Reduction of Shiga toxin-producing Escherichia coli in a beef abattoir.

The aim of this work was to reinforce actions tending to reduce Shiga toxin-producing Escherichia coli (STEC) in beef products from an Argentinean commercial abattoir implementing Hazard Analysis and Critical Control Point (HACCP) practices. An environmental stx map was built with 421 environmental samples from the slaughter, quartering, cool chamber and deboning sectors (February-May 2013). For stx determination, 125 carcass and 572 anatomical cut samples were used. Based on the environmental stx mapping results, improvement actions were designed and implemented (June and July 2013). After implementing improvement actions, 160 carcass and 477 anatomical cut samples were collected to identify stx and verify the impact of improvement actions (August-December 2013). Our results showed stx-positivity in pre-operational (10.1%) and operational (15.5%) environmental samples and in carcass and beef cut samples before (4.8 and 10.1%; p = 0.144) and after (1.2 and 4.8%; p = 0.0448) implementing improvement actions, respectively. Although improvement actions reduced stx in beef cuts, it is difficult to implement and sustain a system based on stx zero-tolerance only by reinforcing Good Manufacturing Practices, Sanitation Standard Operating Procedures and HACCP practices. The application of combined intervention strategies to reduce STEC in carcasses and beef cuts should be therefore considered.

Results in comparison between 30 gauge ultrathin wall and 27 gauge needle in sutureless intraocular lens flanged technique in diabetic patients: 24-month follow-up study.

AIMS: Intraoperative complications in cataract surgery are more common in diabetic patients. Solving aphakia in these circumstances remains a challenge, as the scleral structure has been shown to be different in diabetes. This study aims to analyze the role of a secondary sutureless scleral intraocular lens (IOL) flanged fixation in diabetic patients without capsular support and to compare the anatomical and functional outcomes using a 30 gauge (G) ultrathin wall needle vs. a 27G needle. METHODS: Retrospective, observational cohort study. 105 eyes (105 patients) who underwent PPV with secondary IOL fixation using a sutureless 27G (n = 51) or a 30G ultrathin wall (UTW) needle technique (n = 54) and had a 24 months postoperative follow up. Consecutive patients' records were reviewed for lens stability and centration parameters, intra- and postoperative complications at 7 days, 1, 3, 6, 12, and 24 months after surgery. Correlations between outcome measures and needle size (27G vs. 30G UTW) were analyzed. RESULTS: IOL displacement occurred in 30 patients (41.2%) in the 27G group and did not occur in the 30G UTW needle group (p < 0.001). Mean time until IOL displacement was 10.5 ± 7.0 months (range: 7 days-24 months). IOL centricity was significantly better in the 30G ultrathin wall needle group compared to 27 G (p = 0.001). Additional surgical interventions were necessary only in the 27G group (n = 14). CONCLUSIONS: Sutureless IOL flanged technique using a 30G UTW needle is more predictable and has less complications in aphakic diabetic patients, compared to a 27G needle technique.

Evaluation of intervention measures at different stages of the production chain in Argentinian exporting abattoirs.

Antimicrobial treatments could help to decrease the transmission of microorganisms to beef carcasses and abattoir environments. The aim of this study was to evaluate the effectiveness of interventions in reducing Shiga toxin genes (stx1 and stx2) presence in a commercial abattoir. Intervention measures included the application of electrolytically generated hypochlorous acid to steer pens (experiment 1), chlorinated water, electrolytically generated hypochlorous acid, and isoclor to steer pens (experiment 2), electrolytically generated hypochlorous acid to knocking pens (experiment 3), and aqueous ozone and electrolytically generated hypochlorous acid onto beef carcasses (experiment 4). Detection of stx in samples was performed with BAX® System Real-Time PCR Assay. Our results showed that treatment with pressurized electrolytically generated hypochlorous acid and isoclor were effective to reduce stx presence from hides on steer pens. Although there is no single strategy to ensure the reduction of stx presence in a commercial abattoir, the combined application of several antimicrobial interventions would be ideal.

UNDERDIAGNOSED OPTIC DISK PIT MACULOPATHY: Spectral Domain Optical Coherence Tomography Features For Accurate Diagnosis.

PURPOSE: To report a cohort with optic disk pit maculopathy (ODPM) presenting with neurosensory macular detachment that were initially misdiagnosed and mistreated; and to describe structural features on spectral domain optical coherence tomography in misdiagnosed and all other consecutive cases of ODPM. METHODS: Multicenter international retrospective cohort study. PARTICIPANTS: 59 eyes from 59 patients with ODPM. MAIN OUTCOME MEASURES: 1) Proportion of patients with ODPM initially misdiagnosed, inaccurate diagnosis and treatment. 2) Morphologic features on spectral domain optical coherence tomography: other causes of subretinal and/or intraretinal fluid, inner/outer retinoschisis, communication with optic disk pit, and retinal pigment epithelium alterations. 3) Visual and anatomical outcomes 6 months after proper treatment. RESULTS: Fifteen patients (25.4%) with ODPM were correctly diagnosed initially and those were significantly younger than misdiagnosed cases (age 33.8 ± 15.2 vs. 58.7 ± 15.8 years, P < 0.0001). Forty of forty-four misdiagnosed eyes (90.9%) were treated for their presumed diagnosis before referral. Eyes with initial misdiagnosis had significantly more outer retinoschisis at baseline (88.4 vs. 40.0%, P = 0.0002) and more retinal pigment epithelium alterations (90.0 vs. 27.3%, P < 0.0001) 6 months after proper treatment. CONCLUSION: Optic disk pit maculopathy is an underdiagnosed entity and can mimic other causes for subretinal fluid. Awareness and identification of pertinent spectral domain optical coherence tomography features can help avoid inappropriate and delayed treatment.

Prevalencia de trastornos temporomandibulares en adolescentes del Sur de Chile, año 2015 / Prevalence of temporomandibular disorders in adolescents of Southern Chile in 2015

Objetivo Determinar la prevalencia de trastornos temporomandibulares en adolescentes del Sur de Chile, año 2015. Material y métodos Estudio de prevalencia. Se seleccionaron 186 adolescentes (promedio de edad de 15,4 ± 1,25 años; 51,1% hombres) de 29 colegios de Valdivia entre junio y octubre de 2015. Un investigador calibrado (kappa = 0,86) realizó el examen clínico según las indicaciones del eje I y algunas preguntas del eje II del instrumento Criterios diagnósticos para la investigación de trastornos temporomandibulares (CDI/TTM), clasificando el tipo de TTM según el algoritmo diagnóstico: trastornos musculares (grupo 1), trastornos articulares (grupo 2) y daño articular (grupo 3). Se registró un autorreporte de dolor en cabeza, sensación de apriete de dientes y de ruido articular. Se analizó la prevalencia de TTM según la edad y el sexo (Chi-cuadrado y «t¼ de Student; p < 0,05). Resultados Un 41% de la muestra manifestó dolor en alguna región de la cabeza, un 32,5% con sensación de apriete de dientes y un 25,8% sintió algún ruido articular. Según CDI/TTM la prevalencia de TTM fue 26,88%, siendo una proporción hombre:mujer de 1:1,27 (p = 0,24). De ellos, un 10,8% presentaron trastorno muscular, un 9,6% trastorno articular y un 11,3% daño articular. Conclusión Cuatro de cada 10 adolescentes manifestaron algún tipo de dolor o molestia temporomandibular, siendo mayoritariamente en mujeres. La prevalencia de TTM fue mayor a estudios similares en población, pero menor a la reportada en adultos jóvenes.

Objective To determine the prevalence of temporomandibular disorders (TMD) in adolescents of southern Chile, in 2015. Material and methods A prevalence study was conducted on a selected group of 186 adolescents with a mean of age of 15.4 ± 1.25 years, and 51.1% male, from 29 schools in Valdivia, Chile, between June and October 2015. A calibrated researcher calibrated (kappa = 0.86) carried out a clinical examination according to the instructions of the Axis I and some questions of the Axis II of Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) application. The type of TMD was classified according to the diagnostic algorithm: muscular disorder (group 1), articular disorder (group 2), and articular damage (group 3). A self-report of headache, clenching teeth sensation, and articular noise was registered. The prevalence of TMD was analysed according to age and gender of the patients (Chi-squared and Student t test; P < .05). Results Headache was recorded by 41% of the adolescents, with 32.5% reporting a sensation of clenching teeth, and 25.8% felt some articular noise. According to the RDC/TMD, the prevalence of TMD was 26.66%, with a male: female ration of 1:1.27 (P = .24). A muscular disorder was present in 10.8% of them, and 11.3% had articular damage. Conclusion Four out of ten adolescents, mostly female, manifested some kind of pain or temporomandibular discomfort. The prevalence of TMD was higher in number when compared to similar studies, but lower than that reported in young adults.