On the implementation of good manufacturing practices in a small processing unity of mozzarella cheese in Brazil

This study reports the implementation of GMPs in a mozzarella cheese processing plant. The mozzarella cheese manufacturing unit is located in the Southwestern region of the state of Parana, Brazil, and processes 20,000 L of milk daily. The implementation of GMP took place with the creation of a multi-disciplinary team and it was carried out in four steps: diagnosis, report of the diagnosis and road map, corrective measures and follow-up of GMP implementation. The effectiveness of actions taken and GMP implementation was compared by the total percentages of non-conformities and conformities before and after implementation of GMR Microbiological indicators were also used to assess the implementation of GMP in the mozzarella cheese processing facility. Results showed that the average percentage of conformity after the implementation of GMP was significant increased to 66%, while before it was 32% (p < 0.05). The populations of aerobic microorganisms and total coliforms in equipment were significantly reduced (p < 0.05) after the implementation of GMP, as well as the populations of total coliforms in the hands of food handlers (p < 0.05). In conclusion, GMP implementation changed the overall organization of the cheese processing unity, as well as managers and food handlers' behavior and knowledge on the quality and safety of products manufactured. (C) 2011 Elsevier Ltd. All rights reserved.

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Background: Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. Methods/Design: Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments (TM) threshold sensibility test, Pinch Gauge T, Boston Carpal Tunnel Questionnaire and two point discrimination test. Discussion: This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome. Trial registration: Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184