Risk Factor Violations Associated With Sporadic Salmonella Cases.

Routine clinical inspections in Norwegian marine salmonid sites: A key role in surveillance for freedom from pathogenic viral haemorrhagic septicaemia (VHS)

Effects of Helicobacter pylori and Nonsteroidal Anti-Inflammatory Drugs on Peptic Ulcer Disease: A Systematic Review

This Month in Gastroenterology

This Month in Gastroenterology

Ninety pig carcasses and twenty one food contact surfaces (FCSs) were tested for Salmonella in a slaughterhouse processing ca. 380 pigs/h between 2014-2015. Sampling was performed during seven sessions. Four carcass sites of 100 cm2 each (back, belly, jowl externally, and the diaphragmatic area internally) were swabbed after evisceration. Meat conveyors and dressing tables were tested swabbing areas of 200 to 400 cm2. After pre-enrichment in buffered peptone water, samples were tested by Salmonella MDS® assay and the presumptive positives were confirmed by the ISO 6579 method. Salmonella isolates were serotyped following the Kauffman-White-Le Minor scheme and genotyped by XbaI pulsed field gel electrophoresis. Salmonella was isolated from 16/90 [17.8%; confidence interval (CI) 95%=11.2-26.9] carcasses and 4/21 (19.0%; CI 95%=7.7-40.0) FCSs. Four serovars were identified on carcasses. S. enterica 4,[5],12:i:-was the most prevalent (43.75%), followed by S. Rissen (31.25%), S. Derby (12.5%) and S. Bovismorbificans (12.5%). Two serovars were found on FCSs, namely S. Derby (75%) and S. Livingstone (25%). During one sampling session, a failure in carcass dehairing occurred and caused significantly higher prevalence of carcass contamination (60%) than in the remaining sessions. Moreover, in the same session, Salmonella prevalence was marginally significantly higher on FCSs than in the remaining sampling days, suggesting that dehairing affects contamination not only on carcasses, but also on the working surfaces.

Investigating the risk factors of cardiomyopathy in pregnant mothers

Association of Metabolic Syndrome With Proximal and Synchronous Colorectal Neoplasm

Risk factors of mydelodysplastic syndromes (MDS) remain largely unknown. We conducted a hospital-based case-control study consisting of 403 newly diagnosed MDS patients according to World Health Organization classification and 806 individually gender and age-matched patient controls from 27 major hospitals in Shanghai, China, to examine relation of lifestyle, environmental, and occupational factors to risk of MDS. The study showed that all MDS (all subtypes combined) risk factors included anti tuberculosis drugs [odds ratio (OR)(adj) = 3.15; 95% confidence interval (CI) = 1.22-8.12] as an independent risk factor, benzene (OR(adj) = 3.73; 95% CI = 1.32-10.51), hair dye use (OR = 1.46; 95% CI = 1.03-2.07), new building and renovations (OR = 1.69; 95% CI = 1.11-2.00), pesticides (OR = 2.16; 95% CI = 1.22-3.82), and herbicides (OR = 5.33; 95% CI = 1.41-20.10) as relative risk factors. Risk factors of MDS subtype refractory cytopenia with multiple dysplasia (RCMD) were benzene (OR(adj) = 5.99; 95% CI = 1.19-30.16) and gasoline (OR(adj) = 11.44; 95% CI = 1.31-100.03) as independent risk factors, and traditional Chinese medicines (OR = 2.17; 95% CI = 1.15-4.07), pesticides (OR = 2.92; 95% CI = 1.37-6.25), and herbicides (OR = 12.00; 95% CI = 1.44-99.67) as relative risk factors. Smoking tobacco was significantly associated with refractory anemia with excess of blasts (RAEB) (OR(adj) = 2.43; 95% CI = 1.02-5.77). Education is shown as an independent protective factor against all MDS (OR(adj) = 0.90; 95% CI = 0.83-0.99) and RCMD (OR(adj) = 0.89; 95% CI = 0.79-0.99). These findings suggest that multiple modifiable behavioral, environmental, and occupational factors play a role in MDS etiology, and various MDS subtypes may have different susceptibility.

Introduction: Migraine is a chronic disabling neurological disease, with an estimated expense of $15-20 million/year. Several studies with a small number of patients have studied risk factors for migraine such as cardiovascular disorders, stroke, smoking, demographic, and genetic factors but this is the first comprehensive study for evaluation of vascular and nonvascular risk factors. It is important to evaluate all the risk factors that help to prevent the healthcare burden related to migraine. Methodology: We performed a retrospective cross-sectional analysis of the Nationwide Inpatient Sample (NIS) (years 2013-2014) in adult (>18-years old) hospitalizations in the United States. Migraine patients were identified using ICD-9-CM code to determine the demographic characteristics, vascular, and nonvascular risk factors. Univariate analysis was performed using the chi-square test and a multivariate survey logistic regression analysis was performed to identify the prevalence of the risk factors and evaluate the odds of prevalence of risk factors amongst migraine patients compared to nonmigraine patients, respectively.Results: On weighted analysis, after removing missing data of age, gender and race, from years 2013 to 2014, of the total 983,065 (1.74%) migraine patients were identified. We found that younger (median age 48-years vs. 60-years), female (82.1% vs. 58.5%; p<0.0001), white population (76.8% vs. 70.5%; p<0.0001), and privately insured (41.1% vs. 27.4%; p<0.0001) patients were more likely to have migraine than others. Cerebral atherosclerosis, diabetes mellitus, ischemic heart disease, atrial fibrillation, and alcohol abuse were not significantly associated with migraine. Migraineurs had higher odds of having hypertension [odds ratio (OR): 1.44; 95% confidence interval (CI): 1.43-1.46; 44.49% vs. 52.84%], recent transient ischemic attack (TIA) (OR: 3.13; 95%CI: 3.02-3.25; 1.74% vs. 0.67%), ischemic stroke (OR: 1.40; 95%CI: 1.35-1.45; 2.06% vs. 1.97%), hemorrhagic stroke (OR: 1.11; 95%CI: 1.04-1.19; 0.49% vs. 0.46%), obesity (OR: 1.46; 95%CI: 1.44-1.48; 19.20% vs. 13.56%), hypercholesterolemia (OR: 1.33; 95%CI: 1.30-1.36; 5.75% vs. 5.54%), substance abuse (OR: 1.51; 95%CI: 1.48-1.54; 7.88% vs. 4.88%), past or current consumption of tobacco (OR: 1.40; 95%CI: 1.38-1.41; 31.02% vs. 27.39%), AIDS (OR: 1.13; 95%CI: 1.04-1.24; 0.33% vs. 0.41%), hypocalcemia (OR: 1.09; 95%CI: 1.03-1.14; 0.77% vs. 0.89%), and vitamin D deficiency (OR: 1.93; 95%CI: 1.88-1.99; 2.47% vs. 1.37%) than patients without migraine. Female patients were at a higher risk of migraine (OR: 3.02; 95%CI: 2.98-3.05) than male.Conclusion: In this study, we have identified significant risk factors for migraine hospitalizations. Early identification of these risk factors may improve the risk stratification in migraine patients.

Colorectal cancer (CRC) is one of the most common gastrointestinal tumors in the world. This study aimed to compare the clinical manifestations and risk factors of CRC and adenomas in native patients of Guangzhou. Patients who underwent colonoscopy for the first time at Nanfang Hospital between July 2008 and July 2009 were recruited. Data on demographic information, main clinical manifestations, results of endoscopies and pathology, and possible risk factors of colorectal tumor were collected. Chi-square test and logistic regression were used to compare the clinical characteristics and risk factors for CRC and adenomas. Hematochezia and body weight loss were more frequent in proximal and distal CRC groups, respectively (P ≤ 0.05). Older age [odds ratio (OR), 1.079; 95% confidence interval (CI), 1.065-1.093], smoking status (OR, 1.712; 95% CI, 1.158-2.531), BMI =18.5-24.9 and ≥ 25.0 (OR, 2.384; 95% CI, 1.250-4.549; OR, 2.162; 95% CI, 1.044-4.478, respectively) were significant risk factors for advanced adenoma, while female (OR, 0.638; 95% CI, 0.429-0.949) and using aspirin (OR, 0.188; 95% CI, 0.042-0.845) were significant protective factors. Hyperlipemia (OR, 0.109; 95% CI, 0.013-0.886) was identified as a protective factor for proximal CRC. Smoking (OR, 1.717; 95% CI, 1.093-2.696), drinking (OR, 1.817; 95% CI, 1.145-2.883), DM history (OR, 2.204; 95% CI, 1.044-4.652) were identified as independent risk factors for distal CRC, and using aspirin (OR, 0.190; 95% CI, 0.043-0.840) was a protective factor. Drinking (OR, 3.288; 95% CI, 1.546-6.994; OR, 1.862; 95% CI, 1.037-3.343, respectively) was an independent risk factor for both poorly to moderately differentiated CRC and well-differentiated CRC. Besides, DM (OR, 3.761; 95% CI, 1.615-8.762) and hypertension (OR, 0.384; 95% CI, 0.178-0.828) were identified as independent risk factor and protective factor for well-differentiated CRC, respectively. Hematochezia and body weight loss were representative manifestations for distal and proximal CRC, respectively. For southern Chinese the most important influential factors for colorectal tumor are age, smoking, drinking, nutritional state, DM, hypertension, and the use of aspirin.

Cardiovascular disease (CVD) refers to any disease that affects the cardiovascular system, such as cardiac disease, vascular diseases of the brain and kidney and peripheral arterial diseases. CVDs are among the leading causes of morbidity and mortality in Zambia. A case-control study was conducted among 74 patients suffering from cardiovascular disease (CVD) at Kitwe Teaching Hospital (KTH) and 74 controls (patients without CVD). All participants completed a questionnaire regarding socio-demographics, risk factors of CVD and Knowledge based questions of CVD. Chi-square test was used to determine significant associations and a result yielding a p value of less than 5% was considered statistically significant. Independent factors associated with development of CVD were established using a Binary Logistic Regression. Unadjusted odds ratio (OR) and Adjusted odds ratios (AOR) and their 95% confidence intervals (CI) are reported. The independent risk factors which were significantly associated with the development of CVD were hypertension (OR 59.143, 95% CI 20.122-173.833; AOR 97.289, 95% CI 24.479 -386.662), diabetes mellitus (OR 3.725, 95% CI 1.722 – 8.057; AOR 6.033, 95% CI 1.630 -22.332), family history (OR 2.504, 95% CI 1.242-5.050; AOR 0.862, 95% CI 0.244 -3.041), smoking (OR 1.587, 95% CI 0.731-3.448; AOR 0.746, 95% CI 0.164 -3.403), alcohol consumption (OR 1.387, 95% CI 0.725 -2.654; AOR 3.392, 95% CI 0.833 – 13.823), high blood cholesterol (OR 4.364, 95% CI 0.894 – 21.293; AOR 4.482, 95% CI 0.242- 82.888) and increased age (P value: 0.039). Three factor were significantly associated with reduced risk of developing CVD. These were physical activity (OR 0.575, 95% CI 0.287-1.150; AOR 1.849, 95% CI 0.507 – 6.751), balanced diet (OR 0.890, 95% CI 0.456 – 2.195; AOR 1.451, 95% CI 0.404 – 5.214) and regular weight check and control (OR 0.897, 95% CI 0.471 – 1.710; AOR 0.593, 95% CI 0.177 – 1.990). Interventions such as proper control of hypertension and diabetes pharmacologically or non – pharmacologically, as well as providing health education on life style risk factors that are associated with CVD may significantly reduce morbidity and mortality due to the disease.

To collect the clinical data of non-cardiac inpatients with coronary heart disease risk factors and analyze the pathogenic factors and prognosis features of these inpatients with acute myocardial infarction. Retrospective analyses were performed for 650 cases of consecutive non-cardiac inpatients with coronary heart disease risk factors at Tianjin Union Medical Center between January 2009 and January 2012.They were divided into non myocardial infarction (UnAMI, n = 551) and myocardial infarction groups (AMI, n = 99). Firstly the method of single factor analysis was employed to screen some significant influencing factors of acute myocardial infarction.Secondly multivariate Logistic regression analysis was performed to analyze the risk factors associated with the onset of AMI. Also the cardiovascular death event rates during hospitalization were compared between two groups. Cox regression analysis was performed to analyze independent risk factors for cardiovascular death of two group during hospitalization. (1) The significant influencing factors of AMI included total cholesterol (TC), low-density lipoprotein (LDL), advanced age, discontinuation of antiplatelet drug, recent episodes of angina above II grade, arrhythmia, 5 years of PCI or CABG history, blood glucose control or not, cardiac dysfunction (NYHA II-IV), dehydration, severe inflammatory response, infection, peroperative period, emergency operation and without cardiological consultation. (2) Multivariate Logistic regression analysis showed that LDL (OR (odds ratio): 2.047, 95% CI (confidence interval): 1.066-3.930, P = 0.031), discontinuation of antiplatelet drug therapy (OR:15.213, 95% CI: 5.746-40.281, P = 0.000), recent episodes of angina above II grade (OR: 1.990, 95%CI: 1.155-3.430, P = 0.013), glucose non-control (OR: 2.991, 95% CI:1.485-6.026, P = 0.002), advanced age (OR: 2.499, 95% CI: 1.299-4.808, P = 0.006), severe inflammation (OR:4.425, 95% CI: 2.984-6.561, P = 0.000), infection (OR:2.405, 95% CI: 1.058-5.464, P = 0.036), emergency operation (OR:4.365, 95% CI: 1.580-12.060, P = 0.004) were all AMI-related occurring factors. And cardiologic consultation (OR: 0.011, 95% CI:0.003-0.040, P = 0.000) was a favorable factors to reduce AMI; (3) AMI group during hospitalization for cardiovascular death event rate was higher than the UnAMI group; (4) Advanced age (β = 0.776, OR = 0.460, 95% CI: 0.217-0.974, P = 0.042) and without consultation of cardiology department (β = 1.366, OR = 3.918, 95% CI: 1.549-9.912, P = 0.004) were cardiovascular death independent risk factors. (1) Non cardiac inpatients during hospitalization LDL, discontinuation antiplatelet drug therapy, recent episodes of angina above II grade, blood sugar non-control, advanced age, severe inflammatory response, infection and without cardiologic consultations were significant risk factors for AMI. (2) The treatment of Department of Cardiology specialist for non cardiac inpatients with coronary heart disease risk factors to improve the prognosis of them.

Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand

A food premise’s sanitation level can be reflected by the cleanliness of its food contact surfaces. Contaminated food contact surfaces along with poor handling methods by food handlers may increase the risk of foodborne diseases through cross-contamination events. This study aimed to assess the microbiological contamination levels on food contact surfaces of 12 residential college cafeterias in a local university and its correlation with the cafeteria’s premise grade. The presence of selected indicator and pathogenic microorganisms (total viable count (TVC), total coliform, Escherichia coli, Staphylococcus aureus, Salmonella spp., and Shigella spp.) on food contact surfaces were also determined. Cutting boards, knives and utensils (cutleries, bowls and plates) that were used for ready-to-eat food were sampled for this study. The cafeteria’s premise grade was obtained based on the food premise inspection report by the university Health Centre. Three cafeterias have significantly higher (p 0.01). This study demonstrated that the sanitation level of food contact surfaces in the residential college cafeterias was only average. Improvements need to be done to increase the sanitation level of the cafeterias, thus assuring the safety of the food for consumers. DOI : http://dx.doi.org./10.17576/JSKM-2018-1602-05

Risk factors associated with severe perineal lacerations during vaginal delivery: a 10-year propensity score–matched observational study