Pseudo-outbreak of Phaeoacremonium parasiticum from a hospital ice dispenser.

In 31 patients, Phaeoacremonium parasiticum was recovered from bronchoscopy specimens (biopsies and aspirates). The pseudo-outbreak was caused by contaminated ice used to control hemorrhage during bronchoscopy and was associated with deficiencies in equipment cleaning. The bronchoscopy technique was modified, the ice dispenser was disinfected, bronchoscope reprocessing was improved, and there were no recurrences.

Quality evaluation of cook-chilled chicory stems (Cichorium intybus L., Catalogna group) by conventional and sous vide cooking methods.

BACKGROUND: Chicory stems, appreciated both raw and cooked, represent a nutritious and refined food. In this study the effects on the quality of stems cooked by conventional (boiling, steaming and microwaving) and innovative (sous vide) methods were analysed. Several physical, chemical and sensory traits were compared using two local varieties (Galatina and Molfettese) of southern Italy (Puglia region). RESULTS: Independently of the variety, the sous vide method did not significantly affect (redness, yellowness and hue angle) or had the least impact on (lightness and total colour difference) quality parameters among the four methods as compared with the raw product. Following sensory analysis, the sous vide product always showed the highest score among the cooking methods. Moreover, this innovative method did not affect total phenol (TP) content and antioxidant activity (AA) compared with uncooked stems of both varieties. Microwaving increased TP content and AA (though associated with higher weight loss), while different responses depending on the chicory variety were observed after boiling and steaming. CONCLUSION: The results indicate the sous vide technique as optimal to preserve several traits, including organoleptic ones, for the quality of cook-chilled chicory stems. They also provide product-specific information usually required for cooking process strategies in the industrial sector of ready-to-eat vegetables.

Artificial fertilisation in a terrestrial toadlet (Pseudophryne guentheri): effect of medium osmolality, sperm concentration and gamete storage.

Anurans exhibit a greater reproductive diversity than any other vertebrate order. However, studies investigating the effects of the external fertilisation environment on fertilisation success are limited to aquatic-breeding species. This study investigated the effects of fertilisation medium osmolality, sperm concentration and short-term oocyte storage on fertilisation success in a terrestrial-breeding anuran, Pseudophryne guentheri. Split-clutch experimental designs were used to determine optimal fertilisation conditions. To determine the effect of short-term sperm storage, sperm viability was assessed using fluorescence microscopy and percentage sperm motility and velocity quantified with a computer-assisted sperm analysis system. Fertilisation success was highest in media ranging in osmolality from 25 mOsm kg⁻¹ to 100 mOsm kg⁻¹, representing a broader range and higher optimal osmolality than previously reported for aquatic breeders. High rates of fertilisation (>75%) were achieved in relatively low sperm concentrations (2.5×104 mL⁻¹). Oocytes stored in isotonic solutions (200 mOsm kg⁻¹) retained fertilisation capacity (32%) after 8h of storage, while sperm suspensions maintained motility (≥26%) for 13 days. Additional studies on terrestrial-breeding anurans will be required to ascertain whether the optimal fertilisation conditions reported reflect adaptations to achieve fertilisation in a terrestrial environment.

Unusual hand frostbite caused by refrigerant liquids and gases.

BACKGROUND: The refrigerant liquids and gases used widely in industry, farming and medicine for their cooling properties may cause severe frostbite. Despite their widespread use, only a few reports on frostbite of the hand involving these liquids and gases have been published. In this study, the circumstances accompanying these injuries, several adjunctive therapies and preventive measures are discussed. METHODS: A retrospective analysis of hand frostbite injuries was conducted between June 2005 to June 2009 in a burn care center in Istanbul, Turkey. Seventeen patients (13 men, 4 women) were treated for hand frostbite injuries due to contact with refrigerant liquids and gases. RESULTS: There was a preponderance of male patients (76.5%). Ages ranged from 22 to 52 years (mean age, 30.82 years). Eleven patients were treated conservatively. The hospital stay for treatment of their burns ranged from 16 to 52 days, with a mean stay of 30 days. CONCLUSION: Frostbite injuries of the hand are uncommon and their etiologies vary. Thus, the low incidence of these injuries and limited experience in handling rare cases of this nature may lead to misjudgments in treatment that can have grave consequences. Decreasing the exposure time is an important first step in the treatment approach. After exposure to gas, quick delivery of the patient to a burn center is essential.

Effect of thawing and cold storage on frozen chicken thigh meat quality by high-voltage electrostatic field.

One of the most popular issues in electrostatic biology is the effects of a high-voltage electrostatic field (HVEF) on the thawing of chicken thigh meat. In this study, chicken thigh meat was treated with HVEF (E-group), and compared to samples stored in a common refrigerator (R-group), to investigate how HVEF affects chicken thigh meat quality after thawing at low temperature storage (-3 and 4 degrees C). The results showed that there were no significant differences in biochemical and microorganism indices at -3 degrees C. However, the HVEF can significantly shorten thawing time for frozen chicken thigh meat at -3 degrees C. After thawing chicken thigh meat and storing at 4 degrees C, the total viable counts reached the Intl. Commission on Microbiological Specification for Foods limit of 10(7) CFU/g on the 6 and 8 d for the R- and E-group, respectively. On the 8th d, the volatile basic nitrogen had increased from 11.24 mg/100 g to 21.9 mg/100 g for the E-group and 39.9 mg/100 g for the R-group, respectively. The biochemical and microorganism indices also indicated that the E-group treatment yielded better results on thawing than the R-group treatment. The application of this model has the potential to keep products fresh.

Carbon dioxide emission implications if hydrofluorocarbons are regulated: a refrigeration case study.

The U.S. is strongly considering regulating hydrofluorocarbons (HFCs) due to their global climate change forcing effects. A drop-in replacement hydrofluoroether has been evaluated using a gate-to-grave life cycle assessment of greenhouse gas emissions for the trade-offs between direct and indirect carbon dioxide equivalent emissions compared to a current HFC and a historically used refrigerant. The results indicate current regulations being considered may increase global climate change.

Loss of triglycerides and carotenoids in human milk after processing.

OBJECTIVE: Human milk (HM) is considered to be the best nutrition for preterm infants. However, storage, heating or tube feeding can cause a decline in essential nutrients, which can lead to the loss of antioxidant vitamins, resulting in an increased risk for oxygen radical diseases. Recently we found that carotenoids, present in human milk, can play a role in the antioxidant protection of preterm infants. In this study we evaluated the effect of processing HM and infant formula on the triglycerides and carotenoid concentrations. DESIGN: The triglyceride, alpha- and beta-carotene, lutein and lycopene concentrations of 30 samples of mature HM of mothers who delivered a term infant and 10 samples of infant formula were measured after refrigeration, freezing, microwave heating and tube feeding with and without exposure to normal light and phototherapy, imitating the clinical feeding routine in the NICU. RESULTS: After tube feeding triglyceride, lutein and beta-carotene concentrations decreased with 33%, 35% and 26% respectively. The decrease in triglycerides in HM accounts for 16% of the total caloric intake of neonates. Triglyceride and carotenoid concentrations in HM remained stable after refrigeration, freezing or low temperature microwave heating, except for lutein which decreased after refrigeration and freezing. In infant formula no differences were found. CONCLUSIONS: Mature human milk can be stored safely in a freezer and heated in a microwave oven without loss of fat or carotenoids. The clinically important loss of fat during tube feeding is probably the most important contributing factor to the decrease in lutein and beta-carotene in tube feeding, with only a small role for peroxidation during light-exposure.

Effects of refrigeration on the bactericidal activity of human milk: a preliminary study.

This study analyzed the bactericidal activity of human milk and how it is influenced by refrigerated storage. Nine samples of mature human milk were collected and divided into 3 aliquots. One was analyzed immediately, and the other 2 were refrigerated at 4 degrees C to 6 degrees C for 48 and 72 hours, respectively. All of the fresh samples exhibited bactericidal activity with an average value of 83.47% +/- 18.37%. Refrigeration for 48 hours did not cause significant modifications, whereas storage beyond 72 hours significantly lowered the degree of bacteriolysis versus fresh milk. In conclusion, human milk possesses bactericidal activity that remains stable during the first 48 hours of refrigerated storage, but it is significantly reduced beyond 72 hours.

Estudio de las torres de refrigeración asociadas a brotes comunitarios de legionelosis / Study of refrigeration towers associated with community outbreaks of legionellosis

Objetivo: Evaluar los factores de riesgo de las torres de refrigeración asociadas a un brote comunitario de legionelosis según sus características de mantenimiento y la calidad del agua. Método: Comparar los datos recogidos entre los 4 tipos de torres de refrigeración: control 1, control 2, probable y confirmada. Se han estudiado un total de 184 torres de refrigeración asociadas a 17 brotes comunitarios de legionelosis de la provincia de Barcelona durante el año 2004, de las cuales 112 son control 1, 54 control 2, 8 probables y 10 confirmadas. Resultados: Las torres confirmadas se caracterizan por: niveles elevados de conductividad, aerobios totales, dureza cálcica, sólidos totales en disolución, temperatura y turbidez; concentraciones de cloro deficientes (< 2 ppm); utilización del hipoclorito como desinfectante en un 10% de las instalaciones; mayor grado de incumplimiento del programa de revisión y limpieza de los elementos internos de las torres (bandeja, relleno y separador de gotas); grado de cumplimiento de las desinfecciones periódicas y de la limpieza de depósitos del 100%. Un 47% de las torres investigadas no utilizan los tratamientos previos del agua a pesar de disminuir los valores de las variables fisicoquímicas. Conclusiones: Se deberían establecer medidas de prevención de la legionelosis que garanticen una buena calidad del agua y el seguimiento de sus variables fisicoquímicas, unos niveles de cloro superior a 2 ppm, la evaluación del riesgo individual para cada instalación, y el cumplimiento del 100% del programa de revisión de los elementos internos de las torres

Objetive: To evaluate the factors of risk of the risk cooling towers associated to a community outbreak of legionellosis according to its characteristics of maintenance and the quality of the water with the purpose of improving the systems of prevention of this one disease. Method: To compare the piece of information gathered between the 4 types of cooling towers: control 1, control 2, probable and confirmed. A total of 184 cooling towers have been studied associated to 17 community outbreak of legionellosis of the province of Barcelona (Spain) during the year 2004, of which 112 are control 1, 54 control 2, 8 probable and 10 confirmed. Results: The confirmed towers are characterized by: high levels of conductivity, total aerobes, calcic hardness, total solids in dissolution, temperature and turbidity; low levels of chlorine (< 2 ppm); of use hypochlorite as disinfectant in a 10%; greater degree of breach of the revision program and cleaning of the internal elements of the tower (tray, stuffed and separating of drops); degree of performance of the periodic disinfections and the cleaning of deposits of the 100%. A 47% of the investigated towers do not use the previous treatments of the water in spite of diminishing the parametric values of the quantitatives variables. Conclusions: Measures of prevention of the legionellosis would be due to guarantee: a good quality of the water and the pursuit of its quantitatives variables; chlorine levels superior to 2 ppm; the evaluation of the individual risk for each installation; the performance of the 100% of the program of revision of the internal elements of the towers

Prolonged storage of red blood cells affects aminophospholipid translocase activity.

BACKGROUND AND OBJECTIVES: Loss of phospholipid asymmetry in the membrane of red blood cells (RBC) results in exposure of phosphatidylserine (PS) and to subsequent removal from the circulation. In this study, we investigated the effect of long-term storage of RBCs on two activities affecting phospholipid asymmetry: the ATP-dependent aminophospholipid translocase (or flippase, transporting PS from the outer to the inner leaflet) and phospholipid scrambling (which will move PS from the inner to the outer leaflet). MATERIALS AND METHODS: Standard leukodepleted RBC concentrates were stored in saline-adenine-glucose-mannitol (SAGM) at 4 degrees C for up to 7 weeks. PS exposure was determined by measurement of AnnexinV-FITC binding to the cells, flippase activity by measurement of the inward translocation of NBD-labelled PS. Scrambling activity was determined by following the inward translocation of fluorescent NBD-phosphatidylcholine. In parallel, intracellular ATP levels were determined. RESULTS: PS exposure amounted to only 1.5 +/- 0.3% positive cells (n = 8) after 5 weeks of storage, which slightly increased to 3.5 +/- 0.7% (n = 8) after 7 weeks of storage. Flippase activity started to decrease after 21 days of storage and reached 81 +/- 5% of the control value after 5 weeks of storage (n = 6) and 59 +/- 6% (n = 6) after 7 weeks. Also in RBC obtained by apheresis, flippase activity decreased upon storage. Scrambling activity remained virtually absent during storage, explaining the low PS exposure despite the decrease in flippase activity. Rejuvenation of RBC after 7 weeks to increase ATP levels only partially restored flippase activity, but in combination with a correction of the intracellular pH to that of fresh cells, almost complete restoration was achieved. The decrease in flippase activity after prolonged storage did make the RBCs more prone to PS exposure after activation of phospholipid scrambling. CONCLUSION: This study shows that, although PS exposure remains low, prolonged storage does compromise the RBC membrane by affecting flippase activity. When the metabolic changes induced by storage are corrected, flippase activity can be restored.

Reduced potency after refrigerated storage of botulitum toxin A: human extensor digitorum brevis muscle study.

To determine whether the potency of botulinum toxin A (BTA) decreases after being reconstituted with normal saline and stored in refrigerator, we injected one side of the extensor digitorum brevis muscle with 2.5 units of botulinum toxin A that had been immediately reconstituted with saline, and the contralateral side with identical material that had been reconstituted and stored in a refrigerator for preselected periods (1, 2, and 4 weeks) in 32 healthy volunteers. Mean compound muscle action potential amplitudes expressed as a percentage of the baseline amplitude were more reduced in sides injected with immediately reconstituted BTA than in sides injected with BTA stored for 1 week or more (P < 0.05). No bacterial growth was observed in any stored BTA samples. Storage of reconstituted BTA at low temperatures may affect the potency of the toxin. Therefore, the use of BTA after refrigerated storage is not recommended.

Cold storage of citrated whole blood induces drastic time-dependent losses in factor VIII and von Willebrand factor: potential for misdiagnosis of haemophilia and von Willebrand disease.

This study investigates the effect of pre-analytic storage conditions on the laboratory evaluation of von Willebrand disease (VWD) and haemophilia. Samples from healthy controls and patients with VWD were stored as whole blood and as separated plasma, both at room temperature and on crushed ice, for two different time periods (3 or 6 h). In samples from healthy individuals (n=10) and in patients with suspected type 1 VWD (n=10), storage of whole blood on ice caused a drastic time-dependent decrease in von Willebrand factor (VWF):ristocetin cofactor activity, in VWF:antigen activity and factor VIII activity (mean+/-SD) to 35+/-18, 55+/-23 and 53+/-15% of baseline levels after 6 h storage, respectively. Patients with type 2 VWD and non-detectable VWF:ristocetin cofactor activity did not demonstrate such drastic cold-induced losses in VWF and factor VIII levels. Storage of plasma caused only minor changes in VWF levels. The cold-induced loss in VWF might thus depend on the presence of platelets and of high molecular weight VWF. Chilling of platelets induces a clustering of the glycoprotein Ib subunit. We therefore hypothesize that cold-induced loss in VWF might be due to a cold-promoted binding of VWF to glycoprotein VWF receptor Ib alpha. These results suggest a serious potential for misdiagnosis of haemophilia or VWD due to inappropriate pre-analytical handling of blood.

Prevalencia de Legionella en torres de refrigeración de la Comunidad de Madrid / Prevalence of Legionella in cooling towers in the Community of Madrid

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Crohn's disease: the cold chain hypothesis.

A recent published hypothesis proposed that Crohn's disease was provoked by infantile exposure to micro-organisms that can survive refrigerator temperature. A case-control study was accordingly devised. The mean age at first fridge was 5.6 years amongst 88 patients with Crohn's disease, 5.5 years in 88 patients with ulcerative colitis (UC) and 7.6 years in 88 controls, but a majority of individuals had always been exposed to refrigerated food. Differences were more striking in subjects aged above the median (10.3, 10.9 and 15.0 years for Crohn's disease, UC and controls, respectively). This support for the hypothesis reached statistical significance for those with Crohn's disease compared to the controls (p=0.045).

Is stored expressed breast milk an alternative for working Egyptian mothers?

Expression and storage of breast milk is way to maintain breastfeeding when mother and infant are separated, if the nutritional value can be conserved. Three expressed breast milk samples were collected from 61 healthy lactating mothers in Cairo, Egypt, for determination of total protein, fat, lactose and zinc content, as well as vitamins C, A and E concentrations. One sample was analysed immediately without storage, 1 after storage for 24 hours in a refrigerator (4 degrees C) and 1 after storage for 1 week in a home freezer (-4 degrees C to -8 degrees C). Refrigeration and freezing of breast milk caused a statistically significant decline in levels of vitamins C, A and E. Nevertheless, the values of all nutrients were still within the international reference ranges for mature breast milk.

Crohn's disease: the cold chain hypothesis.

Crohn's disease is the result of an abnormal immune response of the gut mucosa triggered by one or more environmental risk factors in people with predisposing gene variations, including CARD15 mutations. Epidemiological data allow assessment of familial environmental risk factors related to western lifestyle, diet, bacteria, and domestic hygiene. All findings point to refrigeration as a potential risk factor for Crohn's disease. Furthermore, cold-chain development paralleled the outbreak of Crohn's disease during the 20th century. The cold chain hypothesis suggests that psychrotrophic bacteria such as Yersinia spp and Listeria spp contribute to the disease. These bacteria have been identified in Crohn's disease lesions and we discuss their pathogenic properties with respect to our knowledge of the disease. From a molecular perspective, we postulate that the disease is a result of a defect in host recognition by pathogenic bacterial components that usually escape the immune response (eg, Yop molecules), which results in an excessive host response to these bacteria.

Salt intake, cured meat consumption, refrigerator use and stomach cancer incidence: a prospective cohort study (Netherlands).

OBJECTIVE: Many case-control studies have reported that salt and cured meat intake are positively, and refrigerator use is inversely, associated with stomach cancer risk. In the current prospective study these associations were evaluated. METHODS: The Netherlands Cohort Study consisted of 120,852 men and women ages 55-69 years at baseline in 1986. Salt exposure was measured by calculating mean daily sodium intake (dietary salt) from 150 food items and by specific salt questions. After 6.3 years of follow-up, 282 incident stomach cancer cases were available for analyses. Case-cohort analyses were based on the 282 cases and 3123 subcohort members. RESULTS: In multivariate analyses adjusted for age, sex, smoking, education, stomach disorders, history of stomach cancer in the family, rate ratios (RR) for increasing quintiles of energy-adjusted intake of dietary salt were 1.00, 1.49, 1.03, 1.54 and 1.18, respectively (p trend = 0.43). An inverse association was found between stomach cancer and salt added at the hot meal (p trend = 0.04). For salt added to home-made soup, use of salt at the table, salt preference and duration of refrigerator use, no associations were observed. Positive associations were found for bacon (RR highest/lowest intake = 1.33; 95% CI = 1.03-1.71) and other sliced cold meat (RR highest/lowest intake = 1.29; 95% CI = 0.96-1.72), but not for smoked sausage, total cold meats, rashers/bacon, boiled ham and smoked beef/pork loin roll. Separate analyses among subjects with self-reported stomach disorders revealed higher RR of stomach cancer for dietary salt and several types of cured meat. CONCLUSION: The present findings suggest that intake of dietary salt and several types of cured meat were weakly positively associated with stomach cancer risk.