Ehec

by Márcio Cabral de Moura 

EHEC crisis: farmers throw away tons of vegetables, German

                For fear of the intestinal bacterial EHEC huge amounts of German vegetable land in the trash. Desperate farmers require a clear statement of policy.

                

Farmers in northern Germany to throw because of the EHEC pathogen tons of lettuce, tomatoes and cucumbers in the trash. Although Spanish Import cucumber as a carrier of the dangerous intestinal germ EHEC have been identified, consumers are also in German vegetables still very skeptical.

        

                              

Ehec : Diagnosis of Human Illness

Hemorrhagic colitis is diagnosed by isolation of E. coli of serotype O157:H7 or other verotoxin-producing E. coli from diarrheal stools. Alternatively, the stools can be tested directly for the presence of verotoxin. Confirmation can be obtained by isolation of E. coli of the same serotype from the incriminated food.

5.Associated Foods:

Undercooked or raw hamburger (ground beef) has been implicated in many of the documented outbreaks, however E. coli O157:H7 outbreaks have implicated alfalfa sprouts, unpasteurized fruit juices, dry-cured salami, lettuce, game meat, and cheese curds. Raw milk was the vehicle in a school outbreak in Canada.

6. Relative Frequency of Disease:

Hemorrhagic colitis infections are not too common, but this is probably not reflective of the true frequency. In the Pacific Northwest, E. coli O157:H7 is thought to be second only to Salmonella as a cause of bacterial diarrhea. Because of the unmistakable symptoms of profuse, visible blood in severe cases, those victims probably seek medical attention, but less severe cases are probably more numerous.

Course of Disease and Complications:

Some victims, particularly the very young, have developed the hemolytic uremic syndrome (HUS), characterized by renal failure and hemolytic anemia⁴. From 0 to 15% of hemorrhagic colitis victims may develop HUS. The disease can lead to permanent loss of kidney function.

In the elderly, HUS, plus two other symptoms, fever and neurologic symptoms, constitutes thrombotic TTP (TTP). This illness can have a mortality rate in the elderly as high as 50%.

Ehec : BBB - Escherichia coli O157:H7 (EHEC)

Name of the Organism:

Escherichia coli O157:H7

(enterohemorrhagic E. coli or EHEC)

Currently, there are four recognized classes of enterovirulent E. coli (collectively referred to as the EEC group) that cause gastroenteritis in humans. Among these is the enterohemorrhagic (EHEC) strain designated E. coli O157:H7. E. coli is a normal inhabitant of the intestines of all animals, including humans. When aerobic culture methods are used, E. coli is the dominant species found in feces. Normally E. coli serves a useful function in the body by suppressing the growth of harmful bacterial species and by synthesizing appreciable amounts of vitamins. A minority of E. coli strains are capable of causing human illness by several different mechanisms. E. coli serotype O157:H7 is a rare variety of E. coli that produces large quantities of one or more related, potent toxins that cause severe damage to the lining of the intestine. These toxins [verotoxin (VT), shiga-like toxin] are closely related or identical to the toxin produced by .Shyella Dysentriae

2. Nature of Acute Disease:

Ehec

Hemorrhagic colitis is the name of the acute disease caused by E. coli O157:H7.

3. Nature of Disease:

The illness is characterized by severe cramping (abdominal pain) and diarrhea which is initially watery but becomes grossly bloody. Occasionally vomiting occurs. Fever is either low-grade or absent. The illness is usually self-limited and lasts for an average of 8 days. Some individuals exhibit watery diarrhea only.

Infective dose -- Unknown, but from a compilation of outbreak data, including the organism's ability to be passed person-to-person in the day-care setting and nursing homes, the dose may be similar to that of Shigella spp w(as few as 10 organisms).

Read more :

Bermocoll EHEC 

 Medicine Of EHEC 

ehec : Woman in critical condition in EHEC case

Ehec : Medicine Of EHEC

Ehe

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rEAD moRE :  

ehec : Woman in critical condition in EHEC case 

Ehec : Bermocoll EHEC

Ehec : Bermocoll EHEC

Ehec

Cellulose is a natural polymer and the chief component of wood and plant fibers. Cotton, for example, is almost pure cellulose. Cellulose is a polysaccharide composed of individual anhydroglucose (AHG) units, which are held together by ß-1,4 glycoside linkages that make cellulose a long, rigid molecule. The number of AHG in the polymer chain is defined as the degree of polymerization (DP).

Pure cellulose has large crystalline regions due to hydrogen bonds between the -OH groups on different chains. In manufacturing Bermocoll, purified cellulose is activated in a first step with sodium hydroxide solution. In this alkalization reaction, the structures of the crystalline areas are expanded, allowing the hydroxyl groups to be transformed into alcoholate. This cellulose alcoholate is termed alkali cellulose.
 
The strong attractive forces between cellulose chains due to interchain hydrogen bonds will be greatly reduced by alkylating the greater portion of the -OH groups, thereby preventing hydrogen bonding. Such chemical modification results in significantly changed characteristics with regard to solubility, surface activity, chemical resistance and enzyme resistance. In this way, it is possible to produce sets of cellulose ethers with carefully calculated performance characteristics. 

Read more : Woman in critical condition in EHEC case

In Bermocoll, the hydroxyl groups are modified with ethyl and ethylene oxide substituents. The properties of the cellulose ether are determined by the type of substituents, and also by their number and distribution along the molecule chain.

ehec : Woman in critical condition in EHEC case

Ehec

Doctors in Halland in western Sweden are unable to concrete prognosis for the woman who is reported to be suffering from kidney problems and is being treated with a dialysis and respirator.

"How long the dialysis treatment will take is difficult to say. It could be a couple of days, a couple of weeks or become a chronic disease," said doctor Mats Erntell.

The Local reported earlier on Monday that six more Swedes have been infected by the EHEC bacteria, bringing the total number of cases in Sweden to 39.

The Swedish Institute for Communicable Disease Control (Smitskyddsinstitutet – SMI) believes that all cases of the diseases reported so far in Sweden originated in Germany and there are no indications thus far that the disease is spreading within Sweden.

Nevertheless, the agency said in a statement on Sunday that the number of reported cases could very well increase in the coming days.

Current cases have been reported across the country, from Scene in the south to in the north.

Aorta : Branches of the aorta

Three great vessels arise from the top of the aortic arch. On the right is the innominate artery, which divides into the right subclavian artery and the right common carotid artery for the head and neck. On the left there is no innominate, the left subclavian and carotid arising directly from the arch. Only the lower parts of these vessels lie within the thorax, the level of the innominate bifurcation being at the inner end of the clavicle; they are closely applied to the trachea. The corresponding veins lie more superficially and there is an innominate vein on both sides; the vessel equivalent to the common carotid is the internal jugular vein. The small coronary arteries spring from the very beginning of the aorta, immediately above the semilunar valves. There is a right and left vessel, and any disease of these impairs the circulation in the muscular wall of the heart.

The descending aorta gives off on each side the pairs of intercostal arteries that encircle the chest in the intercostal spaces; the corresponding veins do not enter the venae cavae directly but through intervening channels, the azygous veins.

The aortic arch forms a great sweep from the front of the chest to the back, with an upward convexity from which arise the main arteries of the head, neck, and arms. The concavity of the arch embraces the pulmonary arteries and veins and the bronchi, entering the roots of the lungs. There is also a little artery running the length of the back of the sternum, from above downwards. This is the internal mammary artery, a branch of the subclavian in the neck; it ends below by entering the sheath of the rectus muscle as the superior epigastric artery to anastomose (see anastomosis) with the inferior epigastric from below.

Aorta

The aorta is the main  The aorta is the main  arteryof the body from which all others derive. It marks the beginning of the general or systemic circulation – as distinct from the pulmonary circulation. The aorta arises from the summit of the left ventricle (the main pumping chamber) of the heart, arches over the top of the heart, and descends in front of the backbone. It gives off large and small branches and finally divides to form the right and left iliac arteries in the legs.

Anatomically, the aorta is traditionally divided into the ascending aorta, the aortic arch, and the descending aorta. The short ascending portion runs up to the left of the superior . The aortic arch curves horizontally backward in front of the lower part of the trachea and over the left bronchus. The descending aorta runs down the spinal column and subdivides into the thoracic aorta, which descends within the chest, and the abdominal aorta, which descends within the abdomen.

american diabetes association : History and mission

Diabet 2

Type 2

Formed in 1940, the ADA was founded by 28 physicians^.  During its first 30 years, the Association limited its membership to physicians, health professionals and corporations. In 1970, the Association underwent a reorganization during which membership was expanded to include general members. Now the ADA is a driven organization based in Alxandtra, Virginia with affiliate offices across the United States.

The mission of the ADA is to prevent and cure diabetes and to improve the lives of all people affected by diabetes.To fulfill this mission, the Association funds research, publishes scientific findings, provides information and other services to people with diabetes, their families, health professionals and the public. The Association is also actively involved in advocating for scientific research and for the rights of people with diabetes. The Association acts on its mission through a number of critical programs and activities that are directed to a broad range of constituents, including consumers, research scientists, health care professionals, corporations and communities.

Diabetes Care

In 1994, the Chronicle of Philanthropy, an industry publication, study showed that the American Diabetes Association was ranked as the 18th "most popular charity/non-profit in America" from over 100 charities researched with 33.8% of Americans over the age of 12 choosing Love and Like A Lot for the American Diabetes Association.

american diabetes association : diabetes Type 2

Type 2 diabetes is the most common form of diabetes. Millions of Americans have been diagnosed with type 2 diabetes, and many more are unaware they are at high risk. Some groups have a higher risk for developing type 2 diabetes than others. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans, Native Hawaiians and other Pacific Islanders, as well as the aged population.

In type 2 diabetes, either the body does not produce enough insulin or the cells ignore the insulin. Insulin is necessary for the body to be able to use glucose for energy. When you eat food, the body breaks down all of the sugars and starches into glucose, which is the basic fuel for the cells in the body. Insulin takes the sugar from the blood into the cells. When glucose builds up in the blood instead of going into cells, it can lead to diabetes complication.

heat rash

Prickly Heat

Prickly heat or miliaria rubra is the most common type of heat rash. In this form of heat rash, the sweat duct becomes red and inflamed, and may cause a 'prickling' or stinging sensation. This type of heat rash may also cause mild hitching.

The inflamed sweat ducts look like small bumps with a red halo around them and can usually be found grouped together under a child's clothing and inside the folds of his skin, such as his neck, armpits, and groin. Infants who wear a hat may also get a heat rash on their forehead and scalp.

Miliaria Crystallina

Just like prickly heat, this type of heat rash occurs when the sweat ducts become blocked and rupture. These sweat ducts are closer to the skin surface though and don't get inflamed, leading to the classic appearance of small clear vesicles on the child's skin, without any redness or other symptoms, typically on their neck, head, or upper chest.

Preventing Heat Rash

Most methods of preventing heat rash have the goal of not allowing your child to get overheated and include:

• dressing your child in weather appropriate, loose fitting clothing, so that he doesn't get overheated.
• avoiding excessive heat and humidity when possible.
• avoiding occlusive ointments, including moisturizers, or oil based products on a child's skin, which can also block the sweat ducts.
•  
• Read more :
•  
• * heat rash : 
• * Heat Rash Types (Miliaria)
• * causes of heat rash 

heat rash :

Heat rash — also known as prickly heat and miliaria — isn't just for babies. Though it's common in infants, heat rash can affect adults too, especially during hot, humid weather.

read more : What Exactly is Heat Rash?

Heat rash develops when your sweat ducts become blocked and perspiration is trapped under your skin. Symptoms range from superficial blisters to deep, red lumps. Some forms of heat rash can be intensely itchy or prickly feeling.

Read : 

Heat rash usually goes away on its own. Severe forms of heat rash may need medical care, but the best way to relieve symptoms is to cool your skin and prevent sweating.

heat rash : Heat Rash Types (Miliaria)

Miliaria is the medical term for the heat related skin condition where tiny, pinpoint, pink to clear bumps form over a body area like the face or neck. It is caused when small sweat particles are trapped in the skin. This trapping of sweat may cause inflammation and itching around the sweat pores. Miliaria is very common in infants but may also occur in adults. This condition occurs especially after repeated episodes of sweating in a hot, humid environment. Miliaria may look like small clear blisters or like gooseflesh.

There are four types of miliaria:

1. clear (miliaria crystalline),
   
2. white/yellow (miliaria pustulosa),
   
3. red (miliaria rubra),
   
4. deep (miliaria profunda).

heat rash

Adult Skin Problems Slideshow Pictures

What are the causes of heat rash?

It is uncertain why some people get heat rashes and others don't.

The sweat gland ducts can get blocked if gexcessive sweatingoccurs, and that sweat is not allowed to evaporate from a specific area. Some examples of how blockage may occur include the following:

• Creases in the skin like the neck, armpit, or groin have skin touching adjacent skin, which makes it difficult for air to circulate preventing sweat evaporation.
  
• Tight clothing that prevents sweat evaporation.
  
• Bundling up in heavy clothing or sheets. This may occur when a person tries to keep warm in wintertime or when chilled because of an illness and fever
  
• Heavy creams or lotions can clog sweat ducts.

Babies have immature sweat glands that aren't able to get rid of all the sweat they produce, which can cause a heat rash if they are exposed to warm weather, are overdressed, excessively bundled, or have a fever.

heat rash : What Exactly is Heat Rash?

What exactly is heat rash?

Heat rash (prickly heat) is usually a red or pink rash commonly uncovered on entire body areas coated by outfits. It may possibly acquire when the sweat ducts develop into blocked and swell and generally prospects to discomfort and itching. Warmth rash is most frequent in infants, but may perhaps affect grown ups in warm, humid climates.

What leads to warmth rash?

In babies, warmth rash may be triggered by well-meaning mother and father who gown their child too warmly, but it can take place to any infant in really hot climate. A child need to be dressed as an grownup could well be to be relaxed with the identical temperature and activity level. Babies' fingers and feet might really feel awesome to your touch but that will not indicate they ought to be dressed as well warmly in hot weather.

What are the symptoms of warmth rash?

Heat rash appears like dots or very small pimples. In youthful small children, heat rash can seem on the head, neck, and shoulders. The rash locations can get irritated by clothes or scratching, and, hardly ever, a secondary skin infection might create.

heat exhaustion : Preventing Heat-Related Illnesses

Your sweat is your body's main system for getting rid of extra heat. When you sweat, and the water evaporates from your skin, the heat that evaporates the sweat comes mainly from your skin. As long as blood is flowing properly to your skin, extra heat from the core of your body is "pumped" to the skin and removed by sweat evaporation. If you do not sweat enough, you cannot get rid of extra heat well, and you also can't get rid of heat as well if blood is not flowing to the skin. Dehydration will make it harder for you to cool of in two ways: if you are dehydrated you won't sweat as much, and your body will try to keep blood away from the skin to keep your blood pressure at the right level in the core of your body. But, since you lose water when you sweat, you must make up that water to keep from becoming dehydrated. If the air is humid, it's harder for your sweat to evaporate -- this means that your body cannot get rid of extra heat as well when it's muggy as it can when it's relatively dry. One way to determine the effect of humidity with high temeperature is the  heat index. 

The best fluid to drink when you are sweating is water. Although there is a little salt in your sweat, you don't really lose that much salt with your sweat, except in special circumstances; taking salt tablets may raise your body's sodium level to hazardous levels. (Your doctor can tell you whether or not you need extra salt.) "Sport drinks" such as Gatorade® will also work, but water is usually easier to obtain.

It's also important to be sensible about how much you exert yourself in hot weather. The hotter and more humid it is, the harder it will be for you to get rid of excess heat. The clothing you wear makes a difference, too: the less clothing you have on, and the lighter that clothing is, the easier you can cool off. Football players are notoriously prone to heat illness, since football uniforms cover nearly the whole body, and since football practice usually begins in late summer when the temperature outside is highest. Therefore, football players should pay extra attention to the fluids they drink and lose: teams and coaches should limit practice and wear light clothing for practice on very hot days, and athletes must be able to drink all the water they want during practice.

Krabbe Disease :

Krabbe disease is an autosomal recessive sphingolipidosis caused by deficient activity of the lysosomal hydrolase galactosylceramide beta-galactosidase (GALC). GALC degrades galactosylceramide, a major component of myelin, and other terminal beta-galactose–containing sphingolipids, including psychosine (galactosylsphingosine). Increased psychosine levels are believed to lead to widespread destruction of oligodendroglia in the CNS and to subsequent demyelination.

Red more :Krabbe Disease : Causes, incidence, and risk factor of Krabbe Disease

Krabbe originally described a condition with infantile onset that was characterized by spasticity and a rapidly progressive neurologic degeneration leading to death. Since the original description, numerous cases have been documented that show a wide distribution in age of onset. 

Read more : Krabbe Disease

Krabbe disease has the following 4 clinical subtypes, distinguished by age of onset:

• Type 1 - Infantile
• Type 2 - Late infantile
• Type 3 - Juvenile
• Type 4 - Adult

Hallmarks of the classic infantile form include irritability, hypertonia, hyperesthesia, and psychomotor arrest, followed by rapid deterioration, elevated protein levels in cerebrospinal fluid (CSF), neuroradiologic evidence of white matter disease, optic atrophy, and early death.

Studies indicate that early unrelated hematopoietic stem cell transplantation in both the infantile and late-onset forms is associated with at least short-term benefits on neurocognitive parameters, lifespan, and quality of life^.  Because of this evidence of success, the addition of Krabbe disease to newborn screening panels has occurred in some states and is under consideration in others

Krabbe Disease : Causes, incidence, and risk factor of Krabbe Disease

A defect in the GALC gene causes Krabbe disease. Persons with this gene defect do not make enough of a substance called galactocerebroside beta-galactosidase (galactosylceramidase).

The body needs this substance to make myelin, the material that surrounds and protects nerve fibers. Without it, myelin breaks down, brain cells die, and nerves in the brain and other body areas do not work properly.

There are two forms of Krabbe disease.

• Early-onset Krabbe disease appears in the first months of life. Most children with this form of the disease die before they reach age 2. 
• Read : What is Krabbe disease?
• Late-onset Krabbe disease begins in late childhood or early adolescence.
• Read more : Krabbe Disease Treatment

Krabbe disease is inherited, which means that it runs in families. To get this disease, each of your parents must pass you a copy of the faulty GALC gene. (See: Autosomal ressive Pttern )

This condition is very rare. It is most common among people of Scandinavian descent.

Krabbe Disease :

Krabbe disease (KRAH-bay disease) is an inherited, often fatal disorder affecting the central nervous system. Krabbe disease affects about 1 in every 100,000 people in the United States.

The disease affects muscle tone and movement, and may cause vision and hearing loss, among other devastating effects. In most cases, Krabbe disease develops in babies before 6 months of age, although it can occur in older children and in adults.

 Read more : What is Krabbe disease?

There's no cure for Krabbe disease and treatment mainly involves approaches designed to ease symptoms. However, early studies using stem cell transplants to treat Krabbe disease before symptoms begin have had some success.

What is Krabbe disease?

Krabbe disease (also called globoid cell leukodystrophy) is a degenerative disorder that affects the nervous system. It is caused by the shortage (deficiency) of an enzyme called galactosylceramidase. This enzyme deficiency impairs the growth and maintenance of myelin, the protective covering around certain nerve cells that ensures the rapid transmission of nerve impulses. Krabbe disease is part of a group of disorders known as leukodystrophies, which result from the loss of myelin (demyelination). This disorder is also characterized by the abnormal presence of globoid cells, which are globe-shaped cells that usually have more than one nucleus.

The symptoms of Krabbe disease usually begin before the age of 1 year (the infantile form). Initial signs and symptoms typically include irritability, muscle weakness, feeding difficulties, episodes of fever without any sign of infection, stiff posture, and slowed mental and physical development. As the disease progresses, muscles continue to weaken, affecting the infant's ability to move, chew, swallow, and breathe. Affected infants also experience vision loss and seizures.
Less commonly, onset of Krabbe disease can occur in childhood, adolescence, or adulthood (late-onset forms). Visual problems and walking difficulties are the most common initial symptoms in this form of the disorder, however, signs and symptoms vary considerably among affected individuals.

ehec : Recommendations to reduce the public health risk

EColi

To ensure that those who come directly or indirectly into contact with food are not likely to contaminate it with EHEC, food handlers should follow the Recommended International Code of Practice, General Principles of Food Hygiene (CAC/RCP 1-1969, Rev. 3-1997, Amd. (1999); Section VII - Establishment: personal hygiene), contained in: Joint FAO/WHO Food Standards Programme, Codex Alimentarius Commission. General requirements (food hygiene). FAO/WHO, Rome, 2001 (Second edition) .

Basic good food hygiene practice, as described in the WHO Five keys to safer food , can prevent the transmission of pathogens responsible for many foodborne diseases, and also protect against foodborne diseases caused by EHEC. Such recommendations should in all cases be implemented, especially "Cook thoroughly" so that at least the centre of the food reaches 70°C.

Read more : 

* ehec : Encounter and history:

* Enterohaemorrhagic Escherichia coli (EHEC)

ehec : Control and prevention methods of ehec

Ecoly

The prevention of infection requires control measures at all stages of the food chain, from agricultural production on the farm to processing, manufacturing and preparation of foods in both commercial establishments and the domestic environment. Available data are not sufficient to enable the recommendation of specific intervention methods on the farm in order to reduce the incidence of EHEC in cattle. However, risk assessments conducted at national level have predicted that the number of cases of disease might be reduced by various mitigation strategies for ground beef (for example, screening the animals preslaughter to reduce the introduction of large numbers of pathogens in the slaughtering environment). Good hygienic slaughtering practices reduce contamination of carcasses by faeces, but do not guarantee the absence of EHEC from products. Education in hygienic handling of foods for abattoir workers and those involved in the production of raw meat is essential to keep microbiological contamination to a minimum. 

ehec : Encounter and history

Preventive measures for E. coli O157:H7 infection are similar to those recommended for other foodborne diseases (see basic food hygiene practice described below). However, some of the measures may need to be reinforced for EHEC, particularly in view of its importance in vulnerable groups such as children and the elderly. Since a number of EHEC infections have been caused by contact with recreational water, it is also important to protect such water areas, as well as drinking-water sources, from animal wastes.

Enterohaemorrhagic Escherichia coli (EHEC)

 

ehec : Sources of infection

Ecoli

Escherichia coli 

Most available information relates to serotypesince it is easily differentiated biochemically from other E. coli strains. The reservoir of this pathogen appears to be mainly cattle and other ruminants such as camels. It is transmitted to humans primarily through consumption of contaminated foods, such as raw or undercooked ground meat products and raw milk. Faecal contamination of water and other foods, as well as cross-contamination during food preparation (with beef and other meat products, contaminated surfaces and kitchen utensils), will also lead to infection. Examples of foods implicated in outbreaks of E. coli O157:H7 include undercooked hamburgers, dried cured salami, unpasteurized fresh-pressed apple cider, yogurt, cheese and milk. An increasing number of outbreaks are associated with the consumption of fruits and vegetables (sprouts, lettuce, coleslaw, salad) whereby contamination may be due to contact with faeces from domestic or wild animals at some stage during cultivation or handling. EHEC has also been isolated from bodies of water (ponds, streams), wells and water troughs, and has been found to survive for months in manure and water-trough sediments. Waterborne transmission has been reported, both from contaminated drinking-water and from recreational waters.

Person-to-person contact is an important mode of transmission through the oral-faecal route. An asymptomatic carrier state has been reported, where individuals show no clinical signs of disease but are capable of infecting others. The duration of excretion of EHEC is about one week or less in adults, but can be longer in children. Visiting farms and other venues where the general public might come into direct contact with farm animals has also been identified as an important risk factor for EHEC infection.

Enterohaemorrhagic Escherichia coli (EHEC)

EColi

The diseases caused by EHEC

Symptoms of the diseases caused by EHEC include abdominal cramps and diarrhoea that may in some cases progress to bloody diarrhoea (haemorrhagic colitis). Fever and vomiting may also occur. The incubation period can range from three to eight days, with a median of three to four days. Most patients recover within 10 days, but in a small proportion of patients (particularly young children and the elderly), the infection may lead to a life-threatening disease, such as haemolytic uraemic syndrome (HUS). HUS is characterized by acute renal failure, haemolytic anaemia and thrombocytopenia. It is estimated that up to 10% of patients with EHEC infection may develop HUS, with a case-fatality rate ranging from 3% to 5%. Overall, HUS is the most common cause of acute renal failure in young children. It can cause neurological complications (such as seizure, stroke and coma) in 25% of HUS patients and chronic renal sequelae, usually mild, in around 50% of survivors.

The incidence of EHEC infections varies by age group, with the highest incidence of reported cases occurring in children aged under 15 years (0.7 cases per 100 000 in the United States). Sixty-three to 85% of cases are a result of exposure to the pathogen through food. The percentage of EHEC which progress to HUS varies between sporadic cases (3%-7%) and those associated with outbreaks (20% or more). In epidemiological terms, there is generally a background of sporadic cases, with occasional outbreaks. Some of these outbreaks have involved a high number of cases, such as in Japan in 1996, where an outbreak linked to contaminated radish sprouts in school lunches caused 9 451 cases. Data on the situation in developing countries are limited, as surveillance for this pathogen is not done routinely.

 

ehec : Encounter and history:

Ecoli

Escherichia coli are gram negative, rod shaped bacteria that are often used in laboratory studies and are usually harmless, residing in the human digestive tract as part of the normal flora. E. coli 0157:H7 is a pathogenic strain of E. coli that was first identified as a cause of disease in the United States in 1982, during an investigation into an outbreak of gastrointestinal illness.

The organism is also called enterohemorrhagic E. coli (EHEC) because it causes abdominal pain with diarrhea that may contain blood. It lives in the intestines of healthy cattle and can contaminate meat during slaughter. It is believed that the widespread use of antibiotics by American farmers has promoted the horizontal gene transfer of antibiotic resistance genes and pathogenicity islands that has led to the creation of new pathogenic strains such as E. coli 0157:H7. The verotoxins that cause the disease are also called shiga toxins because they were acquired from Shigella strains. The illness predominantly occurs in the U.S., Canada, Japan and other industrialized nations of Europe. 

The average incidence in most countries ranges from 1-30 per 100,000 and the number of confirmed cases is increasing. In the U.S, about 73,000 people are infected anually, with an average of 61 deaths per year. 

Vitamin D Deficiency Symptoms

Symptoms of Deficiency Vit.D

Vitamin- Vitamin D deficiency mostly results from inadequate intake coupled with inadequate sunlight exposure. It can be also the result of disorders that limit vitamin D absorption or conditions that impair conversion of vitamin D into active metabolites, such as liver or kidney disorders.

Vitamin D is vital for the proper functioning of our body. It regulates the calcium and phosphorus levels in the blood and helps to absorp these minerals from food in the intestines. Vitamin D also manages the re-absorption of calcium in the kidneys. The cause of vitiam D deficiency can be manifold and the symptoms of vit D deficiency are sometimes difficult to interpret.

Who gets vitamin D deficiency?

Vitamin D

Vitamin D deficiency means that there is not enough vitamin D in the body. Broadly speaking, this can occur in three situations:

1. The body has an increased need for vitamin D.
2. The body is unable to make enough vitamin D.
3. Not enough vitamin D is being taken in the diet.

Increased need for vitamin D

Growing children, pregnant women, and breast-feeding women need extra vitamin D because it is required for growth. So, vitamin D deficiency is more likely to develop in the following groups of people:

• Pregnant or breast-feeding women. Vitamin D deficiency is even more likely to develop in women who have had several babies with short gaps between pregnancies. This is because the body's stores of vitamin D get used up, and there is little time for them to be built up before another pregnancy.
• Breast-fed babies whose mothers are lacking in vitamin D, or with prolonged breast-feeding, as there is little vitamin D in breast milk. (Note: there are significant advantages to breast-feeding; you should not stop breast-feeding due to concern about vitamin D levels - your baby can simply have vitamin D supplements as drops by mouth.)

Situations where the body is unable to make enough vitamin D

People who get very little sunlight on their skin are also at risk of vitamin D deficiency. This is more of a problem in the most northern parts of the world where there is less sun. In particular:

• People who stay inside a lot. For example, those in hospital for a long time, or housebound people.
• People who cover up a lot of their body when outside. For example, wearing veils such as the niqab or burqa.
• People with pigmented (coloured) skins. This includes black and Asian people. Caucasian (white) people are less at risk.
• Strict sunscreen use can potentially lead to vitamin D deficiency, particularly if high sun protection factor (SPF) creams (factor 15 or above) are used. Nevertheless, children especially should always be protected from the harmful effect of the sun's rays and should never be allowed to burn or be exposed to the strongest midday sun.
• Elderly people have thinner skin than younger people and so are unable to produce as much vitamin D. This leaves older people more at risk of vitamin D deficiency.
• Some medical conditions can affect the way the body handles vitamin D. People with Crohn's disease, coeliac disease, and some types of liver and kidney disease, are all at risk of vitamin D deficiency.
• Vitamin D deficiency can also occur in people taking certain medicines - examples include: carbamazepine, phenytoin, primidone, barbiturates and some anti-HIV medicines.

Vitamin D Deficiency

Vitamin D

Vitamin D

What is vitamin D?

Vitamins are a group of chemicals that are needed by the body for good health. Vitamin D is a fat-soluble vitamin. The fact that it dissolves in fat is important, because it means the body can store it for future use. Unlike other vitamins, we do not need to get vitamin D from the food that we eat. This is a good thing because most foods contain very little vitamin D naturally. Foods that contain vitamin D include:

• Oily fish (such as sardines, pilchards, herring, trout, tuna, salmon and mackerel).
• Egg yolk.
• Fortified foods (this means they have vitamin D added to them) such as margarine, some cereals, infant formula milk.

Our main source of vitamin D is that made by our own bodies. 90% of our vitamin D is made in the skin with the help of sunlight.

Ultraviolet sunlight rays convert cholesterol in the skin into vitamin D. Darker skins need more sun to get the same amount of vitamin D as a fair-skinned person. The sunlight needed has to fall directly on to bare skin (through a window is not enough). 2-3 exposures of sunlight per week in the summer months (April to September) are enough to achieve healthy vitamin D levels that last through the year. Each episode should be 20-30 minutes to bare arms and face. This is not the same as suntanning; the skin simply needs to be exposed to sunlight.

Note: The sun's rays can be damaging and sunburn should be avoided at all costs (mainly because it can increase your risk of skin cancer).

Reference Intakes Vitamin D

D

Vit D

Intake reference values for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences) . DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people. These values, which vary by age and gender, include:

• Recommended Dietary Allowance(RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy people.

• Vitamin D 

• Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy.
• Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects.

The FNB established an RDA for vitamin D representing a daily intake that is sufficient to maintain bone health and normal calcium metabolism in healthy people. RDAs for vitamin D are listed in both International Units (IUs) and micrograms (mcg); the biological activity of 40 IU is equal to 1 mcg (Table 2). Even though sunlight may be a major source of vitamin D for some, the vitamin D RDAs are set on the basis of minimal sun exposure.

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Vitamin D

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D [25(OH)D], also known as calcidiol. The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D [1,25(OH)₂D], also known as calcitriol

Vitamin D promotes calcium absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts  Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D also helps protect older adults from osteoporosis.

Vitamin D has other roles in the body, including modulation of cell growth, neuromuscular and immune function, and reduction of inflammation. Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D. Many cells have vitamin D receptors, and some convert 25(OH)D to 1,25(OH)₂D.

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calories in watermelon :

Daily Values

Legend:

Fat Protein Carbs

Alcohol Other

Good points

Sunburn and Sun Poisoning

Sunburn Treatments and Remedies

Certain medical treatments have been tried and studied to treat sunburn. However, in general, most remedies have not shown any clinically proven benefit as far as speeding the recovery or reversing the damage. Therefore most of the treatments available are only used to treat symptoms.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) in oral (ibuprofen, Motrin, Naprosyn, Advil etc.) or topical diclofenac 0.1% gel (Solaraze) forms have shown to reduce redness if applied before or immediately after UVB exposure. This benefit may be diminished after 24 hours. These medications may also help relieve the symptoms of sunburn such as pain and discomfort.
  
• Topical steroid creams have not shown any significant improvement in sunburn symptoms. Oral steroids such as prednisone have not proven to be beneficial and have been associated with some significant side effects.
  
• Applying Aloe Vera gel to the skin also has not been beneficial in treating the actual sunburn. However, this may be beneficial in treating the symptoms.
  
• Topical anesthetics: Advertised remedies such as topical anesthetics (benzocaine) may help with symptoms of sunburn, however, very little clinical data is available to substantiate their effectiveness.

What is sunburn?

Sunburn is an inflammation of the skin that is caused by overexposure to ultraviolet (UV) radiation from the sun. A similar burn can follow overexposure to a "sun" (UV or tanning) lamp. UV radiation can also damage the eyes, although no surface burn is apparent.

Sunburn is a very common condition. In the United States, approximately 30% to 40% of adults and close to 80% of children and adolescents report having at least one sunburn in the preceding year.

Can sunburn cause permanent damage?

Yes. Sunburn early in life increases the risk of developing skin cancer later on. Repeated overexposure to ultraviolet rays can also scar, freckle, dry out, and wrinkle the skin prematurely. In addition, frequent overexposure to ultraviolet rays can increase the risk of developing eye cataracts and macular degeneration, a leading cause of blindness.

Sun Poisoning: What Are the Symptoms?

sun poisoning

If your symptoms are limited to mild discomfort, treat your skin the way you would treat any sunburn. Stay hydrated, apply ice or cold compresses to reduce swelling or itching, and take aspirin. Apply aloe if it helps and keep out of the sun. Try taking beta-carotene supplements as they've been shown to ease inflammation. Avoid using oils or anything that contains potential irritants such as fragrances and exfoliants.

sun poisoning : Other Types of Sun Poisoning

On the other hand, if the burn is more painful or you exhibit any of the systemic symptoms listed above, step up your efforts to cool down and hydrate. Drink plenty of fluids and take a bath in cool (not cold) water. Pat skin dry-don't rub-and stay in a cool environment until your symptoms ease.

sun poisoning

Symptoms are a severe skin rash, usually appearing within 30 minutes to several hours of going out in the sun. The rash may be itchy and have these characteristics:

sun poisoning : Signs and Symptoms of Sun Poisoning

• Small bumps all over the body
• Dense clumps of bumps
• Hives, usually on the arms, lower legs, and chest

A hereditary form of PMLE occurs in Native Americans. 

sun poisoning : Other Types of Sun Poisoning

 

sun poisoning : Other Types of Sun Poisoning

What's Making You Sweat?

Polymorphous light eruption (PMLE). At least one in 10 Americans is affected by PMLE, a reaction that does not appear to be linked to drugs or diseases. More common in women than in men and beginning at any age, PMLE occurs in people who are susceptible and are exposed to intense sunlight that they are not used to. For example, people living in northern climates could experience this if taking a winter vacation in a tropical climate.

n some cases, this reaction gets better each year, but some people have reactions that become more extensive without treatment. And, how much sunlight individuals can tolerate varies from person to person.

sun poisoning : Signs and Symptoms of Sun Poisoning

Within just 15 minutes of being in the sun, you can become sunburned, but you might not know it right away.

Severe sunburn or sun poisoning can cause symptoms such as:

• Skin redness and blistering
• Pain and tingling
• Swelling
• Headache

sun poisoning :

What's Making You Sweat?

Sun poisoning doesn't really mean you've been poisoned. It is often the term used for a severe case of sunbu, This is a burn from ultraviolet (UV) radiation that inflames your skin Sun poisoning can also refer to other reactions. Two examples are polymorphous light eruption and solar urticaria.

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d & c : Pre-op: What happens before surgery?

 

Before a D&C, the same general recommendations as for other outpatient procedures apply. It is recommended that the patient take nothing by mouth (food, water, etc.) for at least 7 hours before the scheduled operation. Often, the doctor will see the patient the day before surgery to discuss the procedure and the potential complications in greater detail.

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d & c : Dilation and curettage (D&C)

Dilation and curettage (D&C) is a procedure in which your doctor removes tissue from the inside of your uterus. Dilation and curettage is used to diagnose or treat various uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.

In a dilation and curettage, which is sometimes spelled "dilatation and curettage," your doctor dilates, or opens, your cervix. Your cervix is the lower part of your uterus that separates your vagina and uterus. A surgical instrument called a curette is then inserted into your uterus to remove tissue. Curettes used in a dilation and curettage can be sharp or can use suction.

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d & c : Is a D&C necessary after a miscarriage?

 

About 50% of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice, best decided after talking with your health care provider.

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