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At least 67 people contract botulism after trying to paralyze their stomach

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Increase / Micrograph of Clostridium botulinum

Healthcare representatives in Europe botulism outbreak warning associated with unsuccessful weight loss procedures carried out in Turkey, the purpose of which was to paralyze the abdominal muscles to reduce appetite. Authorities have identified 67 cases so far – 53 in Turkey, 12 in Germany and one each in Austria and Switzerland.

Botulism is a life-threatening nerve condition caused by botulinum toxin, which is produced by bacteria. Clostridium botulinum. There several forms of botulism, but in this outbreak, cases are a form called iatrogenic botulism, which occurs when too much toxin is injected during medical procedures. Iatrogenic botulism is associated with generalized muscle weakness, drooping eyes, difficulty swallowing, and difficulty breathing. Outbreak cases ranged from mild to severe, with several people in intensive care. This was announced by the European Center for Disease Prevention and Control (ECDC)..

Botulinum toxin is one of the most poisonous natural substances known; total dose 1 nanogram per kilogram of body weight is lethal. However, it has been used for cosmetic purposes, such as to smooth expression lines and in some cases. medicinal purposesfor example, treatment overactive bladder another chronic migraine headaches.

Although it was also used in the stomach for weight loss. research on this app Was mixed in efficiency. idea is that the toxin paralyzes the muscles of the stomach, slowing down digestion and the rate of gastric emptying. This is intended to keep people feeling full for longer, resulting in decreased appetite for as long as the effects of the toxin last, which can last up to three months. The injection is done using an endoscope, a tube-like device equipped with a syringe to inject the toxin directly into the stomach muscle after passing through the mouth and throat.

outbreaks

But things go wrong when too much botulism is injected, as is apparently the case in Turkey. Officials in Europe have traced cases in Germany, Austria and Switzerland to a single clinic in Istanbul. Cases in Turkey are also associated with this clinic, with the exception of three that were found in a private hospital in Izmir, Turkey. The ECDC noted that European patients were coordinating their risky medical tourism through a WhatsApp group.

In the past, such clusters of iatrogenic botulism have been associated with counterfeit toxin products, as was the case with outbreak in Egypt in 2017. last August, World Health Organization warns of counterfeit batches of botulinum toxin a product called Dysport. Bad batches have been found in several countries, including Turkey. But a Turkish investigation into the current outbreak found it to be related to legal, licensed products, though not approved for stomach use, ECDC said. Turkish authorities have reportedly suspended medical procedures at both identified medical facilities and launched further investigations into the medical workers involved.

Meanwhile, patients with botulism have a long and painful journey ahead of them. Recovery can take weeks to months. During a 2017 outbreak linked to a counterfeit product, it took patients six to 12 weeks to fully recover. Because iatrogenic botulism is relatively rare, the mortality rate is unclear. But food botulism, caused by eating improperly preserved or canned foods contaminated with the toxin, has a mortality rate of 5 to 10 percent, the ECDC notes.

Antitoxin hero

Treatment for botulism may include mechanical ventilation in case of respiratory failure, as well as doses of an antitoxin called heptavalent botulinum antitoxin (HBAT), which is made from horses. HBAT contains antibodies from horses immunized with low doses of botulinum toxin. HBAT antibodies work by binding to the toxin while it is in the blood, before it can irreversibly bind to presynaptic nerve endings and lead to paralysis. Thus, the antitoxin can only prevent further paralysis; it cannot reverse a paralysis that has already occurred. However, even though current mortality rates are below 10 percent, prior to the development of an antitoxin mortality was 50 percentaccording to the US Centers for Disease Control and Prevention.

Horses are often used for such antibody-based therapies because their large body size means a large volume of blood, which in turn means that large amounts of antibodies or other valuable proteins can be collected. In the US, a single Thoroughbred named First Flight was the only source of anti-botulism antitoxin serum from its initial development in the 1970s until the 1990s.

The first flight was a retired racehorse who briefly worked as a caisson horse at a military funeral at the Arlington National Ceremony before reportedly carry the general’s coffin. In 1978, at the age of 10, he was transferred to the U.S. Army Medical Research Institute for Infectious Diseases at Fort Detrick, Maryland, where he became the only living factory in the country to produce botulinum antitoxin, and also earned a reputation for his cheeky personality. After donating nearly 16,000 liters of blood in the 1980s and 1990s, First Flight was retired. He died in his paddock at Fort Detrick of natural causes at the age of 31. the halter and leash are in the Smithsonian National Museum of American History..

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Giant algae blob targets Florida and Mexico beaches

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Giant swarms of kelp could soon settle along beaches in Florida and across the Gulf of Mexico, scientists warn, polluting popular tourist destinations for months.

Seaweed is a type of leafy floating algae called sargassum — typically spends most of the year swinging in a 5,000-mile-wide mass across the Atlantic Ocean. Sargassum is generally helpful while at sea, providing food and breeding grounds for a variety of species, including fish, sea turtles, and seabirds.

The real danger of the Sargassum comes when it is washed ashore. Seaweed begins to rot after a few days on land, releasing hydrogen sulfide gas that smells like rotten eggs and leaving behind a brown sludge that can contaminate beaches for weeks. Hydrogen sulfide can threaten human health, and the sheer amount of seaweed could be too much for local crews.

Parts of the Yucatan Peninsula in Mexico were enveloped by approximately 200 tons sargassum earlier in March, prompting warnings of “surplusAlgae levels near the popular Playa del Carmen. Officials have warned that some beaches are at risk of up to 3 feet of seaweed a week, with no signs of sargassum decreasing as summer approaches.

A worker shovels Sargassum off the coast of Playa del Carmen, Mexico, Wednesday, May 8, 2019.

The media in Key West also reported much earlier than usual. sargasso floods last week.

Past flowers prompted state of emergency in the Virgin Islands and polluted islands in the caribbeanAnd every year there are only more of them.

For the first time scientists noted supercharged seaweed rafts in 2011. Some researchers suggest that they may increase as the runoff of fertilizers and agricultural waste flows into the ocean in large quantities.

“These flowers are getting bigger and bigger, and this year looks set to be the biggest on record.” – Brian Lapointe, research professor at Florida Atlantic University said New York Times. “It’s pretty early to see so much, so soon.”

Large areas of sargassum are currently floating in the northern Caribbean and near the east of Mexico’s Yucatan Peninsula.

University of South Florida, which monitors annual seaweed bloom, predicts that 2023 will be “mainSargassum year, upcoming tourist plans and the threat to coastal ecosystems.

scientists they said they were expecting Sargassum scourge has become the new normal.

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Los Angeles healthcare operators charged with 14 COVID-19 deaths

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On Tuesday, operators at a high-profile dementia care facility in Los Angeles were charged with elder abuse and other felony charges related to the death of an employee and 13 residents in the early days of the pandemic.

The Silverado Beverly Place Memory Care Community, near the Fairfax area, specializes in caring for older residents with Alzheimer’s and dementia and was the site of the March 2020 COVID-19 outbreak.

An employee and residents died during the outbreak, when 45 employees and 60 residents were infected, according to the Los Angeles County District Attorney’s office. The operators of the facility were sued in civil court by the family of several residents and the deceased employee. The object was the subject of a 2020 Times investigation.

The facility was supposed to be closed to visitors, prosecutors said, when a patient from a New York psychiatric ward was admitted there. Silverado Beverly Place’s own protocols required it to keep anyone out of a high-risk area like New York City, which at the time was considered the epicenter of COVID-19.

Prosecutors say the patient was not tested for coronavirus when he was admitted to the hospital and developed symptoms the next morning. But after they tested positive, they were not placed in quarantine, according to the criminal charge.

The prosecutor’s office claims that the institution’s management did not block visitors who traveled within the country or abroad for 14 days to areas where cases of COVID-19 were confirmed.

“These careless decisions created conditions that unnecessarily exposed Silverado personnel and residents to serious injury and, unfortunately, death,” Dist. Atti This is stated in the statement of George Gascon.

The three managers were charged with 13 counts of felony endangering the elderly and five counts of misdemeanor resulting in death. The latest charges were brought in connection with the management of the company’s health and safety of employees. Lauren Bernard Shook, Jason Michael Russo, and Kimberly Cheryl Batrum were charged, along with Irvine-based Silverado Senior Living Management Inc.

Prosecutors say the New York City patient was admitted to Silverado Beverly Place for financial reasons.

Investigators from the California Division of Occupational Safety and Health conducted a two-and-a-half-year investigation at Silverado Beverly Place, whose parent company operates several nursing facilities across the country. According to Cal/OSHA, Silverado Beverly Place was cited for violating the airborne disease standard, which is designed to protect “employees who are at increased risk of contracting certain airborne infections due to their work activities. “.

The facility listed $114,500 in proposed fines for violations, the unit said, but it appealed the fines.

Email Silverado Senior Living Management Inc. asking for comment on the allegations was not immediately resolved.

Gascon also read out the names of the 14 dead during a press conference in downtown Los Angeles. These nurses are Brittany Bruner-Ringo, Elizabeth Cohen, Joseph Manduke, Catherine Apotaker, Jake Khorsandi, Albert Sarnoff, Dolores Sarnoff, Myrna Frank, Frank Piumetti, Jay Tedeman, Luba Paz, Kay Kiddu, Richard Herman and Michael Horn.

Bruner-Ringo told her mother that the newly admitted patient was showing signs of illness – profuse sweating, a “productive” cough and a temperature close to 103 degrees, her mother told The Times.

“I said, ‘It’s definitely problematic,’” recalls Kim Bruner-Ringo, an experienced nurse in Oklahoma City.

The patient was so ill that Brittany Bruner-Ringo called 911 for an ambulance, but it was too late. In the days and weeks that followed, the virus spread throughout the facility.

According to her family, Bruner-Ringo stopped breathing on April 20, 2020 in the intensive care unit at Harbor-UCLA Medical Center. she was 32

“Every day I just prayed that Brittany could tell her own story,” her sister Breanna Hurd said.

Los Angeles criminal defense attorney Alan Eisner, who is not involved in the case, said the allegations are unique because they concern decisions made by senior care facility leaders in the early days of the pandemic.

“This is a once-in-a-generation pandemic,” Eisner said. “I don’t want to ignore all the people who died. But this is a high bar that prosecutors must prove and show that the institution is responsible for the death of all other patients and even a nurse.”

Jody Moore, an attorney representing seven clients who either became ill with COVID-19 or died in Silverado, said that by early 2020, the federal government had provided guidance to long-term care facilities on how to protect older residents, including screening and testing policies. .

“It doesn’t make sense to say loved ones can’t get in, private caregivers can’t get in because their paperwork says we’re putting residents at significant risk by exposing them to what can enter through the front door.” Moore said. “What they let in through the front door was someone with dollars attached. And that’s what’s really egregious misconduct here.”

Helena Apotaker received an email from the institution in the early days of the pandemic informing her that she would not be able to visit her mother Katherine. The announcement said the facility is being closed for the safety of elderly residents.

“No one was allowed in,” Apotaker told The Times. “They were going to protect our loved ones. This was their top priority. Well, not 30 days later, I think they lost their top priority.”

According to Apotaker, her mother had early stages of Alzheimer’s but was generally in good health. After her mother tested positive for COVID-19, Apotaker placed her in a hospice and was finally allowed to visit in person.

“I was in the building with my mother for a week when she died,” Apotaker said. “I can’t imagine what it was like for everyone who had to watch their parents die through a window or watch their loved ones die on FaceTime.”

Upon hearing the news that Silverado Beverly Place was under criminal investigation, Apohacker was filled with a sense of justice because it seems that people have forgotten about the pandemic and the people who have died.

“But I remember that my mother died,” she said. “The only thing I had to hold on to was the thought that maybe one day I would get justice.”

Times Staff Writer Harriet Ryan contributed to this report.

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Geometric deep optical sounding | The science

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The review discusses the latest developments in the field of optical sensing and imaging.

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