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Read Ebook {PDF EPUB} Ache by P.J. Post Ache by P.J. Post. Quorn is the brand name of meat substitutes that are made from a vat-grown fungus. Some people have dangerous reactions to the fungus and suffer nausea, vomiting, diarrhea, and occasionally hives or difficulty breathing. Some people react the first time they eat Quorn, while some react only after building up a sensitivity. Two deaths have been linked to Quorn. The parents of an 11-year-old California boy sued the maker of Quorn in March 2015. Medical studies have proven that Quorn's fungal ingredient is an allergen, but the U.S. Food and Drug Administration and the United Kingdom's Food Standards Agency still allow its sale. All of us at CSPI have heard from more than 2,000 consumers in Europe, the United States, and Australia/New Zealand who suffered reactions to Quorn. Despite what some of the manufacturer's marketing materials indicated, the fungus used in Quorn is only distantly related to mushrooms, truffles, or morels. While all are members of the fungus kingdom, Quorn is made from a less appetizing fungus (or mold) called Fusarium venenatum ( venenatum is the Latin word for venomous). Medical Evidence Shows that Quorn Causes Adverse Reactions. The first evidence that Quorn causes severe vomiting and stomach ache came in 1977 from a clinical study conducted by the developer of Quorn. That research was never published. In subsequent years, more research has demonstrated that Quorn causes gastrointestinal and other adverse reactions, including hives and breathing difficulties. These are the key studies: RHM (unpublished 1977-78 study) This controlled clinical study was conducted by the company that developed Quorn. Ten percent of the 200 subjects who ate Quorn experienced nausea, vomiting, or stomach ache, compared to five percent of 100 subjects in a control group. This is the first known study that demonstrated that Quorn could cause adverse effects. It appears that when Marlow Foods notified the Food and Drug Administration that Quorn should be considered "Generally Recognized As Safe," it did not acknowledge the existence or results of this study. It is not known whether the study was submitted to the British government when Quorn was first used. The study was obtained from a food additive petition filed with the FDA. Udall JN, Lo CW, Young VR, Scrimshaw NS. (Am J Clin Nutr. 1984;40:285-292) This study did not find any problem in 100 college students who ate Quorn for 30 days. However, co-author Nevin Scrimshaw in 2003 told the U.S. Food and Drug Administration that "I have no doubt from the evidence currently available that the fungal product being marketed as Quorn, and that is causing an alarmingly high frequency of allergic reactions, some of them quite serious, is not the same product we tested. He added: "I am appalled that this material is allowed to stay on the market." Tee RD et al. (Clin Exper Allergy. 1993;23:257-260) This study was the first to appear in the medical literature and indicated possible safety problems with Quorn. The study involved 10 Britons who believed that Quorn caused vomiting or stomach ache. The study used classic allergy tests (like the skin-prick test) to assess the patients. There were weak indications that Quorn was allergenic, but the test methods used are considered insensitive and not highly accurate. The subjects were not fed Quorn foods, which might have elicited adverse reactions. Katona SJ, Kaminski ER. (J Clin Pathol. 2002 Nov;55(11):876-877) This letter from British researchers reported sensitivity to Quorn in a mold-allergic patient. Hoff M et al. (J Allergy Clin Immunol. 2003 May;111(5):1106-1110) These European researchers proved that Quorn caused an asthmatic reaction in a patient. They identified the particular protein that caused the allergic reaction. This paper is important. Jacobson, MF. (Allergy. 2003 May;58(5):455-456) This letter, submitted by the then executive director of the Center for Science in the Public Interest, described the adverse reactions reported by the first 284 people who contacted CSPI. It was the first item in the medical literature that indicated that Quorn caused widespread reactions, including vomiting, stomach ache, hives, and breathing difficulties. Van Durme P, Ceuppens JL, Cadot P. (J Allergy Clin Immunol. 2003 Aug;112(2): 452-454) Belgian researchers identified a young woman who suffered a severe anaphylactic-type allergic reaction after her first ingestion of Quorn. Skin prick tests were highly positive with Quorn extracts. The researchers deduced that Quorn can be cross-reactive with inhaled mold spores. Jacobson, MF. (Am J Med 2003 Sep;115:334) This letter, submitted by the then executive director of the Center for Science in the Public Interest, described the adverse reactions received by CSPI. The letter cites a survey suggesting that mycoprotein is more likely to cause adverse reactions than shellfish, milk, peanuts, and other common food allergens. Sandhu M. (AllergyCases.org) This case report describes a 14-year-old boy who had a reaction within two minutes of eating Quorn imitation chicken. The symptoms included throat irritation followed by itchiness, difficulty breathing, and swelling of the lip, tongue, eye, and laryngeal edema. A positive skin test demonstrated a sensitivity to small amounts of Quorn (and other molds). Jacobson, MF, DePorter J. (Ann Allergy Asthma Immunol. 2018 Mar;120:626-630) This article analyzes 1,752 self-reports of adverse reactions to Quorn reported to the Center for Science in the Public Interest. Allergic reactions, including hives and anaphylaxis, occurred within 4 hours of consumption in 312 people, and gastrointestinal symptoms, including vomiting and diarrhea, occurred within 8 hours of consumption in 1,692 people. Prepatellar bursitis. Definition/ Description [ edit | edit source ] Prepatellar bursitis is also called housemaid's knee or carpenter's knee. A bursa is a fluid-filled sac which ensures there is less friction between body parts. The prepatellar bursa is located superficially between the skin and the patella. The inflammation of a bursa is called bursitis. This inflammation can take form by either an infectious nature (30%) or a non-infectious nature (70%). A direct fall on the patella, an acute trauma, repeated blows or friction on the knee may cause prepatellar bursitis. Other causes include infections or low-grade inflammatory conditions, such as gout, syphilis, tuberculosis or rheumatoid arthritis. [1] Prepatellar bursitis often occurs in specific jobs which involves a position where they work on their knees for a prolonged period of time such as miners, gardeners, carpet layers and mechanics. [1] Clinically Relevant Anatomy [ edit | edit source ] The patella is a triangular-shaped bone in front of the knee. It moves up and down in the groove of the femur when you bend and straighten your knee. The patellar tendon is a thick structure that connects the bottom of the patella with the tibia. The upper part of the patella is connected to the quadriceps, which allows the knee extension and moves the patella upwards. B ursae around the knee can be divided into two groups- those around the patella (suprapatellar bursa, the superficial and deep infrapatellar bursae & prepatellar bursa) and those that occur elsewhere (pes anserinus bursa and the iliotibial bursa) [2] [1] Epidemiology [ edit | edit source ] Prepatellar bursitis affects men more often than women and it can emerge at all ages. 80% of the people with prepatellar bursitis are men aged between 40 – 60 years. 1/3 of the prepatellar bursitis are septic and 2/3 are non-septic. [3] An infectious prepatellar bursitis emerges more often with children than grown-ups. Prepatellar bursitis occurs often, with at least an annual incidence of 10/100 000. The incidence of prepatellar bursa is probably underestimated because most of the case are non-septic and only patients with the most severe cases of prepatellar bursitis requires admission in the hospital. [4] Etiology [ edit | edit source ] Direct trauma/blow to the anterior knee Frequent falls on the knee Constant friction between the skin and the patella [1] can be a cause of this condition. By the impact, the damaged blood vessels in the knee result in inflammation and swelling of the bursa. Actually, a bacterial seeding of the bursal sac caused by a hematoma is rare, because of the limited vascular supply of the bursal tissue. Infection:Typically for a septic prepatellar bursitis is a break in the skin near the bursa, which leads to swelling and pain around this area. This happens when a bacteria (for example S. Aureus, 80% of the cases) have passed across the soft tissues from a break in the skin and begins to multiply within the bursa. [2] When a bursa is infected it can probably cause pain, fever, tenderness and an elevated amount of white blood cells. Co-existing inflammatory disease- rheumatoid arthritis, gout etc. Characteristics/Clinical Presentation [ edit | edit source ] Pain Swelling [5] Differential warmth around the knee Painful and limited ROM at the knee If bursitis is caused by an infection, pain is associated with fever and chills. Differential Diagnosis [ edit | edit source ] Prepatellar bursitis is often confused with other causes of knee pain including: [6] Diagnostic Procedures [ edit | edit source ] [7] Bursitis can be diagnosed through a detailed history (about the onset of symptoms, the pattern of knee pain and swelling and how the symptoms affect their lifestyle) [8] and a physical examination, however, X-ray, MRI and CT-scan can be done to rule out the possibility of a fracture or soft tissue injury. If it is uncertain whether or not the bursa is infected, an arthrocentesis can be done.