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Poultry processing establishments use antimicrobial aids on broiler parts to minimize Campylobacter contamination. A silver-stabilized hydrogen peroxide (SHP) product was assessed for use as an antimicrobial processing aid. In a series of experiments, wing segments with skin were inoculated with 103 to 107 cells of Campylobacter coli, followed by treatment with SHP at 15,000 or 30,000 mg/L, peroxyacetic acid (PAA) at 300 or 3,000 mg/L (parts per million), or water. Each treatment was applied by either dip or spray. Rinsates from each wing segment were analyzed for direct counts and prevalence of Campylobacter. Treatment with SHP or PAA significantly reduced Campylobacter levels compared with water controls by up to 2.22 log CFU/mL. At high inoculum levels (106 to 107), SHP and PAA applied by dip had up to 1.27 log CFU/mL further reductions of Campylobacter levels compared with spray-treated wing segments. Additionally, wing drumettes were observed to retain higher levels and prevalence of Campylobacter recovery compared with wing flats at a low inoculation level (103). The results indicated that there was no carryover effect of SHP (same day versus 24 h) and dip treatment with SHP or PAA decreased Campylobacter recovery on broiler chicken wing segments compared with a water control. Although a 2-log reduction was modest, SHP had similar efficacy as the commonly used processing aid PAA. SHP shows potential for further investigation as an antimicrobial processing aid for use on poultry parts. HIGHLIGHTS

Objective: To identify and document the incidence of severe, clinically symptomatic stenosis in a general intensive care unit (ICU) population and thus to identify airway interventions that are associated with stenosis. Design: A prospective, observational study over five years. Setting: Clinical investigation in a district general hospital adult intensive care unit. Subjects: One hundred and thirty-six consecutive, intubated patients with an ICU stay of five or more days and who survived to be followed up to six months were studied. Interventions: None. Measurements and main results: Detailed information was recorded for every patient on the type of intubation, number of reintubations and mode of ventilation. Post-discharge patients were clinically examined and had full pulmonary function tests, with flow loops, performed at two and six months post-ICU discharge. Of the 136 patients, 48 had open operative tracheostomies performed and 37 patients were reintubated twice or more; 120 had pulmonary function ...

Alterations in intestinal permeability reflect one component of intestinal epithelial barrier function. The objective of this study was to assess the degree of derangement of intestinal permeability in critically ill patients and to investigate the relationship of this to markers of disease severity and sepsis. Sixteen patients admitted to the intensive care unit for a variety of problems were studied with the severity of illness and degree of sepsis recorded daily. A differential sugar absorption test, using lactulose and mannitol as markers, was performed, and in 10 patients this was repeated after an interval of between 4-11 days. The use of the lactulose/mannitol (L/M) ratio corrects for variables unrelated to permeability such as gastric emptying. The L/M ratio was significantly higher in patients (median 0.98) compared to normal controls (median 0.008). The ratios showed no relation to disease severity or sepsis. These results establish that increased intestinal permeability occurs in the general ICU patient but that it is not uniquely related to sepsis. The extent of this abnormality suggests that further study is required to show the various influences on this process.

Thirty-seven patients with a wide range of illnesses were studied during mechanical ventilation of the lungs in an intensive care unit. Fifteen were sedated with a continuous propofol infusion, with analgesia provided by bolus doses of papaveretum. Twelve received a continuous infusion of papaveretum, supplemented by bolus doses of midazolam. The level of sedation was assessed every four hours and measurements were made of haemodynamic and respiratory variables. Levels of sedation were generally satisfactory in both groups. Six patients who received propofol required the use of muscle relaxants, because of their strong respiratory drives, to achieve synchronisation with the ventilator. There was no significant difference in respiratory or haemodynamic variables between the groups, but several patients required inotropic support because of their disease. There was no evidence of inhibition of adrenal steroidogenesis in the propofol group. Propofol can be a useful sedative agent in the intensive care unit, but sedative regimens should be tailored to individual patient requirements.

The accumulation of matrix cracking is examined using continuum damage mechanics lamination theory. A phenomenologically based damage evolutionary relationship is proposed for matrix cracking in continuous fiber reinforced laminated composites. The use of material dependent properties and damage dependent laminate averaged ply stresses in this evolutionary relationship permits its application independently of the laminate stacking sequence. Several load histories are applied tocrossply laminates using this model and the results are compared to published experimental data. The stress redistribution among the plies during the accumulation of matrix damage is also examined. It is concluded that characteristics of the stress redistribution process could assist in the analysis of the progressive failure process in laminated composites.

Summary The haemodynamic response to tracheal intubation was compared in 303 patients in whom anaesthesia was induced with either thiopentone 4 mg/kg, etomidate 0.3 mg/kg or propofol 2.5 mg/kg, with and without fentanyl 2 μg/kg. There was after propofol alone a significant decrease in arterial blood pressure, which did not increase above control values after intubation. Significant increases in arterial pressure followed intubation in patients induced with thiopentone or etomidate alone. Increases in heart rate occurred with all agents after laryngoscopy. The use of fentanyl resulted in arterial pressures lower than those after the induction agent alone, and in an attentuation, but not abolition of the responses to largyngoscopy and intubation.

This report summarizes research completed during a four year period under AFOSR grant no. AFOSR-84-0067 and originally detailed under Texas A&M research Foundation proposal no. RF-84-34 and dated October 1983. The objective of this research has been to develop an accurate damage model for predicting strength and stiffness of continuous fiber laminated composite media subjected to fatigue or monotonic loading and to verify this model with experimental results obtained from composite specimens of selected geometry and makeup. Further details of this research can be found in the three previous annual reports available either from AFOSR or the author. Keywords: Composites, Damage, Experimental mechanics, Continuum mechanics, Internal state variables, Laminated composites.

The airway pressures at ventilatory frequencies of 15, 60, 100, 120 and 150 breaths per minute were measured in eight adult patients undergoing coronary artery bypass grafting. Measurements were made perioperatively at four stages: precardiopulmonary bypass with the chest closed, precardiopulmonary bypass with the chest open, postcardiopulmonary bypass with the chest open and postcardiopulmonary bypass with the chest closed. In five patients thoracic compliance and airways resistance were also measured at these times. Neither sternotomy nor cardiopulmonary bypass made any significant difference to the airway pressures during normal and high frequency ventilation, nor were lung mechanics affected.

The influence of specimen thickness on the fracture toughness of two laminates and three specimen geometries was investigated. As thickness increased the toughness decreased and approached an asymptotic value that was dependent upon the type of laminate but was practically independent of specimen geometry. Enhanced X-ray photographs and removal of an outside ply revealed that most of the delaminations were surface effects.

History. —W. F. N., male child, aged 2, up to Dec. 23, 1909, had had no serious illness. About 3 a. m., December 23, the child awoke and seemed to be in great pain. Half an ounce of castor-oil was given by the parents. About 5 a. m. the child began vomiting. Pain and vomiting continuing, a physician was called about noon. He prescribed calomel and more castoroil, but everything given by mouth was rejected. On the second day several enemas were given, and, excepting a very small stool following the first enema, neither feces nor flatus passed. There had been no mucus nor blood passed per rectum. Pain, vomiting and absolute constipation had been continuous from the beginning of the illness. I was called on the evening of the fourth day and found that the child had died a few minutes before my arrival. I asked for an autopsy and