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Background Numerous Dupuytren’s fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren’s disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren’s disease and unite current limited fasciectomy practice that varies considerably between surgeons. Methods We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3−5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. Results From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P=0.001), and the time to recurrence was significantly longer (5.0±0 years vs. 4.0±0.2 years; P Conclusions Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren’s flexion deformity.

Background Hydrodilatation (HD) has been shown to improve pain and function in patients with adhesive capsulitis (AC). There is no consensus concerning how HD should be performed or what volume should be injected. It has distinct advantages compared to surgery; however, it is a painful procedure and is often poorly tolerated. Methods We retrospectively reviewed all patients referred for HD over a 2.5-year period aiming to assess whether volume injected influences outcome. Results There were 107 patients treated with HD; of these, 76 (43 female, 32 male) had full data for analysis. The majority were classified as primary AC ( n = 57) with an average age of 55.5 years. The mean improvement in Oxford Shoulder Score (OSS) was 12.1, with females (13.9) and post-traumatic cases of AC (14.1) demonstrating the best outcome. No complications were observed during the HD process. There was a negative correlation observed between volume injected and OSS improvement. Only two patients experienced a poor outcome and required further treatment with manipulation +/– arthroscopic arthrolysis. Conclusions The present study supports the use of HD as a first line treatment for AC regardless of the underlying cause, and also demonstrates that the volume injected does appear to influence the outcome.

Campylobacter is an important cause of human gastroenteritis worldwide. Chicken meat is frequently contaminated with this organism and is considered to be a significant source of infection. It has been predicted that lowering the numbers of Campylobacter on chicken meat can reduce the risk to public health. The aims of the current study were to investigate the susceptibility of Campylobacter to high intensity near ultraviolet/visible (NUV-vis) 395±5nm light and to examine its potential for the microbiological decontamination of raw chicken and contact surfaces. Exposure of Campylobacter jejuni and Campylobacter coli to NUV-vis light of irradiances was assessed at three distances (3, 12 and 23 cm) from the light source for up to 10 min, corresponding to doses of 0.06 to 18J/cm(2). Overall, levels of inactivation in liquid and on raw chicken improved with longer exposure times and shorter distances from the light source. Reductions of more than 7log(10)CFU/mL were achieved for Campylobacter isolates in liquid following 2 min exposure at 3 cm. Exposure of skinless chicken fillet to NUV-vis light for 1 or 5 min at 3 cm distance reduced C. jejuni by 2.21 and 2.62 log(10)CFU/g, respectively. Increasing the treatment time to 10 min did not significantly increase the level of inactivation. In general, NUV-vis light treatment did not affect the colour of raw chicken. Excluding treatments which resulted in excessive heating (>50°C) of chicken skin, a maximum reduction of 0.95 log(10)CFU/g was achieved for C. jejuni following 10 min exposure to NUV-vis light at 12 cm (P

This study investigated the ability of pulsed electric fields (PEF) to inactivate a range of microorganisms in liquid media and on raw chicken meat. The susceptibilities of ten Campylobacter isolates (seven Campylobacter jejuni isolates and three Campylobacter coli isolates), Escherichia coli (ATCC 25922) and Salmonella Enteritidis (ATCC 13076) to PEF in liquid media were investigated. All Campylobacter isolates tested in liquid were susceptible to PEF treatment (65 kV/cm, 5 μs, 500 Hz) with reductions of between 4.33 and 7.22 log 10 CFU/mL observed for the longest treatment (30 s). Significant differences in susceptibility were observed between Campylobacter isolates subjected to equivalent PEF treatments ranging from 2.41 to 5.19 log 10 CFU/mL. Campylobacter isolates processed in liquid media were found to be more sensitive to PEF than E. coli and S. Enteritidis ( P C. jejuni , E. coli or S. Enteritidis. Therefore, under the conditions used in this study, PEF technology may not be suitable as a food safety intervention measure for the control of microbial contaminants on broilers during processing although it may have potential to reduce contamination of process water (e.g. scald or spin chill water).

The application of sonication and thermosonication (53 ± 1 °C) was investigated as potential methods for reducing numbers of Campylobacter, enterobacteriaceae and total viable counts (TVC) on raw poultry. Sonication equipment included a high-intensity unit (HI) and a low-intensity unit (LI), which produced 20,000 and 20 W/L, respectively. The susceptibility of ten Campylobacter isolates in liquid media to thermosonication treatment was also investigated to determine whether differences between isolates existed. All Campylobacter strains were susceptible to thermosonication in the HI unit with inactivations ranging from 2.97–4.15 log10 CFU/mL. Campylobacter jejuni was more susceptible to thermosonication than to thermal or sonication treatment with mean inactivations of 4.72, 1.45 and 3.17 log10 CFU/mL, respectively. Following 16 min thermal, sonication and thermosonication treatments of broiler skin pieces in the HI unit, no viable Campylobacter or enterobacteriaceae were detected and TVC were reduced by 1.93, 1.34 and 2.49 log10 CFU/g, respectively. Thermosonication treatment in the LI unit reduced enterobacteriaceae and TVC populations by 2.74 and 1.69 log10 CFU/g, respectively. Thermosonication treatment was generally more effective against Campylobacter in liquid matrices in comparison to inoculated poultry products.

Antimicrobial-resistant bacteria pose a threat to public health. Three Yersinia enterocolitica strains cultured from patients presenting with diarrhea and resistant to nalidixic acid were studied. Target gene mutations in gyrA alone were identified as part of the genetic basis for this phenotype. Efflux activity was also noted, since the presence of the efflux pump inhibitor, phenylalanine-arginine-β-naphthylamide, increased susceptibility to nalidixic acid.

The application of crust freezing (CF) applied as a stand-alone treatment or in combination with ultraviolet (UV) light for reducing the level of artificially inoculated Campylobacter jejuni on raw chicken was investigated. CF air temperatures of -5, -15 and -27 °C (±3 °C) with freezing times of 70, 15 and 6 min, respectively, were used. The level of C. jejuni on chicken was also examined following subsequent refrigerated (0-4 °C) storage at 3 and 7 days. All CF treatments resulted in significant reductions compared to untreated controls (P0.05). Although combining CF with UV also resulted in significant reductions for C. jejuni, the combined treatments were generally no more effective than treatment by CF alone. Overall, the color of chicken drumsticks was not affected by CF treatments (P ≥ 0.05). In general, CF resulted in increased drip loss (P0.05), which increased over storage time and was greater at higher CF temperatures. The current study indicates that CF has potential for reducing the levels of C. jejuni by between 0.5 and 1.5 log(10) CFU/g and impacts minimally on the color of treated skin.

UV light was investigated for the decontamination of raw chicken, associated packaging, and contact surfaces. The UV susceptibilities of a number of Campylobacter isolates (seven Campylobacter jejuni isolates and three Campylobacter coli isolates), Escherichia coli ATCC 25922, and Salmonella enterica serovar Enteritidis ATCC 10376 in liquid media were also investigated. From an initial level of 7 log CFU/ml, no viable Campylobacter cells were detected following exposure to the most intense UV dose (0.192 J/cm(2)) in liquid media (skim milk subjected to ultrahigh-temperature treatment and diluted 1:4 with maximum recovery diluent). Maximum reductions of 4.8 and 6.2 log CFU/ml were achieved for E. coli and serovar Enteritidis, respectively, in liquid media. Considerable differences in susceptibilities were found between the Campylobacter isolates examined, with variations of up to 4 log CFU/ml being observed. UV treatment of raw chicken fillet (0.192 J/cm(2)) reduced C. jejuni, E. coli, serovar Enteritidis, total viable counts, and Enterobacteriaceae by 0.76, 0.98, 1.34, 1.76, and 1.29 log CFU/g, respectively. Following UV treatment of packaging and surface materials, reductions of up to 3.97, 4.50, and 4.20 log CFU/cm(2) were obtained for C. jejuni, E. coli, and serovar Enteritidis, respectively (P < 0.05). Overall, the color of UV-treated chicken was not significantly affected (P ≥ 0.05). The findings of this study indicate that Campylobacter is susceptible to UV technology and that differences in sensitivities exist between investigated isolates. Overall, UV could be used for improving the microbiological quality of raw chicken and for decontaminating associated packaging and surface materials.

Thermotolerant Campylobacter jejuni and Campylobacter coli are recognized as foodborne pathogens causing a significant burden of disease in human populations in both developing and developed countries. The gastrointestinal tracts of animals are often colonized by these bacteria and fecal contamination of foods can occur during the harvest phase, including milking. Raw milk and raw dairy products can be contaminated with Campylobacter s and consequently consumption of these foods has been linked to enteric disease in humans.

The efficacy of high-intensity light pulse (HILP) technology (3 Hz, maximum of 505 J/pulse, and a pulse duration of 360 μs) for the decontamination of raw chicken and associated packaging and surface materials was investigated. Its ability to reduce microbial counts on raw chicken through plastic films was also examined. Complete inactivation of Campylobacter spp., Escherichia coli, and Salmonella Enteritidis in liquid was achieved after 30 sec HILP treatment. Reductions of 3.56, 4.69, and 4.60 log₁₀ cfu/cm²) were observed after 5 sec HILP treatment of Campylobacter jejuni, E. coli, and Salmonella Enteritidis inoculated onto packaging materials and contact surfaces, respectively. The greatest reductions on inoculated chicken skin were 1.22, 1.69, and 1.27 log₁₀ cfu/g for C. jejuni, E. coli, and Salmonella Enteritidis, respectively. Corresponding reductions on inoculated skinless breast meat were 0.96, 1.13, and 1.35 log₁₀ cfu/g. The effectiveness of HILP treatment for reducing microbial levels on chicken increased as the film thickness decreased. HILP treatments of 2 sec did not significantly affect the color of raw chicken although treatments of 30 sec impacted color. This study has shown HILP to be an effective method for the decontamination of packaging and surface materials. Additionally, it has demonstrated the potential of HILP to be used as a decontamination method for packaged chicken.

1. This study investigated the potential of a commercially available acidified water treatment (PWT) for reducing the number of Campylobacter in vitro and other bacteria in the gut of live broilers. 2. In vitro tests indicated that PWT was highly effective for reducing Campylobacter jejuni and Campylobacter coli at the recommended concentration in water, reducing populations by greater than 7 log10 CFU/ml after 24 h exposure. The decrease in the number of Salmonella serovar Enteritidis and Escherichia coli was not significant. 3. Addition of PWT to the broiler drinking water for the first 7 d, 2 d before and 2 d after each feed change and at feed withdrawal prior to slaughter or only after feed withdrawal had no effect on the number of Campylobacter in caecal samples on farm before thinning and depopulation compared to untreated controls. 4. Although PWT was effective for reducing Campylobacter in water, the results suggest that it does not reduce the number of Campylobacter in the caeca of broilers prior to slaughter under the conditions used in the study.