Risk Factors for Salmonella Detection in Commercial Layer Flocks in Spain

Trends in Salmonella human infections are assumed to be related to the distribution of the pathogen in the animal reservoir/food products, and cases in humans are most often linked to poultry and poultry products (eggs, meat). Therefore, ongoing Salmonella national control programs (NCPs) in European Union Member States have the objective of monitoring and reducing its prevalence in commercial poultry flocks. Results from NCPs have shown certain factors (housing systems, season of sampling and if sampling is conducted by food business operators (FBOps) or competent authorities (CAs), among others) can influence detection rates, but associations are often not consistent. Here, we analyzed data from the Spanish NCP on 7216 laying hen flocks subjected to 36,193 sampling events over a six-year period to characterize its performance and identify variables influencing detection rates. Overall, 1205 sampling events were positive for Salmonella spp. (any serovar) and 132 for S. Enteritidis-S. Typhimurium/monophasic. Bayesian multivariable models adjusting for multiple covariates concluded that sampling events later in the year, in caged flocks with older animals and conducted by CAs had increased odds of positivity for Salmonella spp., revealing aspects linked with a differential estimation of Salmonella levels in laying hen flocks.

Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD

To assess the clinical impact of noninvasive mechanical ventilation (NIMV) on stable hypercapnic chronic obstructive pulmonary disease, changes in exercise capacity, dyspnoea and simple physiological parameters were evaluated. The time course of these effects during treatment and recovery was also assessed. Patients were randomly allocated to NIMV (n=27) or sham-NIMV (n=15), applied 3 h.day-1, 5 days a week, for 3 weeks. A 6-min walking distance (6MWD), arterial blood gases, spirometry, pattern of breathing, mouth occlusion pressure (P0.1), and respiratory system impedance (P0.1/tidal volume (VT)/inspiratory time (tI)) were measured weekly during treatment and 2 weekly during follow-up. Transition dyspnoea index (TDI) was also measured. During NIMV, carbon dioxide arterial tension decreased progressively, concomitantly with a slow deep pattern of breathing, a proportional increase in the forced expiratory volume in one second (FEV1), the forced vital capacity and significant reductions of P0.1 and P0.1/VT/tI. The 6MWD improved by a mean of 76 m after NIMV, and by 73 m and 61 m 1 and 2 weeks, respectively, after treatment. Dyspnoea improved with a mean TDI of three points. Changes in 6MWD were highly related to TDI and to a lesser extent to changes in FEV1 (r=0.60). The current authors conclude that noninvasive mechanical ventilation has significant and sustained clinical impact in stable hypercapnic chronic obstructive pulmonary disease.

[Clinical aspects of ventricular fibrillation in the development of myocardial infarction]

We report 13 patients who suffered ventricular fibrillation (VF) during the in-hospital course of an acute myocardial infarction (AMI). We compare the clinical features of this patients with other two groups; patients without VF and patients with intraventricular conduction defects. In 38% of the cases VF appeared after 5th day of the AMI. The group of patients with VF was characterized by an increased incidence of heart failure, supra-ventricular and ventricular premature beats, and also intra-ventricular conduction defects. In 2 patients VF appeared during the course of treatment with therapeutic doses of lidocaine. Sixty two percent of the patients with VF were discharged alive. We recommend that patients with AMI who display the above mentioned risk factor, should remain in the coronary care unit for a more prolonged period of time. By proceeding in this way, we had the opportunity to observe and immediately treat 5 further patients with AMI and VF. All of them recovered.