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Background: ERCP is a technically challenging procedure. Glyceryl Trinitrate [GTN] has been shown to reduce sphincter of Oddi pressure. Several randomized controlled trials have sought to assess the clinical effect of GTN in ERCP. The objective of this study is to assess in a meta-analysis the benefit of routine GTN use in ERCP in cannulation success and post-ERCP pancreatitis. Methods: A comprehensive literature search was conducted using online databases PubMed, Medline and Cochrane database of randomised controlled trials. Studies included had to be randomised controlled trials of GTN use as in ERCP. The outcomes of interest were cannulation success and/or rate of post-ERCP pancreatitis. Data Collection and Analysis: Seven Randomised Controlled Trials were identified. Data was analysed using Cochrane Collaboration Review Manager software. Each study was weighted in accordance with its size and event rate. Outcome of interest from each study and pooled results had Risk Ratio and 95% confidence intervals calculated. Results: A total of six studies and 1321 patients were analysed for effect on cannulation success. A pooled Risk Ratio of 0.66 [95% CI 0.43–1.01] represents a relative risk reduction of 34%, though not statistically significant. Four studies and a total of 854 patients were analysed for rate of post ERCP pancreatitis. A pooled Risk Ratio of 0.56 [95% CI 0.37–0.85] represents a significant relative risk reduction of 44%. Conclusions: GTN administration in ERCP reduces the rate of post ERCP pancreatitis and may have a small benefit in cannulation success. [ABSTRACT FROM AUTHOR]

Aim: To investigate the aerobiology of the environment around mechanically ventilated broiler sheds with the aim of understanding dispersion in the surrounding environment. Methods and Results: Aerosol samples were collected weekly on four different commercial broiler farms through the cycle of 55 days from 2005 to 2007. Samples were collected inside the shed and at varying distances from the sheds. Litter and dust from within the shed were also examined. Members of the genera Staphylococcus (and to a lesser extent Corynebacterium) dominated (106 CFU m−3) in the outside air at 20 m from the fan and were shown to decrease with distance. At distances of around 400 m, the levels of staphylococci/coryneforms returned to levels typical of those present before the placement of chickens. Escherichia coli levels were low (maximum 100 CFU m−3) at 20 m. Fungi were present at uniform levels across the broiler cycle. Conclusions: Staphylococci are the dominant organisms present in the air around mechanically ventilated broiler sheds and have the potential to act as an airborne ‘marker organism’. Significant Impact of the Study: The outcomes of this study suggest that the impact of aerosols emitted from broiler sheds could be monitored and managed by examining the levels of staphylococci/coryneforms. [ABSTRACT FROM AUTHOR]

This study assessed the levels of two key pathogens, Salmonella and Campylobacter, along with the indicator organism Escherichia coli in aerosols within and outside poultry sheds. The study ranged over a 3-year period on four poultry farms and consisted of six trials across the boiler production cycle of around 55 days. Weekly testing of litter and aerosols was carried out through the cycle. A key point that emerged is that the levels of airborne bacteria are linked to the levels of these bacteria in litter. This hypothesis was demonstrated by E. coli. The typical levels of E. coli in litter were 108 CFU g-1 and, as a consequence, were in the range of 102 to 104 CFU m-3 in aerosols, both inside and outside the shed. The external levels were always lower than the internal levels. Salmonella was only present intermittently in litter and at lower levels (103 to 105 most probable number [MPN] g-1) and consequently present only intermittently and at low levels in air inside (range of 0.65 to 4.4 MPN m-3) and once outside (2.3 MPN m-3). The Salmonella serovars isolated in litter were generally also isolated from aerosols and dust, with the Salmonella serovars Chester and Sofia being the dominant serovars across these interfaces. Campylobacter was detected late in the production cycle, in litter at levels of around 107 MPN g-1. Campylobacter was detected only once inside the shed and then at low levels of 2.2 MPN m-3. Thus, the public health risk from these organisms in poultry environments via the aerosol pathway is minimal. [ABSTRACT FROM AUTHOR]