Effect of preinoculation growth media and fat levels on thermal inactivation of a serotype 4b strain of Listeria monocytogenes in frankfurter slurries.

Preinoculation growth conditions and fat levels were evaluated for effects on the heat resistance of Listeria monocytogenes strain MFS 102 in formulated frankfurter slurries and on frankfurter surfaces. Comparison of linear inactivation rates (D-values) for cells heated in frankfurter slurry showed that growth conditions were significant (P<0.05) factors affecting subsequent thermal resistance. The average D(60 degrees C)-values for the five preinoculation growth media tested from most resistant to least heat resistant were: tryptic soy broth with 0.6% yeast extract (TSBYE) (2.2 min) and 8.5% fat slurry (2.2 min), followed by 23% fat slurry (1.7 min) and 11% fat slurry (1.7 min), and then TSYBE with quaternary ammonium compounds added (TSBYE+Q) (1 min). The fat level in the frankfurter heating media also had a significant (P<0.05) effect on the thermal death rate of L. monocytogenes. Cells heated in 8.5% fat slurry had a significantly higher (P<0.05) D(60 degrees C)-value (2.2 min) than those heated in 11% fat (1.0 min) and 23% fat slurry (0.9 min). Growth media (TSBYE, 8.5% fat slurry, and TSBYE+Q), and fat level (15% and 20%), however, were not significant factors (P>0.05) affecting thermal inactivation rates on frankfurter surfaces. Heat inactivation rates were consistently higher on frankfurter surfaces compared to similar treatments done in frankfurter slurry. On frankfurter surfaces, a 2.3- to 5.1-log(10) reduction was achieved after 15 min depending on frankfurter surface type. The time necessary to achieve a 3-log(10) reduction using post-processing pasteurization of frankfurters in a hot water-bath at 60 degrees C almost doubled for cells grown in TSBYE and heated in 23% fat frankfurter slurry (19.6 min) versus cells grown and heated in 8.5% fat frankfurter slurry (10.8 min).

A predictive model to describe the effects of temperature, sodium lactate, and sodium diacetate on the inactivation of a serotype 4b strain of Listeria monocytogenes in a frankfurter slurry.

A modified Gompertz equation was used to model the effects of temperature (55, 60, and 65 degrees C), sodium lactate (0, 2.4, and 4.8%), and sodium diacetate (0, 0.125, and 0.25%) on inactivation of Listeria monocytogenes strain MFS 102 (serotype 4b) in frankfurter slurry. The effects of these factors were determined on the shouldering region (parameter A), maximum death rate (parameter B), and tailing region (parameter C) of microbial inactivation curves. Increased temperature or sodium diacetate concentrations increased the death rate, whereas increased sodium lactate concentrations decreased heat resistance. Complex two-way interactive effects were also observed. As both temperature and sodium lactate increased, the death rate decreased; however, as temperature and sodium diacetate increased, the death rate increased. The effect of the interaction between sodium lactate and sodium diacetate on the maximum death rate varied with temperature. Increases in both acidulants at temperatures above 56.7 degrees C decreased the death rate, whereas at temperatures below 56.7 degrees C, increases in both acidulants increased the death rate. To test for significant differences between treatments, D-values were calculated and compared. This comparison revealed that, in general, sodium lactate increased heat resistance and sodium diacetate decreased heat resistance of L. monocytogenes. This information is important for reducing and minimizing contamination during postprocessing thermal treatments.

Decontamination of strawberries using batch and continuous chlorine dioxide gas treatments.

Efficacy of chlorine dioxide (ClO2) gas in reducing Escherichia coli O157:H7 and Listeria monocytogenes on strawberries was determined using batch and continuous flow ClO2 gas treatment systems. Effects of continuous ClO2 gas treatment on total aerobic plate count, color, and residual ClO2 and chlorite on strawberries were also evaluated. Strawberries were spot inoculated with 7 to 8 log CFU per strawberry of each pathogen (E. coli O157:H7 and L. monocytogenes), stored for 1 day at 4 degrees C, and treated at 22 degrees C and 90 to 95% relative humidity with 0.2 to 4.0 mg/liter ClO2 gas for 15 or 30 min using a batch treatment system or with 0.6, 1.8, and 3.0 mg/liter for 10 min using a continuous treatment system. Surviving microbial populations were determined using a membrane-transfer plating recovery method. Increased ClO2 gas concentrations resulted in increased log reductions of each pathogen for both the batch and continuous systems. A batch treatment of strawberries with 4 mg/liter ClO2 for 30 min and continuous treatment with 3 mg/liter ClO2 for 10 min achieved greater than a 5-log reduction for both E. coli O157:H7 and L. monocytogenes. After continuous exposure to 3.0 mg/liter ClO2 gas for 10 min followed by 1 week of storage at 4 degrees C, no aerobic microorganisms were detected and the color of the strawberry surface did not change significantly (P > 0.05). Residues of ClO2 and chlorite on strawberries after the treatment were 0.19 +/- 0.33 mg ClO2 per kg and 1.17 +/- 2.02 mg Cl2 per kg, respectively, whereas after 1 week of storage no ClO2 residues were detected and residual chlorite levels were down to 0.07 +/- 0.12 mg Cl2 per kg. These results suggest that ClO2 gas treatment is an effective decontamination technique for improving the safety of strawberries while extending shelf life.

[Ultrasonography of the inferior vena cava (IVC) in the diagnosis and monitoring of therapy in patients with chronic congestive heart failure]. / Sonographie der Vena cava inferior (VCI) zur Diagnostik und Therapiekontrolle bei chronischer Stauungs-Herzinsuffizienz.

OBJECTIVE: This prospective clinical study investigated whether the relatively simple and cost-effective ultrasonography of the inferior vena cava (IVC) represents a valid clinical tool to assess the effectiveness of diuretic therapy in patients with chronic congestive heart failure (CHF). METHODS: Measurement of the resting and inspiratory diameter of the VCI repeatedly during diuretic therapy in 23 consecutive patients (11 women, 70 +/- 10 years) with CHF and comparing the results to the daily measured body weight and serum creatinine in these patients. Results were compared with the IVC diameter obtained in 33 healthy controls (16 women, 42 +/- 15 years). In addition, the IVC collapse index was calculated to assess inspiratory movements of the IVC in patients on day 1 and 10 of therapy. RESULTS: The IVC diameter at rest was 2.4 +/- 0.6 cm and decreased to 2.0 +/- 0.7 cm at inspiration, which was significantly greater than in healthy controls (1.4 +/- 0.4 cm at rest and 1.05 +/- 0.5 cm at inspiration; p = 0.008 and p = 0.01, respectively). The IVC diameter decreased continuously and significantly (p < 0.003) from day 1 to day 10 during diuretic therapy without a concomitant rise in serum creatinine. At beginning of therapy, the collapse-index of the IVC was significantly greater in patients than in controls. However, after 10 days of therapy this index reached similar values to those observed in controls. CONCLUSION: Ultrasonographic measurements of IVC diameter and inspiratory movements are a quantifiable and reliable approach to assess the hypervolemia associated with CHF. Normalization of inspiratory IVC collapse movement correlates with successful diuretic therapy and can be reliably used for bedside assessment and monitoring treatment in CHF patients.

Gracile, cuneate, and spinal trigeminal projections to inferior olive in rat and monkey.

In the cat, somatosensory nuclei send substantial projections to the inferior olive, where they terminate in a somatotopic fashion. Although the organization of the cat inferior olive has been used to interpret data from other species, published data suggest this organization may not occur universally. The present study investigated whether the inferior olive in albino rats and cynomolgus monkeys receives the same brainstem somatosensory inputs, whether these inputs are organized somatotopically and, if so, how the organization compares with that in the cat. Projections from the gracile, cuneate and spinal trigeminal nuclei were labeled with wheat germ agglutinin conjugated to horseradish peroxidase or with biotinylated dextran. The results were compared with data from cats (Berkley and Hand [1978] J. Comp. Neurol. 180:253-264). In the rat and monkey, the gracile, cuneate and spinal trigeminal nuclei all project to the contralateral inferior olive, where each nucleus has a distinct preferred terminal field. As in the cat, projections to the medial accessory olive and caudal dorsal accessory olive did not terminate in a precisely organized fashion. Projections to the rostral dorsal accessory olive, however, formed a clear somatotopic map. These somatotopic maps differed from those in the cat in that input from the trigeminal nucleus was confined rostrally, so that the caudal end only received input from the gracile and cuneate nuclei. These data indicate that similar organizational principles characterize the somatosensory projections to the inferior olives of the three species. Nevertheless, distinct species differences occur with regard to the details of this organization.

From paternalism to partnership: family and professional collaboration in children's mental health.

A survey of 455 caregivers of children with severe emotional disorders identified four empirically distinct dimensions of collaboration between mental health professionals and the children's family members. Characteristics of families, professionals, and the service delivery process associated with the dimensions are examined, as is the relationship between collaboration and family satisfaction.

Valproate (VPA) metabolites in various clinical conditions of probable VPA-associated hepatotoxicity.

Of a cohort of 470 epileptic patients in whom valproate (VPA) serum metabolites had been measured, 170 subjects without symptoms or signs of hepatic side effects were chosen as a reference group to establish the usual metabolic pattern. A wide interindividual variation of VPA metabolite concentrations was noted. Infants receiving VPA monotherapy and comedication with other antiepileptic drugs (AEDs) showed lower concentrations of the potential hepatotoxin 4-ene-VPA than did older children. In 11 patients with early symptoms and signs of possible fatal VPA-associated hepatotoxicity, the following spectrum of benign clinical conditions was observed: unusually severe side effect during initiation of VPA therapy (1 patient), high VPA dosage (2 patients), reversible impairment of coagulation with bleeding manifestations in association with a slight increase in transaminase levels (1 child), and reversible liver dysfunction associated with febrile illness (7 patients). Reversible or irreversible fulminant liver failure had occurred in 5 children. Three of the 4 children with a fatal outcome had massive lactic acidosis. In all patients with probable VPA-associated hepatotoxicity, some aspects of VPA metabolism differed distinctly from that of the reference group, but the inter-individual profile of metabolites varied considerably, even in the subgroup of 4 children who died. Impairment of VPA beta-oxidation and increase of metabolites of alternative metabolic pathways (omega- and omega 1-hydroxylation, dehydrogenation reactions) were the most frequent findings. Increased values of 2-n-propyl-4-pentenoic acid metabolite of VPA (4-ene-VPA), could be detected only in 1 of the 5 patients with fulminant liver failure and in one other child with a slight hepatic dysfunction, indicating that this VPA metabolite is not the decisive hepatotoxin or indicator of hepatotoxicity. Because we cannot distinguish between benign and life-threatening hepatic adverse reactions on the basis of VPA metabolites, all identified changes are considered secondary to an as-yet-unknown primary metabolic event. The most toxic compound could be VPA itself, which may unmask an inborn or an acquired metabolic defect in the processing of fatty acids.

[Thiopental distribution in the blood of surgical patients]. / Thiopentaldistribution im Blut chirurgischer Patienten.

The influence of hematocrit, of the concentration of plasma proteins, and of CO2 pressure on the distribution of thiopental in the blood was studied in vitro in 30 venous blood samples. Thiopental was bound to plasma proteins to 80.3-89.2%, mean 85.0%, at a plasma protein concentration of 60 g/l and a pH of 7.37. Considerable changes in the plasma protein concentration had a considerable influence on the binding rate. By halving the protein concentration the free fraction was almost doubled. Increasing the protein concentration to 90 g/l led to binding rates of around 88-89%. When the pCO2 was increased from 40 to 60 torr protein binding decreased slightly, indicating that this barbiturate is mainly bound in its anionic form. At a hematocrit of just under 40 vol.%, 14-34% of the thiopental was absorbed by the erythrocytes. Changes in the plasma protein binding rate influenced the thiopental proportion of erythrocytes, as changes in the hematocrit influenced the plasma thiopental proportion. The concentration of liposoluble thiopental acid physically dissolved in the plasma fluid, just under 8% of the thiopental in the blood, changed relatively little on variation of the hematocrit and the CO2 pressure, thanks to the compensatory function of the plasma proteins and erythrocytes. Since most of the thiopental in the blood is bound to plasma proteins, changes in the protein concentration had the greatest effect on the proportion of thiopental acid of the barbiturate content of the blood.

The polyethylene glycol precipitation technique and the particle-counting immunoassay for detection of circulating immune complex-like material in liver cirrhosis and septicemia.

Both the PEG-N technique and the PACIA were applied to determine ICLM in sera from patients with liver cirrhosis and gram-negative septicemia, that have been shown to yield positive reactions for endotoxemia with the LAL test. The precision of the PEG precipitation technique, with a stabilized fraction of human HAG of known molecular size used as a calibrator, was satisfactory. In liver cirrhosis, the detectable ICLM was mainly composed of IgG and C3, whereas in gram-negative septicemia IgM, IgG, and C3 were found. PACIA also measured significantly elevated levels of ICLM with rheumatoid factor-binding activity in both patient groups, although the two assay systems did not correlate. PEG precipitates from both patient groups analyzed by gel-chromatography and passive hemolysis test contained large immune aggregates and various amounts of immunoglobulins with specificity directed toward lipid A, the least variable portion of endotoxin. These compositional differences of detected substances may imply the presence of different types of ICLM in patients with liver cirrhosis and gram-negative septicemia.

[Long-term experience in intrauterine contraception a comparison between Lippes' loop, Dalcon-shield and copper-t (author's transl)]. / Langzeiterfahrungen mit der intrauterinen Empfängnisverhütung. Ein Vergleich von Lippes-Schleife, Dalkonschild und Kupfer-T.

Three different models of intrauterine pessaries are compared with each other in respect of tolerance and safety. They were worn for different lengths of time, partly for up to ten years. The comparison shows that the Pearl index in its conventional form is not a suitable indicator. It does provide a pointer if the individual collectives are reduced to the same wearing period. The Life-Table method yields better results. It relates the events for a total of 100 women in each case to the same interval periods. This shows that the most favourable rate of complications and quota of failures is obtained with Cu-T 200. During the first three years this quota decreases steadily. Hence it is recommended to effect intrauterine contraception according to this model wherever suitable and to allow Cu-T to be retained in position for at least three years if it is well tolerated.

PIP: Results of observations of 3 groups of women using either the Lippes loop, the Dalkon shield, or the Copper-T 200 IUD are reported. Of 49 women who began use of the Lippes loop, 23 were still using it after 3 years. There were 13 cases of complications and 2 pregnancies. The tolerance rate decreased from 84% in the first year to 46% after the 3rd year of use. Of the 301 women who began Dalkon shield use, 93 were still using it after 3 years. The complication and pregnancy rates were determined according to the Life Table Method and varied for each year of IUD use. The tolerance rate sank from 73% to 30% after 3 years of use. Of 484 women who began Copper-T 200 use, 171 used it for 3 years. The complication rate decreased from 11.0 to 1.2 and the pregnancy rate from 2.5 to .6, according to the Life table Method, during the 3 years of IUD use. The tolerance rate decreased from 78% to 37%. The most favorable results were obtained for the Copper-T-200, especially if the device remains in place for 3 years.