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In order to improve the safety of refrigerated ready-to-eat food products prepared at retail deli departments, a better understanding of current practices in these establishments is needed. Food employees in deli departments at six chain and three independent retail establishments in Maryland and Virginia were observed, using notational analysis, as they prepared deli products for sale. The frequency of contact with objects and deli products before sale, hand washing and glove changing during preparation, and equipment, utensil, and surface cleaning and sanitizing was determined. Compliance with the U.S. Food and Drug Administration's 2005 model Food Code recommendations, which must be adopted by the individual state and local jurisdictions that are responsible for directly regulating retail establishments, was also assessed. Observations indicated there were a large number of actions for which hand washing was recommended at independent and chain stores (273 recommended of 1,098 total actions and 439 recommended of 3,073 total actions, respectively). Moreover, 67% (295 of 439) of the actions for which hand washing was recommended at the chain stores and 86% (235 of 273) of those at the independent stores resulted from employees touching nonfood contact surfaces prior to handling ready-to-eat food. Compliance with hand washing recommendations was generally low and varied depending on store type with independent stores exhibiting lower compliance than chain stores (5 instances of compliance for 273 recommended actions and 73 instances of compliance for 439 recommended actions, respectively). Potential risk mitigation measures that may reduce the frequency of hand washing actions needed during ready-to-eat food preparation in retail deli departments are discussed. More research is needed to determine the impact of such measures on food safety. [ABSTRACT FROM AUTHOR]

The paper presents data on the sodium, potassium, and water content of ileostomy dejecta from 12 patients with new ileostomies and six patients with established ones. The effects of administration of electrolytes and codeine on these parameters are described. The literature on the chemistry of ileostomy is critically reviewed. [ABSTRACT FROM PUBLISHER]

Renal size and volume decrease with age, accompanied by intrarenal vascular changes. The number of glomeruli decreases and the mass of the juxtamedullary nephrons falls. The result is a decrease in the filtration area of the glomerular basement membrane and decreased permeability. The glomerular filtration rate (GFR) is reduced with aging. The GFR is approximated by the endogenous creatinine clearance, which falls in parallel with the inulin clearance (the true measure of GFR) and is always greater because of tubular excretion of creatinine. Analytical methods for serum and urine creatinine overestimate its concentration and suffer, to varying degrees, from interferences, making the normal range method dependent. A further uncertainty arises from the use of a correction to standard surface area. Serum creatinine concentration is an insensitive indicator of renal function in the elderly. Deduction of creatinine clearance from serum creatinine concentration, weight and age using one of many formulae gives only approximate values, usually too high, and is unsuitable for debilitated and seriously ill patients. Tubular function, in general, is decreased in the elderly. The ability of the kidney to concentrate urine maximally after water deprivation decreases with age, as does the ability to excrete a water and salt load, particularly during the night. Nocturnal polyuria is common in the elderly. The aged kidney can maintain acid-base balance under normal conditions, but not when subjected to an acid load.

The effect of 100 mg of vitamin B6 twice a day on plasma and red blood cell (RBC) magnesium was evaluated in nine premenopausal subjects during the period of one month. According to reported normal ranges for plasma and RBC magnesium (1.7 to 2.3 and 4.7 to 7.0, mg per dl, respectively), three subjects had low plasma magnesium, and all subjects had low RBC magnesium during the control period. Following vitamin B6 administration, the mean plasma and RBC magnesium levels were significantly elevated, with a doubling of RBC levels after four weeks of therapy. These results support the postulate that vitamin B6 plays a fundamental role in the active transport of minerals across cell membranes.

A program for drug-testing in the workplace requires careful planning. There should be a written policy, detailing for which drugs should there be testing, personnel to be tested, frequency and mode of testing, and sanctions if the tests are positive. Urine collection is best carried out under direct vision, but this may create problems because of invasion of privacy. A chain of custody for the urine specimen must be established and confidentiality of the employee's name maintained. The choice of drugs depends on the employer's objectives, but the illicit "street" drugs should be included. The drug testing laboratory should be carefully selected. Drug screening should be by an antibody method and all positive screening tests must be confirmed by gas chromatography or, even better, by gas chromatography/mass spectrometry. Concentrations of drugs constituting a positive test should be established. These values are usually set by the manufacturers of the reagent kits. Interpretation of positive results should be made by an expert and not by lay staff. Positive results for some drugs may result from prescription medication or food.