ABSTRACT
Use of noninvasive ventilation provided by a helmet increased globally during and after the COVID-19 pandemic. This approach may reduce need for intubation and its associated clinical complications in critically ill patients. Use of helmet interface minimizes virus aerosolization while enabling verbal communication, oral feeding and coughing/expectoration of secretions during its administration. Although improved oral hydration is a recognized benefit of helmet NIV, relatively little is known about the safety and efficiency of swallowing during helmet NIV. Risk of aspiration is a key consideration given the fragile pulmonary status of critically ill patients requiring respiratory support, and therefore the decision to initiate oral intake is best made based on multidisciplinary input. We reviewed the current published evidence on NIV and its effects on upper airway physiology and swallowing function. We then presented a case example demonstrating preservation of swallowing performance with helmet NIV. Last, we offer provisional multidisciplinary guidance for clinical practice, and provide directions for future research.
ABSTRACT
The global use of noninvasive respiratory support provided by different supportive ventilation delivery methods (SVDMs) has increased, but the impact of these devices on the upper airway structures of patients with amyotrophic lateral sclerosis (ALS) is not known. We aimed to compare the pharyngeal cross-sectional area during spontaneous breathing with four different SVDMs: intranasal masks, oronasal masks, high-flow nasal cannula (HFNC), and helmet in patients with ALS. We compared measures of the pharyngeal area during spontaneous breathing and SVDM use. The greatest increase was observed with intranasal mask use, followed by HFNC, oronasal mask, and helmet respectively. In conclusion, upper airway opening in patients with ALS is enhanced by positive pressure with intranasal masks and HFNC, showing promise for increasing pharyngeal patency. Future studies should explore its applicability and effectiveness in maintaining long-term pharyngeal patency, especially in this population with bulbar weakness.
ABSTRACT
Listeria monocytogenes is of notable concern to the food industry, due to its ubiquitous nature and ability to grow in adverse conditions. This study aimed to determine the genotypic profile of L. monocytogenes strains isolated from refrigerated chickens marketed in the southern part of Rio Grande do Sul, Brazil. The strains of L. monocytogenes isolated were characterized by serotyping and Pulsed Field Gel Electrophoresis (PFGE). Three different serotypes (1/2a, 1/2b and 4e) were evaluated by PFGE, and the macrorestriction patterns utilizing enzymes AscI and ApaI, revealed five different pulsotypes. The presence of such varied genotypic profiles demonstrates the prevalence of L. monocytogenes contamination of chicken processing environments, which combined with ineffective cleaning procedures, allowing the survival, adaptation and proliferation of these pathogens, not only in the processing environment, but also in local grocery stores.
Listeria monocytogenes é uma notável preocupação para a indústria de alimentos, devido à sua natureza ubíqua e a capacidade de se multiplicar em condições adversas. Este estudo objetivou determinar o perfil genotípico de L. monocytogenes isolada a partir de frangos refrigerados comercializados na região sul do Rio Grande do Sul, Brasil. As cepas de L. monocytogenes foram selecionadas e caracterizadas por sorotipagem e Eletroforese em Gel de Campo Pulsado (PFGE). Três sorotipos diferentes (1/2a, 1/2b e 4e) foram avaliados por PFGE, e a combinação dos padrões de macrorestrição utilizando as enzimas AscI e ApaI revelou cinco diferentes pulsotipos. A presença de diferentes perfis genotípicos demonstra a importância da contaminação no ambiente de processamento de frangos, o qual, juntamente com procedimentos de limpeza ineficazes, permitem a sobrevivência, adaptação e proliferação desses patógenos, não somente no ambiente de processamento, mas também no local de comercialização destes produtos.
ABSTRACT
ABSTRACT: Listeria monocytogenes is of notable concern to the food industry, due to its ubiquitous nature and ability to grow in adverse conditions. This study aimed to determine the genotypic profile of L. monocytogenes strains isolated from refrigerated chickens marketed in the southern part of Rio Grande do Sul, Brazil. The strains of L. monocytogenes isolated were characterized by serotyping and Pulsed Field Gel Electrophoresis (PFGE). Three different serotypes (1/2a, 1/2b and 4e) were evaluated by PFGE, and the macrorestriction patterns utilizing enzymes AscI and ApaI, revealed five different pulsotypes. The presence of such varied genotypic profiles demonstrates the prevalence of L. monocytogenes contamination of chicken processing environments, which combined with ineffective cleaning procedures, allowing the survival, adaptation and proliferation of these pathogens, not only in the processing environment, but also in local grocery stores.
RESUMO: Listeria monocytogenes é uma notável preocupação para a indústria de alimentos, devido à sua natureza ubíqua e a capacidade de se multiplicar em condições adversas. Este estudo objetivou determinar o perfil genotípico de L. monocytogenes isolada a partir de frangos refrigerados comercializados na região sul do Rio Grande do Sul, Brasil. As cepas de L. monocytogenes foram selecionadas e caracterizadas por sorotipagem e Eletroforese em Gel de Campo Pulsado (PFGE). Três sorotipos diferentes (1/2a, 1/2b e 4e) foram avaliados por PFGE, e a combinação dos padrões de macrorestrição utilizando as enzimas AscI e ApaI revelou cinco diferentes pulsotipos. A presença de diferentes perfis genotípicos demonstra a importância da contaminação no ambiente de processamento de frangos, o qual, juntamente com procedimentos de limpeza ineficazes, permitem a sobrevivência, adaptação e proliferação desses patógenos, não somente no ambiente de processamento, mas também no local de comercialização destes produtos.
ABSTRACT
ABSTRACT: Listeria monocytogenes is of notable concern to the food industry, due to its ubiquitous nature and ability to grow in adverse conditions. This study aimed to determine the genotypic profile of L. monocytogenes strains isolated from refrigerated chickens marketed in the southern part of Rio Grande do Sul, Brazil. The strains of L. monocytogenes isolated were characterized by serotyping and Pulsed Field Gel Electrophoresis (PFGE). Three different serotypes (1/2a, 1/2b and 4e) were evaluated by PFGE, and the macrorestriction patterns utilizing enzymes AscI and ApaI, revealed five different pulsotypes. The presence of such varied genotypic profiles demonstrates the prevalence of L. monocytogenes contamination of chicken processing environments, which combined with ineffective cleaning procedures, allowing the survival, adaptation and proliferation of these pathogens, not only in the processing environment, but also in local grocery stores.
RESUMO: Listeria monocytogenes é uma notável preocupação para a indústria de alimentos, devido à sua natureza ubíqua e a capacidade de se multiplicar em condições adversas. Este estudo objetivou determinar o perfil genotípico de L. monocytogenes isolada a partir de frangos refrigerados comercializados na região sul do Rio Grande do Sul, Brasil. As cepas de L. monocytogenes foram selecionadas e caracterizadas por sorotipagem e Eletroforese em Gel de Campo Pulsado (PFGE). Três sorotipos diferentes (1/2a, 1/2b e 4e) foram avaliados por PFGE, e a combinação dos padrões de macrorestrição utilizando as enzimas AscI e ApaI revelou cinco diferentes pulsotipos. A presença de diferentes perfis genotípicos demonstra a importância da contaminação no ambiente de processamento de frangos, o qual, juntamente com procedimentos de limpeza ineficazes, permitem a sobrevivência, adaptação e proliferação desses patógenos, não somente no ambiente de processamento, mas também no local de comercialização destes produtos.
ABSTRACT
A two-phase study was conducted to compare the efficacy of several enrichment selective-broth steps associated to different plating media for recovery of Salmonella sp. from finishing swine feces. In a first phase, Rappaport-Vassiliadis broth (RV) incubated at 42ºC, Tetrathionate Müller-Kauffmann broth at 37ºC (TMK37) and 42ºC (TMK42), and Selenite Cystine broth (SC) at 37ºC, in combination with three selective plating media Rambach agar (RA), Xylose-Lysine-Tergitol 4 agar (XLT4), and Brilliant-Green Phenol-Red Lactose Sucrose agar (VB) were compared for recovery of Salmonella from artificially contaminated swine feces. In a second phase, RV, TMK37, and TMK42, associated with XLT4 and VB , were tested with naturally contaminated swine feces. In this study RV, TMK42 and TMK37 were superior to SC for isolating Salmonella sp. from artificially contaminated feces. TMK42 and RV were more productive than TMK37 for recovery of Salmonella from naturally contaminated feces samples. Selectivity and indication capability of the plating media were remarkably affected by the selective enrichment step effectiveness. The TMK42/XLT4 association was the most sensitive and RV/XLT4 the most specific. The use of VB agar is also recommended to increase the likelihood of isolating atypical H2S-late producing/ non-producing Salmonella. In this study RV and TMK42 were the most efficient selective enrichment for recovery of Salmonella sp. from swine feces.
Através de um estudo em duas fases comparou-se a eficiência de etapas de enriquecimento seletivo, associadas a diferentes meios seletivos, na recuperação de Salmonella sp. de fezes de suínos de terminação. Em uma primeira fase, as amostras foram contaminadas artificialmente e os caldos Rappaport-Vassiliadis (RV) incubado a 42ºC, Tetrationato Müller-Kauffmann a 37ºC (TMK37) e 42ºC (TMK42), e Selenito Cistina (SC) a 37ºC foram testados, em associação com meios sólidos seletivos: ágar Rambach (RA), ágar Xilose-Lisina-Tergitol 4 (XLT4), e ágar Verde-brilhante Vermelho-neutro Lactose Sacarose (VB). Na segunda fase os caldos RV, TMK37, and TMK42, semeados nos meios XLT4 and VB, foram testados com amostras naturalmente contaminadas. No isolamento de Salmonella sp. em amostras artificialmente contaminadas o RV, TMK42 e TMK37 foram superiores ao SC. Na segunda fase o TMK42 e RV foram mais eficientes que o TMK37. O desempenho destas etapas de enriquecimento seletivo influenciou diretamente a capacidade seletiva e indicadora dos meios sólidos seletivos utilizados. No presente estudo, a associação TMK42/XLT4 demonstrou ser a mais sensível, e a RV/XLT4 a mais específica. O uso do meio VB também é recomendado para aumentar a probabilidade do isolamento de colônias atípicas de Salmonella - produtoras tardias ou não produtoras de H2S. No presente estudo, RV e TMK42 foram as etapas de enriquecimento seletivo mais eficientes para o isolamento de Salmonella de fezes de suínos.
ABSTRACT
Fifteen different serovars of Salmonella were isolated from a swine farm, two of the isolated serovars, Mbandaka and Tennessee, were also found in the feed supplied to the animals. This study demonstrated the diversity of serovars that could occur in a farm and the need of a better understanding on epidemiology of Salmonella infection.
Em uma granja de suínos, foram isolados quinze sorotipos diferentes de Salmonella. Dois dos sorotipos isolados, Mbandaka e Tennessee, foram também encontrados na ração fornecida aos animais. Este estudo demonstrou a diversidade de sorotipos que podem estar presentes em uma granja e a necessidade de um melhor entendimento da epidemiologia da infecção por Salmonella.
ABSTRACT
Fifteen different serovars of Salmonella were isolated from a swine farm, two of the isolated serovars, Mbandaka and Tennessee, were also found in the feed supplied to the animals. This study demonstrated the diversity of serovars that could occur in a farm and the need of a better understanding on epidemiology of Salmonella infection.
Em uma granja de suínos, foram isolados quinze sorotipos diferentes de Salmonella. Dois dos sorotipos isolados, Mbandaka e Tennessee, foram também encontrados na ração fornecida aos animais. Este estudo demonstrou a diversidade de sorotipos que podem estar presentes em uma granja e a necessidade de um melhor entendimento da epidemiologia da infecção por Salmonella.