Foodborne botulism in southwest Romania during the post-communism period 1990–2007

SummaryObjectivesThis study was a retrospective investigation of botulism cases over a period of 18 years following major political and economic changes, addressing the question of whether this disease is still an important health concern in southwest Romania.MethodsThe medical records of botulism cases were used as the source of data. Patients from five southwest Romanian counties were hospitalized at Victor Babes Hospital of Infectious Diseases in Timisoara during the period 1990–2007.ResultsThe median annual incidence of botulism cases in southwest Romania decreased from 0.1 per 100 000 persons during 1990–1998, to 0.05 per 100 000 persons during 1999–2007. Most of the cases (18.6%) were diagnosed in 1990, immediately following the communism period. The median age of the patients was 38 years (range 16–73 years); 24 (55.8%) were male; the case fatality rate was 2.3%. A significantly higher incidence rate of 2.7 cases per 100 000 persons occurred in rural areas, even though most of the cases (53.5%) were inhabitants of urban areas. The clinical pattern included: difficulty swallowing (79.1%), double and/or blurred vision (69.8%), dry mouth (60.5%), drooping eyelids (51.2%), vomiting (39.5%), mydriasis (37.2%), constipation (27.9%), abdominal pain (23.3%), and slurred speech (18.6%). All cases were attributed to contaminated food sources, mainly home-prepared traditional pork products.ConclusionsAlthough the botulism cases decreased over the study period in southwest Romania, this life-threatening disease continues to be an important concern. A strategy addressing individual behaviors in the home is needed to improve food safety

Clinical improvement after treatment with VEGF165 in patients with severe chronic lower limb ischaemia

The present study focuses on the application of a therapeutic strategy in patients with chronic severe lower limb ischaemia using a plasmid vector encoding the vascular endothelial growth factor (phVEGF165). It has been shown that VEGF promotes neo-vascularization and blood vessel network formation and thus might have the ability to improve blood-flow at the level of the affected limbs. However, little information is available regarding the necessary level of expression of VEGF and its possible related adverse effects. We have subcloned VEGF165isoform into pCMV-Script expression vector (Stratagene) under the control of the CMV promoter. Three patients with chronic ischaemia of the lower limb, considered as not suitable for surgical re-vascularization, received intramuscular injection with 0.5 ml saline solution containing 1011 copies of VEGF165 plasmid. The clinical evolution has been monitored by angiography and estimated by walking time on the rolling carpet (Gardner protocol). Two months after therapy, all three patients showed complete relief of rest pain, improvement of ischaemic ulcer lesions and increased walking distance on the rolling carpet most probably due to appearance of newly formed collateral vessels

Human trichinellosis in children from Timis County, Romania: epidemiological features from a retrospective study conducted between 1990 and 2006

Trichinellosis, a parasitic zoonosis caused by the ingestion of inadequately cooked pork containing Trichinella larvae, has been a serious health problem in Timis, the largest of the Romanian counties. The authors conducted a survey on trichinellosis in children from Timis County, emphasising epidemiological aspects. Medical records from 106 children who were hospitalised at the Victor Babes Infectious Diseases Hospital in Timisoara from 1990 to 2006 were investigated. Children affected by trichinellosis were predominantly in the 10- to 14-year-old age group (34.9%). Most patients (59.43%) were inhabitants of urban areas and 59.43% of cases were males. Winter was the season when the number of cases peaked (76.42%). The highest prevalence of disease (18.87%) was recorded in 1994. For 38.68% of the patients, eosinophilia ranged between 10% and 20%. The length of hospitalisation ranged from 8 to 14 days in 50.94% of cases. In recent years, human trichinellosis has decreased in Timis County as a result of an improvement in the implementation of hygiene measures. The highest prevalence of the disease recorded in 1994 can be explained by an economic transition period when national pig farms began to close. Winter was the season with the highest prevalence because people eat a lot of pork during the traditional holidays