ABSTRACT
Objective:To investigate the short-term outcome of Heidelberg triangle dissection in laparoscopic pancreaticoduodenectomy (LPD) for pancreatic cancer.Methods:The clinical data of 84 patients with pancreatic head cancer who underwent LPD from July 2015 to September 2020 in the Department of Hepatobiliary and Pancreatic Surgery of the Cangzhou Central Hospital were retrospectively analyzed. According to the scope of surgical dissection, the patients were divided into the control group ( n=45) and the Heidelberg group ( n=39). In the control group, routine lymph node dissection was performed, and in the Heidelberg group, all blood vessels, lymphatic tissue and nerve tissue in the Heidelberg triangle area were dissected on the basis of routine lymph node dissection. Operation-related indicators (operation duration, intraoperative blood loss, cases of patients with intraoperative blood transfusion, fasting time and hospitalization duration after operation), postoperative complications (pancreatic fistula, biliary fistula, lymphatic fistula, bleeding and delayed gastric emptying) and postoperative pathological parameters (surgical margin, degree of differentiation, tumor size, cases of nerve invasion, number of dissected lymph nodes, lymph node metastasis and TNM stage) were compared between the two groups. Results:Compared with the control group, the operation time of the Heidelberg group was longer [ (334.85±24.95)min vs (305.09±24.54)min], theincidence of lymphatic fistula was higher (15.4% vs 2.2%), the rate of >1 mm at surgical margin was higher (76.9% vs 53.3%), and the total number of lymph nodes dissection was more [ (11.31±2.46) vs (9.49±2.28)]. All the differences between the two groups were statistically significant ( P<0.05). However, there were no significant differences on the intraoperative blood loss, cases of patients with intraoperative blood transfusion, postoperative hospital stay and fasting time, incidence of pancreatic fistula and biliary fistula, bleeding, delayed gastric emptying, degree of differentiation, tumor size, cases of nerve invasion, lymph node metastasis and TNM stage between the two groups. Conclusions:LPD combined with Heidelberg triangle dissection for pancreatic cancer was feasible and safe, which can increase the R 0 resection rate, remove more lymph nodes, reduce the local recurrence of pancreatic cancer and improve the prognosis of patients.
ABSTRACT
Salmonella is a major cause of foodborne illness worldwide, and poultry and its derived products are the most common food products associated with salmonellosis outbreaks. Some countries, including Brazil, have experienced an increased prevalence of Salmonella Heidelberg among their poultry flocks. Some isolates have also presented high resistance to antimicrobial agents and persist in the poultry farm environment. This study aimed to compare the susceptibility of S. Heidelberg strains isolated in 2006 with those isolated in 2016 against disinfectants and antimicrobial agents. The results showed that all the strains were highly susceptible to sodium hypochlorite, regardless of the conditions and year of isolation. Resistance to benzalkonium chloride varied according to the conditions applied, but not to the year of isolation. Increased antimicrobial resistance from 2006-2016 was observed only for tetracycline. The results suggest that the antimicrobial and disinfectant resistance of S. Heidelberg did not increase for ten years (2006-2016). However, further analysis should include a larger number of S. Heidelberg isolates from poultry origin and additional antimicrobial agents for more precise conclusions about the increasing in antimicrobial resistance in the last years.(AU)
Salmonella é uma das principais causas das doenças transmitidas por alimento em todo o mundo, e a carne de frango e produtos derivados são os principais alimentos associados com surtos de salmonelose em humanos. Alguns países, incluindo o Brasil, têm observado um aumento da ocorrência de Salmonella Heidelberg nas suas granjas avícolas. Além disto, alguns isolados têm apresentado alta resistência aos antimicrobianos e têm persistido no ambiente de produção avícola. Neste contexto, o objetivo deste estudo foi comparar a susceptibilidade de cepas de S. Heidelberg isoladas em 2006 com aquelas isoladas em 2016 contra desinfetantes e agentes antimicrobianos. Os resultados demonstraram que as cepas foram altamente resistentes a hipoclorito de sódio, independentemente das condições e do ano de isolamento. A resistência ao cloreto de benzalcônio variou de acordo com as condições testadas, mas não com o ano de isolamento. Um aumento da resistência aos antimicrobianos de 2006 a 2016 foi observado apenas para tetraciclina. Os resultados sugerem que a resistência aos desinfetantes e aos antimicrobianos não aumentou em um período de dez anos (2006-2016). Entretanto, novas análises devem incluir um número maior de cepas de S. Heidelberg isoladas de fontes avícolas e outros agentes antimicrobianos para uma conclusão mais precisa sobre o aumento da resistência antimicrobiana nos últimos anos.(AU)
Subject(s)
Animals , Poultry/microbiology , Salmonella Infections, Animal/microbiology , Disinfectants/analysis , Anti-Infective Agents/analysisABSTRACT
ABSTRACT: Salmonella is a major cause of foodborne illness worldwide, and poultry and its derived products are the most common food products associated with salmonellosis outbreaks. Some countries, including Brazil, have experienced an increased prevalence of Salmonella Heidelberg among their poultry flocks. Some isolates have also presented high resistance to antimicrobial agents and persist in the poultry farm environment. This study aimed to compare the susceptibility of S. Heidelberg strains isolated in 2006 with those isolated in 2016 against disinfectants and antimicrobial agents. The results showed that all the strains were highly susceptible to sodium hypochlorite, regardless of the conditions and year of isolation. Resistance to benzalkonium chloride varied according to the conditions applied, but not to the year of isolation. Increased antimicrobial resistance from 2006-2016 was observed only for tetracycline. The results suggest that the antimicrobial and disinfectant resistance of S. Heidelberg did not increase for ten years (2006-2016). However, further analysis should include a larger number of S. Heidelberg isolates from poultry origin and additional antimicrobial agents for more precise conclusions about the increasing in antimicrobial resistance in the last years.
RESUMO: Salmonella é uma das principais causas das doenças transmitidas por alimento em todo o mundo, e a carne de frango e produtos derivados são os principais alimentos associados com surtos de salmonelose em humanos. Alguns países, incluindo o Brasil, têm observado um aumento da ocorrência de Salmonella Heidelberg nas suas granjas avícolas. Além disto, alguns isolados têm apresentado alta resistência aos antimicrobianos e têm persistido no ambiente de produção avícola. Neste contexto, o objetivo deste estudo foi comparar a susceptibilidade de cepas de S. Heidelberg isoladas em 2006 com aquelas isoladas em 2016 contra desinfetantes e agentes antimicrobianos. Os resultados demonstraram que as cepas foram altamente resistentes a hipoclorito de sódio, independentemente das condições e do ano de isolamento. A resistência ao cloreto de benzalcônio variou de acordo com as condições testadas, mas não com o ano de isolamento. Um aumento da resistência aos antimicrobianos de 2006 a 2016 foi observado apenas para tetraciclina. Os resultados sugerem que a resistência aos desinfetantes e aos antimicrobianos não aumentou em um período de dez anos (2006-2016). Entretanto, novas análises devem incluir um número maior de cepas de S. Heidelberg isoladas de fontes avícolas e outros agentes antimicrobianos para uma conclusão mais precisa sobre o aumento da resistência antimicrobiana nos últimos anos.
ABSTRACT
Salmonella detection is a key point in food safety testing, because of the frequent association of this pathogen with food poisoning in humans. The standard bacteriological tests currently used for Salmonella-detection are time-consuming; therefore, there is a need to develop alternative methods to accelerate the detection. In order to accelerate Salmonella diagnosis, we used the immunomagnetic separation assay associated with bacteriophage P22 for the rapid detection of the following Salmonella serovars in chicken rinses of drumsticks, artificially contaminated with 5, 10, and 100 CFU/25mL of bacteria: Salmonella enterica subsp. enterica serovar Heidelberg (S. Heidelberg), Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis) and Salmonella enterica subsp. enterica serovar Typhimurium (S. Typhimurium). The efficiency of the technique, represented by the time required for detection of positive and negative samples, was compared with that of the standard diagnostic tests used for this pathogen, the bacteriological assay and the polymerase chain reaction (PCR)-based test. This study confirmed the ability of the bacteriophage-associated immunomagnetic separation assay to identify 99.6% of Salmonella-positive samples of the three serovars tested. In contrast, the bacteriological assay and PCR-based test detected 95.1% and 98.5% of the Salmonella-positive samples respectively.(AU)
A detecção de Salmonella é um ponto crucial para a segurança alimentar, devido a frequente associação deste patógeno com infecções alimentares em humanos. O método padrão para detecção de Salmonella é o bacteriológico, mas o tempo requerido para o processamento das amostras e o diagnóstico final é longo, por isso existe a necessidade de desenvolvimento de métodos alternativos que visem acelerar esta etapa. Para isto utilizamos a separação imunomagnética associada ao bacteriófago P22 como técnica de detecção rápida para os seguintes sorovares de Salmonella: Salmonella enterica subsp. enterica sorovar Heidelberg (S. Heidelberg), Salmonella enterica subsp. enterica sorovar Enteritidis (S. Enteritidis) e Salmonella enterica subsp. enterica sorovar Typhimurium (S. Typhimurium), os quais foram inoculados artificialmente em lavados de sobre-coxas de frango nas seguintes concentrações: 5, 10 e 100 UFC/25mL. A eficiência da técnica, representada pelo tempo requerido para detecção de amostras positivas ou negativas, foi comparado com os testes rotineiramente utilizados para detecção de Salmonella, o exame bacteriológico e a reação em cadeia da polimerase (PCR). Este estudo confirmou a capacidade do teste de separação imunomagnética associado a bacteriófago, o qual identificou 99,6% das amostras positivas para Salmonella, dos três sorovares testados. Já o bacteriológico e PCR identificaram respectivamente 95,1% e 98,5% das amostras positivas.(AU)
Subject(s)
Animals , Poultry/microbiology , Salmonella enterica/pathogenicity , Diagnostic Techniques and Procedures/veterinaryABSTRACT
·AIM: To compare choroidal thickness at the macula in eyes with unilateral idiopathic full - thickness macular holes (FTMH) with that of unaffected fellow eyes, and eyes of normal control patients. ·METHODS: Cross-sectional study. Thirty patients with unilateral idiopathic FTMH and thirty age, sex, and race-matched controls were recruited. Axial lengths were measured using laser interferometry. Enhanced depth imaging optical coherence tomography images were obtained using Heidelberg spectral - domain optical coherence tomography. Choroidal thickness was measured at the fovea, and at 1 mm and 2 mm nasally, temporally, superiorly and inferiorly from the center of the fovea. Statistical analysis was performed using independent and paired t-tests, chi-square tests, and Pearson correlation tests (P<0.05). ·RESULTS:The mean subfoveal choroidal thickness was 201.0±44.0 μ m in the FTMH group,225.3± 51.4 μ m in the fellow eye group and 262.3±70.3 μ m in the control group. The choroid was thinner in FTMH eyes at all locations when compared to control eyes(P<0.05). The fellow eye group also had thinner choroids than the control group at all locations except at 1 mm and 2 mm nasal to the fovea (P<0.05). Choroidal thickness in the FTMH group was lower than in the fellow eye group, but the differences were not statistically significant (P > 0.05). Choroidal thickness was generally highest subfoveally and lowest nasally. Subfoveal choroidal thickness was negatively correlated with age (r = -0.278, P = 0.032), and axial length (r=-0.328,P=0.011). ·CONCLUSION:Choroidal thickness is lower in both eyes of patients with unilateral FTMH compared to healthy control eyes.
ABSTRACT
Background: Heidelberg retina tomogram (HRT) and optical coherence tomography (OCT) are two widely used imaging modalities to evaluate the optic nerve head (ONH) in glaucoma. Purpose: To compare the ONH parameters of HRT3 and high‑definition OCT (HD‑OCT) and evaluate their diagnostic abilities in perimetric and preperimetric glaucoma. Design: Cross‑sectional analysis. Methods: 35 control eyes (24 subjects), 21 preperimetric glaucoma eyes (15 patients), and 64 perimetric glaucoma eyes (44 patients) from the Longitudinal Glaucoma Evaluation Study underwent HRT3 and HD‑OCT examinations. Statistical Analysis: Agreement between the ONH parameters of HRT and HD‑OCT were assessed using Bland–Altman plots. Diagnostic abilities of ONH parameters were evaluated using area under the receiver operating characteristic curves (AUCs), sensitivity at fixed specificity, and likelihood ratios (LR). Results: Optic disc area, vertical cup to disc ratio, and cup volume with HD‑OCT were larger than with HRT, while the rim area was smaller with HD‑OCT (P < 0.001 for all comparisons). AUCs of all HD‑OCT ONH parameters (0.90–0.97 in perimetric and 0.62–0.71 in preperimetric glaucoma) were comparable (P > 0.10) to the corresponding HRT ONH parameters (0.81–0.95 in perimetric and 0.55–0.72 in preperimetric glaucoma). LRs associated with diagnostic categorization of ONH parameters of both HD‑OCT and HRT were associated with larger effects on posttest probability of perimetric compared to preperimetric glaucoma. Conclusions: ONH measurements of HD‑OCT and HRT3 cannot be used interchangeably. Though the diagnostic abilities of ONH parameters of HD‑OCT and HRT in glaucoma were comparable, the same were significantly lower in preperimetric compared to perimetric glaucoma.
ABSTRACT
PURPOSE: We compared the abilities of Stratus optical coherence tomography (OCT), Heidelberg retinal tomography (HRT) and standard automated perimetry (SAP) to detect the progression of normal tension glaucoma (NTG) in patients whose eyes displayed localized retinal nerve fiber layer (RNFL) defect enlargements. METHODS: One hundred four NTG patients were selected who met the selection criteria: a localized RNFL defect visible on red-free fundus photography, a minimum of five years of follow-up, and a minimum of five reliable SAP, Stratus OCT and HRT tests. Tests which detected progression at any visit during the 5-year follow-up were identified, and patients were further classified according to the state of the glaucoma using the mean deviation (MD) of SAP. For each test, the overall rates of change were calculated for parameters that differed significantly between patients with and without NTG progression. RESULTS: Forty-seven (45%) out of 104 eyes displayed progression that could be detected by red-free fundus photography. Progression was detected in 27 (57%) eyes using SAP, 19 (40%) eyes using OCT, and 17 (36%) eyes using HRT. In early NTG, SAP detected progression in 44% of eyes, and this increased to 70% in advanced NTG. In contrast, OCT and HRT detected progression in 50 and 7% of eyes during early NTG, but only 30 and 0% of eyes in advanced NTG, respectively. Among several parameters, the rates of change that differed significantly between patients with and without progression were the MD of SAP (p = 0.013), and the inferior RNFL thickness (p = 0.041) and average RNFL thickness (p = 0.032) determined by OCT. CONCLUSIONS: SAP had a higher detection rate of NTG progression than other tests, especially in patients with advanced glaucoma, when we defined progression as the enlargement of a localized RNFL defect. The rates of change of the MD of SAP, inferior RNFL thickness, and average RNFL thickness differed between NTG patients with and without progression.
Subject(s)
Female , Humans , Male , Middle Aged , Disease Progression , Intraocular Pressure/physiology , Low Tension Glaucoma/diagnosis , Retina/pathology , Tomography, Optical Coherence/methods , Visual Field Tests/methods , Visual Fields/physiologyABSTRACT
Salmonellaenterica serovar Heidelberg es uno de los principales agentes causantes de salmonelosis en humanos en Estados Unidos y Canadá, sin embargo, resulta infrecuente en los países de Sudamérica y Europa. En este trabajo se caracterizó un aislamiento de S. Heidelberg resistente a oximino-cefalosporinas recuperado de un paciente internaen un hospital de la Ciudad de Buenos Aires. Se evidenció la presencia de un plásmido de 97 kbperteneciente al grupo de incompatibilidad IncN, portador del gen blaCMY-2. ISEcp1 fue localizado corriente arriba de blaCMY-2, promoviendo su expresión y movilización.El aislamiento de S. Heidelberg correspondió al secuenciotipo 15 y en la virotipifi cación se detectó el gen sopE. En este trabajo describimos por primera vez la producción de CMY-2 en una cepa de S. Heidelberg en nuestro país y América Latina
Salmonellaenterica serovar Heidelberg ranks among the most prevalent causes of human salmonellosis in the United States and Canada, although it has been infrequently reported in South American and European countries.Most Salmonella infections are self-limiting; however, some invasive infections require antimicrobial therapy. In this work we characterized an oxyimino-cephalosporin resistant S. Heidelberg isolate recovered from an inpatient in a Buenos Aires hospital. CMY-2 was responsible for the ß-lactam resistance profi le. S. Heidelberg contained a 97 kb plasmid belonging to the Inc N groupharboring blaCMY-2. ISEcp1 was located upstream blaCMY-2 driving its expression and mobilization.The isolate belonged to sequence type 15 and virotyping revealed the presence of sopE gene. In this study we identifi ed the fi rst CMY-2 producing isolate of S. Heidelberg in Argentina and even in South Americ
Subject(s)
Humans , Male , South America/epidemiology , beta-Lactamases/analysis , Salmonella enterica/isolation & purification , Plasmids/analysis , Salmonella enterica/pathogenicityABSTRACT
Background Heidelberg Retinal Tomograph (HRT) has been widely used in clinical diagnosis of glaucomatous optic neuropathy,importantly,the measurement results of HRT may be affected by myopia.Therefore,studying the effect of different refractive status and axial length on structural parameters of the optic disc is important.Objective This study was to evaluate the influence of refractive error and axial length to optic nerve head parameter measured by HRT.Methods The parents who participate in Guangzhou Twin Study were enrolled in this investigation from July 2006 to August 2011.The regular eye examinations,including visual acuity,slit lamp,fundus,auto-refraction,HRT-Ⅲ and intraocular lens (IOL) Master,were performed on all the subjects.Thc data from right eyes of subjects were collected and analyzed.The linear correlation analysis and multiple linear regression analysis were applied to analyze the correlation between HRT optic papilla configuration parameter and equivalent sphere and ocular axis length.Results A pilot prospective series cases observational study was designed.1748subjects were enrolled in this study.The disc area (DA) (P=0.021),rim area (RA) (P＜0.001),rim volume (RV) (P＜0.001),mean retinal nerve fiber layer thickness (mRNFLt) (P＜0.001) and retinal nerve fiber layer cross section area (RNFLcsa) in the high myopia were greater than those of the emmetropic group,with significant difference between the two groups (P＜0.001).However,the cup area (CA),cup/disk area ratio (C/DAR) and cup volume (CV) were less in the high myopic group than those of the emmetropic group (P=0.004,P＜0.001 and P＜O.001),respectively.In the mild-moderatc myopic group,the RV,mRNFLt and RNFLcsa were greater than those of the emmetropic group (all of the P value less than 0.001),but the numbers of DA,CA,C/DAR,and CV were less than those of the emmetropic group,the differences were significant and their P valuables were 0.038,＜ 0.001,＜0.001 and 0.001 respectively.The differences of structure parameters between the hyperopia group and the emmetropic group were not statistically significant (P＞0.05).The DA,CA,RA,C/DAR,CV,RV,mean cup depth (MCD),maximum cup depth (MxCD),cup shape measure (CSM),mRNFLt and RNTLcsa were (2.04±0.43) mm2,(0.49±0.34) mm2,(1.55 ± 0.34) mm2,0.23-0.13,(0.11 ± 0.12) mm3,(0.45 ± 0.19) mm3,(0.21 ± 0.09) mm,(0.60±0.21) mm,-0.21 ± 0.07,(0.29 ± 0.07) mm and (1.46 ± 0.36)mm2,respectively,in the 1748 eyes of 1748 subjects.No significant correlation was found between the DA value with SE (r=-0.032,P =0.186).However,weaker positive correlations were seen between the CA,C/DAR,CV,MCD,MxCD with SE (r=0.139,0.163,0.130,0.004,0.054,P＜ 0.05) and negative correlation between RA,RV,mRNFLt and RNFLcsa with SE (r =-0.178,-0.331,0.241,-0.239,P＜0.001).With the increase of the ocular axial length,the DA,RA,RV,mRNFLt and RNFLcsa values were enlarged,and the CV value was smaller.With the increase of CA,the RA,C/DAR,CV,RV,MCD,MxCD,CSM and RNFLcsa values elevated,but mRNFLt value was decreased.Conclusions Refractive error is not associated with DA,but the measuring results are different among various refractive groups.Refractive error,ocular axial length and DA affect the measuring result of HRT.
ABSTRACT
Background Normal adult optic disc rim width follows inferior ≥ superior ≥ nasal ≥ temporal (ISNT) rule.Analysis of the optic disc structural parameters with Heidelberg retina tomograph (HRT) can understand whether ISNT principle is suitable to other optic disc structure parameters.Objective This study was to investigate the characteristics of optic nerve head structure parameters in normal Chinese adults.Methods The parents of twins who participated Guangzhou Twin Eye Study were enrolled in Zhongshan Ophthalmic Center from 2006 June to 2011 August.All subjects received the routine eye examinations,including visual acuity,slit lamp microscope,direct ophthalmoscope examination,auto-refraction examination and HRT Ⅲ examination.All data from the right eyes were collected and analyzed.HRT values from different quadrants of optical nerve head were compared with one-way analysis of variance,and the multiple comparison between quadrants was carried out by Bonferroni test.The differences of optical nerve head parameters in different gender were analyzed using independent sample t test and Bland-Altman test.Results In this study,1672 eyes of 1672 subjects were included,with the 759 male and 913 female persons and average age of (41.8±5.3)years.No significant differences were seen in the disc area (DA)between the superior and inferior,as well as the nasal and temporal quadrants among the subjects (P＞0.05).In addition,there were not significantly different in the rim area (RA) between the superior and nasal disc as well as the rim volume (RV) among the inferior,superior and nasal disc (P＞O.05).However,significant differences were found in the cup area (CA),cup/disk area ratio (C/DAR),cup volume (CV),mean cupdepth (MCD),maximum cup depth (MxCD),height variation contour (HVC),cup shape measure (CSM),mean retinal nerve fiber layer thickness (mRNFLT) and retinal nerve fiber layer cross section area (RNFLcsa) among the different quadrants (P＜0.001).The local differences from only DA and RA complied with an ordination of the ISNT rule.The values of DA,CA,C/DAR,CV,MCD,MxCD from male individuals were higher,but those of the RV,HVC,mRNFLT RNFLcsa were lower in comparison with female individuals.Nevertheless,all the differences were ＜ 0.1 with a maximal mean difference in DA and CA (both 0.07 mm2).Conclusions The optical nerve head configurations measured by HRT have different distributing characteristics in four quadrants in normal adults.Most parameters show the higher values in the inferior and superior than those in nasal and temporal of disc,but DA and RA meet ISNT rule.The differences of most parameters between male and female subjects can be ignored.
ABSTRACT
Objetivou-se avaliar a ação de três princípios ativos rotineiramente utilizados na higienização de abatedouros avícolas frente a amostras de Salmonella Heidelberg isoladas em diferentes pontos da tecnologia de abate de um mesmo frigorífico. Foram testadas 20 amostras de S. Heidelberg (14 isoladas em 2005 e seis em 2009) frente a clorexidina (0,5%), amônia quaternária (0,5%) e ácido peracético (1%) nos tempos de contato de 5, 10, 15 e 20 minutos. Todas as amostras foram sensíveis ao ácido peracético 1% em todos os tempos testados. Observou-se que 100% das amostras isoladas em 2005 foram sensíveis a amônia quaternária enquanto que as isoladas em 2009 apresentaram 33% de resistência com 5 minutos de contato e 16,6% com 10 minutos de contato. Com relação à clorexidina, 25% dos isolados em 2005 mostraram-se resistentes após 5 minutos de contato enquanto que 33% das amostras isoladas em 2009 foram resistentes neste tempo e 17% no tempo de 10 minutos de contato. Pode-se concluir que o ácido peracético teve ação in vitro sobre as amostras isoladas em 2005 e 2009, enquanto que a clorexidina e a amônia quaternária tiveram sua ação reduzida frente às amostras de 2009, indicando a progressão da resistência bacteriana frente a estes sanitizantes e a necessidade de testes periódicos e rotação de princípios ativos nos programas de higienização dos frigoríficos.
The objective of this investigation was to evaluate the in vitro sensibility of Salmonella Heidelberg to three commercially available disinfectants used for sanitization in poultry slaughterhouses. A total of 20 S. Heidelberg were tested (14 isolated in 2005 and six in 2009), and as active ingredients were used chlorhexidine (0.5%), quaternary ammonium (0.5 %) and peracetic acid (1%) at contact intervals of 5, 10, 15 e 20 minutes. All isolates were found to be sensitive to peracetic acid at four specific contact intervals. One hundred percent of S. Heidelberg isolated in 2005 was found to be sensitive to quaternary ammonium, while 33% of 2009 isolates were resistant at a 5-minute contact interval and 16.6% at 10-minutes. With respect to chlorhexidine, 25% of the 2005 isolates were resistant at a 5-minute contact interval, 33% of the 2009 isolates were resistant with the same time, and 17% at a 10-minute contact interval. It can be concluded that the highest disinfectant activity in vitro was found to be with peracetic acid for S. Heidelberg isolates in 2005 and 2009, whereas chlorhexidine and quaternary ammonium had a reduced action against 2009 isolates, indicating the progression of bacterial resistance against these sanitizers and the need for periodic evaluation and rotation of active principles for sanitization.
Subject(s)
Animals , Ammonia , Poultry/methods , Chlorhexidine , Abattoirs/standards , Peracetic Acid , Poultry , Salmonella/isolation & purification , Disinfectants , DisinfectionABSTRACT
Over the years, Salmonella Heidelberg (SH) has gained prominence in North America poultry production and in the poultry production of other countries. Salmonella Heidelberg has been isolated and reported from poultry and poultry products in Brazil since 1962, whereas Salmonella Enteritidis (SE) has only emerged as a serious problem in poultry and public health since 1993. These strains of Salmonella can cause intestinal problems in newly hatched chicks, and infection may persist until adulthood. Upon slaughter of chickens, Salmonella can contaminate carcasses, a condition that poses a threat to human health. The aim of this study was to compare the fecal excretion of Salmonella Enteritidis and Salmonella Heidelberg in newly hatched chicks (orally inoculated with 10(5)ufc/mL each) until 20 days of age. In addition, the ratio of cecal villus height:crypt depth (morphometry) and liver and cecum cell counts was analyzed in chicks ranging from 0 to 3 days of age and infected with these two Salmonella strains. One hundred seventeen chicks were separated into one of three experimental groups: a control group, an SE-infected group and an SH-infected group. Eight chicks per group were euthanized at 6, 12 and 72 hours post-inoculation (pi) to allow for Salmonella isolation from the liver and cecum and for the collection of the cecum for villi and crypt analysis. Other birds were allowed to mature to 20 days of age and cloacal swabs were taken at 2, 6, 13 and 20 days pi to compare the fecal excretion of inoculated strains. The Salmonella Enteritidis group had a higher number of cells excreted during the trial. Both strains were isolated from the liver and cecum by 6h pi. At 12h pi the Salmonella Heidelberg group had high cell counts in the cecum. No difference was found in liver cell counts. Both strains showed lower villus height:crypt depth ratio than the control group post-infection.
Subject(s)
Animals , Microscopy, Electron , Poultry , Salmonella Infections, Animal , Salmonella enteritidis/isolation & purification , Colony Count, Microbial , Food Samples , Methods , Serial Passage , MethodsABSTRACT
Purpose: The purpose was to study the dimensions of the foveal avascular zone (FAZ) using Heidelberg Retinal Angiogram-2 (HRA-2; Heidelberg Engineering GmBH, Dossenheim, Germany). Materials and Methods: An observational study of the FAZ area and circumference was done with fundus fluorescein angiography (FFA) using HRA-2 in 31 normal individuals. The FAZ was studied using both contrast-adjusted and nonadjusted methods. Contrast adjustment was done to obtain better visualization of the finer capillaries around the fovea enabling more precise measurements of the FAZ in normal eyes. Results: The mean area of the FAZ calculated by the contrast-adjusted method was 0.2753 mm2 (±0.074) and the mean circumference was 2.22 mm (±0.048). By the conventional method, the area and circumference of the FAZ were 0.6241 mm2 (±0.177) and 3.23 mm (±0.454), respectively. Conclusion: The measurements of area and circumference of FAZ using contrast-adjusted methods were significantly smaller than the conventional method.
Subject(s)
Adult , Capillaries/diagnostic imaging , Female , Fluorescein Angiography , Fovea Centralis/anatomy & histology , Fovea Centralis/blood supply , Fundus Oculi , Humans , Male , Reference Values , Retinal Vessels/diagnostic imaging , Young AdultABSTRACT
PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Subject(s)
Aged , Female , Humans , Male , Double-Blind Method , Ginkgo biloba , Laser-Doppler Flowmetry , Low Tension Glaucoma/drug therapy , Optic Disk/blood supply , Phytotherapy/methods , Plant Extracts/therapeutic use , Regional Blood Flow/drug effects , Retina/physiopathology , Retrospective Studies , Time Factors , Visual FieldsABSTRACT
PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.
Subject(s)
Aged , Female , Humans , Male , Double-Blind Method , Ginkgo biloba , Laser-Doppler Flowmetry , Low Tension Glaucoma/drug therapy , Optic Disk/blood supply , Phytotherapy/methods , Plant Extracts/therapeutic use , Regional Blood Flow/drug effects , Retina/physiopathology , Retrospective Studies , Time Factors , Visual FieldsABSTRACT
Background Many studies showed that attenuation of retinal nerve fiber layer(RNFL)in early glaucoma is one of the important signs.How to accurately and quantitatively measure RNFL thickness is very important for the early diagnosis and monitoring of glaucoma.0bjective This study was to evaluate the clinical value of Optovue RTVue OCT and Heidelberg Retina Tomograph Ⅲ(HRT-Ⅲ)confocal scanning laser ophthalmoscopy in glaucomatous eyes. Methods This cross-sectional study included 40 eyes of 26 patients with suspected open-angle glaucoma(SOAG),48 eyes of 29 patients with open-angle glaucoma and 48 eyes of 27 healthy subjects.Optical nerve head(ONH) parameters and peripapillary RNFL thickness were measured in all the subjects with Optovue RTVue OCT and HRT-Ⅲ,meanwhile all the eyes received perimetry with Humphrey 750-I.Glaucoma variables obtained from Optovue RTVue OCT and HRT-Ⅲ were analyzed among the groups.Topographic Optovue RTVue OCT and HRT-Ⅲ parameters,including disc area(DA),cup area(CA),rim area(RA),rim volume(RV),cup volume(CV),cup/disc area ratio(C/DAR)as well as superior,temporal,inferior and nasal average RNFL thickness,were analyzed.The relationship of ONH parameters and RNFL thickness was analyzed using a linear correlation.The correlation between the mean defect(MD)of the visual field and the tomography parameters in glaucomatous eyes was described by bivariate Pearson correlation coefficients.Resuits The ONH parameters and RNFL thickness obtained by HRT-Ⅲ and OCT showed significant difference(P<0.05).ONH parameters such as RA,C/DAR,CA and RV were statistically changed in SOAG and the POAG patients compared with the normal subjects(q=6.47,q=7.67,P<0.05).The superior and inferior RNFL thickness parameters in three groups were positively correlated between HRT-Ⅲand OCT(r=0.362,r=0.441,r=0.395,P<0.05),Topographic Optovue RTVue OCT and HRT-Ⅲ parameters including CV,CA,RA and C/DAR fitted Pearson analysis(all P<0.05).In POAG group。The RA,RV,CV,C/DAR from Optovue RTVue OCT were correlated with MD with the significant coefficient 0.284,0.286,0.340,0.371 respectively(P<0.05),and evidently correlations also were found between RA,RV,C/DAR with MD respectively with the coefficient 0.339,0.859,0.422(P<0.05)by HRT-Ⅲ. Conclusion Both Optovue RTVue OCT and HRT-Ⅲ can difierentiate ONH analysis with a similar outcome in glaucomatous eye.The C/D value.RA,superior and inferior RNFL thickness based on Optovue RTVue OCT and HRT-Ⅲare distinguishing indexes in the diagnosis of early glaucomatous damage.
ABSTRACT
Purpose: To compare the diagnostic performance of the Heidelberg retinal tomograph (HRT) glaucoma probability score (GPS) with that of Moorfield’s regression analysis (MRA). Materials and Methods: The study included 50 eyes of normal subjects and 50 eyes of subjects with early-to-moderate primary open angle glaucoma. Images were obtained by using HRT version 3.0. Results: The agreement coefficient (weighted k) for the overall MRA and GPS classification was 0.216 (95% CI: 0.119 – 0.315). The sensitivity and specificity were evaluated using the most specific (borderline results included as test negatives) and least specific criteria (borderline results included as test positives). The MRA sensitivity and specificity were 30.61 and 98% (most specific) and 57.14 and 98% (least specific). The GPS sensitivity and specificity were 81.63 and 73.47% (most specific) and 95.92 and 34.69% (least specific). The MRA gave a higher positive likelihood ratio (28.57 vs. 3.08) and the GPS gave a higher negative likelihood ratio (0.25 vs. 0.44).The sensitivity increased with increasing disc size for both MRA and GPS. Conclusions: There was a poor agreement between the overall MRA and GPS classifications. GPS tended to have higher sensitivities, lower specificities, and lower likelihood ratios than the MRA. The disc size should be taken into consideration when interpreting the results of HRT, as both the GPS and MRA showed decreased sensitivity for smaller discs and the GPS showed decreased specificity for larger discs.
Subject(s)
Adult , Diagnostic Techniques, Ophthalmological , Glaucoma, Open-Angle/diagnosis , Humans , Middle Aged , Ophthalmoscopy , Optic Disk/pathology , Regression Analysis , Sensitivity and SpecificityABSTRACT
OBJETIVO: Valorar la correspondencia entre los resultados obtenidos con el tomógrafo retiniano de Heildelberg y la perimetría azul-amarillo en pacientes sospechosos de glaucoma. MÉTODOS: Se realizó un estudio descriptivo, prospectivo de corte longitudinal en 30 pacientes sospechosos de glaucoma, desde de noviembre de 2006 hasta abril de 2007. Se les realizaron tres exámenes topográficos de la papila óptica y tres exámenes perimétricos con un intervalo de 2 meses en un período de 6 meses. RESULTADOS: Predominó la edad mayor de 40 años (56,67 por ciento). Se observaron hallazgos topográficos sugestivos de glaucoma en un 63,3 por ciento de la muestra y fueron los más frecuentes: la excavación mayor de 0,6 en su eje vertical y el adelgazamiento del anillo neurorretiniano (56,67 por ciento en ambos casos). Aparecieron cambios perimétricos en 43,3 por ciento de los casos estudiados y los más frecuentes fueron en el primer estudio, el aumento de la mancha ciega y la pérdida general de la sensibilidad (10 por ciento). También estas manifestaciones fueron las más frecuentes en el segundo estudio (13,33 por ciento); el tercer estudio arrojó de forma similar una pérdida general de la sensibilidad en 43,33 por ciento de los pacientes. CONCLUSIONES: Los cambios topográficos precedieron en un mayor número de casos a los cambios perimétricos.
OBJECTIVE: To assess the correlation between the results achieved with the Heidelberg retinal tomography and the blue-on-yellow perimetry in glaucoma-suspected patients. METHODS: A prospective longitudinal and descriptive study was conducted on 30 glaucoma-suspected patients, from November 2006 to April 2007. Three topographic tests and three perimetric tests were performed on these patients in a 6-month period at 2- month intervals. RESULTS: Over 40 years of age prevailed (56,67 percent). Topographic findings indicative of glaucoma were observed in 63,3 percent of the sample and the most frequent were excavation higher than 0,6 in the vertical axis and the reduction of the neuroretinal ring (56,67 percent in both cases). Perimetric changes appeared in 43,3 percent in all the studied cases and the most common changes were increase of the blind spot and the general loss of sensitivity (10 percent) in the first study, and also in the second study (13,33 percent); the third study similarly yielded a general loss of sensitivity in 43,33 percent of patients. CONCLUSIONS: Topographic changes occurred before the perimetric changes in a high number of cases.
ABSTRACT
Background: Assessment of optic disc size is an important component of optic nerve head examination. Agreement between different methods of disc size measurements is not very good. Purpose: To assess the agreement between the disc size assessed by Heidelberg retina tomograph (HRT) and stereobiomicroscopy with a 90 diopter (D) lens. To report the clinical (measured by biomicroscopy) disc diameters of small, average and large optic discs categorized by HRT disc areas. Setting and Design: Observational study of subjects examined in the glaucoma clinic of a tertiary eye institute. Materials and Methods: Seventy-five eyes of 75 glaucoma subjects were studied. Disc diameter was measured using stereobiomicroscopy and HRT. The agreement between the two sets of measurements was assessed by intraclass correlation coefficient (ICC). Discs were classified into small (<1.6 mm2), average (1.6-2.6 mm2) and large (>2.6 mm2) depending on cutoffs provided by the manufacturers of HRT. The means (95% CI) of the corresponding vertical disc diameter in these groups were assessed. Statistical Analysis: ICC, Bland and Altman plots. Results: ICC for measurements of clinical and HRT horizontal disc diameter was 0.518 and for vertical disc diameter measurement was 0.487. The mean difference between the clinical and HRT measurements as analyzed by the Bland and Altman plot was 0.17 (95% CI, 0.13- 0.47) for horizontal and 0.22 (95% CI, 0.11- 0.54) for vertical disc diameter. Of the 75 eyes, 3 eyes had small discs, 54 average and 18 large discs. The mean clinical vertical disc diameter for small discs was 1.55 mm (95% CI, 1.2-1.7), for average discs was 1.91 mm (95% CI, 1.87-1.96) and for large discs was 2.15 mm (95% CI, 2.03–2.27). Conclusion: The agreement between clinical and HRT disc diameter measurements is moderate. Disc diameter measurement on stereobiomicroscopy can be used to categorize discs into small, average and large discs.
Subject(s)
Diagnostic Techniques, Ophthalmological , Female , Glaucoma/complications , Glaucoma/diagnosis , Humans , Male , Middle Aged , Observer Variation , Optic Disk/pathology , Optic Nerve Diseases/diagnosis , Optic Nerve Diseases/etiology , Reproducibility of Results , Retrospective Studies , Severity of Illness Index , Tomography/methodsABSTRACT
AIM: To show frequency of progression and progres-sion at the optic disc in primary open angle glaucoma (POAG).METHODS: A total of 33 patients (66 eyes), 14 male and 19 female, aged 14 to 79 with POAG were imaged using the Heidelberg Retina Tomography II (HRT II) three or more times during follow-up periods of 6 years (2000-2006). Disc progression was determined by regression analysis of global and segmental changes in optic disc parameters. Every patient was tested by Octopus G1 once a year. Imaged optic disc parameters with scanning laser tomography were: rim area (ra), cup/disc (C/D), rim volume (rv), mean RNFL thickness (mRNFL). Imaged segments of the optic disc were: global (G), temporal (T), temporal superior (TS), temporal inferior (TI), nasal (N), nasal superior (NS) and nasal inferior (NI).RESULTS: Global frequency of progression according to c/d ratio existed in 34 eyes (51%), but 32 eyes (48%) were without frequency of progression. Progression existed in 12 eyes (18%) in temporal, 7 eyes (10.6%) in temporal superior (TS), 14 eyes (21%) in temporal inferior (TI), 8 eyes (12%) in nasal (N), 7 eyes (10.6%) in nasal superior (NS), and 13 eyes (20%) in nasal inferior (NI) segment. Without progression were 5 eyes (8%).CONCLUSION: Disc progression in our study was mostly in nasal (N) and temporal inferior (TI) segments. Most frequently were stricken temporal inferior (TI) and nasal inferior (NI), but most infrequently nasal superior (NS) segment. Most sensitive parameter was c/d ratio. Segmental scanning is of importance in POAG progression analysis.