International outbreak of Salmonella Oranienburg due to German chocolate

BACKGROUND: This report describes a large international chocolate-associated Salmonella outbreak originating from Germany. METHODS: We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE). RESULTS: From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3–26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2–23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1–47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures. CONCLUSIONS: Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks

Acute cardiopulmonary repercussions in the correct use of the dry-powder inhalers

Modelo do estudo: Trata-se de estudo original, transversal, clínico e comparativo. Objetivo do estudo: Avaliar as repercussões cardiorrespiratórias agudas no uso correto de inaladores aerossóis de pó seco (IPS) em pacientes com asma. Metodologia: Foram avaliados, em dois momentos, 17 pacientes adultos asmáticos em uso de IPS (Formoterol e Budesonida). As variáveis avaliadas, pré e pós-uso do IPS, foram: antropométrica, cognitiva, força muscular, sinais vitais, saturação de oxigênio, pressões respiratórias e pico de fluxo. No primeiro momento (M1) foi avaliada e monitorada a execução rotineira antes e imediatamente após uso do IPS e entregue folheto explicativo sobre o uso correto. No segundo momento (M2), 30 dias após M1, houve a mesma avaliação, entretanto, com execução correta do IPS. Resultados: No M2 ocorreram aumentos significativos da pressão inspiratória de 64,2±2,03 para 74,1±31,7 (cmH2O); pressão expiratória de 71,05±33,8 para 80±31,4 (cmH2O); capacidade vital de 3,3±0,9 para 3,9±0,9 (l) e reduções na frequência de pulso de 80,310,7 para 72,2±9,4 (bpm) e do duplo produto de 10001±1693 para 8846±1416 (teste t-Student pareado, p<0,05). Conclusões: O uso correto de IPS traz ao paciente repercussões cardiorrespiratórias positivas, melhorando as condi- ções respiratórias e reduzindo o trabalho cardíaco><0,05) Conclusões: O uso correto de IPS traz ao paciente repercussões cardiorrespiratórias positivas, melhorando as condições respiratórias e reduzindo o trabalho cardíacoStudy model: It is a cross-over, clinical and comparative study. Objective: To evaluate the acute respiratory and cardiac respercussions in correct use of the dry powder inhalers (DPI) in patients with asthma. Methodology: Seventeen adult patients with asthma using DPI (Formoterol and Budesonide) were evaluated in two moments. The mensuared variables, before and after use of DPI, were: anthropometric, cognitive, muscle strength, vital signs, periferic oxygen saturation, respiratory pressures and peak expiratory flow. In the first moment (M1) was evaluated and monitored the usual performance before and immediately after using DPI and delivered an explicative leaflet about the correct use. In the second moment (M2), 30 days after M1, there was the same evaluation, however, with correct use of the DPI. Results: In the M2 there were increases to inspiratory pressure of 64,2±2,03 to 74,1±31,7 (cmH2O); expiratory pressure of 71,05±33,8 to 80±31,4 (cmH2O); vital capacity of 3,3±0,9 to 3,9±0,9 (l) and reductions in the pulse frequence of 80,3±10,7 to 72,2±9,4 (bm) and double product of 10001±1693 to 8846±1416 (paired t test, p<0,05). Conclusions: The correct use of the DPI promoves the positive respiratory and cardiac repercussions, improving respiratory conditions and reducing cardiac work><0,05).  Conclusions: The correct use of the DPI promoves the positive respiratory and cardiac repercussions, improving respiratory conditions and reducing cardiac wor

Stem cell-based Lung-on-Chips: The best of both worlds?

Pathologies of the respiratory system such as lung infections, chronic inflammatory lung diseases, and lung cancer are among the leading causes of morbidity and mortality, killing one in six people worldwide. Development of more effective treatments is hindered by the lack of preclinical models of the human lung that can capture the disease complexity, highly heterogeneous disease phenotypes, and pharmacokinetics and pharmacodynamics observed in patients. The merger of two novel technologies, Organs-on-Chips and human stem cell engineering, has the potential to deliver such urgently needed models. Organs-on-Chips, which are microengineered bioinspired tissue systems, recapitulate the mechanochemical environment and physiological functions of human organs while concurrent advances in generating and differentiating human stem cells promise a renewable supply of patient-specific cells for personalized and precision medicine. Here, we discuss the challenges of modeling human lung pathophysiology in vitro, evaluate past and current models including Organs-on-Chips, review the current status of lung tissue modeling using human pluripotent stem cells, explore in depth how stem cell based Lung-on-Chips may advance disease modeling and drug testing, and summarize practical consideration for the design of Lung-on-Chips for academic and industry applications. (C) 2018 Elsevier B.V. All rights reserved.Pathogenesis and treatment of chronic pulmonary disease

Primary Human Lung Alveolus-on-a-chip Model of Intravascular Thrombosis for Assessment of Therapeutics

Pulmonary thrombosis is a significant cause of patient mortality; however, there are no effective in vitro models of thrombi formation in human lung microvessels that could also assess therapeutics and toxicology of antithrombotic drugs. Here, we show that a microfluidic lung alveolus-on-a-chip lined by human primary alveolar epithelium interfaced with endothelium and cultured under flowing whole blood can be used to perform quantitative analysis of organ-level contributions to inflammation-induced thrombosis. This microfluidic chip recapitulates in vivo responses, including platelet-endothelial dynamics and revealed that lipopolysaccharide (LPS) endotoxin indirectly stimulates intravascular thrombosis by activating the alveolar epithelium, rather than acting directly on endothelium. This model is also used to analyze inhibition of endothelial activation and thrombosis due to a protease activated receptor-1 (PAR-1) antagonist, demonstrating its ability to dissect complex responses and identify antithrombotic therapeutics. Thus, this methodology offers a new approach to study human pathophysiology of pulmonary thrombosis and advance drug development