[Evaluation of the effectiveness of a cognitive remediation program in anorexia nervosa using new neuropsychological tools: A case study]. / Évaluer un programme de remédiation cognitive dans l'anorexie : nouveaux outils.

The management of anorexia nervosa (AN) remains complex with insufficient success rates. Based on clinical and empirical observations implicating neuropsychological difficulties in AN, cognitive remediation (CR) therapy appears to show positive effects. Nevertheless, these results remain subject to debate as some studies do not show this improvement, or in the case of positive improvements, a smaller effect size on cognitive performance. A possible explanation could lie in the cognitive tests used to assess CR. The aim of this study is to propose a new protocol for the evaluation of cognitive remediation for patients suffering from ED through the presentation of a case study.

MC3T3-E1 cell response to microporous tantalum oxide surfaces enriched with Ca, P and Mg.

The formation of a porous oxide surface doped with osteoconductive elements, Ca, P and Mg, to enhance osseointegration, was achieved through micro arc oxidation. Micro arc oxidation parameters, such as electrolyte composition, concentration and applied voltage, were studied to understand their effect on the morphology and chemical composition of the samples surface. Considering the optimum atomic concentration reported in literature for each osteoconductive element, microporous Ta anodic oxide samples treated with calcium acetate (CaA) and ß-glycerophosphate (ß-GP) revealed that an increase of ß-GP molarity in the electrolyte boosts Ca incorporation, as well as, increasing the porosity. In adding magnesium acetate (MgA) to the electrolyte, when composed by CaA + ß-GP, both addition and variation of MgA did not affect the surface morphology along the samples, being incorporated into the oxide layer for 0.1 M. Finally, in vitro tests were carried out to study the biocompatibility of Ta, to verify the cytotoxicity of the samples and their behavior towards cells, by performing adhesion and differentiation tests with the MC3T3-E1 cell line. Cytotoxicity tests revealed that the samples were non-toxic. Despite none of the samples having been raised up through cell adhesion tests, cell differentiation revealed promising results for the Ta-CaP.

Water temperature modulates mercury accumulation and oxidative stress status of common goby (Pomatoschistus microps).

Mercury (Hg) is a widespread pollutant across estuarine and coastal areas, raising concern on its potential impact on aquatic organisms. Hg may origin from natural and anthropogenic sources, being persistent and potentially toxic to biota, ultimately representing a serious risk to human health. Hg accumulation and toxicity may also induce reactive oxygen species (ROS) production in marine organisms, responsible for cell and tissue damage. Additionally, the temperature is undoubtedly an important environmental factor to consider regarding accumulation, due to its marked influence on the physiology and ecology of aquatic organisms. This study aimed to investigate the effect of different temperature scenarios (15, 20 and 25 °C) on the Hg accumulation in Pomatoschistus microps (Krøyer, 1838) liver and muscle, as well as on oxidative stress responses and energy metabolism, after short-term exposure to a naturally contaminated sediment with an environmentally relevant [Hg] (1.2 µg g-1). The results showed that Hg accumulation tends to increase along the temperature gradient with higher values of Hg accumulated in liver than in muscle tissue. The action of antioxidant enzymes and stress proteins seems to be effective in combating oxidative stress in the liver. Despite the action of antioxidant defences in the muscle, oxidative damage was observed at the protein level concomitantly with a decrease in aerobic energy production after exposure to Hg at higher temperatures. These findings are ecologically relevant and highlight the importance of further investigation of combined effects of Hg and other stressors, especially in a scenario of a changing climate where events leading to rapid alterations on water parameters are more frequent.

Associating sporadic, foodborne illness caused by Shiga toxin-producing Escherichia coli with specific foods: a systematic review and meta-analysis of case-control studies.

Shiga toxin-producing Escherichia coli (STEC) infections are a significant public health issue, with foodborne transmission causing >1 million illnesses worldwide each year. We conducted a systematic review and meta-analysis (PROSPERO registry # CRD42017074239), to determine the relative association of different food types with sporadic illnesses caused by STEC. Searches were conducted from 01 August to 30 September 2017, using bibliographic and grey literature databases, websites and expert consultation. We identified 22 case-control studies of sporadic STEC infection in humans, from 10 countries within four World Health Organization subregions, from 1985 to 2012. We extracted data from 21 studies, for 237 individual measures in 11 food categories and across three status types (raw or undercooked, not raw and unknown). Beef was the most significant food item associated with STEC illness in the Americas and Europe, but in the Western Pacific region, chicken was most significant. These findings were not significantly moderated by the raw or cooked status of the food item, nor the publication year of the study. Data from the African, South-East Asian and Eastern Mediterranean subregions were lacking and it is unclear whether our results are relevant to these regions.

Risk-Benefit Assessment of Foods.

Food is an elementary requirement for human life, providing nutrients and essential energy needed for optimal health. But at the same time, food can also be a vehicle of hazardous substances or pathogens that could affect human health negatively. Risk-benefit assessment (RBA) of foods, a relatively new methodology for decision support, integrates nutrition, toxicology, microbiology, chemistry and human epidemiology for a comprehensive health impact assessment. By integrating health risks and benefits related to food consumption, RBA facilitates science-based decision-making in food-related areas and the development of policies and consumer advice. The present work programme aimed to allow the fellow to become acquainted with the process of RBA and the associated tools needed to assess quantitatively the risks and the benefits through three main activities (i) to learn the different methodologies used for RBA; (ii) to apply these methodologies to a specific case-study - RBA of raw milk consumption; and (iii) to participate in the main activities of the Risk-Benefit research group at DTU Food regarding risk-benefit issues. For the RBA of raw milk consumption, microbiological pathogens (Listeria monocytogenes, Salmonella spp., Campylobacter jejuni and Shiga toxin-producing Escherichia coli), probiotic bacteria and nutritional components (vitamins B2 and A) were considered, as well as the potential impact of raw milk consumption in the reduction of the allergies' prevalence. Two major approaches were applied: the bottom-up (estimating the disease incidence due to the exposure) and the top-down (using epidemiological and incidence data to the estimate the number of cases attributable to a certain exposure). Through all the training and hands-on activities performed, the present work programme enabled the fellow to extend the knowledge on the quantitative RBA, specifically in the context of raw milk consumption. EU-FORA programme also provided an exceptional opportunity of networking and establishment of future research lines of collaboration.

Being born small-for-gestational-age is associated with an unfavourable dietary intake in Danish adolescent girls: findings from the Danish National Birth Cohort.

Individuals born small have an increased risk for developing type 2 diabetes. Altered food preferences in these subjects seem to play a role; however, limited evidence is available on the association between being born small-for-gestational-age (SGA) at term and food intake in adolescence. Alterations in leptin, ghrelin and dopamine levels are suggested mechanisms linking SGA with later food intake. From a large prospective Danish National Birth Cohort, we compared dietary intake of adolescents being born SGA with normal-for-gestational-age (NGA) adolescents. Intake of foods and nutrients was assessed by a validated food frequency questionnaire in a subsample of 15,607 14-year-old individuals born at term. SGA was defined by birth weight (BW) <10th percentile (n = 1470) and NGA as BW between 10 and 90th percentile (n = 14,137) according to sex and gestational age-specific BW standard curves. Girls born SGA had a 7% (95% CI: 3-12%, P = 0.002) higher intake of added sugar and a 2-8% lower intake of dietary fibre, vegetables, polyunsaturated fatty acids, and total n-6, compared with NGA girls (P < 0.05). Adjusting for parental socio-occupational status, maternal smoking and diet in pregnancy did not substantially change the differences in dietary intake, except from dietary fibre, which were no longer statistically significant. No significant differences in dietary intake between SGA and NGA boys were found. In summary, girls born SGA had an unfavourable dietary intake compared with NGA girls. These differences persisted after controlling for potential confounders, thus supporting a fetal programming effect on dietary intake in girls born SGA at term. However, residual confounding by other factors operating early in childhood cannot be excluded.

Cardiac protein expression patterns are associated with distinct inborn exercise capacity in non-selectively bred rats.

In the present study, we successfully demonstrated for the first time the existence of cardiac proteomic differences between non-selectively bred rats with distinct intrinsic exercise capacities. A proteomic approach based on two-dimensional gel electrophoresis coupled to mass spectrometry was used to study the left ventricle (LV) tissue proteome of rats with distinct intrinsic exercise capacity. Low running performance (LRP) and high running performance (HRP) rats were categorized by a treadmill exercise test, according to distance run to exhaustion. The running capacity of HRPs was 3.5-fold greater than LRPs. Protein profiling revealed 29 differences between HRP and LRP rats (15 proteins were identified). We detected alterations in components involved in metabolism, antioxidant and stress response, microfibrillar and cytoskeletal proteins. Contractile proteins were upregulated in the LVs of HRP rats (α-myosin heavy chain-6, myosin light chain-1 and creatine kinase), whereas the LVs of LRP rats exhibited upregulation in proteins associated with stress response (aldehyde dehydrogenase 2, α-crystallin B chain and HSPß-2). In addition, the cytoskeletal proteins desmin and α-actin were upregulated in LRPs. Taken together, our results suggest that the increased contractile protein levels in HRP rats partly accounted for their improved exercise capacity, and that proteins considered risk factors to the development of cardiovascular disease were expressed in higher amounts in LRP animals.

A proteomic road to acquire an accurate serological diagnosis for human tegumentary leishmaniasis.

Diagnostic tools are important for clinical management and epidemiological evaluation of Tegumentary (TL) and Visceral (VL) Leishmaniasis. Serology is not frequently used for the diagnosis of the TL form because low antibody titers and cross-reaction with VL. Therefore, it is crucial to identify specific and immunogenic antigens from species associated with the TL form. Here we employed a proteomic approach coupled to an in silico analysis and identified the most abundant and immunogenic proteins from Leishmania amazonensis, Leishmania braziliensis and Leishmania infantum. Of 16 species specific proteins, nine were from the species causative of the TL form (L. amazonensis and L. braziliensis). In silico analysis revealed 18 B-cell epitopes with 0% similarity to Trypanosoma cruzi orthologs and, therefore, less likely to crossreact with sera of patients with Chagas disease. Two proteins reacted exclusively with serum from TL patients and presented several B-cell epitopes without similarity to T. cruzi orthologs: the hypothetical protein GI 134063939 and the metallo-peptidase Clan MA(E)-Family M3. The immunoassay revealed nine peptides with strong reactivity to sera from TL patients. These proteins and peptides may be good candidates to improve the specificity and sensibility of serological tests aiming to diagnose the TL of this neglected human disease. BIOLOGICAL SIGNIFICANCE: As no gold-standard test for tegumentary leishmaniasis (TL) exists, a combination of different diagnostic techniques is often necessary to obtain precise results. Thus, the identification of species-specific, highly immunogenic and abundant proteins that stimulate the humoral immune response in the host should help in the development of serological tests for human TL. Herein we searched for these potential antigens in Leishmania species related to American Leishmaniasis (L. amazonensis, L. braziliensis and L. infantum). To this end, we employed an immunoproteomic approach using proteins from these Leishmania species and sera from TL and Visceral Leishmaniasis (VL) patients. Our study unveils specific proteins and peptides that may represent antigens that will help the efforts to improve the accuracy of serological tests to diagnose the TL form.

Immunoproteomic and bioinformatic approaches to identify secreted Leishmania amazonensis, L. braziliensis, and L. infantum proteins with specific reactivity using canine serum.

Leishmania spp have a wide range of hosts, and each host can harbor several Leishmania species. Dogs, for example, are frequently infected by Leishmania infantum, where they constitute its main reservoir, but they also serve as hosts for L. braziliensis and L. amazonensis. Serological tests for antibody detection are valuable tools for diagnosis of L. infantum infection due to the high levels of antibodies induced, unlike what is observed in L. amazonensis and L. braziliensis infections. Likewise, serology-based antigen-detection can be useful as an approach to diagnose any Leishmania species infection using different corporal fluid samples. Immunogenic and secreted proteins constitute powerful targets for diagnostic methods in antigen detection. As such, we performed immunoproteomic (2-DE, western blot and mass spectrometry) and bioinformatic screening to search for reactive and secreted proteins from L. amazonensis, L. braziliensis, and L. infantum. Twenty-eight non-redundant proteins were identified, among which, six were reactive only in L. amazonensis extracts, 10 in L. braziliensis extracts, and seven in L. infantum extracts. After bioinformatic analysis, seven proteins were predicted to be secreted, two of which were reactive only in L. amazonensis extracts (52kDa PDI and the glucose-regulated protein 78), one in L. braziliensis extracts (pyruvate dehydrogenase E1 beta subunit) and three in L. infantum extracts (two conserved hypothetical proteins and elongation factor 1-beta). We propose that proteins can be suitable targets for diagnostic methods based on antigen detection.

Attributing foodborne salmonellosis in humans to animal reservoirs in the European Union using a multi-country stochastic model.

A Bayesian modelling approach comparing the occurrence of Salmonella serovars in animals and humans was used to attribute salmonellosis cases to broilers, turkeys, pigs, laying hens, travel and outbreaks in 24 European Union countries. Salmonella data for animals and humans, covering the period from 2007 to 2009, were mainly obtained from studies and reports published by the European Food Safety Authority. Availability of food sources for consumption was derived from trade and production data from the European Statistical Office. Results showed layers as the most important reservoir of human salmonellosis in Europe, with 42·4% (7 903 000 cases, 95% credibility interval 4 181 000-14 510 000) of cases, 95·9% of which was caused by S. Enteritidis. In Finland and Sweden, most cases were travel-related, while in most other countries the main sources were related to the laying hen or pig reservoir, highlighting differences in the epidemiology of Salmonella, surveillance focus and eating habits across the European Union.

Using surveillance and monitoring data of different origins in a Salmonella source attribution model: a European Union example with challenges and proposed solutions.

Microbial subtyping approaches are commonly used for source attribution of human salmonellosis. Such methods require data on Salmonella in animals and humans, outbreaks, infection abroad and amounts of food available for consumption. A source attribution model was applied to 24 European countries, requiring special data management to produce a standardized dataset. Salmonellosis data on animals and humans were obtained from datasets provided by the European Food Safety Authority. The amount of food available for consumption was calculated based on production and trade data. Limitations included different types of underreporting, non-participation in prevalence studies, and non-availability of trade data. Cases without travel information were assumed to be domestic; non-subtyped human or animal records were re-identified according to proportions observed in reference datasets; missing trade information was estimated based on previous years. The resulting dataset included data on 24 serovars in humans, broilers, laying hens, pigs and turkeys in 24 countries.

Nursing home care: exploring the role of religiousness in the mental health, quality of life and stress of formal caregivers.

Despite the high number of studies on family caregivers, there is little research on the impact of religiosity on formal caregiving (paid providers). We examine the role of religiousness in the mental health, quality of life and stress of nurse aides (NA) who provide care for patients in a nursing home. NA in a Brazilian nursing home were invited to participate. Because of its coping function, we hypothesized that religiousness was related to better mental health and quality of life. Linear regression was used to test this hypothesis and control for confounders. Compared with the Brazilian general population, NA scored higher on measures of religious involvement. Intrinsic religiosity was associated with better mental health and quality of life. Organizational religiosity was associated with better social functioning, better general mental health and fewer anxiety symptoms. Non-organizational religiosity (prayer), however, was associated with negative outcomes, such as higher stress, poorer general health perceptions and more anxiety symptoms. Most NA indicated that they had prayed for and with their patients. In conclusion, paid caregivers (NA) have a strong sense of religiousness, which plays an important role in many ways, including the type of care they provide, their mental health and their quality of life.

[Analysis of medication prescription in an Argentinian geriatric hospital]. / Análisis de la prescripción de medicamentos en una comunidad geriátrica Argentina.

BACKGROUND: Although polypharmacy may be justified in elderly patients with multiple diseases, it may be dangerous, especially when it includes potentially inappropriate medications (PIM). AIM: To identify inappropriate medication and factors associated with the most relevant prescriptions among older people. MATERIAL AND METHODS: Cross-sectional observational analysis of drugs prescribed during the first trimester of 2010 to 179 older adults aged 77 ± 8 years (98 women), living in a geriatric reference hospital in Argentina. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2012. RESULTS: The mean number of drugs prescribed per individual was 6.1 ± 2.7. The most commonly used drugs were anti-ulcer agents (58.1%), agents acting on the renin-angiotensin system (54.2%), antithrombotic medications (50.8%) and benzodiazepines (50.8 %). The use of antacids and anti-ulcer agents, psychotropic drugs and PIM was significantly higher among patients using six or more drugs daily, compared to the less medicated group (odds ratio (OR) = 6.8, 95% confidence intervals (CI) 3.5-13.2; OR=15.0, 95%CI 5.9-38.4; OR=5.0; 95%IC 2.6-9.8, respectively). Thirty one percent of participants using non-steroidal anti-inflammatory drugs, were not receiving medications for gastric protection. One to four drugs included in the Beers list were prescribed to 66% of participants. CONCLUSIONS: Despite the high prevalence of use of antacids and anti-ulcer agents, these drugs were not prescribed to a significant proportion of patients using non-steroidal anti-inflammatory drugs. Strategies to optimize pharmacotherapy in the elderly population are urgently required.

Análisis de la prescripción de medicamentos en una comunidad geriátrica Argentina / Analysis of medication prescription in an Argentinian geriatric hospital

Background: Although polypharmacy may bejustified in elderly patients with multiple diseases, it may be dangerous, especially when it includes potentially inappropriate medications (PIM). Aim: To identify inappropriate medication and factors associated with the most relevant prescriptions among older people. Material and Methods: Cross-sectional observational analysis of drugs prescribed during the first trimester of 2010 to 179 older adults aged 77 ± 8 years (98 women), living in a geriatric reference hospital in Argentina. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2012. Results: The mean number of drugs prescribed per individual was 6.1 ± 2.7. The most commonly used drugs were anti-ulcer agents (58.1%), agents acting on the renin-angiotensin system (54.2%), antithrombotic medications (50.8%) and benzodiazepines (50.8 %). The use of antacids and anti-ulcer agents, psychotropic drugs and PIM was significantly higher among patients using six or more drugs daily, compared to the less medicated group (odds ratio (OR) = 6.8, 95% confidence intervals (CI) 3.5-13.2; OR=15.0, 95%CI 5.9-38.4; OR=5.0; 95%IC 2.6-9.8, respectively). Thirty one percent of participants using non-steroidal anti-inflammatory drugs, were not receiving medications for gastric protection. One to four drugs included in the Beers list were prescribed to 66% of participants. Conclusions: Despite the high prevalence of use of antacids and anti-ulcer agents, these drugs were not prescribed to a significant proportion of patients using non-steroidal anti-inflammatory drugs. Strategies to optimize pharmacotherapy in the elderly population are urgently required.

Source attribution of human campylobacteriosis using a meta-analysis of case-control studies of sporadic infections.

Campylobacter spp. is a widespread and important cause of human illness worldwide. Disease is frequently associated with foodborne transmission, but other routes of exposure, such as direct contact with live animals and person-to-person transmission, are also recognized. Identifying the most important sources of human disease is essential for prioritizing food safety interventions and setting public health goals. Numerous case-control studies of sporadic infections of campylobacteriosis have been published. These studies investigated a variety of potential risk factors for disease, often using different methodologies and settings. Systematic reviews (SRs) consist of a formal process for literature review focused on a specific research question, and include the identification of relevant literature, quality assessment of relevant studies, summarization or statistical analysis of data, and conclusions. With the objective of identifying the most important risk factors for human sporadic campylobacteriosis, we performed a SR of case-control studies of human sporadic cases and a meta-analysis of the obtained results. A combined SR focusing on Salmonella and Campylobacter studies was performed and the results analysed separately. From 1295 identified references, 131 passed the relevance screening, 73 passed the quality assessment stage, and data was extracted from 72 studies. Of these, 38 focused on campylobacteriosis. Information on exposures of cases and controls, and estimated odds ratios for investigated risk factors were collected and analysed. In the meta-analysis, heterogeneity between the studies and possible sources of bias were investigated, and pooled odds ratios for identified risk factors were estimated. Results suggest that travelling abroad, eating undercooked chicken, environmental sources, and direct contact with farm animals were significant risk factors for campylobacteriosis. Sub-analyses by geographical region, age group, and study period were performed, and differences were discussed.

Source attribution of human salmonellosis using a meta-analysis of case-control studies of sporadic infections.

Salmonella is an important cause of human illness. Disease is frequently associated with foodborne transmission, but other routes of exposure are recognized. Identifying sources of disease is essential for prioritizing public health interventions. Numerous case-control studies of sporadic salmonellosis have been published, often using different methodologies and settings. Systematic reviews consist of a formal process for literature review focused on a research question. With the objective of identifying the most important risk factors for salmonellosis, we performed a systematic review of case-control studies and a meta-analysis of obtained results. Thirty-five Salmonella case-control studies were identified. In the meta-analysis, heterogeneity between studies and possible sources of bias were investigated, and pooled odds ratios estimated. Results suggested that travel, predisposing factors, eating raw eggs, and eating in restaurants were the most important risk factors for salmonellosis. Sub-analyses by serotype were performed when enough studies were available.

Saberes e atitudes dos adolescentes frente à contracepção / Knowledge and attitudes of adolescents on contraception

OBJETIVO: Descrever e analisar os saberes e atitudes dos adolescentes sobre a contracepção. MÉTODOS: Estudo descritivo com análise quantitativa, compreendendo uma amostra de 499 adolescentes de cinco escolas estaduais de Cuiabá, MT, utilizando-se um questionário fechado. Os dados foram processados e analisados pelo programa Epi-Info, com análises bivariadas. RESULTADOS: Entre os adolescentes estudados, constatou-se que 36 por cento têm vida sexual ativa, sendo o uso atual de algum método contraceptivo presente em 77 por cento das meninas e 66 por cento dos meninos; com relação aos métodos contraceptivos mais conhecidos pelos adolescentes, 55 por cento declararam conhecer o preservativo juntamente com os anticoncepcionais orais e injetáveis; identificou-se entre os adolescentes sexualmente ativos que apenas 40 por cento dos meninos e 58 por cento das meninas conversam sempre com seus namorados(as)/parceiros(as) sobre maneiras de evitar a gravidez; 54 por cento das meninas e 40 por cento dos meninos declararam que quem deve usar o método contraceptivo deve ser tanto o homem quanto a mulher; a fonte de indicação dos métodos contraceptivos foram os amigos(as) para 22 por cento dos meninos e os médicos para 36 por cento das meninas. CONCLUSÕES: Apesar de os adolescentes apresentarem alguns conhecimentos e atitudes adequadas em relação à contracepção, ainda há a necessidade de ações de prevenção e orientação sexual, tendo em vista o relato de pouco diálogo entre os parceiros, a não adoção de métodos de prevenção em todas as relações sexuais e a ocorrência de gravidez.

OBJECTIVE: To describe and analyze adolescents' knowledge and attitudes in relation to contraception. METHODS: Descriptive study with a quantitative analysis comprising a sample of 499 adolescents of five state schools of Cuiabá, MT, Brazil, with a structured questionnaire. Data were processed and analyzed by Epi-Info software, with bivariate analysis. RESULTS: Among the studied adolescents, 36 percent were sexually active; the use of contraceptive methods was referred by 77 percent of the girls and 66 percent of the boys; 55 percent stated they were more familiar with condoms associated with oral and injectable contraceptives; among the adolescents who were sexually active, 40 percent of the boys and 58 percent of the girls talk with their lovers/partners on ways to avoid pregnancy; 54 percent of the girls and 40 percent of the boys stated that both the man and the woman should use a contraceptive method; the source of indication of contraceptive methods were friends for 22 percent of the boys and physicians for 36 percent of the girls. CONCLUSIONS: Although adolescents present some knowledge and adequate attitudes about contraception, there is still the need for prevention and sexual orientation in face of the lack of dialogue between partners, the non-adoption of preventive methods in all sexual intercourses and the reported pregnancy rate.

Trends in slaughter pig production and antimicrobial consumption in Danish slaughter pig herds, 2002-2008.

Overuse of antimicrobials in food-animal production is thought to be a major risk factor for the development of resistant bacterial populations. Data on non-human antimicrobial usage is essential for planning of intervention strategies to lower resistance levels at the country, region or herd levels. In this study we evaluated Danish national antimicrobial usage data for five antimicrobial classes used in slaughter pigs in different herd sizes and data on the number of slaughter pigs produced per herd, between 2002 and 2008, in Denmark. The objective was to ascertain if there is an association between herd size and amount of antimicrobials consumed. During this period, the overall number of herds with slaughter pigs decreased by 43%, with larger herds becoming more prevalent. The tetracycline treatment incidence (TI) rate increased from 0·28 to 0·70 animal-defined daily dose (ADD)/100 slaughter pig-days at risk while macrolide TI presented a more moderate increase, from 0·40 to 0·44 ADD/100 slaughter pig-days at risk during the study period. Linear regression analyses revealed a significant association between herd size and TI rates for tetracyclines, macrolides, sulfonamides/trimethoprim and cephalosporins, with small herds presenting significantly higher TI than moderate, large and the largest herds. This study highlights the importance of establishing an antimicrobial consumption monitoring programme, integrated with comprehensive food-animal production surveillance. Further research should be performed to address the potential causes of the detected associations between herd sizes and antimicrobial consumption in pigs.

Source attribution of human Salmonella cases in Sweden.

The aim of this study was to identify the sources of sporadic domestic Salmonella cases in Sweden and to evaluate the usefulness of a source-attribution model in a country in which food animals are virtually free from Salmonella. The model allocates human sporadic domestic Salmonella cases to different sources according to distribution of Salmonella subtypes in the different sources. Sporadic domestic human Salmonella cases (n=1086) reported between July 2004 and June 2006 were attributed to nine food-animal and wildlife sources. Of all Salmonella cases, 82% were acquired abroad and 2·9% were associated with outbreaks. We estimated that 6·4% were associated with imported food, 0·5% with food-producing animals, and 0·6% with wildlife. Overall, 7·7% could not be attributed to any source. We concluded that domestic food-producing animals are not an important source for Salmonella in humans in Sweden, and that the adapted model is useful also in low-prevalence countries.