Relationship between Salmonella infection, shedding and serology in fattening pigs in low-moderate prevalence areas.

Salmonella is a major foodborne pathogen causing important zoonosis worldwide. Pigs asymptomatically infected in mesenteric lymph nodes (MLN) can be intermittent shedders of the pathogen through faeces, being considered a major source of human infections. European baseline studies of fattening pig salmonellosis are based on Salmonella detection in MLN. This work studies the relationship between Salmonella infection in MLN and intestinal content (IC) shedding at slaughter and the relationship between the presence of the pathogen and the serologic status at farm level. Mean Salmonella prevalence in the selected pigs (vertically integrated production system of Navarra, Spain) was 7.2% in MLN, 8.4% in IC and 9.6% in serum samples. In this low-moderate prevalence context, poor concordance was found between MLN infection and shedding at slaughter and between bacteriology and serology. In fact, most of shedders were found uninfected in MLN (83%) or carrying different Salmonella strains in MLN and in IC (90%). The most prevalent Salmonellae were Typhimurium resistant to ACSSuT ± Nx or ASSuT antibiotic families, more frequently found invading the MLN (70%) than in IC (33.9%). Multivariable analysis revealed that risk factors associated with the presence of Salmonella in MLN or in IC were different, mainly related either to good hygiene practices or to water and feed control, respectively. Overall, in this prevalence context, detection of Salmonella in MLN is an unreliable predictor of faecal shedding at abattoir, indicating that subclinical infections in fattening pigs MLN could have limited relevance in the IC shedding.

An insight into a combination of ELISA strategies to diagnose small ruminant lentivirus infections.

A single broadly reactive standard ELISA is commonly applied to control small ruminant lentivirus (SRLV) spread, but type specific ELISA strategies are gaining interest in areas with highly prevalent and heterogeneous SRLV infections. Short (15-residue) synthetic peptides (n=60) were designed in this study using deduced amino acid sequence profiles of SRLV circulating in sheep from North Central Spain and SRLV described previously. The corresponding ELISAs and two standard ELISAs were employed to analyze sera from sheep flocks either controlled or infected with different SRLV genotypes. Two outbreaks, showing SRLV-induced arthritis (genotype B2) and encephalitis (genotype A), were represented among the infected flocks. The ELISA results revealed that none of the assays detected all the infected animals in the global population analyzed, the assay performance varying according to the genetic type of the strain circulating in the area and the test antigen. Five of the six highly reactive (57-62%) single peptide ELISAs were further assessed, revealing that the ELISA based on peptide 98M (type A ENV-SU5, consensus from the neurological outbreak) detected positives in the majority of the type-A specific sera tested (Se: 86%; Sp: 98%) and not in the arthritic type B outbreak. ENV-TM ELISAs based on peptides 126M1 (Se: 82%; Sp: 95%) and 126M2 0,65 0.77 (Se: 68%; Sp: 88%) detected preferentially caprine arthritis encephalitis (CAEV, type B) and visna/maedi (VMV, type A) virus infections respectively, which may help to perform a preliminary CAEV vs. VMV-like typing of the flock. The use of particular peptide ELISAs and standard tests individually or combined may be useful in the different areas under study, to determine disease progression, diagnose/type infection and prevent its spread.

Sensitivity of the ISO 6579:2002/Amd 1:2007 standard method for detection of Salmonella spp. on mesenteric lymph nodes from slaughter pigs.

The ISO 6579:2002/Amd 1:2007 (ISO) standard has been the bacteriological standard method used in the European Union for the detection of Salmonella spp. in pig mesenteric lymph nodes (MLN), but there are no published estimates of the diagnostic sensitivity (Se) of the method in this matrix. Here, the Se of the ISO (Se(ISO)) was estimated on 675 samples selected from two populations with different Salmonella prevalences (14 farms with a ≥ 20% prevalence and 13 farms with a <20% prevalence) and through the use of latent-class models in concert with Bayesian inference, assuming 100% ISO specificity, and an invA-based PCR as the second diagnostic method. The Se(ISO) was estimated to be close to 87%, while the sensitivity of the PCR reached up to 83.6% and its specificity was 97.4%. Interestingly, the bacteriological reanalysis of 33 potential false-negative (PCR-positive) samples allowed isolation of 19 (57.5%) new Salmonella strains, improving the overall diagnostic accuracy of the bacteriology. Considering the usual limitations of bacteriology regarding Se, these results support the adequacy of the ISO for the detection of Salmonella spp. from MLN and also that of the PCR-based method as an alternative or complementary (screening) test for the diagnosis of pig salmonellosis, particularly considering the cost and time benefits of the molecular procedure.

Salmonellosis in finishing pigs in Spain: prevalence, antimicrobial agent susceptibilities, and risk factor analysis.

A herd-based survey of Salmonella in pigs was carried in a major pig producing region of Spain. Mesenteric lymph nodes were collected from the carcasses of 25 pigs from each of 80 herds at time of slaughter. Salmonella spp. were isolated from 31% of animals and 94% of herds. Within-herd prevalence ranged from 4 to 88%, with the prevalence in most herds being greater than 10%. A large diversity of Salmonella serotypes was found, with Typhimurium, 4,[5],12:i:-, and Rissen being the most prevalent. Two or more serotypes coexisted in 73% of the herds. Salmonella Typhimurium was present in 68% of the herds. Most (82%) of the Salmonella isolates belonged to serogroups targeted by enzyme-linked immunosorbent assay tests for pig salmonellosis. Resistance to at least one antimicrobial agent was detected in 73% of the strains, and one or more resistant strains were recovered from pigs in 93% of the herds. Antimicrobial agent resistance (AR) was more frequent among the most prevalent than it was among the rarer serotypes. Twenty-five multi-AR patterns were found. Resistance to three or more families of antimicrobial agents was found in 75% of AR strains. The finding that many of the herds yielded isolates of several multi-AR patterns indicates that Salmonella infections were acquired from multiple sources. High prevalence of Salmonella in herds was associated with lack of rodent control programs, herds from farms with only finishing pigs, herds managed by more than one full-time worker, herds for which the source of drinking water was not a city supply, and relatively long fattening times.

Dispositivo supraglótico I-gel® en cirugía ginecológical aparoscópica ambulatoria / No disponible

Objetivo: La cánula I-gel® es un dispositivo de ventilación supraglótico de reciente aparición que incorpora un canal de acceso gástrico. En este estudio valoramos su eficacia en cirugía ginecológica laparoscópica. Material y métodos: Estudio descriptivo prospectivo de 30 pacientes intervenidos de cirugía ginecológica la paroscópica mediante anestesia general. Tras la inducción se colocó la mascarilla asignada y se valoró la facilidad de inserción. Se midieron los siguientes parámetros ventilatorios: presión pico (Pp), presión media(Pm), complianza, volumen corriente y frecuencia respiratoria (VT/FR) al inicio, y a los 10, 30 y 60 minutos de iniciada la intervención. Se comprobaron las condiciones del paso de una sonda nasogástrica y la visualización mediante la cámara de laparoscopia del tamaño del estómago (al comienzo y final de la cirugía) deforma directa. Los datos se tomaron con el paciente en posición de Trendelenburg y con un neumoperitoneo que no superó los 15 mmHg. Resultados: La cánula I-gel® se colocó al primer intento en el 95% de los pacientes. El tiempo medio de colocación fue de 14 segundos. Se colocó la sonda nasogástrica en el 85% de los pacientes. La presión de fuga de la vía aérea era parecida al principio y al final de la cirugía 25 ± 9 cm H2O y en todos los casos se mantuvieron las presiones pico por debajo de 21. La media de valoración por parte del cirujano en el tamaño del estómago al comienzo de la cirugía fue de 2 y al final de 3,5. Coincidió en un único caso la diferencia al final y al principio, donde se describió un vómito al despertar. Conclusión: La cánula I-gel® es un dispositivo fácil de colocar al primer intento. Asimismo resultó un dispositivo seguro para el sellado de la vía aérea y la minimización de las fugas en la ventilación para la cirugía laparoscópica ginecológica (AU)

Background: The I-gel® is a new single-use supraglottic airway device with a non inflatable cuff and an esophageal vent. In this study we evaluated the I-gel® in gynecological laparoscopic surgery. Material and methods: 30 women, ASA I-II undergoing gynaecological laparoscopic surgery in the Trendelenburg position were included in this prospective, observational study. We evaluated ease in inserting the I-gel®, seal pressure, gastric leak, complications during insertion and removal, ease in inserting the gastric tube and ventilatory parameters during positive pressure ventilation. Results: Insertion was easy and performed at the first attempt in 95% of cases. After creation of the pneumoperitoneum average peak pressure was 19,40 mmHg and average plateau pressure 18,20 mmHg. The gastric tube insertion was easily achieved 85%of cases. One case of vomiting occurred. Conclusion: The I-gel® is a reliable, easily inserted airway device that provides an adequate seal, and very few complications. It seems to be an efficient and safe device for gynecological laparoscopicsurgery (AU)

Estudio prospectivo de la eficacia del bloqueo de los nervios pudendos para analgesia postoperatoria de cirugía hemorroidal ambulatoria / No disponible

Introducción: La cirugía de hemorroides presenta un dolor postoperatorio de intensidad moderada-severa. La realización una técnica anestésico-analgésica multimodal garantiza el éxito de este procedimiento en cirugía ambulatoria. Realizamos un estudio observacional para valorar la eficacia del bloqueo de los nervios pudendos en cirugía hemorroidal en pacientes ambulatorios. Pacientes y métodos: Estudio prospectivo en cuarenta y tres pacientes divididos en dos grupos según técnica quirúrgica utilizada(Milligan-Morgan o Longo), a los cuales se les realizó bloqueo bilateral de los nervios pudendos, con 20 ml de levobupivacaína 0.5%. El dolor fue valorado con la escala verbal numérica en la sala de reanimación, al alta hospitalaria, y a las 24, 48,72 horas. Resultados: Ambos grupos fueron homogéneos con respecto alas variables demográficas, estado físico, antecedentes, duración de la cirugía y de la anestesia. El bloqueo pudendo se realizo con éxito en todos los pacientes. La evaluación del dolor postoperatorio al alta hospitalaria y a las 24 horas postalta muestra diferencias estadísticamente significativas entre ambas técnicas. Sin embargo, posteriormente no existen diferencias entre ambas técnicas. En las primeras 24 horas en el domicilio ningún paciente presento dolor severo, independientemente del grupo y solo 4 pacientes precisaron analgesia de rescate en el domicilio a las 48 y 72 horas, dos en cada grupo. Conclusiones: Nuestros resultados muestran que el bloqueo bilateralde los nervios pudendos con levobupivacaína al 0.5% asociadoa la anestesia general proporciona un buen control del dolor postoperatorio en las primeras 24 horas con baja incidencia de complicaciones en ambos grupos (AU)

Introduction: Hemorrhoids surgery presents a post-operative pain of moderate to severe in intensity. So we must make a multimodalanalgesic anesthetic technique to ensure the success of this procedure in the outpatient setting. We conducted a comparative study to assess the efficacy of pudendal nerve in hemorrhoidal surgery in ambulatory patients. Patients and methods: Prospective study forty-three patients divided into two groups according to surgical technique (Milligan-Morgan or Longo), underwent bilateral blockade of the pudendalnerve, with 20 ml of levobupivacaine 0.5%. The pain was assessed with the verbal numeric scale in the recovery room, hospital discharge, and 24, 48.72 hours. Results: two groups were similar with respect to demographic variables, physical status, history, duration of surgery and anesthesia. Pudendal block was performed successfully in all patients. The assessment of postoperative pain at discharge and 24 hours of highstatistically significant difference between both techniques. Even afterthe first 24 hours in any severe pain. Only 4 patients required rescue analgesia at home at 48 and 72 hours, two in each group. Conclusions: Our results show that the bilateral blockade of the pudendal nerve with 0.5% levobupivacaine associated with general anesthesia reduces postoperative pain, as well as the additional analgesic medication consumption (AU)

Utilidad de la heparina de bajo peso molecular en la sepsis abdominal / The usefulness of low molecular weight heparin in abdominal sepsis

Los fenómenos trombóticos secundarios a procesos sépticos abdominales son causa de una importante postoperatoria. Para su prevención, se ha empleado la heparina regular. Las fracciones de menor peso molecular tienen el mismo efecto, aunque menos efectos secundarios. En el presente trabajo se estudió la utilidad de la enoxaparina, una heparina de bajo peso molecular, para la prevención de los fenómenos trombóticos que ocurren después de un proceso séptico abdominal. Para tal efecto se estudiaron cinco grupos de 10 ratas cada uno. A todos los animales del estudio se les provocó peritonitis fecal. Durante el periodo posoperatorio, al grupo 1 se le administró heparina regular, al grupo 2 enoxaparina, al grupo 3 el antibiótico pefloxacina y a los grupos 4 y 5 la combinación de cada una de las heparinas con pefloxacina. Después de dar muerte a los animales, se realizó estudio de histopatología. Los resultados fueron evaluados con análisis estadístico no paramétrico de Kruskal-Wallis y Mann Whitney. En todas las ratas se produjo sepsis abdominal. El edema intraveolar fue mayor en el grupo de heparina regular comparado con el de enoxaparina con una p de 0.028; el resto de los grupos no tuvo diferencia estadística. Ninguna de las heparinas mostró efecto directo sobre el fenómeno séptico abdominal. En comparación con la heparina regular, la enoxaparina consiguió que las ratas con sepsis tuvieran menor edema intralveolar. No hubo diferencia en cuanto a la prevención de fenómenos trombóticos