Programa de educación para la salud dirigido a pacientes con esclerosis múltiple y sus cuidadores principales.

Introducción. La esclerosis múltiple (EM) es una enfermedad crónica e inflamatoria del sistema nervioso central (cerebro y médula espinal) de origen desconocido. Representa la segunda causa de invalidez en adultos jóvenes, después de los traumatismos, y se suele diagnosticar en la edad más productiva a todos los niveles. Es una patología que muestra una variabilidad individual considerable y que precisa de la asistencia de muchos profesionales y de las familias de los pacientes. Objetivos. Ayudar a los pacientes con EM y a sus cuidadores principales a desarrollar una imagen realista de la enfermedad a través de la formación, asesoramiento y puesta en práctica de estrategias que supongan una mejora en los aspectos más importantes de la enfermedad. Metodología. Se ha realizado una búsqueda bibliográfica en diferentes bases de datos, revistas científicas, libros actualizados en materia de EM, Guías de Práctica Clínica y se han consultado páginas web de entidades y asociaciones de EM. Teniendo esto cómo base, se ha elaborado un programa de educación para la salud dirigido a pacientes con EM y sus cuidadores principales, que se divide en cuatro sesiones de una hora en las que se pretende cumplir los objetivos descritos en el programa. Conclusión. Aunque la EM se considere una enfermedad grave, la disponibilidad de alternativas terapéuticas cada vez son mejores y permiten tener un cierto optimismo en la calidad de vida futura de pacientes y familiares. Palabras clave. “Esclerosis múltiple”, “esclerosis”, “clínica”, “epidemiología”, “diagnóstico”, “tratamiento”, “cuidados de enfermería”, “cuidadores principales” e “impacto social”

Salmonella Shedding in Slaughter Pigs and the Use of Esterified Formic Acid in the Drinking Water as a Potential Abattoir-Based Mitigation Measure

Pigs shedding Salmonella at slaughter are considered a source of carcass contamination and human infection. To assess this potential risk, the proportion of Salmonella shedders that arrive for slaughter was evaluated in a population of 1068 pigs from 24 farms. Shedding was present in 27.3% of the pigs, and the monophasic variant of Salmonella Typhimurium, an emerging zoonotic serotype, was the most prevalent (46.9%). Antimicrobial resistance (AMR) in Salmonella isolates was common, but few isolates showed AMR to antimicrobials of critical importance for humans such as third-generation cephalosporins (5%), colistin (0%), or carbapenems (0%). However, AMR to tigecycline was moderately high (15%). The efficacy of an esterified formic acid in the lairage drinking water (3 kg formic acid/1000 L) was also assessed as a potential abattoir-based strategy to reduce Salmonella shedding. It was able to reduce the proportion of shedders (60.7% in the control group (CG) vs. 44.3% in the treatment group (TG); p < 0.01). After considering clustering and confounding factors, the odds of shedding Salmonella in the CG were 2.75 (95% CI = 1.80–4.21) times higher than those of the TG, suggesting a potential efficacy of reduction in shedding as high as 63.6%. This strategy may contribute to mitigating the burden of abattoir environmental contamination.Publishe

Control de la salmonelosis porcina en maternidades mediante la adición de manano oligosacáridos en la alimentación de las madres.

La salmonelosis es una de las enfermedades más frecuentes transmitidas por los alimentos, lo que supone un problema importante de Salud Pública. Aunque se asocia principalmente al consumo de huevos y carne de pollo, recientemente han aumentado los brotes asociados al consumo de carne de cerdo. Teniendo en cuenta que el cerdo actúa como reservorio y que los lechones pueden infectarse a partir de las madres durante la lactación, es interesante buscar métodos de control de Salmonella a nivel de maternidad para evitar así su paso al resto de la cadena productiva y, posteriormente, al consumidor. Resultados previos han demostrado el efecto beneficioso de la adición de un β-galactomanano (Salmosan®) en el pienso de cerdos de cebo para reducir la excreción de Salmonella spp. En este contexto, el objetivo es determinar si se produce el mismo efecto en las cerdas durante la maternidad. Este producto, además de evitar la excreción de Salmonella, mejoraría la calidad del calostro, puesto que podría estimular la respuesta inmune de la cerda. Para ello, se seleccionó un grupo control de 21 cerdas y un grupo tratamiento del mismo número. Se administró Salmosan® al pienso del grupo tratamiento tres semanas antes del parto y hasta el destete y se monitorizaron ambos grupos mediante muestreos semanales. Se llevaron a cabo análisis microbiológicos de muestras de heces y serológicos tanto de las madres como de los lechones, así como de calidad del calostro. Además, los lechones se pesaron al nacimiento y al destete. Los resultados obtenidos indican que, en general, la adición de Salmosan® al pienso de las madres no produce diferencias en la calidad del calostro ni en la excreción de Salmonella, a pesar de observarse diferencias en uno de los lotes. Sin embargo, parece ser beneficioso para los valores de GMD de los lechones, siendo superiores en el grupo tratado

Building a predictive model for assessing the risk of Salmonella shedding at slaughter in fattening pigs

Salmonellosis continues to be a major cause of foodborne outbreaks worldwide, and pigs are one of the main sources of human infection. Salmonella pork contamination is a major concern for abattoirs and is related to the presence of Salmonella in pigs' feces at slaughter. Being able to predict the risk of Salmonella shedding in pigs arriving at the slaughterhouse could help mitigate abattoir and carcass contamination. For this purpose, 30 batches of 50 pigs each were selected from 30 different fattening units. The pigs were tagged and bled for the detection of antibodies against Salmonella approximately one month before slaughter. Pooled floor fecal samples were also collected from 10 pens per unit for Salmonella detection, and a questionnaire on biosecurity was administered to each farm. At the abattoir, colon content was collected from each tagged pig for the Salmonella shedding assessment. A predictive model for Salmonella shedding at slaughter was built with two-third of the pigs by employing random-effects logistic regression analysis, with Salmonella shedding as the dependent variable and pig serology and other farm/environmental characteristics as the independent variables. The model included farm as the grouping factor. Data from the remaining one-third of the pigs were used for model validation. Out of 1,500 pigs initially selected, 1,341 were identified at the abattoir and analyzed. Salmonella was detected in 13 (43.3%; 95%CI = 27.4–60.8) of the fattening units. The mean batch seroprevalence (cut-off OD% ≥40) among the fattening units was 31.7% (95%CI = 21.8–41.0), and a total of 316 pigs (23.6%; 95%CI = 21.4–25.9) shed Salmonella at slaughter. The model predicted reasonably well (Area under the curve = 0.76; P &lt; 0.05) whether a pig would shed Salmonella at slaughter, with estimates of sensitivity and specificity at 71.6% and 73.6%, respectively. Serology, the percentage of Salmonella-positive pens on the farm, and the internal biosecurity score were significantly associated (P &lt; 0.05) with Salmonella shedding at the abattoir, and several scenarios were observed by the model. The study highlighted that although serology may be helpful for identifying batches of pigs at risk of shedding Salmonella upon their arrival at the abattoir, it may not be necessary in some scenarios

<i>Salmonella</i> Control in Fattening Pigs through the Use of Esterified Formic Acid in Drinking Water Shortly before Slaughter

The presence of Salmonella in pig feces is a major source of abattoir and carcass contamination, and one of the main sources of human salmonellosis. This study assessed whether using a form of esterified formic acid (30% formic acid) in drinking water (10 kg/1000 L) 5 days before slaughter could be a helpful strategy to mitigate this public health issue. Thus, 240 pigs from three Salmonella-positive commercial fattening farms were selected. From each farm, 40 pigs were allocated to a control group (CG) and 40 to a treatment group (TG). At the abattoir, fecal samples from both groups were collected for Salmonella detection (ISO 6579-1:2017) and quantification (ISO/TS 6579-2:2012). Salmonella was present in 35% (95% IC = 29.24–41.23) of the samples collected. The prevalence was significantly higher in the CG than in the TG (50% vs. 20%; p Salmonella were 5.63 times higher (95% CI = 2.92–10.8) for the CG than for the TG. Thus, the proportion of pigs shedding Salmonella that was prevented in the TG due to the use of this form of organic acid was 82.2%. In addition, a Chi-squared analysis for trends showed that the higher the Salmonella count, the higher the odds of the sample belonging to the CG. These results suggest that adding this type of acid to drinking water 5 days before slaughter could reduce the proportion of Salmonella-shedding pigs and the Salmonella loads in the guts of shedder pigs

Salmonella Infection in Nursery Piglets and Its Role in the Spread of Salmonellosis to Further Production Periods

Few studies have focused on assessing Salmonella infection in the nursery and its role in further pig production periods. Mesenteric lymph nodes, intestinal content, and meat juice from 389 6-week-old male piglets intended for human consumption from five breeding farms and 191 pooled floor fecal samples from gilt development units (GDU) from the same farms were analyzed to estimate and characterize (by pulsed-field gel electrophoresis and antimicrobial resistance analyses) Salmonella infection. The prevalence of infection and shedding among piglets was 36.5% and 37.3%, respectively, shedding being significantly associated with infection (Odds Ratio = 12.7; CI 7.3–22.0). Salmonella Rissen; S. 4,[5],12:i:-; and S. Derby were the most common serotypes. A low level of Salmonella-specific maternal antibodies at the beginning of the nursery period suggested it was a period of high risk of infection. Resistance to 3rd- and 4th-generation cephalosporins was detected in piglet isolates although the piglets never received antibiotics, indicating they could be vectors of antimicrobial resistance. The same Salmonella clones were detected in piglet and GDU isolates, suggesting that infected piglets play a significant role in the infection of gilts and consequently of finishing pigs in the case of production farms. The control of Salmonella infection in nursery piglets may decrease the risk of abattoir and carcass contamination.Publishe

The Vascular Niche for Adult Cardiac Progenitor Cells

Research on cardiac progenitor cell populations has generated expectations about their potential for cardiac regeneration capacity after acute myocardial infarction and during physiological aging; however, the endogenous capacity of the adult mammalian heart is limited. The modest efficacy of exogenous cell-based treatments can guide the development of new approaches that, alone or in combination, can be applied to boost clinical efficacy. The identification and manipulation of the adult stem cell environment, termed niche, will be critical for providing new evidence on adult stem cell populations and improving stem-cell-based therapies. Here, we review and discuss the state of our understanding of the interaction of adult cardiac progenitor cells with other cardiac cell populations, with a focus on the description of the B-CPC progenitor population (Bmi1+ cardiac progenitor cell), which is a strong candidate progenitor for all main cardiac cell lineages, both in the steady state and after cardiac damage. The set of all interactions should be able to define the vascular cardiac stem cell niche, which is associated with low oxidative stress domains in vasculature, and whose manipulation would offer new hope in the cardiac regeneration field