Oxytrol

Jerrold H. Levy, MD, FAHA

• Professor and Deputy Chair for Research
• Emory University School of Medicine
• Director of Cardiothoracic Anesthesiology
• Cardiothoracic Anesthesiology and Critical Care
• Emory Healthcare
• Atlanta, Georgia

In Southern States medicine vocabulary oxytrol 5 mg amex, chili and other hot peppers are dried treatment tinnitus buy generic oxytrol 5 mg on line, packaged medicine 877 buy discount oxytrol 5 mg, and stored at 0 to 10 °C (32 to 50 °F) medicine 770 purchase 5 mg oxytrol amex. Moisture content of chili and other hot peppers during storage should be low (10 to 15%) to prevent mold growth. With a high moisture content, pods may be too pliable for grinding and may have to be redried. With lower moisture content (<10%), pods may be so brittle they shatter during handling, causing loss and release of dust, which is irritating to the skin and respiratory system. Physiological Disorders Blossom end rot is characterized by a slightly discolored or dark sunken lesion at the blossom end of the fruit. Postharvest Pathology the most common decay microorganisms are Botrytis, Alternaria, and soft rots of fungal and bacterial origin. Hot water dips at 53 to 55 °C (126 to 130 °F) for 4 min can effectively control botrytis rot without causing fruit injury. The presence of alternaria black rot, especially on the stem end, is a symptom of chilling injury. Soft rots can occur on washed or hydrocooled peppers when water sanitation is inadequate. Peppers are also affected by many of the disease, virus, insect, and nematode pests that affect tomato. The use of polyethylene film liners within bags allows better storage and reduces dust. The liners ensure that the pods maintain constant moisture content during storage until the time of grinding. Manufacturers of hot-pepper products hold part of their raw material in cold storage at 0 to 10 °C but prefer to grind peppers immediately and store the dried product in air-tight containers. Whole peppers are also dried until they are brittle and the seeds and pulp are completely dry. The dried product is used in flavoring and improving the appearance of various products, including canned products. Some sliced peppers are partially dried and mixed with salt for preservation for ultimate use in various processed products. Deterioration of individually wrapped and non-wrapped bell peppers during long term storage. Improvement of the postharvest keeping quality and color development of bell pepper (cv. Mode of action of plastic film in extending life of lemon and bell pepper fruits by alleviation of water stress. Influence of modified atmosphere packaging on the microflora and quality of fresh bell peppers. Precooling Conditions Herbs should be cooled to just above 0 °C (32 °F) immediately after harvest. Scientific Names and Introduction Perennial culinary herbs include chives (Allium schoenoprasum L. Due to their strong flavors and aromas, these culinary herbs are generally used in small quantities. Quality Characteristics and Criteria Herbs should appear fresh and green, with no yellowing, decay, insect damage, or mechanical damage. Horticultural Maturity Indices Most herbs for fresh culinary use are best if harvested before flowering. Exceptions are marjoram and oregano (sometimes sold with flower buds) and chive blossoms (sometimes used in salads or as edible garnishes). Chilling Sensitivity these perennial herbs are not chilling sensitive and should be stored as close to 0 °C (32 °F) as possible without freezing. Ethylene Production and Sensitivity Ethylene production is low, but sensitivity is high. Storage at 0 °C (32 °F) minimizes effects of ethylene on visual quality (Cantwell and Reid 1993, Cantwell 1997). They are bunched and tied with twist-ties or rubberbands, packaged in plastic bags or clamshell containers, and then packed in corrugated cartons. A color atlas of post-harvest diseases and disorders of fruits and vegetables, vol.

In areas where the prevalence of anemia is at least 40% or above medicine rash oxytrol 2.5 mg sale, it is recommended to continue supplementation until 24 months of age medications list form oxytrol 5 mg order with amex. However denivit intensive treatment 2.5 mg oxytrol purchase mastercard, adherence is often limited due to a combination of factors: the syrup has an unpleasant metallic aftertaste medications jamaica buy oxytrol 2.5 mg free shipping, leaves dark stains on teeth, and high doses cause abdominal discomfort (6). Furthermore, there are technical disadvantages associated with the use of liquid iron preparations such as short shelf life, high transportation costs due to the weight of the bottles, and difficulty in accurately dispensing the drops, especially among illiterate populations, as the caregiver is required to measure a decimal volume from a dropper (7, 8). The root cause of the ineffectiveness of many programs has been an inability to develop a sustainable framework to reach the most vulnerable populations with appropriate and costeffective solutions. This article describes each stage in the development of the Sprinkles intervention for the control of anemia and micronutrient deficiencies in infants and young children. The Sprinkles concept was based on the principle that targeted food fortification has been successful in the West and was inspired by a legacy at the Hospital for Sick Children, where Pablum (the first fortified infant cereal) was invented in 1929 to control the epidemic of rickets which was rampant in Canada at that time. In Sprinkles, the iron (ferrous fumarate) is encapsulated within a thin lipid layer to prevent the iron from interacting with food, thereby limiting changes to the taste, color, or texture of the food. Caregivers are instructed to add the entire contents of one sachet daily to any semi-solid food prepared for their infant or young child in the household, immediately before serving. Other essential micronutrients including zinc, iodine, vitamins C, D and A, and folic acid may be added to Sprinkles sachets. The first efficacy study involved only anemic children and demonstrated that Sprinkles achieved a similar cure rate as compared to the reference standard, iron drops (9). Fifty-eight percent of children who received Sprinkles went from an anemic (Hb<100 g/L) to a non-anemic state (Hb 100 g/L) in 2 months. Given that the study took place during the wet season, when malaria transmission is high, the anemia cure rate of close to 60% was considered very successful. Children who were treated for anemia in this study were included in a maintenance phase study for 6 months to determine whether continued intake of Sprinkles was needed to sustain their non-anemic status. Results showed that in most children who had been successfully treated for anemia, further intervention was not needed. In an effort to reproduce the efficacy of Sprinkles among this population, another study was conducted in the same area during the dry season, when malarial transmission is lower. This study demonstrated that Sprinkles (with or without added zinc) were efficacious to treat anemia with an average cure rate of 69% (11). Elsewhere, in non-malaria endemic areas, it was observed that: 1) 91% of 62 children aged 1 to 6 years who had anemia raised their hemoglobin to above 125 g/L after receiving Sprinkles for two months in Bolivia (unpublished, J. Cataudella et al, 2001); and 2) among 70 anemic young children aged 12­ 24 months (with very little hookworm infestation) given Sprinkles for 2 months in Bangladesh, mean hemoglobin increased from 97 g/L to 113 g/L (12). To determine the bioavailability of the microencapsulated iron and zinc in Sprinkles, stable-isotope studies were conducted. Then, to evaluate the efficacy, bioavailability, acceptability, and safety of Sprinkles, community-based clinical trials were conducted in several regions ranging from Northern Canada to Asia, Africa, and Latin America involving both anemic and non-anemic infants and young children. In addition, studies and pilot projects were conducted to generate data on effectiveness. Findings from other research groups using Sprinkles are also included in this publication. Efficacy and bioavailability For the efficacy studies described below, details on study location, sample size, age group, length 272 Table 17. Length of intervention Group Micronutrient formulation Study Baseline Hb, sFt2, malaria, anthropometry Hb, sFt, anthropometry Hb, sFt, serum retinol, anthropometry Hb, sFt, serum retinol, malaria, anthropometry. To be included in the studies, all infants were required to be ingesting at least one weaning food daily in addition to breastmilk. Based on these data, further studies were carried out to determine the most appropriate dose of iron to include in a Sprinkles sachet for program settings and the most appropriate duration of intervention. A dose-response study was first conducted in rural Ghana to compare the hemoglobin response in anemic children to iron drops containing 15 mg of iron as ferrous sulfate, or to Sprinkles containing either 12. After 2 months of intervention, the prevalence of anemia in all groups dropped to less than 45%, with no difference between the groups. At the end of the intervention, there were no differences in anemia prevalence between groups (unpublished, S.

Purchase oxytrol 5 mg visa. Questionnaire Survey.

Mature will ripen the fruit more uniformly without speeding up the rate of ripening treatment for pneumonia generic oxytrol 5 mg with visa. Gentle handling of fruit treatment 0f gout oxytrol 2.5 mg purchase fast delivery, short hauling medications prescribed for adhd oxytrol 5 mg purchase online, avoiding foliar nutrient sprays within 15 days of harvest symptoms 2dp5dt oxytrol 5 mg purchase, and following suggested guidelines for preharvest fungicide spray intervals will reduce inking. Postharvest Pathology Brown rot, caused by Monilinia fructicola, is the most important postharvest disease of peaches. It can occur during storage if fruit have been contaminated through harvest and handling wounds. Avoiding mechanical injuries and good temperature management are effective controls. The disorder can manifest itself as dry, mealy, woolly, or hard-textured fruit; flesh or pit cavity browning; or flesh translucency usually radiating through the flesh from the pit. An intense red color development of the flesh ("bleeding") usually radiating from the pit may be associated with this problem in some peach cultivars. At the shipping point, fruit should be cooled and held near or below 0 °C (32 °F). Among them, preripening fruit before storage is being used successfully in California. Inking occurs as a result of abrasion damage in combination with contamination by heavy metals (iron, copper, and aluminum). It 468 Quarantine Issues Because some insects, such as Conotracherlus nenuphar (plum curculio), Cydia pomonella (codling moth), Rhagoletis pommonella (apple maggot), and Tetranychus pacificus are not present in some of our import markets, phytosanitary restrictions have been established. Issues associated with exotic pest quarantines, addressing either imported or exported peaches, can change rapidly. For peaches, there are three main ways to deal with these phytosanitary requirements: inspection prior to shipment (including use of screened crates transported in sealed containers), methyl bromide fumigation, and a systems approach. Peaches must be free of Anarsia ineatella (peach twig borer), Conotracherlus nenuphar (plum curculio), Cydia pomonella (codling moth), Erwinia amylovora (fire bright), Rhagoletis pomonella (apple maggot), Tetranychus pacificus (Pacific spider mite), and Ceratitis capitata (Mediterranean fruit fly). If these conditions are not met, fruit must receive an appropriate treatment prior to shipment. A phytosanitary certificate is required to import California peaches into British Columbia. Suitability as Fresh-Cut Product the optimal ripeness for preparing fresh-cut peach slices is a flesh firmness of 13 to 27 N (3 to 6 lbforce). Special Considerations Because peaches area a climacteric fruit, they are harvested after they reach a minimum maturity but before they are completely ripe (that is, ready to eat). Detailed ripening protocols for shippers, retail handlers, warehouse managers, and produce managers have been developed. Acknowledgments Some of the information in this chapter is from the University of California, Davis, website on "Produce Facts" at postharvest. Susceptibility to chilling injury of peach, nectarine, and plum cultivars grown in California. Influence of cooling and temperature maintenance on the quality of California grown stone fruit. Pear fruit require a period of cold storage at -1 °C (30 °F) to induce normal ripening and develop high dessert quality upon ripening. When pear fruit meet the chilling requirement after a period of cold storage, they should be ripened at 20 °C (68 °F) in air for 4 to 7 days depending on the variety for the development of high dessert quality. The fleshy part of pear fruit consists of the fused base of the calyx (sepals), corolla (petals), and stamens, which are interpreted by one school of anatomists as being the "receptacle. Commercial pear production on the Pacific Coast is largely confined to nine districts including the Wenatchee and Yakima Valley areas in central Washington, the Hood River Valley in north central Oregon, and the Rogue River Valley around Medford in southern Oregon. In California, production is mainly in the foothill district of Eldorado, Placer, and Nevada counties; the Sacramento River district; the coast district north of San Francisco Bay known as the Santa Clara Valley district; and the southern California acreage mostly in the Antelope Valley in Los Angeles County (Childers 1949). Pears rank third among the most important tree fruits grown in the world and fourth among all fruits for which statistics are available (Childers 1949). Pear fruit harvested at improper maturity are more susceptible to physiological disorders and have a shorter storage life.

Introduction Losses caused by postharvest diseases are greater than generally realized because the value of fresh fruits and vegetables increases several-fold while passing from the field to the consumer (Eckert and Sommer 1967) treatment lymphoma 5 mg oxytrol purchase with mastercard. Postharvest losses are estimated to range from 10 to 30% per year despite the use of modern storage facilities and techniques (Harvey 1978) schedule 6 medications oxytrol 2.5 mg on-line. Postharvest diseases affect a wide variety of crops medications 563 discount oxytrol 5 mg overnight delivery, particularly in developing countries that lack sophisticated postharvest storage facilities (Jeffries and Jeger 1990) symptoms 0f pregnancy cheap oxytrol 5 mg buy on line. Infection by fungi and bacteria may occur during the growing season; at harvest time; during handling, storage, transport and marketing; or even after purchase by the consumer (Dennis 1983). Reduction of losses in perishable food crops resulting from postharvest diseases has become a major objective of international organizations (Kelman 1989). The reality is that there is a portending food crisis that will require the concerted efforts of all who are involved in food production to redouble their efforts. Specific causes of postharvest losses of fruits and vegetables may be classed as parasitic, nonparasitic, or physical (Cappellini and Ceponis 1984). This chapter deals with the parasitic causes that are of microbiological origin that begin as Factors that Influence Postharvest Pathology Postharvest losses vary each year. Prevailing weather while the crop is growing and at harvest contribute greatly to the possibility of decay. Certain cultivars are more prone than others to decay caused by specific pathogens. Condition of the crop, as determined by fertilizer and soil factors, is very important in susceptibility of the crop to disease. Maturity of the crop at harvest, handling, and type of storage have great influence on how long the crop can be stored without decay. The following sections address how these preharvest factors lead to disease in specific crops. Weather affects many factors related to plant diseases, from the amount of inoculum that overwinters successfully to the amount of pesticide residue that remains on the crop at harvest (Conway 1984). Abundant inoculum and favorable conditions for infection during the season often result in heavy infection by the time the produce is harvested. Pinpoint or storage scab of apple caused by the same fungus that causes apple scab and gray mold caused by the fungus Botrytis cinerea are also 111 very much influenced by the weather. Storage scab only occurs in years with unusually wet summers and early falls, when the fruit remain wet for a day or more. These late-season infections may not become visible until the apples are in storage (Pierson et al. Flowers and fruit are most vulnerable to Botrytis cinerea infection when conditions are wet. For example, in grapes infection occurs at 15 to 20 єC (59 to 68 єF) in the presence of free water after approximately 15 h (Bulit and Dubos 1988). In wet seasons, strawberries and raspberries may be harvested in apparently sound condition only to decay during transit and marketing (Snowdon 1990). Postharvest decay involves further development of preharvest infections together with new infections arising from germination of spores on the fruit surface. From these examples it is apparent that decay often has a weather component, making thorough weather records an important source of information for predicting possible decay in storage. Condition of produce at harvest determines how long the crop can be safely stored. For example, apples are picked mature but preclimacteric to ensure that they can be stored safely for several months. The onset of ripening and senescence in various fruit and vegetables renders them more susceptible to infection by pathogens (Kader 1985). On the other hand, fruit and vegetables can be made less prone to decay by management of crop nutrition. For example, calcium has been more closely related to disease resistance than any other cation associated with the cell wall (Sams 1994). In a study on the effect of increased flesh calcium content of apples in storage, fruit were treated with solutions of CaCl2 by dipping, vacuum, or pressure infiltration. Both vacuum and pressure infiltration increased calcium content of the fruit sufficiently to significantly reduce decay (Conway 1982). Increased calcium contents in potatoes and peaches have also been documented with reduced postharvest decay (Conway 1989). In general, produce containing adequate levels of calcium do not develop physiological disorders 112 and can be stored longer before they breakdown or decay.

The governing terms and results of these positive and negative factors will depend on the particular conditions of the system of interest symptoms 6 months pregnant oxytrol 5 mg order amex. Most receiving water flows are turbulent treatment lymphoma 5 mg oxytrol purchase with amex, which increases the distribution of microorganisms within the waterbody medicine valium oxytrol 2.5 mg buy. As a result treatment 4 anti-aging discount oxytrol 2.5 mg buy on-line, it is common to find models that assume complete mixing of pathogens and other fine suspended matter through the water column in receiving streams. However, recent research has shown that a variety of processes favor pathogen deposition in small streams and treatment devices. Pathogens are known to readily associate with soils, fecal and wastewater solids, and other natural sedimentary material (Dai and Boll 2003, Jamieson et al. This lends credibility to models incorporating sediment association as a removal mechanism. Additionally, recent research shows that hydrodynamic surface-subsurface exchange carries pathogens into the shallow subsurface (streambed, hyporheic zone, etc. Resuspension is strongly dependent on the bacteria associations with particulates and the shear stresses applied to the exposed sediment. Davis (1979) stated that bacteria contamination of waterways during and following storm events is a function of the stream sediment bacteria concentrations, the concentrations of bacteria in soils adjacent to the stream (and source areas in an urban watershed), and the stream velocities. There is ample evidence that sediments can contain substantial bacterial concentrations (Davis 1979, Pitt and Bozeman 1979, Geldreich et al. Recently, a variety of relatively simple model formulations have been employed to assess the effects of microorganism association with background sediments, sedimentation, and subsurface filtration on pathogen transport in streams and rivers. While these studies indicate a clear need to include these processes in field-scale models for transmission of zoonotic pathogens, very little data are available to evaluate the necessary modeling parameters, such as degree of association with different sediment types and sizes and the resulting settling velocity distributions. Further, the available data are very sporadic and normally focus on only one or two microorganisms. Many of these processes have been isolated in laboratory experiments; however, there is little data that shows how these processes interact with and affect pathogen transport in surface water systems. The limited field studies conducted to date suggest that association with suspended and bed sediments play an important role in the overall migration of zoonotic pathogens such as Cryptosporidium and Campylobacter spp. In summary, although fluid transport processes are generally understood in concept, and some factors are commonly incorporated into models, there are some additional complexities related to physically based removal and transport processes in surface water for microorganisms that are still not well understood, particularly with regard to particle associations. Additional research and technical development is needed in this area to provide a more comprehensive state of practice for modeling. In addition, properties of the porous media cannot be considered homogeneous and isotropic. The presence of macropores can lead to extensive pathogen inputs to both groundwater and surface waterbodies (Aislabie et al. These organisms, when entrapped in the soil, may need to compete with native microorganisms for nutrients. However, nutrient concentrations typically decrease lower in the soil profile and cyclical aerobic-anaerobic conditions may occur, requiring microorganisms to adapt or die. Physical straining as a function of soil pore size and microbial geometry has been viewed as the primary process that retards pathogen transport through the vadose zone (Matthess and Pekdeger 1988, Foppen et al. Under natural soil conditions, however, many processes affect transport, including biological straining, sorption and preferential flow through macropores and fractures. These macropores develop as a result of nematodes, dead roots, soil aggregation and/or geological processes. In macropores, wetting fronts propagate to significant depths by bypassing matrix pore space (Brusseau et al. Additionally, pathogens are living organisms with attachment capabilities and evolved sensorial mechanisms. These traits allow pathogens to perceive their surroundings and seek the most suitable place. Sorption of fecal bacteria in soils had been typically investigated using cultured bacteria suspended in distilled water and found to be proportionally related to the percentage of clay content (Ling et al. There is a challenge, though, in translating these mono-strain, free cells suspended in inert solutions to field conditions (Guzman et al.

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