured foods.
OBJECTIVE:Hypertension (HTN) is one of the most common risk factors for congestive heart failure (HF). Evidence suggests that increased cardiorespiratory fitness (CRF) may attenuate the risk of CHF ...in the general population. However, it is not known if the increased HF risk attributed to HTN can be attenuated by increased CRF. The hypothesis was that improved CRF will attenuate the risk of HF in hypertensive patients.
DESIGN AND METHOD:We studied a total of 9,070 hypertensive men (mean age 59.5 ± 10.5) underwent routine exercise tolerance testing. None of the patients had a diagnosis of HF at baseline. Participants completed a maximal exercise tolerance test (ETT) as a part of clinical evaluation and Metabolic equivalents (METs) were estimated based on the peak exercise time and treadmill grade. We established four fitness categories based on age-stratified quartiles of peak metabolic equivalents (MET) achievedLeast-fit (4.4 ± 1.2 METs; n = 2,108); Low-Fit (6.6 ± 1.2 METs; n = 2,926); Moderately-Fit (7.9 ± 1.3 METs; n = 2,423); and Highly-Fit (10.6 ± 2.2 METs; n = 2,076). Cox proportional hazard models were applied after adjusting for age, BMI, race, family history of CV disease, CV/antihypertensive medications, and risk factors. P-values < 0.05 using two sided tests were considered statistically significant.
RESULTS:During a mean follow-up period of 11.9 ± 6.5 (median 11.8), there were 1,216 incidences of CHF (12.7%) or 11.2 events per 1000 person-years of follow-up. The association between new onset CHF risk and fitness was inverse and graded. For every 1-MET increase in exercise capacity, the risk was lowered by 14% (HR = 0.86; CI0.84–0. 89; p < 0.001). When compared to the individuals in the Least-Fit category, the risk for developing CHF was progressively lower, ranging from 33% (HR = 0.67; CI0.58–0.78; p < 0.001) for the next fitness category (Low-Fit) to 44% (HR = 0.56; CI0.48–0.65; p < 0.001) for the Moderately-Fit and 62% those in the highest fitness category (HR = 0.38; CI0.32–0.46; p < 0.001).
CONCLUSIONS:Increased CRF modulates the risk of developing HF in hypertensive patients. The CRF-HF association is independent, inverse and graded. For every 1-MET increase in exercise capacity, the HF risk was lowered by 14%.
Objective
To determine contamination rates of scrub suits worn by veterinary surgeons and nurses following a single shift.
Materials and Methods
Cross‐sectional preliminary study at a UK small animal ...referral centre. Sterilised scrub suits were distributed to veterinary surgeons (n = 9) and nurses (n = 9) at the beginning of their clinical shift and worn for at least 8 hours. They were then analysed for bacterial contamination before and after home laundry at 30°C. A questionnaire was distributed to hospital clinical staff regarding workwear habits.
Results
Median bacterial counts were 47 (interquartile range: 14 to 162) and 7 (interquartile range: 0 to 27) colony forming units per cm2 before and after laundering scrub suits. Bacteria identified included Staphylococcus sp., Enterococcus sp.,
Escherichia coli
, Bacillus sp.,
Pseudomonas aeruginosa
, Micrococcus sp., β‐haemolytic Streptococci and a Group G Streptococcus. From 101 staff surveyed, 64.0% reported wearing fresh, clean scrub tops and 58.4% fresh, clean trousers each day, while 64.4% left the workplace wearing the same clothing in which they undertook clinical work.
Clinical Significance
Workwear contamination risks spread of pathogens into the community and personnel compliance with workplace guidelines warrants further attention. Home laundry at 30°C significantly decreases, but does not eliminate, the bacterial burden after a single shift.
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