RESUMEN
Although seafood is considered to be an important part of a balanced diet, many national food consumption surveys suggest that seafood is not consumed in sufficient amounts. As consumers are moving to diversify their diet from animal-based protein, it is important to understand the factors influencing consumption of marine foods. This review aims to assess the characteristics of seafood consumers as well as the influences on seafood consumption in Europe, USA, Canada, Australia and New Zealand. Systematic search strategies were used to identify relevant journal articles from three electronic databases (PubMed, Web of Science and Embase). Three searches were carried out and identified 4405 unique publications from which 121 met the criteria for the review process. The reviewed studies revealed that seafood consumers were more likely to be older, more affluent and more physically active and were less likely to smoke compared with non-seafood consumers. Sex and BMI did not appear to have a directional association with seafood consumption. The most commonly reported barriers to seafood consumption were cost, followed by sensory or physical barriers, health and nutritional beliefs, habits, availability and cooking skills. The most commonly reported influences were beliefs about the contribution of seafood to health, environmental influences and personal preferences. Based on the findings of this review, future intervention strategies to increase seafood consumption may need to consider affordability and education in terms of health, nutrition and cooking skills. More research is needed to explore the effectiveness of specific interventions at increasing the consumption of seafood.
Asunto(s)
Dieta , Alimentos Marinos , Animales , Australia , Canadá , Europa (Continente) , Nueva Zelanda , Encuestas y Cuestionarios , Estados UnidosRESUMEN
INTRODUCTION: Historically, there has been variability in the methods for determining preventable death within the US Department of Defense. Differences in methodologies partially explain variable preventable death rates ranging from 3% to 51%. The lack of standard review process likely misses opportunities for improvement in combat casualty care. This project identified recommended medical and non-medical factors necessary to (1) establish a comprehensive preventable death review process and (2) identify opportunities for improvement throughout the entire continuum of care. METHODS: This qualitative study used a modified rapid assessment process that includes the following steps: (1) identification and recruitment of US government subject matter experts (SMEs); (2) multiple cycles of data collection via key informant interviews and focus groups; (3) consolidation of information collected in these interviews; and (4) iterative analysis of data collected from interviews into common themes. Common themes identified from SME feedback were grouped into the following subject areas: (1) prehospital, (2) in-hospital and (3) forensic pathology. RESULTS: Medical recommendations for military preventable death reviews included the development, training, documentation, collection, analysis and reporting of the implementation of the Tactical Combat Casualty Care Guidelines, Joint Trauma System Clinical Practice Guidelines and National Association of Medical Examiners autopsy standards. Non-medical recommendations included training, improved documentation, data collection and analysis of non-medical factors needed to understand how these factors impact optimal medical care. CONCLUSIONS: In the operational environment, medical care must be considered in the context of non-medical factors. For a comprehensive preventable death review process to be sustainable in the military health system, the process must be based on an appropriate conceptual framework implemented consistently across all military services.
Asunto(s)
Testimonio de Experto/métodos , Medicina Militar/normas , Gestión de Riesgos/métodos , Testimonio de Experto/estadística & datos numéricos , Humanos , Medicina Militar/métodos , Investigación Cualitativa , Gestión de Riesgos/tendenciasRESUMEN
Despite the ever increase in rigorous control and monitoring measures to assure safe food along the entire farm-to-fork chain, the past decade has also witnessed an increase in microbial food alerts. Hence, research on food safety and quality remain of utmost importance. Complementary, and at least as important, is the necessity to be able to assess the potential microbial risks along the food chain. Risk assessment relies on sound scientific data. Unfortunately, often, quality data are limited if not lacking. High-throughput tools such as next-generation sequencing (NGS) could fill this gap. NGS approaches can be used to generate ample qualitative and quantitative data to be used in the risk assessment process. NGS applications are not new in food microbiology with applications ranging from pathogen detection along the food chain, food epidemiology studies, whole genome analysis of food-associated microorganisms up to describing complete food microbiomes. Yet, its application in the area of microbial risk assessment is still at an early stage and faces important challenges. The possibilities of NGS for risk assessment are ample, but so are the questions on the subject. One of the major strengths of NGS lies in its capacity to generate a lot of data, but to what extend can this wealth be of use in hazard identification, hazard characterisation and exposure assessment to perform a sound risk characterisation, which in turn will make it possible to take substantiated risk management decisions.
RESUMEN
The delineation of ground beef batches has implications for the management of product disposition policies in the event of Shiga toxin-producing Escherichia coli contamination. Analysis of individual contributor animal-specific DNA profiles can provide valuable empirical data for understanding the dynamics of ground meat production processes and can act as a surrogate for cross-contamination. A genetic method was developed for characterizing the source raw material flow and carryover between discrete batches of ground beef in a large-scale commercial beef grinding operation. The application developed involves the introduction of a genetically distinct source raw material batch into the grinding system and comprehensive sampling of that index batch and subsequent batches followed by single nucleotide polymorphism genotyping of random subsamples. Capture-mark-recapture statistical techniques were used to estimate (i) the number of carcass contributors and (ii) the associated level of carryover between batches. Carryover, expressed as a percentage of the total weight of the batch material (in pounds), was observed between the genetically distinct index batch and the next sequential batch at approximately 1%. The nondetection of additional carryover to subsequent batches, with a detection level of approximately 0.2%, supports a serial dilution model of same source raw material carryover, consistent with the recorded weight of beef trimmings used in each batch. For ground beef manufacturers, this method is a simple approach for validating the independence of finished batches of beef in their grind systems in support of product disposition policies.
Asunto(s)
Genotipo , Carne Roja , Animales , Bovinos , Escherichia coli O157 , Contaminación de Alimentos , Microbiología de Alimentos , Carne , Productos de la Carne , Prevalencia , Escherichia coli Shiga-Toxigénica/genéticaRESUMEN
Linguiça is a Portuguese traditional fermented sausage whose microbiological quality and safety can be highly variable. In order to elucidate risk factors and the particularities of the manufacturing technology that explain the between-batch variability in total viable counts (TVC), Enterobacteriaceae, Staphylococcus aureus and Listeria monocytogenes in the product; microbiological and physicochemical characterisation of linguiça at five stages of production (i.e., raw pork meat, mixed with ingredients, macerated, smoked and ripened) was carried out. A total of six production batches were surveyed from two factories; one utilised curing salts and polyphosphate in their formulation (Factory II). The delayed fermentation in the nitrite-formulated sausages was partly responsible for the increase (p<0.01) in Enterobacteriaceae, S. aureus and L. monocytogenes from raw meat (3.21logCFU/g, 1.30logCFU/g and 22.2CFU/g, respectively) to the end of maceration (4.14logCFU/g, 2.10logCFU/g and 140CFU/g, respectively) while the better acidification process in the nitrite-free sausages (Factory I) led to lower counts of S. aureus (2.64logCFU/g) and L. monocytogenes (10CFU/g) in the finished products. In Factory II, although L. monocytogenes entered the chain at the point of mixing, it became steadily inactivated during smoking and ripening (<50CFU/g), despite the initially-delayed fermentation. Nitrite had a strong effect on reducing Enterobacteriaceae throughout smoking (r=-0.73) and ripening (r=-0.59), while it failed to control the growth of S. aureus. The main hurdle preventing the development of S. aureus in linguiça is the pH, and other factors contributing to its control are: longer ripening days (p=0.019), low S. aureus in raw meat (p=0.098), properly-washed casings (p=0.094), and less contamination during mixing (p=0.199). In the case of L. monocytogenes, at least three hurdles hinder its development in linguiça: low aw (p=0.004), low pH (p=0.040) and nitrite (p=0.060), and other factors contributing to its control are: longer ripening (p=0.072) and maceration (p=0.106) periods, lower aw at the end of smoking (p=0.076) and properly-washed casings (p=0.099). Results have shown that there is a need to standardise the productive process of linguiça, to optimise the initial acidification process, and to reinforce proper programmes of quality control of ingredients and good hygiene practices, so as to minimise the introduction of Enterobacteriaceae and pathogens from external sources.
RESUMEN
Guidelines on prudent antimicrobial use in veterinary medicine have been developed to reduce inappropriate prescribing of antimicrobials. Such guidelines focus mainly on the clinical and pharmacological indications for prescribing. A questionnaire study of veterinary surgeons engaged in cattle practice was completed to determine if non-clinical issues influence the decision to prescribe antimicrobials, and to assess if pharmacological and non-pharmacological issues influence the choice of antimicrobial prescribed. Non-clinical issues, including issues related to professional stress, influenced the prescribing decision of the majority of respondents. However, the nature of the veterinarian-client relationship did not influence the prescribing behaviour of the majority of respondents. Pharmacological and non-pharmacological issues influenced the choice of antimicrobial prescribed. The veterinary surgeon's prior experience of a drug was considered 'often' or 'always' by 95.7 per cent of respondents when making this decision. The findings of this study have implications for the recognition and management of stress within the profession, and for the development of intervention strategies to reduce inappropriate antimicrobial prescribing.
Asunto(s)
Antiinfecciosos/uso terapéutico , Enfermedades de los Bovinos/tratamiento farmacológico , Enfermedades Transmisibles/veterinaria , Toma de Decisiones , Veterinarios/psicología , Animales , Bovinos , Enfermedades Transmisibles/tratamiento farmacológico , Humanos , Irlanda , Guías de Práctica Clínica como Asunto , Encuestas y Cuestionarios , Veterinarios/estadística & datos numéricos , Medicina Veterinaria/normasRESUMEN
Central retinal artery occlusion (CRAO) is an uncommon eye disorder, but one that typically produces severe and irreversible vision loss in the affected eye. The retina has a dual blood supply, with the retinal circulation supplying the inner layers and the choroidal circulation supplying the outer layers. In CRAO, vision loss results from cell death in the inner retinal layers despite relative sparing of the outer layers. If supplemental oxygen is provided, however, oxygen from the choroidal circulation may diffuse in adequate quantity to the inner layers of the retina to maintain retinal function and restore vision. In some patients this can be achieved with normobaric hyperoxia; in others, hyperbaric oxygen (HBO2) may be required. The challenge is to provide the supplemental oxygen early enough after the onset of vision loss to prevent irreversible damage to the retina. In experimental models of complete CRAO, the ischemic time window before permanent retinal damage occurs is just over 90 minutes; in the clinical setting where occlusion may be incomplete, return of vision may be achieved even after delays of eight to 24 hours. In patients with a clinical picture of CRAO who present within 24 hours of vision loss, supplemental oxygen should be started immediately at the highest possible fraction of inspired oxygen (FiO2). If vision is not quickly restored, emergent HBO2 should be undertaken if feasible. If the patient responds to HBO2, follow-up treatment with supplemental oxygen should be customized to maintain retinal viability until the obstructed retinal artery recanalizes, which typically occurs within the first 72 hours. This paper reviews the pertinent literature on CRAO and HBO2 and provides a treatment algorithm.
Asunto(s)
Algoritmos , Oxigenoterapia Hiperbárica/métodos , Oclusión de la Arteria Retiniana/terapia , Ceguera/etiología , Ceguera/terapia , Medicina Basada en la Evidencia , Humanos , Oxigenoterapia Hiperbárica/economía , Terapia por Inhalación de Oxígeno/métodos , Oclusión de la Arteria Retiniana/complicacionesRESUMEN
Cronobacter species (formerly known as Enterobacter sakazakii) are opportunistic pathogens that can cause necrotizing enterocolitis, bacteraemia and meningitis, predominantly in neonates. Infection in these vulnerable infants has been linked to the consumption of contaminated powdered infant formula (PIF). Considerable research has been undertaken on this organism in the past number of years which has enhanced our understanding of this neonatal pathogen leading to improvements in its control within the PIF production environment. The taxonomy of the organism resulted in the recognition of a new genus, Cronobacter, which consists of seven species. This paper presents an up-to-date review of our current knowledge of Cronobacter species. Taxonomy, genome sequencing, current detection protocols and epidemiology are all discussed. In addition, consideration is given to the control of this organism in the manufacturing environment, as a first step towards reducing the occurrence of this pathogen in PIF.
Asunto(s)
Cronobacter sakazakii/genética , Contaminación de Alimentos/análisis , Microbiología de Alimentos , Fórmulas Infantiles , Antibacterianos/farmacología , Cronobacter sakazakii/clasificación , Cronobacter sakazakii/efectos de los fármacos , Cronobacter sakazakii/aislamiento & purificación , Cronobacter sakazakii/patogenicidad , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Enterobacteriaceae/microbiología , Contaminación de Alimentos/prevención & control , Industria de Alimentos , Humanos , Lactante , Recién Nacido , Polvos , VirulenciaRESUMEN
An apple and dairy based ready-dessert with an added prebiotic was stored and chill temperatures and number of quality attributes were monitored during chill (4 °C) storage for 30 days. All ready-desserts were thermally processed by sous vide (P (90) > 10 min). The stability of the dairy component in ready-desserts was monitored by measuring volatile free fatty acids. Changes in these components were more evident in prebiotic-enriched samples compared to controls. However, no significant differences were observed over storage in control and prebiotic-enriched ready-desserts. This was supported by sensory analysis that showed no significant changes over storage in control or prebiotic-enriched samples. Of the other quality parameters, the addition of prebiotic inclusions resulted in lower L and b values and dry matter (p < 0.05), while increasing (p < 0.05) soluble solids content compared to control samples. Fluctuations in some of the quality parameters were also observed over storage. Rheological characteristics, i.e. flow behaviour (n), consistency index (K), storage (G'), loss (Gâ³) and complex (G*) moduli were unaffected by prebiotic inclusion. However, storage affected the rheological characteristics of ready-desserts. A decrease (p < 0.05) in flow behaviour (n) led to concomitant increases in consistency index (K) and complex modulus (G*) values in control samples.
Asunto(s)
Frío , Almacenamiento de Alimentos , Malus , Ácidos Grasos/química , Análisis de los Alimentos , Cromatografía de Gases y Espectrometría de Masas , Humanos , Prebióticos , Reología , Sensación , VolatilizaciónRESUMEN
Listeria monocytogenes can proliferate at the beginning of cheesemaking as the conditions favor growth. The objective of this study was to establish the growth limits of L. monocytogenes in a cheese matrix, in case of potential contamination of the milk prior to cheese manufacture. A semisoft laboratory scale model cheese system was made at different initial pH and water activity (a(w)) levels with a mix of two strains of L. monocytogenes. A factorial design of five pH values (5.6 to 6.5), four a(w) values (0.938 to 0.96), and two L. monocytogenes inoculation levels (1 to 20 CFU/ml and 500 to 1,000 CFU/ml) was carried out. Each combination was evaluated in six independent replicates. In order to determine if there was a dominant strain, isolated colonies from the cheeses were analyzed by pulsed-field gel electrophoresis. The data relating to growth initiation were fitted to a logistic regression model. The a(w) of milk influenced the probability of growth initiation of L. monocytogenes at both low and high contamination levels. The pH, at the concentrations tested, had a lower effect on the probability of growth initiation. At pH 6.5 and a(w) of 0.99 for low contamination levels and pH 6.5 and a(w) of 0.97 for high contamination levels, increases in population of up to 4 and 2 log were observed at low and high contamination levels, respectively. This shows that if conditions are favorable for growth initiation at the early stages of the cheesemaking process, contamination of milk, even with low numbers, could lead to L. monocytogenes populations that exceed the European Union's microbiological limit of 100 CFU/g of cheese.
Asunto(s)
Queso/microbiología , Contaminación de Alimentos/análisis , Concentración de Iones de Hidrógeno , Listeria monocytogenes/crecimiento & desarrollo , Agua/metabolismo , Recuento de Colonia Microbiana , Seguridad de Productos para el Consumidor , Electroforesis en Gel de Campo Pulsado , Fermentación , Manipulación de Alimentos/métodos , Microbiología de Alimentos , Humanos , Listeria monocytogenes/metabolismoRESUMEN
Antioxidant activity and quality parameters of skin-on apple wedges from 10 cultivars were examined during chill storage and over two growing seasons. Storage of fresh-cut apple wedges had a significant impact on quality parameter indices such as browning index (p < 0.001) and texture firmness (p < 0.001). Headspace gas analysis indicated that the degree of browning negatively correlated to oxygen (-0.69) and positively (0.70) correlated to carbon dioxide levels. Antioxidant capacity as assessed by three in vitro methods (DPPH, FRAP and ORAC) decreased significantly for 9 of the 10 cultivars after 5 days of storage at 3 ± 1 °C (p < 0.001). These indices increased in case of Shampion apples over the same storage period for all three assays. With regard to antioxidant capacity and quality parameters, the cultivars Gloster, Alwa, Idared and Jonica were the best performing overall and could therefore be recommended as a core ingredient in fresh-cut fruit products.
Asunto(s)
Antioxidantes/química , Atmósfera , Embalaje de Alimentos , Malus/química , Malus/clasificación , Fenómenos Químicos , Análisis de los AlimentosRESUMEN
The dynamics of the physicochemical characteristics of foods help to determine the fate of pathogens throughout processing. The aim of this study was to assess the behaviour of Listeria monocytogenes during cheesesmaking and ripening and to model the growth observed under the dynamic conditions of the cheese. A laboratory scale cheese was made in 4 independent replicates from pasteurised or raw cow's milk, artificially contaminated with L. monocytogenes. No growth of L. monocytogenes occurred during raw milk cheese-making, whereas growth did occur in pasteurised milk. During ripening, growth occurred in raw milk cheese, but inactivation occurred in pasteurised milk cheese. The behaviour observed for L. monocytogenes was modelled using a logistic primary model coupled with a secondary cardinal model, taking into account the effect of physicochemical conditions (temperature, pH, water activity and lactate). A novel statistical approach was proposed to assess the optimal growth rate of a microorganism from experiments performed in dynamic conditions. This complex model had an acceptable quality of fit on the experimental data. The estimated optimum growth rates can be used to predict the fate of L. monocytogenes during cheese manufacture in raw or pasteurized milk in different physicochemical conditions. The data obtained contributes to a better understanding of the potential risk that L. monocytogenes presents to cheese producers (growth on the product, if it is contaminated) and consumers (the presence of high numbers) and constitutes a very useful set of data for the completion of chain-based modelling studies.
Asunto(s)
Queso/microbiología , Listeria monocytogenes/crecimiento & desarrollo , Leche/microbiología , Modelos Biológicos , Animales , Microbiología de Alimentos , Concentración de Iones de Hidrógeno , TemperaturaRESUMEN
AIM: To determine growth initiation differences of Listeria monocytogenes between a cheesemaking context, milk and tryptic soy broth (TSB). METHODS AND RESULTS: A laboratory-scale cheese was made with a mix of two strains of L. monocytogenes at four initial pH values, five water activity (a(w)) values and two contamination levels at 30°C. Counts of L. monocytogenes were determined at time 0 and after 8h of cheese manufacture. Milk and TSB at the same pH and a(w) conditions were inoculated with the L. monocytogenes mix in multi-well plates. Growth was determined by plating each well onto Agosti & Ottaviani Listeria Agar after 8h of incubation at 30°C. Each condition was repeated six times, and growth initiation probability was modelled with logistic regression models. Growth initiation boundaries were obtained for each matrix type. The results showed that the growth limits were matrix dependent. In the three matrix types, a(w) was the most important factor affecting the probability of growth initiation. Contamination level affected growth TSB and cheesemaking conditions. CONCLUSIONS: The interface wideness and position in cheese, milk and TSB were dissimilar, indicating that the use of models evaluated in TSB or milk could not be used to predict the behaviour of L. monocytogenes under cheesemaking conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: Predictive models generated in liquid media are not necessarily adaptable to solid food, and the generation of real food models is necessary.
Asunto(s)
Caseínas , Queso/microbiología , Listeria monocytogenes/crecimiento & desarrollo , Leche/microbiología , Hidrolisados de Proteína , Animales , Modelos BiológicosRESUMEN
Salmonella Typhimurium is the predominant serotype isolated from humans in Europe. Pork and pork products are recognized vehicles of Salmonella and are responsible for outbreaks of human salmonellosis. Pigs can become infected with Salmonella on the breeding or fattening farm and during transport, lairage, and slaughter. The aim of this study was to investigate selected points of Salmonella contamination from the time pigs entered the lairage to the time the carcass was processed in the boning hall and to determine the importance of different sources of Salmonella along the Irish pork production chain. A second objective was to evaluate whether the serological status or category of a herd influenced the levels of bacteriological contamination detected on individual carcasses and pork cuts during slaughter and dressing operations. All samples were tested for the presence and numbers of Salmonella. Enterobacteriaceae numbers were also determined. Serotype, phage type, and pulsed-field gel electrophoresis were utilized to determine similarity among Salmonella isolates. Lairage was a major source of cross-contamination with Salmonella as were the hands of evisceration operatives, conveyor belts, and equipment in the boning hall. Cross-contamination within the slaughter plant environment accounted for up to 69 % of Salmonella carcass contamination. In general, herd category reflected the bacteriological status of carcasses and pork cuts. Major findings were a strong association (P < 0.01) between Enterobacteriaceae counts and Salmonella occurrence on prechill carcasses and a significant association (P < 0.05) between Enterobacteriaceae counts and Salmonella occurrence on pork cut samples.
Asunto(s)
Mataderos , Contaminación de Alimentos/análisis , Carne/microbiología , Intoxicación Alimentaria por Salmonella/prevención & control , Salmonella/aislamiento & purificación , Mataderos/normas , Mataderos/estadística & datos numéricos , Animales , Recuento de Colonia Microbiana , Enterobacteriaceae/aislamiento & purificación , Contaminación de Alimentos/prevención & control , Manipulación de Alimentos/métodos , Humanos , Irlanda/epidemiología , Salmonelosis Animal/transmisión , Salmonella typhimurium/aislamiento & purificación , PorcinosRESUMEN
Salmonella is a common contaminant of raw pork and represents a public health risk. Both qualitative and quantitative data on Salmonella in pork at retail are required for assessment of consumer exposure to the pathogen. Pork samples (n=500) were collected at random from butchers' shops and supermarkets in the Republic of Ireland between January and November, 2007 and examined for prevalence and numbers of Salmonella using a PCR screen followed by cultural examination of positive samples. Salmonella numbers were assessed using a three tube most probable number (MPN) technique. Any Salmonella recovered were characterised by serotype, phage type and antibiogram, and subtyped by pulsed-field gel electrophoresis (PFGE). Enterobacteriaceae were also enumerated to see if there was a correlation between the Salmonella status of the pork and hygiene levels at retail outlets. Salmonella spp. were detected on 13/500 (2.6%) pork cuts at numbers between <0.03 and 2.10 MPN/g. The mean Enterobacteriaceae counts was 3.12 log(10) CFU/g (range -0.26-6.52 log(10) CFU/g). Salmonella Typhimurium was the most common serotype and the majority of isolates were multi antibiotic resistant. PFGE analysis showed evidence of persistence of some strains, with an S. Typhimurium U310 recovered from a pork abattoir being identical (100%) to a strain found a year later in a sample from a retail outlet. There was also evidence of cross contamination of Salmonella isolates between samples. There was a direct association between Salmonella contamination of pork and Enterobacteriaceae numbers, which indicates the need for good hygiene practices at retail for control of this pathogen.
Asunto(s)
Enterobacteriaceae/aislamiento & purificación , Contaminación de Alimentos/análisis , Microbiología de Alimentos , Salmonella/aislamiento & purificación , Animales , Recuento de Colonia Microbiana , Farmacorresistencia Bacteriana , Electroforesis , Enterobacteriaceae/genética , Exposición a Riesgos Ambientales , Abastecimiento de Alimentos/normas , Irlanda , Carne , Reacción en Cadena de la Polimerasa , Prevalencia , Salmonella/clasificación , Salmonella/genética , PorcinosRESUMEN
Hyperbaric oxygen therapy (HBOT) is a primary or adjunctive therapy for a variety of medical disorders including some involving the eye. This paper is the first comprehensive review of HBOT for ocular indications. The authors recommend the following as ocular indications for HBOT: decompression sickness or arterial gas embolism with visual signs or symptoms, central retinal artery occlusion, ocular and periocular gas gangrene, cerebro-rhino-orbital mucormycosis, periocular necrotizing fasciitis, carbon monoxide poisoning with visual sequelae, radiation optic neuropathy, radiation or mitomycin C-induced scleral necrosis, and periorbital reconstructive surgery. Other ocular disorders that may benefit from HBOT include selected cases of ischemic optic neuropathy, ischemic central retinal vein occlusion, branch retinal artery occlusion with central vision loss, ischemic branch retinal vein occlusion, cystoid macular edema associated with retinal venous occlusion, post-surgical inflammation, or intrinsic inflammatory disorders, periocular brown recluse spider envenomation, ocular quinine toxicity, Purtscher's retinopathy, radiation retinopathy, anterior segment ischemia, retinal detachment in sickle cell disease, refractory actinomycotiC lacrimal canaliculitis, pyoderma gangrenosum of the orbit and refractory pseudomonas keratitis. Visual function should be monitored as clinically indicated before, during, and after therapy when HBOT is undertaken to treat vision loss. Visual acuity alone is not an adequate measure of visual function to monitor the efficacy of HBOT in this setting. Ocular examinations should also include automated perimetry to evaluate the central 30 degrees of visual field at appropriate intervals. Interpretation of the literature on the efficacy of HBOT in treating ocular disorders is complicated by several factors: frequent failure to include visual field examination as an outcome measure, failure to adequately address the interval from symptom onset to initiation of HBOT, and lack of evidence for optimal treatment regimens for essentially all ocular indications. Because some ocular disorders require rapid administration of HBOT to restore vision, patients with acute vision loss should be considered emergent when they present. Visual acuity should be checked immediately, including vision with pinhole correction. If the patient meets the criteria for emergent HBOT outlined in the paper, normobaric oxygen should be started at the highest inspired oxygen fraction possible until arrangements can be made for HBOT.
Asunto(s)
Oftalmopatías/terapia , Oxigenoterapia Hiperbárica , Intoxicación por Monóxido de Carbono/terapia , Enfermedad de Descompresión/terapia , Embolia Aérea/terapia , Fascitis Necrotizante/terapia , Gangrena Gaseosa/terapia , Humanos , Mucormicosis/terapia , Necrosis/terapia , Traumatismos por Radiación/terapia , Oclusión de la Arteria Retiniana/terapia , Oclusión de la Vena Retiniana/terapia , Esclerótica/patología , Trastornos de la Visión/terapiaRESUMEN
In the field of food safety, meta-analysis can be used to combine results of prevalence studies of pathogens at critical stages within the food processing chain so that policy makers can access reliable and concise information on the effectiveness of interventions for controlling and preventing foodborne illnesses in humans. The objective of this work was to demonstrate the applicability of a parametric approach of meta-analysis to the specific case of determining the overall effect of chilling on Salmonella prevalence on pig carcasses. A meta-analysis was performed on each of two parameters measuring effect size for binary outcomes (relative risk and risk difference). Both meta-analyses confirmed that the chilling operation has a significant beneficial effect (P < 0.001) on the reduction of Salmonella prevalence on pig carcasses. Because risk difference is a parameter sensitive to the differences across studies in carcass swab areas and Salmonella detection methods, its meta-analysis highly reflected this heterogeneity (P < 0.001). However, parameterization of relative risk, not being biased by the above sources of variability, did not give rise to heterogeneity among studies and produced a fixed-effects meta-analysis solution, which is deemed more suitable for compilations based on a small number of individual studies (n = 9). Because of the systematic approach of meta-analysis (i.e., individual studies are weighed according to precision) and its reliance for actual data, the output distribution of the relative risk effect size (approximately eN(-0.868,0.166)) merits consideration for inclusion in the chilling stage of quantitative risk assessments modeling the prevalence of this pathogen along the pork production chain.
Asunto(s)
Contaminación de Alimentos/análisis , Manipulación de Alimentos/métodos , Salmonella/aislamiento & purificación , Porcinos/microbiología , Animales , Frío , Recuento de Colonia Microbiana , Seguridad de Productos para el Consumidor , Humanos , Prevalencia , Medición de Riesgo , Sensibilidad y EspecificidadRESUMEN
AIMS: This study aimed to determine the numbers and types of Salmonella spp. and Enterobacteriaceae on pork cuts in the meat cutting room environment of four commercial pork abattoirs in the Republic of Ireland. METHODS AND RESULTS: Pork oysters (M. gluteus medius; n = 720) and swabs (n = 56) from equipment and surfaces were screened for Salmonella spp. using a DNA-based PCR method and confirmed by culture. Salmonella numbers were assessed using a three-tube most probable number (MPN) technique. Salmonella spp. was detected on 24/720 (3.3%) pork cuts (range of <0.03-0.36 MPN g(-1)) and in 7/56 (12.5%) environmental swabs (range of <0.03-1.10 MPN cm(-2)). There was significant variation in the prevalence of Salmonella on pork between different abattoirs and days of sampling (range of 0-31.7%). The predominant serotype was Salmonella serotype Typhimurium followed by Salmonella serotype Derby. CONCLUSIONS: Overall prevalence data conceal the key finding that there was considerable variation in the incidence of Salmonella on different days. A direct association between Salmonella contamination of pork cuts and equipment/surfaces was observed. SIGNIFICANCE AND IMPACT OF THE STUDY: Prevalence and numbers of Salmonella were low; however, results clearly demonstrate the potential for cross-contamination from equipment and meat contact surfaces in the cutting room environment.
Asunto(s)
Mataderos , Enterobacteriaceae/aislamiento & purificación , Microbiología de Alimentos , Carne/microbiología , Salmonella/aislamiento & purificación , Porcinos , Crianza de Animales Domésticos , Animales , Reservorios de Enfermedades , Humanos , IrlandaRESUMEN
A second-order quantitative Monte Carlo simulation model was developed for Escherichia coli O157:H7 contamination of beef trimmings in Irish abattoirs. The assessment considers initial contamination levels, cross-contamination and decontamination events during the cattle slaughter process. The mean simulated prevalence of E. coli O157:H7 on trimmings was 2.36% and the mean simulated counts of E. coli O157:H7 on contaminated trimmings was -2.69log(10)CFU/g. A parallel validation survey provided some confidence in the model predictions. An uncertainty analysis indicated that microbial test sensitivity is a significant factor contributing to model uncertainty and requires further investigation while also indicating that risk reduction measures should be directed towards reducing the hide to carcass transfer (correlation coefficient 0.25) during dehiding and reducing the initial prevalence and counts on bovine hides (correlation coefficients 0.19 and 0.16, respectively). A characterisation of uncertainty and variability indicating that further research is required to reduce parameter uncertainty and to achieve better understanding of microbial transfer in meat plants. The model developed in this study highlights the need for further development of quantitative risk assessments in the food industry.
RESUMEN
Commercially slaughtered and dressed beef carcass sides (n=30) were followed through a standard commercial chill unit fitted with a new "Jasca" air humidification system adjusted to provide intermittent water spraying of carcass sides (spray cycle 2 min on, 1 min off) for 15 h. Immediately after dressing, and after 24h in the chill unit, the surface water activity, and the weight of each side was measured, and 5 cm2 samples were recovered from four locations, i.e. rump, flank, brisket and neck on the surface of each side. These samples, and similar samples from control sides (n=30) processed in a standard commercial chill unit, were subjected to microbiological examination by direct and resuscitation counts on plate count agar (PCA), MacConkey agar (MAC) and violet red bile glucose agar (VRBGA). No significant differences were observed between bacterial numbers on test and control samples on each of the above agars, at each sample point/occasion. Comparison of direct and resuscitation counts suggested the presence of substantial numbers of injured cells, at both stages (pre- and post-chill), on test and control sides. After 24 h in chill units, test sides exhibited an average weight loss of 1.36% (+/-0.36%), which is significantly less (P<0.001) than the average weight loss (1.55%+/-0.24%) from control sides. These results suggest that the Jasca spray-chilling system can limit carcass shrinkage (on average by 0.19%) without significantly increasing the surface populations of selected bacterial groups.