Toxins of concern to animals and people

Historically veterinarians have diagnosed accidental poisonings and identified possible terrorist events before they have come to the attention of public health authorities. There are many toxins that pose a threat to both humans and animals and the authors examine several of them here, namely, anthrax, tricothecenes, staphylococcal enterotoxin B, botulinum toxins, ricin, saxitoxin and dinoflagellate toxins. By discussing exposure routes, clinical signs and differential diagnoses the authors demonstrate how veterinarians are in a unique position to recognise zoonotic diseases, toxin exposure, and acts of bioterrorism. The work of veterinarians protects the food supply and contributes to human health and this article highlights the importance of coordination and communication between veterinarians and physicians. Sharing information is critical in confirming diagnoses and, in the case of intentional toxin attacks, could also be beneficial in identifying the perpetrators of the crime.     

Changes in vaccine recommendations for children spark concern

The increasing number of vaccinations that newborns and infants receive is causing some confusion and concern among federal health officials and providers. What vaccinations should you be giving, and under what schedule?     

Toxoplasma in animals, food, and humans: an old parasite of new concern

All hosts, including humans, can be infected by any one of the three forms of the parasite Toxoplasma gondii that correspond to three morphological stages: tachyzoite, bradyzoite, and sporozoite form. Felids are definitive hosts for T. gondii, which is an intracellular pathogen that infects a wide range of warm-blooded intermediate hosts. Toxoplasmosis is a disease where the interest of the diverse medical and veterinary specialties converge. Awareness needs to be increased that toxoplasmosis can induce clinical disease not only in immunocompromised patients or through congenital infections, but also in healthy patients. This is a review article that aims at illustrating why toxoplasmosis should be regarded a veterinary public health issue and how veterinary practitioners can contribute in controlling the infection.     

Mode of action and aquatic exposure thresholds of no concern

Threshold concepts of toxicological concern are based on the possibility of establishing an exposure threshold value for chemicals below which no significant risk is to be expected. The objective of the present study is to address environmental thresholds of no toxicological concern for freshwater systems (ETNCaq) for organic chemicals. We analyzed environmental toxicological databases (acute and chronic endpoints) and substance hazard assessments. Lowest numbers and 95th-percentile values were derived using data stratification based on mode of action (MOA; 1 = inert chemicals; 2 = less inert chemicals; 3 = reactive chemicals; 4 = specifically acting chemicals). The ETNCaq values were derived by multiplying the lowest 95th percentile values with appropriate application factors; ETNCaq,MOA1-3 is approximately 0.1 microg/L. A preliminary analysis with complete MOA stratification of the databases shows that in the case of MOA1 or MOA2, the ETNCaq value could be even higher than 0.1 microg/L. A significantly lower ETNCaq,MOA4 value was observed based on the long-term toxicity information in the European Centre for the Ecotoxicology and Toxicology of Chemicals database. Application of the ETNCaq value in a tiered risk-assessment scheme may help chemical producers to set data-generation priorities and to refine or reduce animal use. It also may help to inform downstream users concerning the relative risk associated with their specific uses and be of value in putting environmental monitoring data into a risk-assessment perspective.     

Soil ingestion: a concern for acute toxicity in children.

Several soil ingestion studies have indicated that some children ingest substantial amounts of soil on given days. Although the EPA has assumed that 95% of children ingest 200 mg soil/day or less for exposure assessment purposes, some children have been observed to ingest up to 25-60 g soil during a single day. In light of the potential for children to ingest such large amounts of soil, an assessment was made of the possibility for soil pica episodes to result in acute intoxication from contaminant concentrations the EPA regards as representing conservative screening values (i.e., EPA soil screening levels and EPA Region III risk-based concentrations for residential soils). For a set of 13 chemicals included in the analysis, contaminant doses resulting from a one-time soil pica episode (5-50 g of soil ingested) were compared with acute dosages shown to produce toxicity in humans in clinical studies or case reports. For four of these chemicals, a soil pica episode was found to result in a contaminant dose approximating or exceeding the acute human lethal dose. For five of the remaining chemicals, the contaminant dose from a soil pica episode was well within the reported dose range in humans for toxicity other than lethality. Because both the exposure episodes and the toxicological response information are derived from observations in humans, these findings are regarded as particularly relevant for human health risk assessment. They suggest that, for some chemicals, ostensibly conservative soil criteria based on chronic exposure using current EPA methodology may not be protective of children during acute soil pica episodes.     

继续关注儿童功能性胃肠病临床研究

功能性胃肠病( functional gastrointestinal disorder,FGIDs)原指年龄相关的、慢性或反复发作的胃肠道症候群,是无法用器质性病变或生化异常来解释的一类胃肠道功能性疾病.2016年发布的罗马Ⅳ标准对其重新进行了定义,即功能性胃肠病又称为脑一肠互动异常,强调其症状产生与动力紊乱、内脏高敏感性、黏膜和免疫功能改变、肠道菌群变化及中枢神经系统协调功能异常有关.     

The concern for accurate, quality registry data

The effective use of registries is critical to modern healthcare information management. But you've got to be careful in applying the data.     

Compassion stress and the qualitative researcher

Human subjects are carefully protected in the research process. However, the same consideration is not currently being given to the qualitative researcher, even those investigating topics that are likely to elicit powerful emotions. The role of researcher's emotional responses and the self-care strategies that, in some circumstances, are appropriate for the researcher and other research support personnel have not received the attention they deserve in qualitative research literature. Based on experience in conducting research on the topic of self-directed learning and breast cancer, and on the limited literature available, the author makes the case for the use of strategies such as counseling, peer debriefing, and journal writing as means of dealing with the potential for "compassion stress" as experienced by the researcher and other research support personnel. She also suggests that the preparation of social science researchers should include information on appropriate self-care strategies.     

High-rising epiglottis in children: should it cause concern?

An omega-shaped epiglottis is frequently associated with laryngomalacia. However, an elongated high-rising epiglottis can represent a normal variation of the larynx in a majority of pediatric patients. It is important to consider this in a healthy child with no complaints apart from the sensation of a foreign body in throat. This will avoid triggering any unnecessary investigation or treatment. An elongated epiglottis projecting in the oropharynx can appear as a foreign body and be a source of anxiety for the parents as well as the unaware family practitioner. We present such a case, with a brief discussion of the pediatric larynx and the omega-shaped epiglottis.