Evaluation of the quality of hospital food from the kitchen to the patient.

Food-borne pathogens can multiply if food is not maintained at an appropriate temperature and if there are delays between food preparation and distribution. The aim of this study was to evaluate the quality of meals during transport from the kitchens to the patients in three departments of a university hospital. Meals were transported inside insulated, cooled food carts. We analysed the delays at each step of the transport process, and measured the temperature inside the food cart and inside the meals. The total duration of the transport (mean=85.3 min; range 44-123 min) conformed to the official recommendations (<2 h at a temperature <10 degrees C before consumption). The internal temperature of 73.6% of the 30 food carts followed was below 10 degrees C. The internal temperature of the meals was below 10 degrees C in 91.7% of cases when the food cart was first opened, but in only 12% of cases by the time the last patient was served. No pathogens were isolated from any of the samples. However, 10% of meals, all of which were salads, had total viable counts of bacteria above the recommended limits. This study confirms that it is essential to control time and temperature to ensure food quality and safety in hospitals.

Interdigital clavus: predisposition is the key factor of soft corns.

The soft corn is defined as an interdigital hyperkeratosis. Footwear contributes to interdigital corns when there is a congenital or acquired predisposing factor. These predisposing factors cause apposition of particular bony prominences between adjacent toes. The congenital factors include a short first metatarsal, a short fifth metatarsal, or third and fourth metatarsals of equal length. The acquired predisposing factors are hallux valgus and associated abduction, hammer deformity, burrowing and curling of the lesser toes. Sixty-five per cent of the 1,063 interdigital corns studied occurred in the fourth interspace. Seventy per cent of the fourth interspace corns occurred between the proximal interphalangeal joint of the fourth toe and distal interphalangeal joint of the fifth toe. Conservative treatment is recommended for most cases.

Dissociation of the ammonium ion in water-urea and water-tert-butyl alcohol mixtures.

Dissociation constants for the ammonium ion in water-urea and water-tert-butyl alcohol mixtures (0-40%) have been determined by a potentiometric method.