False-Positive Uptake in Splenic Hemangioma on 68 Ga-DOTATATE PET/CT.

ABSTRACT: Somatostatin receptor imaging using 68 Ga-DOTATATE PET is widely popular for evaluation of neuroendocrine tumors. 68 Ga-DOTATATE PET/CT shows highest physiologic uptake in spleen followed by other organs such as kidneys, adrenal glands, and liver. Hemangiomas, although rare, are the most common primary benign neoplasm of the spleen, composed of endothelial-lined vascular channels. We present a case of 77-year-old man who underwent 68 Ga-DOTATATE PET/CT scan for evaluation of pancreatic neuroendocrine tumor and incidentally demonstrated intense radiotracer uptake in splenic hemangiomata.

Use of Nitrous Oxide for Minimal Sedation in Pediatric Outpatients: A Survey Analysis of Patient Experience and Parent-Guardian Satisfaction.

INTRODUCTION: The use of minimal and moderate sedation in the pediatric population allows for the successful completion of many procedures in both hospital and outpatient settings without the risks involved with general anesthesia. Sanford Children's outpatient sedation clinic had been using oral midazolam for minimal sedation but began using inhaled nitrous oxide in January 2019. The current study examines patient experience and parent/guardian satisfaction with use of inhaled nitrous oxide for minimal sedation. DESIGN/METHODS: A survey was designed to evaluate parent/guardian satisfaction with nitrous oxide for pediatric sedation in various outpatient procedures. Parents'/ guardians' understanding of the sedation and procedural logistics were surveyed as well as their satisfaction with the child's comfort, recovery time, and overall satisfaction were assessed. RESULTS: Thirty-seven surveys completed by parents/guardians of patients ages 1-16 years were collected. Average age of the patient was 6 years old, with 22 female and 15 male patients. Outpatient procedures for which the nitrous oxide sedation was used included 30 botulinum toxin injections, 5 VCUG, 1 vaccine administration, and 1 IV placement. Mean survey results were 9.6 (95 percent CI, 9.3-9.9) for satisfaction of recovery time, 8.5 (95 percent CI, 7.7-9.3) for control of discomfort, and 9.1 (95 percent CI, 8.5-9.7) for overall satisfaction. CONCLUSIONS: When evaluating nitrous oxide as an agent for minimal sedation in pediatric procedures, parents/guardians were most satisfied with the recovery time and least satisfied with its ability to control discomfort. Overall, we concluded that nitrous oxide is a moderately good agent for pediatric patients receiving minimal sedation.

Development of a food composition database to monitor changes in packaged foods and beverages.

In order to monitor nutritional changes in the US food supply and assess potential impact on individual dietary intake, an approach was developed to enhance existing standard food composition tables with time-varying product- and brand-specific information for barcoded packaged foods. A "Crosswalk" was formed between barcoded products and USDA foodcodes in a time-specific manner, such that sales-weighted average nutritional profiles were generated for each foodcode based on corresponding products (275,000 to 350,000 per 2-year cycle). This Crosswalk-enhanced food composition table was applied to dietary intake data from the National Health and Nutrition Examination Survey (cycles 2007-2008, 2009-2010, and 2011-2012). Total energy density of foods consumed by Americans from stores/vending was stable over time and differed by <5 kcal/100g using the Crosswalk-enhanced vs standard database. However, changes in the energy density of food groups were found utilizing the Crosswalk that were not detected using the standard database. Likewise, significant declines in energy intake from beverages among children (288±7.3 to 258±6.8 kcal/d) were found using the Crosswalk-enhanced database but were non-significant using the standard database. The Crosswalk approach can potentially augment national nutrition surveys by utilizing commercial food purchase and nutrient databases to capture changes in the nutrient content of packaged foods.

Estimating added sugars in US consumer packaged goods: An application to beverages in 2007-08.

This study developed a method to estimate added sugar content in consumer packaged goods (CPG) that can keep pace with the dynamic food system. A team including registered dietitians, a food scientist and programmers developed a batch-mode ingredient matching and linear programming (LP) approach to estimate the amount of each ingredient needed in a given product to produce a nutrient profile similar to that reported on its nutrition facts label (NFL). Added sugar content was estimated for 7021 products available in 2007-08 that contain sugar from ten beverage categories. Of these, flavored waters had the lowest added sugar amounts (4.3g/100g), while sweetened dairy and dairy alternative beverages had the smallest percentage of added sugars (65.6% of Total Sugars; 33.8% of Calories). Estimation validity was determined by comparing LP estimated values to NFL values, as well as in a small validation study. LP estimates appeared reasonable compared to NFL values for calories, carbohydrates and total sugars, and performed well in the validation test; however, further work is needed to obtain more definitive conclusions on the accuracy of added sugar estimates in CPGs. As nutrition labeling regulations evolve, this approach can be adapted to test for potential product-specific, category-level, and population-level implications.

An approach to monitor food and nutrition from "factory to fork".

BACKGROUND: Accurate, adequate, and timely food and nutrition information is necessary in order to monitor changes in the US food supply and assess their impact on individual dietary intake. OBJECTIVE: Our aim was to develop an approach that links time-specific purchase and consumption data to provide updated, market representative nutrient information. METHODS: We utilized household purchase data (Nielsen Homescan, 2007-2008), self-reported dietary intake data (What We Eat in America [WWEIA], 2007-2008), and two sources of nutrition composition data. This Factory to Fork Crosswalk approach connected each of the items reported to have been obtained from stores from the 2007-2008 cycle of the WWEIA dietary intake survey to corresponding food and beverage products that were purchased by US households during the equivalent time period. Using nutrition composition information and purchase data, an alternate Crosswalk-based nutrient profile for each WWEIA intake code was created weighted by purchase volume of all corresponding items. Mean intakes of daily calories, total sugars, sodium, and saturated fat were estimated. RESULTS: Differences were observed in the mean daily calories, sodium, and total sugars reported consumed from beverages, yogurts, and cheeses, depending on whether the Food and Nutrient Database for Dietary Studies 4.1 or the alternate nutrient profiles were used. CONCLUSIONS: The Crosswalk approach augments national nutrition surveys with commercial food and beverage purchases and nutrient databases to capture changes in the US food supply from factory to fork. The Crosswalk provides a comprehensive and representative measurement of the types, amounts, prices, locations and nutrient composition of consumer packaged goods foods and beverages consumed in the United States. This system has potential to be a major step forward in understanding the consumer packaged goods sector of the US food system and the impacts of the changing food environment on human health.