valuación del Efecto de Desinfectantes y Desangrantes Naturales en Equipos de Pasteurización de una Planta de Lácteos.

La investigación se realizó en la Planta de Lácteos Tunshi – ESPOCH en los equipos del pasteurizador (tanque de balance, tubería, descremadora y envasadora) que fueron sujetos a la evaluación del efecto de soluciones desinfectantes y desengrasantes, obtenidos de las cenizas de madera de eucalipto, pino y arrayán, para el lavado de los equipos. El uso de estas soluciones pretendía reemplazar a la sosa cáustica en estado puro, pues ocasiona problemas de salud en los operarios y al medio ambiente. La investigación se desarrolló bajo un Diseño Completamente al Azar, con cuatro tratamientos: sosa cáustica, soluciones de eucalipto, pino, arrayán; y cuatro repeticiones por tratamiento. Se evaluó características físico-químicas de las soluciones, parámetros microbiológicos en los equipos y comparaciones de costos entre soluciones. Dentro de las características físico químicas el producto más alcalino fue la sosa cáustica reportando un pH de 11,23 y el menos alcalino la solución de pino con un pH de 8,38, estando todas dentro del rango determinado por la Norma INEN. Todas las soluciones presentaron capacidad desengrasante. En los parámetros microbiológicos ninguna solución mata a todos los microorganismos, la sosa cáustica es la más efectiva y económica pues cada litro de solución tiene un valor de $0,90, seguida por la solución de arrayán con el inconveniente de ser muy costosa ya que cada litro de solución cuesta$1,93. La solución de eucalipto arrojó muy buenos resultados y cada litro de solución cuesta $1,07, por lo que se recomienda su uso.The research was conducted at the Dairy Plant Tunshi – ESPOCH, in the pasteurizer equipment (balance tank, piping, skimmer and packaging), that were subject to the evaluation of the effect of disinfectants and degreasing solutions, obtained from eucalyptus, pine and myrtle wood ash; for the washing equipment. The use of these solutions was pretended to replace the caustic soda in pure form that causes health problems in the workers and the environment. The research was under development Completely Random Design with four treatments: caustic soda, eucalyptus, pine and myrtle solutions, and four replicates per treatment. We evaluated physicochemical characteristics of the solutions, microbiological parameters in the all equipments of study and comparisons of cost between solutions. Within the physicochemical characteristics the most alkaline product was the caustic soda which reported a pH of 11,23 and the less alkaline was the pine solution with a pH of 8,38; all being within the range determined by the standard INEN. All solutions exhibit degreasing capability. In the microbiological parameters none of the solutions kill all the microorganisms, the caustic soda is the most effective and economical solution for each liter has value of$0,90, followed by the solution of myrtle with the disadvantage of being very expensive since each liter of solution cost $1,93. The eucalyptus solution gave us good results and each liter of solution cost$1,07, so its use is recommended

Diseño e implementación de un sistema de gestión de seguridad alimentaria basado en la Norma FSSC 22000 (Food Safety System Certification) V5.0 en una empresa procesadora de cereales.

El objetivo de este estudio fue implementar un sistema de seguridad alimentaria basado en la norma FSSC 22000 V5.0 en una empresa procesadora de cereales, se partió de la evaluación de la situación actual de la organización mediante una auditoría de diagnóstico cumpliendo el 66.7% de los criterios de la norma y, a partir de ello se levantó un plan de acción enlistando todas las tareas necesarias para subsanar las no conformidades. Se actualizaron los procedimientos de prerrequisitos alineados a la realidad que estamos viviendo por la pandemia del COVID-19; el plan de análisis de peligro fue renovado bajo los requerimientos de la norma ISO 22000:2018; profundizando el requisito 8: Operación; se incluyó también la implementación de los requisitos adicionales exigidos por el lineamiento Food Safety Sistem Certification (FSSC 22000), siendo: gestión de servicios y materiales comprados, etiquetado de producto, defensa de los alimentos, mitigación de fraude alimentario, gestión de alérgenos, monitoreo ambiental. A continuación, se diseñó una herramienta informática para llevar a cabo auditorías internas a intervalos planificados a través de la aplicación Google Forms y finalmente se evaluó el sistema con una auditoría interna final logrando el 100% de cumplimiento a los requisitos de la norma. Se concluye que a través de las acciones implementadas se obtiene la certificación FSSC 22000 V5.0 otorgada por el ente certificador corroborando la correcta implementación del sistema.This study is aimed at implementing a food safety system based on the FSSC 22000 V5.0 standard in a cereal processing plant. As a starting point, the current situation of the company was evaluated through a diagnostic audit that met 66.7% of the standard criteria, which was followed by an action plan listing all the required tasks to address the non-compliances. The prerequisite procedures were updated according to the reality we are living due to the COVID-19 pandemic; the risk assessment plan was renewed under the standard requirements of ISO 22000:2018; deepening the requirement 8: Operation; it was also included the implementation of the additional requirements demanded by the Food Safety System Certification (FSSC 22000) guideline, including: management of purchased services and materials, product labeling, food defense, food fraud prevention, allergen management, environmental monitoring. Consequently, a computer tool was designed to carry out internal audits at planned intervals through the Google Forms application and eventually the system was evaluated with a final internal audit, achieving 100% compliance with the requirements of the standard. It is concluded that through the implemented actions the FSSC 22000 V5.0 certification granted by the certifying entity is obtained, corroborating the correct implementation of the system

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030