Aseptic Packaging of Tropical Fruit Purees

The object of this investigation was to develop high quality aseptically packaged mango and passionfruit puree products. Kensington mango puree (acidified to ph 3.5) and deseeded passionfruit pulp (ph 3.0) were sterilised in a scraped-surface heat exchanger, cooled to 20°C in a tubular heat-exchanger, aseptically packaged in sterile laminate bags. Six sterilising time/temperature combinations were compared - 85°C/15 secs, 85°C/60 secs, 90° C/15 secs, 90°/60 secs, 95°C/15 secs, 95°C/60 secs. Products were assessed immediately after processing, and after eight months ambient storage, for microbial, physical, chemical, and sensory quality. All treatments were microbiologically sound and showed no enzyme activity. Sensory quality was very acceptable, and there was no evidence of heat damage. Quality (especially colour and flavour) decreased during storage in all heat treatments.

Aseptic Processing of Foods Containing Particulates

Aseptic processing involves sterilising the product and package separately, and filling under sterile conditions. Advantages include better product quality compared with canned products, lower transport and storage costs compared with frozen products, and virtually no restriction on package size. Problems include ensuring adequate heat penetration into the particles to ensure sterility, preventing separation of particles from the carrier liquid, and retention of particle structure and shape. Particulate foods can be sterilised in scraped - surface heat exchangers. Other methods involve heating the particles separately, and combining them during filling. Projects will commence at the International Food Institute of Queensland (IFIQ) on aseptic packaging of a meat and vegetable product, and aseptically packaged mango pieces.

Aseptic Processing of Meat Products

Aseptic processing involves sterilising the product (most meat products being low-acid foods containing particulates) and package separately, and filling under sterile conditions. Advantages include better product quality compared with canned products, lower transport and storage costs compared with frozen products, and virtually no restriction on package size. Problems include ensuring adequate heat penetration into the particles to ensure sterility, preventing separation of particles from the carrier liquid, and retention of particle structure and shape. Particulate foods can be sterilised in scraped-surface heat exchangers. Other methods involve heating the particles separately, and combining them during filling. The effects of aseptic processing on meat product quality (colour, flavour, texture, and mutrition) are outlined in this paper.

Predicting revision risk for aseptic loosening of femoral components in total flip arthroplasty in individual patients - A finite element study

Advances in surgical procedure, prosthesis design, and biomaterials performance have considerably increased the longevity of total joint replacements. Preoperative planning is another step in joint replacement that may have the potential to improve clinical outcome for the individual patient, but has remained relatively consistent for a longtime. One means of advancing this aspect of joint replacement surgery may be to include predictive computer simulation into the planning process. In this article, the potential of patient-specific finite element analysis in preoperative assessment is investigated. Seventeen patient-specific finite element models of cemented Charnley reconstructions were created, of which six were early (

Nanoscale reinforced orthopaedic bone cement with graphene oxide - a possible solution to aseptic loosening of cemented hip implants? Preliminary results of an ongoing study

Hip replacement surgery is amongst the most common orthopaedic operations performed in the UK. Aseptic loosening is responsible for 40% of hip revision procedures. Aseptic loosening is a result of cement mantle fatigue. The aim of the current study is to analyse the effect of nanoscale Graphene Oxide (GO) on the mechanical properties of orthopaedic bone cement. Study Design A experimental thermal and mechanical analysis was conducted in a laboratory set up conforming to international standards for bone cement testing according to ISO 5583. Testing was performed on control cement samples of Colacryl bone cement, and additional samples reinforced with variable wt% of Graphene Oxide containing composites – 0.1%, 0.25%, 0.5% and 1.0% GO loading. Pilot Data Porosity demonstrated a linear relationship with increasing wt% loading compared to control (p<0.001). Thermal characterisation demonstrated maximal temperature during polymerization, and generated exotherm were inversely proportional to w%t loading (p<0.05) Fatigue strength performed on the control and 0.1 and 0.25%wt loadings of GO demonstrate increased average cycles to failure compared to control specimens. A right shift of the Weibull curve was demonstrated for both wt% available currently. Logistic regression analysis for failure demonstrated significant increases in number of cycles to failure for both specimens compared to a control (p<0.001). Forward Plan Early results convey positive benefits at low wt% loadings of GO containing bone cement. Study completion and further analysis is required in order to elude to the optimum w%t of GO which conveys the greatest mechanical advantage.

Errors associated with the preparation of aseptic products in UK hospital pharmacies: lessons from the national aseptic error reporting scheme

Background Pharmacy aseptic units prepare and supply injectables to minimise risks. The UK National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors, including near-misses, since 2003. Objectives The cumulative reports from January 2004 to December 2007, inclusive, were analysed. Methods The different variables of product types, error types, staff making and detecting errors, stage errors detected, perceived contributory factors, and potential or actual outcomes were presented by cross-tabulation of data. Results A total of 4691 reports were submitted against an estimated 958 532 items made, returning 0.49% as the overall error rate. Most of the errors were detected before reaching patients, with only 24 detected during or after administration. The highest number of reports related to adult cytotoxic preparations (40%) and the most frequently recorded error was a labelling error (34.2%). Errors were mostly detected at first check in assembly area (46.6%). Individual staff error contributed most (78.1%) to overall errors, while errors with paediatric parenteral nutrition appeared to be blamed on low staff levels more than other products were. The majority of errors (68.6%) had no potential patient outcomes attached, while it appeared that paediatric cytotoxic products and paediatric parenteral nutrition were associated with greater levels of perceived patient harm. Conclusions The majority of reports were related to near-misses, and this study highlights scope for examining current arrangements for checking and releasing products, certainly for paediatric cytotoxic and paediatric parenteral nutrition preparations within aseptic units, but in the context of resource and capacity constraints.

MICROORGANISMS OF THE COCCIDIA SUBCLASS: RESISTANCE AND IMPLICATIONS FOR THE ASEPTIC PROCESSING OF HEALTHCARE PRODUCTS

This theoretical study proposes a reflection on the intrinsic resistance of the subclass Coccidia, particularly the genus Cryptosporidium, considered to be potential pathogens for immunocompromised patients, and the implications for nursing practice. Currently, the international and national guidelines support the chemical disinfection of digestive system endoscopes after their cleansing as a safe and effective procedure. However, studies show that microorganisms of the subclass Coccidia, namely Cryptosporidium, responsible for enteric infection, are more resistant than mycobacteria and are not inactivated by high-level disinfectants, except for hydrogen peroxide 6% and 7.5%, which are not currently available in Brazil. We conclude that the legislation should include this agent among test microorganisms for approving high-level disinfectants. Health authorities should make efforts to ensure that healthcare institutions have access to effective disinfectants against Cryptosporidium.

Occurrence of molds on laminated paperboard for aseptic packaging, selection of the most hydrogen peroxide- and heat-resistant isolates and determination of their thermal death kinetics in sterile distilled water

This study aimed at enumerating molds (heat-labile and heat-resistant) on the surface of paperboard material to be filled with tomato pulps through an aseptic system and at determining the most heat-and hydrogen peroxide-resistant strains. A total of 118 samples of laminated paperboard before filling were collected, being 68 before and 50 after the hydrogen peroxide bath. Seven molds, including heat-resistant strains (Penicillium variotii and Talaromyces flavus) with counts ranging between 0.71 and 1.02 CFU/cm(2) were isolated. P. variotii was more resistant to hydrogen peroxide than T. flavus and was inactivated after heating at 85 degrees C/15 min. When exposed to 35 % hydrogen peroxide at 25 degrees C, T. flavus (F5E2) and N. fischeri (control) were less resistant than P. variotti (F1A1). P. citrinum (F7E2) was shown to be as resistant as P. variotti. The D values (the time to cause one logarithmic cycle reduction in a microbial population at a determined temperature) for spores of P. variotii (F1A1) and N. fischeri (control) with 4 months of age at 85 and 90 degrees C were 3.9 and 4.5 min, respectively. Although the contamination of packages was low, the presence of heat-and chemical-resistant molds may be of concern for package sterility and product stability during shelf-life. To our knowledge, this is the first report that focuses on the isolation of molds, including heat-resistant ones, contaminating paperboard packaging material and on estimating their resistance to the chemical and physical processes used for packaging sterilization.

Aseptic tissue necrosis and chronic inflammation after irrigation of penetrating hand wounds using Octenisept®

Penetrating hand wounds are common and these are managed by thorough debridement. However, stab wounds without evidence of divided structures are often treated with irrigation using antiseptic substances, antibiotic therapy, and immobilization. Octenisept® (Schülke & Mayr Ltd) is a widely used antiseptic agent for disinfection of acute or chronic wounds. It has a broad spectrum of antiseptic efficacy and has become an antiseptic of first choice in many hospitals. Within a few months, four patients presented to us with chronic inflammation and severe tissue necrosis after irrigation of penetrating hand wounds with Octenisept®. Repeated surgery and debridement was required in all patients. Wound healing was prolonged and patients had persisting oedema. Penetrating hand wounds must not be irrigated with Octenisept®.

Gelatinase B [matrix metalloproteinase (MMP)-9] and collagenases (MMP-8/-13) are upregulated in cerebrospinal fluid during aseptic and bacterial meningitis in children

We investigated the protein expression of gelatinases [matrix metalloproteinase (MMP)-2 and -9] and collagenases (MMP-8 and -13) in cerebrospinal fluid (CSF) from patients with bacterial (BM, n = 17) and aseptic (AM, n = 14) meningitis. In both, MMP-8 and -9 were increased in 100% of patients, whereas MMP-13 was detectable in 53% and 82% respectively. Three patients with clinical signs of meningitis, without CSF pleocytosis, scored positive for all three MMPs. MMP-8 appeared in two isoforms, granulocyte-type [polymorphonuclear cell (PMN)] and fibroblast/macrophage (F/M) MMP-8. Analysis of kinetic changes from serial lumbar punctures showed that these MMPs are independently regulated, and correlate only partly with CSF cytosis or levels of the endogenous inhibitor, tissue inhibitor of matrix metalloproteinase-1. In vitro, T cells, peripheral blood mononuclear cells (PBMCs) and granulocytes (PMN) release MMP-8 and -9, whereas MMP-13 could be found only in the former two cell types. Using models of exogenous (n-formyl-Met-Leu-Phe, T cell receptor cross-linking) and host-derived stimuli (interleukin-2), the kinetics and the release of the MMP-8, -9 and -13 showed strong variation between these immune cells and suggest release from preformed stocks. In addition, MMP-9 is also synthesized de novo in PBMCs and T cells. In conclusion, invading immune cells contribute only partially to MMPs in CSF during meningitis, and parenchymal cells are an equally relevant source. In this context, in patients with clinical signs of meningitis, but without CSF pleocytosis, MMPs seem to be a highly sensitive marker for intrathecal inflammation. The present data support the concept that broad-spectrum enzyme inhibition targeting gelatinases and collagenases is a potential strategy for adjunctive therapy in infectious meningitis.

Patient-related risk factors leading to aseptic stem loosening in total hip arthroplasty: a case-control study of 5,035 patients

BACKGROUND: We hypothesized that certain patient characteristics have different effects on the risk of early stem loosening in total hip arthroplasty (THA). We therefore conducted a case-control study using register-database records with the aim of identifying patient-specific risk factors associated with radiographic signs of aseptic loosening of the femoral component in THA. METHOD: Data were derived from a multinational European registry and were collected over a period of 25 years. 725 cases with radiographic signs of stem loosening were identified and matched to 4,310 controls without any signs of loosening. Matching criteria were type of implant, size of head, date of operation, center of primary intervention, and follow-up time. The risk factors analyzed were age at operation, sex, diagnosis and previous ipsilateral operations, height, weight, body mass index and mobility based on the Charnley classification. RESULTS: Women showed significantly lower risk of radiographic loosening than men (odds ratio (OR) 0.64). Age was also a strong factor: risk decreased by 1.8% for each additional year of age at the time of surgery. Height and weight were not associated with risk of loosening. A higher body mass index, however, increased the risk of stem loosening to a significant extent (OR 1.03) per additional unit of BMI. Charnley Class B, indicating restricted mobility, was associated with lower risk of loosening (OR 0.78). INTERPRETATION: An increased activity level, as seen in younger patients and those with unrestricted mobility, is an important factor in the etiology of stem loosening. If combined with high BMI, the risk of stem loosening within 10 years is even higher. A younger person should not be denied the benefits of a total hip arthroplasty but must accept that the risk of future failure is increased.