Hygiene auditing in mass catering: a 4-year study in a university canteen.

OBJECTIVES: The outcomes of hygiene audits carried out two times per year were used to determine the correct execution of the procedures foreseen by the Hazard Analysis and Critical Control Points (HACCP) plan over 4 years (2013-2016) in a university canteen producing about 1200 meals a day. STUDY DESIGN: Critical analysis of hygiene audits. METHODS: Hygiene audits were carried out on the basis of a checklist divided into seven main items and subitems that covered all the production areas of the canteen. For each audit subitem, total percentage of inadequacy was calculated as the total number of negative answers (N) divided by the total number of answers (n = 8) collected in the period 2013-2016. RESULTS: The results showed a discontinuous trend among years. In more detail, the highest percentage of inadequacy was seen for food maintaining temperatures, thus highlighting management issues mainly related to time taken for food preparation. A relatively high level of inadequacy was also recorded for staff clothing and hygiene. CONCLUSIONS: The critical analysis of data emerged from the audits was useful to obtain an overview of improvements and emerging criticalities.

Salmonellosis associated with mass catering: a survey of European Union cases over a 15-year period.

Salmonella spp. is the causative agent of a foodborne disease called salmonellosis, which is the second most commonly reported gastrointestinal infection in the European Union (EU). Although over the years the annual number of cases of foodborne salmonellosis within the EU has decreased markedly, in 2014, a total of 88 715 confirmed cases were still reported by 28 EU Member States. The European Food Safety Authority reported that, after the household environment, the most frequent settings for the transmission of infection were catering services. As evidenced by the reviewed literature, which was published over the last 15 years (2000-2014), the most frequently reported causative agents were Salmonella Enteritidis and Salmonella Typhimurium serovars. These studies on outbreaks indicated the involvement of various facilities, including hospital restaurants, takeaways, ethnic restaurants, hotels, in-flight catering, one fast-food outlet and the restaurant of an amusement park. The most commonly reported sources of infection were eggs and/or egg-containing foods, followed by meat- and vegetable-based preparations. Epidemiological and microbiological studies allowed common risk factors to be identified, including the occurrence of cross-contamination between heat-treated foods and raw materials or improperly cleaned food-contact surfaces.

Microbiological monitoring of air quality in a university canteen: an 11-year report.

Over the past decade, an increased tendency to consume meals at dining facilities outside the home has been highlighted; moreover, meals supplied in food businesses have been involved in many foodborne disease outbreaks. Therefore, microbial air contamination in food processing facilities could be a concern and an increase of microbial loads could represent a risk factor, especially for the potential contamination of foods due to undesirable spoiling and pathogenic bacteria. In this paper, the results of an 11-year microbiological monitoring of air quality in a university canteen are reported. The study, which started in the year 2000, was performed within a hazard analysis and critical control point (HACCP) plan implementation of a canteen that produces about 1,000 meals a day in order to verify the effectiveness of corrective actions on the indoor air quality. The primary food preparation room, the kitchen, and three cold rooms underwent air sampling by using a calibrated impaction sampler. Our investigation detected a general and progressive improvement in the air quality of the canteen since the beginning of the study, thus suggesting the appropriateness of the corrective action undertaken during the HACCP implementation program.

Bacterial dynamics in a raw cow's milk Caciotta cheese manufactured with aqueous extract of Cynara cardunculus dried flowers.

AIMS: To investigate the bacterial dynamics of a Caciotta cheese traditionally manufactured in the Montefeltro area (Central Italy) with raw cow's milk and an aqueous extract of dried flowers from Cynara cardunculus as a coagulating agent. METHODS AND RESULTS: Conventional methods and a combined PCR-DGGE approach, relying on culture-dependent and -independent analyses, were used to investigate the cheese bacterial community, with a special focus on lactic acid bacteria. A heterogeneous population, including enterococci, lactococci, lactobacilli, food spoilage and other banal micro-organisms, was found. SIGNIFICANCE AND IMPACT OF THE STUDY: The study contributed to highlighting the influence of different technological parameters on bacterial dynamics of a raw milk Caciotta cheese coagulated with vegetable rennet. CONCLUSIONS: None of the species found in the vegetable rennet became dominant during the cheese-making and a prevailing role of the adventitions microbita coming from the raw milk and the dairy environment was highlighted.

Phenotypic, genotypic and technological characterization of predominant lactic acid bacteria in Pecorino cheese from central Italy.

AIMS: Identification and biotyping of lactic acid bacteria (LAB) isolated from raw-milk Pecorino cheese manufactured in the Marche region (central Italy) for selection of suitable starter cultures or adjuncts. METHODS AND RESULTS: Preliminary characterization with morphological and biochemical assays were undertaken for 112 Gram-positive and catalase-negative isolates. Unequivocal identification of the isolates was obtained through restriction analysis of the amplified 16S rRNA gene and sequencing of 360-380 bp amplicons. Fifty-nine isolates belonging to LAB species generally recognized as safe and potentially utilized as starters or flavour-producing adjuncts were preselected and tested for their acidifying, proteolitic and autolytic activities. Fifty-five of these isolates were also subject to RAPD (randomly amplified polymorphic DNA) fingerprinting and unweighted pair-group method with arithmetic averages (UPGMA) cluster analysis for the estimation of genotypic intra-species variation. As a result, in Pecorino cheese, a heterogeneous lactic acid bacteria population, which includes strains with metabolic characteristics of technological interest, was characterized. CONCLUSIONS: The polyphasic approach proposed allows the bacterial ecology of Pecorino cheese to be investigated and allows to assess the potential role of autochthonous LAB strains for the dairy industry. SIGNIFICANCE AND IMPACT OF THE STUDY: The great economic importance of Pecorino cheese encouraged a deeper knowledge of its microbiota, which is known to influence the peculiar sensory properties of this cheese, also in view of its exploitation.

Motor and non-motor sequence learning in patients with basal ganglia lesions: the case of serial reaction time (SRT).

In order to address the question of whether the basal ganglia are involved exclusively in regulation of motor sequence learning, or if they are involved in non-motor sequence learning as well, two versions of the serial reaction time (SRT) task were administered: First is the standard version of the SRT task in which the sequence is executed motorically, and the second is a non-motor version of the task which requires response only to a particular position of the sequence. Sixteen patients with damage restricted to the region of the basal ganglia and 16 matched control subjects participated in this study. In addition to the motor and non-motor SRT tasks, two declarative memory tests (Visual Paired Associates and Rey Auditory-Verbal Learning Test) were administered to the participants. Results indicate that the two groups did not differ either on learning rate of the two declarative tasks, or on the declarative component of the SRT tasks (i.e., 'generate'). However, the control group was significantly superior to the basal ganglia (BG) group in learning a specific sequence in the motor and non-motor SRT tasks. Results suggest that the basal ganglia are involved in the regulation of non- motor as well as motor sequence learning.

Use of the Stroop phenomenon as a diagnostic tool for malingering.

AIMS: To assess a computerised version of the Stroop test for detection of malingering of cognitive deficit. METHODS: Sixty subjects were assessed using this test. Twenty had cognitive deficits due to brain damage of miscellaneous aetiologies. Ten were healthy, not acquainted with the test, and were asked to simulate cognitive impairment. Another 10 simulators were psychology students trained in the use of the test. Twenty healthy subjects served as controls. Results were analysed for reaction time, error percentage, and the Stroop effect. RESULTS: There was a significant difference in reaction time among groups, showing a direct relation of age among control subjects, and also longer reaction time in patients with brain damage than in controls. Controls and patients with brain damage showed a clear Stroop effect. Simulators had a significantly prolonged reaction time, increased error percentage, and inverted or absent Stroop effect. This alteration of the Stroop effect is never present in organic cognitive deficits and seems to be a characteristic pattern of feigning, independently of knowledge of the test. CONCLUSION: This technique is recommended as a valuable tool to detect feigned cognitive impairment.

SPECT for differential diagnosis of dementia and correlation of rCBF with cognitive impairment.

99mTc-HM-PAO single photon emission computed tomography (SPECT) was used to image 30 patients referred for the assessment of dementia. SPECT images revealed various patterns of regional cerebral perfusion (rCBF) in the subgroups of patients with the clinical diagnoses of Alzheimer's disease (AD, n = 14), Pick's disease (n = 1), and multi-infarct dementia (n = 7). In three patients, SPECT clarified the clinical differential diagnostic possibilities. Using a relative rCBF quantification technique, the relationship between specific cognitive impairments and rCBF in the AD patients was determined. There was a significant correlation between language impairment and left hemisphere hypoperfusion, whereas, apraxia correlated with hypoperfusion in the left parietal region. Thus, HM-PAO SPECT is useful as an aid in the differential diagnosis of dementia and the technique of relative rCBF quantification with SPECT may contribute to the understanding of the clinico-anatomical relations of cognitive deficits in dementia.

Differential effects of semantic and identity priming in patients with left and right hemisphere lesions.

Abstract Patients with single brain lesions in the anterior or posterior left and right hemispheres and a group of controls were studied in two priming experiments. The first experiment employed associative pairs (DOCTOR-NURSE) and the second employed identical pairs (NURSE-nurse). Short and long prime-target stimulus onset asynchronies (SOAs) (i.e., 250 and 1850 msec) were manipulated within block in both experiments. In the first experiment, patients with left hemisphere injury showed a deficient priming effect while patients with right hemisphere injury and controls showed a normal pattern. In contrast, all groups showed an identity priming effect in the second experiment. These results indicate that while entries in the mental lexicon are available for the groups of patients studied, the spread of activation to related concepts in this lexicon is disrupted in the left hemisphere-damaged group.

Motor neuron disease in textile factory workers.

Five cases of motor neuron disease occurred during the period 1983-1987 in 4 small and medium-sized textile factories. These cases were 45% of 11 motor neuron disease patients diagnosed in this period in a population of about 300,000 persons. This observations may be relevant to toxic occupational hazards in the pathogenesis of motor neuron disease.

Inclusion body myositis in post-poliomyelitis muscular atrophy.

A 38-year-old male developed a new muscle weakness in his left thigh 35 years after having acute paralytic poliomyelitis with residual right distal leg weakness and atrophy. EMG studies showed widespread denervation in proximal and distal muscles regardless the clinical involvement. Muscle biopsy from an affected muscle showed the findings of inclusion-body myositis consisting of perivascular and interstitial mononuclear infiltration, sarcoplasmic granular inclusions with membranous whorls and typical filamentous inclusions in several myonuclei. This raises the possibility of inclusion body myositis in other cases of progressive post-poliomyelitis muscular atrophy, especially those with perivascular infiltration of mononuclear cells in the muscle biopsy.

Myophosphorylase deficiency: the course of an unusual congenital myopathy.

A 59-year-old man had proximal weakness and wasting that started in early childhood. EMG was "myopathic," serum CK activity was increased, and muscle biopsy showed accumulations of glycogen. Biochemical studies revealed elevated glycogen concentration and absence of myophosphorylase activity. This unusual presentation of a long-standing, painless, and quite static weakness due to myophosphorylase deficiency represents another example of clinical heterogeneity.

Neurologic complications after gastric restriction surgery for morbid obesity.

We report the occurrence of neurologic complications in 23 patients who underwent gastric restriction surgery for the treatment of morbid obesity. Complications occurred 3 to 20 months after surgery. All the patients had had protracted vomiting for the first 3 months after the operation. The following syndromes were found: chronic or subacute symmetric polyneuropathy (12 patients), acute severe polyneuropathy (1 patient), burning feet syndrome (2 patients), meralgia paresthetica (3 patients), myotonic syndrome (1 patient), posterolateral myelopathy (2 patients), and Wernicke-Korsakoff encephalopathy (2 patients). The patients suffering from burning feet syndrome and those with Wernicke-Korsakoff encephalopathy showed a clear improvement after parenteral thiamine treatment. As to the rest of the patients, the occurrence of the complications seems to be linked to nutritional causes, although no such deficiencies were detected.

Vitamin B12 deficiency neuropathy: sural nerve biopsy study.

A 40-year-old woman developed neuropathy and myelopathy with vitamin B12 deficiency without anemia. Motor and sensory nerve conduction velocities were moderately decreased. Sural nerve biopsy showed the coexistence of demyelination and axonal degeneration.

Primary amyloidosis with peripheral neuropathy and signs of motor neuron disease.

A 51-year-old man had primary amyloidosis, with typical amyloid neuropathy and signs of motor neuron disease, including widespread fasciculation in limb muscles, tongue atrophy and fasciculation, swallowing and chewing difficulty, symmetric hyperreflexia, and bilateral Hoffmann's signs. Fasciculations, fibrillations, and positive sharp waves were found in electromyography of all muscles tested. Motor nerve conduction velocities were moderately slow. Lambda chains were detected in serum and CSF. Amyloid was found in sural nerve biopsy. This combination of amyloid neuropathy and features of amyotrophic lateral sclerosis is related to the motor neuron disease of plasma cell dyscrasias.

Adult muscle phosphorylase "b" kinase deficiency.

A 35-year-old man had severe exercise intolerance and cramps. Venous blood lactate did not rise after ischemic exercise, and electromyographically silent contracture of hand muscles appeared. Histochemistry and electronmicroscopy of a muscle biopsy revealed subsarcolemmal and intermyofibrillar accumulation of glycogen. Biochemical studies showed moderately increased amount of glycogen. Total phosphorylase activity was normal, but the active form "a" was 27% of normal. Phosphorylase kinase activity was 12% of the normal value and was normal in leukocytes and erythrocytes.