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[Advice on intravenous treatment with beta-lactams].

Beta-lactams (BL) are administered at present in dosages which are based only partly on controlled clinical investigations as these are difficult to carry out for all types of infections. Investigations of well-defined infections and animal experiments suggest that the optimal effect is obtained when the BL concentration is kept above the minimal inhibiting concentration (MIG) during treatment. In cases of intermittent BL treatment of serious infections and treatment of patients with compromised immune defence, it is considered advisable to keep the serum concentration constantly above the anticipated limit of sensitivity or MIC. On the basis of a review of the most important pharmacokinetic properties of BL, methods of measurement of the sensitivity of bacteria to BL and development of bacterial resistance to BL, a method is presented of calculating the individual doses and the intervals between doses as regards the sensitivities of the commonest human pathological bacteria to BL although the proposed dosages have not been tested clinically for all types of infections. Employing this, BL may easily be administered individually according to the severity of the infection and possible special conditions in the underlying disease in the patients. The individual doses and intervals between doses recommended in The Danish Medical Codex from 1988 are presented in tabular form and are compared with calculations of the time in which the serum concentration remains above the anticipated limit of sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Cephalosporins↗

[Good Manufacturing Practice (GMP) in the food industry].

The GMP-Rules, which were formulated by the WHO in 1969, were passed into German national lay by April 1st, 1985 as "Betriebsverordnung für pharmazeutische Unternehmer". The aim of this law is to guarantee constant quality of medical supplies. The food producing industry is facing similar requirements formulated either within the Codex Alimentarius or within the Code of Hygienic Practice of FDA (General Requirements for Food Manufacture). The degree of realization for these concepts of quality assurance however is varying extremely between different areas of food production. The requirements with regard to buildings, production plants, process technology, distribution and personnel hygiene as well as the principles of the HAAC-concept are described using examples from soft cheese, milk powder- and sweets industry.

Food-Processing Industry↗

Czechoslovak health legislation.

A history, description and assessment of health legislation in Czechoslovakia are given. The suggestion is made that it could serve as a model for health legislators in other countries, as it is the first universal health codex.

Czechoslovakia↗

[Development of a moral consciousness in medical schools].

In the conditions of developed socialism, changes in social consciousness are also reflected in one of its forms - the morals. The problems of moral education as an inseparable part of communist education is coming to the foreground. It plays its role in all the stages of the education system, having its unsubstitutable place also in the conditions of universities and technical colleges, the faculties of medicine not excluding. It is its task to form the personality of the student and graduate, to make them, among others, acquire the moral codex of a builder of communism (habits of moral behaviour in professional activities - medical ethics). Such crucial situations must be found that are of cardinal importance for the formation of the medical student's moral profile (transition from the secondary school to university, entering the clinic, meeting the patient, running health institutions, positive and negative influences in the health service). The student must live the moral situation, obtain the experience from moral acting on his own self and be an active participant in the events creating his moral qualities, primarily in collective conditions. We stress the necessity of engagement - mobilisation of students to all-round social activities, connection of the theoretical findings of marxist ethics with their particular problems and actual activities. A special accent is laid on the method of personal example, the moral example of the university teacher himself, in the first place his authority based on all the progressive components of his personality.(ABSTRACT TRUNCATED AT 250 WORDS)

Communism↗

Effective reduction of lactose maldigestion in preschool children by direct addition of beta-galactosidases to milk at mealtime.

We examined the efficiency of two beta-galactosidase preparations--one derived from the yeast, Kluyveromyces lactis (Lactaid), the other derived from the fungus, Aspergillus oryzae (Takamine)--to assist the in vivo digestion of lactose consumed by healthy Guatemalan preschool children. Milk prehydrolyzed by in vitro incubation with enzymes was used as the standard of reference, and the degree of incomplete digestion of lactose from 240 mL of milk was determined using the hydrogen breath test. In in vivo dose-response studies, both 3,250 neutral lactose units of Lactaid and 6,635 food and chemical codex lactose units of Takamine completely eliminated excess H2 excretion in a small sample of lactose-maldigesting subjects. When evaluated in a controlled, clinical trial setting, the same dose of Lactaid added directly to the milk at consumption produced an 82% relative reduction in H2 excretion, whereas Takamine was equally as effective as the prehydrolyzed milk. Thus, intraluminal conditions and gastrointestinal transit in the preschool child support the effective assisted digestion of milk lactose in an efficient manner and with the same enzyme to milk ratios as observed previously in adults.

Animals↗

Guidelines for predicting the dietary intake of pesticide residues. Joint FAO/WHO consultation.

These guidelines have been developed to describe procedures for predicting the dietary intake of pesticide residues, and will assist national authorities in their considerations of the acceptability of the Codex maximum residue limits (MRLs). The relevant authorities are invited to consider the basic approaches described in these guidelines, which have been designed to provide reasonable assurance that such MRLs would not result in dietary intakes that exceed the acceptable daily intake (ADI) of a pesticide.

Diet↗

[Epilepsy and Canon Law].

The Canon Law (Codex Iuris Canonici), promulgated in 1917, was a classification of laws and jurisprudence which ruled the early Church, governed the ecclesiastical condition of Roman Church until its reorganisation in 1983. It forbade to be ordained or to exercise orders already received to "those who are or were epileptics either not quite in their right mind or possessed by the Evil One". All the context and in particular the paragraph which treated of bodily lacks, indicated that between these three conditions, there was juxtaposition and no confusion. The texts specified the foundations of these dispositions, not in a malefic view of epilepsy inherited from Morbus Sacer of Antiquity, but in decency and on account of risk incured by Eucharist in case of fit. Some derogations could attenuate the severity of these dispositions--as jurisprudence had taken progresses of Epileptology and therapeutics into consideration. In the new Code of Canon Law (1983) physical disabilities were removed from the text and also possessed evil and epilepsy, the only impediment being "insanity or other psychic defect" appreciation of which is done by experts. Concerning poorly controlled epilepsies, we believe that experts will be allowed to express their opinion and a new jurisprudence will make up for the silence of the law.

Catholicism↗

Comparison of the Volhard and potentiometric methods for the determination of chloride in meat products: collaborative study.

A collaborative study of the determination of chloride in meat products was conducted by the International Organization for Standardization (ISO) to compare the ISO 1841 method (Volhard titration) with the FAO/WHO Codex Alimentarius Committee method (potentiometric titration). Five canned luncheon meat products containing 0.25-2.0% sodium chloride at 4 different spiking levels were analyzed by 11 laboratories. The data were analyzed by ISO statistics (ISO 5725) and by AOAC statistics (Youden-Steiner), the major differences being in the rejection of outliers and in the statement of precision parameters. Good agreement was found between the mean chloride contents of the products as determined by both methods and with the added amounts, although statistically significantly higher sodium chloride recoveries were obtained with the potentiometric method. The within-laboratory variability (repeatability) is greater for the Volhard method, especially for chloride levels below 1.0%. Therefore it is proposed to set the lowest level of determination for the Volhard method at about 1.0% sodium chloride. The among-laboratories variability (reproducibility) of the potentiometric method was comparable with the results from the collaborative studies for chloride in cheese, giving acceptable values for relative standard deviations of 1.5-3.0% for meat products with 0.3-2.0% added sodium chloride. It is recommended that further work be conducted to reduce or eliminate the systematic error present with the potentiometric method as applied to meat and meat products.

Animals↗

Colorimetric and spectrophotometric determination of total and non-phenolic alkaloids in ipeca and its formulations.

A simple method, requiring no chromatographic separation, is presented for the determination of the total and non-phenolic alkaloids in ipeca and its preparations. The complex formed between the alkaloid and methyl orange at pH 5.0 is extracted with chloroform and treated with 0.1N NaOH. The liberated dye, determined at 460 nm, is a measure of the total alkaloids. The chloroform phase remaining is treated with 0.1N H2SO4, and the acid extract is measured at 283 nm for the non-phenolic alkaloids, calculated as emetine. The proposed method was successfully applied to samples of ipeca powder, ipeca tincture, and 3 British Pharmaceutical Codex mixtures containing ipeca tincture, namely, ipecacuanha mixture, pediatric; ipecacuanha and ammonia mixture, pediatric; and belladonna and ipecacuanha mixture, pediatric. The proposed method compares favorably with the Egyptian Pharmacopoeia, British Pharmacopoeia, and USP methods and has a relative standard deviation of 1.54%. The present procedure is less time-consuming and requires about 45 and 90 min for the assay of ipeca tincture and powder, respectively. Only a small sample (0.2 mL tincture of 1.0 g powder) is required.

Ammonia↗

Sodium in nutrition policy.

Salt once was a scarce commodity and for some governments salt tax was an important income. The Na content of a diet without any processed foods or added salt would be approximately 400-500 mg. Food industry contributes substantial amounts of salt. A nutrition policy on Na should include regulation of the Na content in infant formulas and a decreased Na intake to reduce the risk of hypertension and possibly also gastric cancer. Iodized salt is an important source of iodine in many countries. Recommendations regarding Na intake have been given in some recommended dietary intakes and in several dietary guidelines. During the last years a few Western countries have published action programmes regarding Na and hypertension. Very few countries have standards regulating the salt content of certain products but in case any claims are made related to the Na content, this usually has to be declared. Special dietary foods with low Na content and salt substitutes are available in many countries. Standards for such products have been published by the FAO/WHO Codex Alimentarius Commission.

Adult↗

[The influence of so-called "diet" fats high in polyene acids on blood constituents, serum cholesterol and organ systems].

The Effect of Various Alimentary Fats, Especially "Diet" Fats With High Proportions of Polyene Acids on the Blood Count, Cholesterol Levels and Organ Systems: This paper describes our observations on the possible toxicity of highly unsaturated fatty acids on the cell systems of the red blood, the liver and kidney. At the same time the necessity of maintaining a normal level of cholesterol in the blood and a stable pool of saturated fatty acids in the serum is pointed out with reference to our own investigations. By means of a reference record histogram, the lower critical point of cholesterol level is verified. A correlation between the low cholesterol level, relatively low hemoglobin values and low erythrocyte count is substantiated., By means of a nutritional physiology study in patients with defined anemias and cholesterol deficit, an attempt was made to establish a causal connection between low cholesterol and anemia. Further, it could be shown that highly unsaturated fatty acids (polyene acids) of the C189:2 cis ("curved fats") type such as occur in diet margarines, thistle oil and other vegetable oils in high concentrations, can cause damage to cell membranes and the cell systems of the red blood, the liver and kidney by excessive ingestion in the food. Biochemical work on the present knowledge of the formation of lipofuscin (the "age pigment") by polymerization products from unsaturated fatty acids is referred to. In a controlled nutritional physiology trial in pigs the facts observed in human medicine were confirmed. So it is postulated that the curative pronouncements claimed by the bottlers of thistle oil and the manufactures of diet margarines are not valid. Taking the Codex Alimentarius of the FAO/WHO, which gives the acceptable daily dosage in mg/kg body weight as a guide, according to the present state of toxicological information, a maximum of 10 g unsaturated fatty acids of the C18:2 cis type can be consumed for a lifetime without suffering noticeable harm. This corresponds to a highly unsaturated fatty acids proportion of less than 8% in the daily diet.

Anemia↗

Infant food problems and analytical aspects of providing safe and wholesome infant foods.

The technology of milk and infant food production, storage, and handling has advanced to the point that infant foods have had an excellent record of being free of recognized health hazards. The Infant Formula Council has published methods specifically for these foods. Methods are included from Standard Methods for the Examination of Dairy Products, Official Methods of Analysis, Bacteriological Analytical Manual, the Manual of Clinical Microbiology, and the U.S. Pharmacopeia. Criteria for microbiological quality have been issued by the Codex Alimentarius Commission, the International Commission for Microbiological Specifications for Foods, and the Public Health Service. Surveys in the United States and Canada have shown that sanitary standards are met with ease.

Consumer Product Safety↗

Present problems of food colours.

Food colours belong to those food additives which have been most carefully evaluated toxicologically. The colours which are accepted today by international bodies, like the FAO/WHO and Codex Alimentarius, offer an extraordinary high degree of safety. Within these toxicologically accepted colours, the group of colours which naturally occur in foods (for long periods of time) deserves special attention: such colours combine in an ideal way a very long practical human experience with scientific examination under experimental and animal test conditions, and they offer, therefore, a maximum degree of safety. Colours which naturally occur in foods and which are also of industrial importance are: caramel, carotenoids, grape skin extracts and some colouring spices.

Carotenoids↗

Antibody response to and immunity induced by Corynebacterium pyogenes vaccine.

A procedure is described for producing a high quality C. pyogenes vaccine. A satisfactory antibody response was obtained by administering 3 subcutaneous injections of vaccine at 10-day intervals, using doses of 2,0 ml for rabbits, 5,0 ml for sheep and 10,0 ml for cattle. The titres resulting from this procedure compared favourably with those obtained from following the more intensive schedule and higher doses of vaccine recommended by the British Veterinary Codex. The antibody response was at its best 1-2 months after immunization but dropped to a plateau 6 months after immunization. Mice were also successfully immunized against challenge with 1,5x108 organisms by the application of 3 doses of vaccine administered at 10-day intervals.

Agglutinins↗

Reliability of mycotoxin assays--an update.

The precision parameters of the method-performance (collaborative) studies for mycotoxins published in the literature through 1991 have been recalculated on a uniform basis by following the International Union of Pure and Applied Chemistry protocol. About 80% of the 793 accepted assays for mycotoxins, almost all of which have been conducted by thin-layer chromatography (TLC), liquid chromatography (LC), and enzyme-linked immunosorbent assays (ELISA), exhibit relative standard deviations among laboratories (RSDR) that are less than 2 times the values predicted from the Horwitz equation: RSDR, % = 2(1-0.5log10C) where C is the concentration expressed as a decimal fraction. The precision of TLC and LC methods is about the same, but that of ELISA is somewhat poorer. For those commodities for which sufficient data exist to provide a meaningful comparison, the methods applied to cottonseed products have the best precision and corn the worst, with peanuts intermediate. Overall, however, the primary factor affecting RSDR is concentration, more or less independent of analyte, method, matrix, and age of the study. If it is assumed that the test results are normally distributed and that an RSDR of 50% is the point where effective control of the results begins to be lost (a value equivalent to the production of 2% false-negative values), then relying on the Horwitz curve, the limit of quantitative measurement is the single digit, i.e., 5, micrograms/kg (10(-9); ppb) concentration for solid food commodities. Such a value must be considered as a limit applicable to a single analyte, aflatoxin B1, and not as a mean, and not applicable to the sum of the individual components, each of whose associated standard deviation would lie in the unacceptable region. Enforcement of a 5 micrograms aflatoxin B1/kg limit, under the assumptions made, requires that a responsible manufacturer and a prudent regulator operate at opposite extremes of tolerance limits: e.g., the producer at 2 micrograms/kg and the consumer at 10. A proposed Codex "maximum level" of 0.05 micrograms aflatoxin M1/kg milk cannot be supported by the available data applied in an interlaboratory enforcement environment. These conclusions are also supported by an examination of the reported data from the ongoing, large-scale proficiency studies routinely performed by the American Oil Chemists' Society and the International Agency for Research on Cancer.

Databases, Factual↗

Methods of analysis for toxic elements in foods. Part IV. General method of ashing for the determination of toxic elements.

As a result of the request of the Codex Alimentarius Committee on Methods of Analysis and Sampling, a general method for ashing of foods for the determination of toxic elements was assembled. This method consolidates the results of more than a decade of interlaboratory work of numerous USSR food laboratories and specifies the details of wet and dry ashing procedures.

Food Analysis↗

[Food irradiation].

A worldwide standard on food irradiation was adopted in 1983 by Codex Alimentarius Commission of the Joint Food Standard Programme of the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO). As a result, 41 countries have approved the use of irradiation for treating one or more food items and the number is increasing. Generally, irradiation is used to: food loses, food spoilage, disinfestation, safety and hygiene. The number of countries which use irradiation for processing food for commercial purposes has been increasing steadily from 19 in 1987 to 33 today. In the frames of the national programme on the application of irradiation for food preservation and hygienization an experimental plant for electron beam processing has been established in Institute of Nuclear Chemistry and Technology. The plant is equipped with a small research accelerator Pilot (19MeV, 1 kW) and an industrial unit Elektronika (10MeV, 10 kW). On the basis of the research there were performed at different scientific institutions in Poland, health authorities have issued permission for irradiation for: spices, garlic, onions, mushrooms, potatoes, dry mushrooms and vegetables.

Academies and Institutes↗