A Comparative Study of Four Oral Contrast Agents for Small Bowel Distension with Computed Tomography Enterography.

PURPOSE: To assess the efficacy of a variety of oral contrast agents in obtaining small bowel distention for computed tomography (CT) enterography examinations. METHODS: A retrospective study was developed to quantitatively assess small bowel luminal distension during CT enterography by using 4 contrast agents, which included water, Metamucil, polyethylene glycol, and lactulose. A total of 256 patients were enrolled in the study and included 64 individuals for each oral regimen. The widest loop of small bowel in each of 4 quadrants on representative coronal images was separately measured for luminal distension. Overall distension and the greatest number of "useful" quadrants were evaluated. Overall distension was calculated by summing the 4 quadrant values into an overall luminal diameter distention score (cm). A "useful" quadrant was defined as having a measurement of ≥2 cm. Each "useful" quadrant was assigned a score of 1, with values that ranged from 0-4. RESULTS: For overall distension, multivariable liner regression analysis showed that the lactulose group had a significantly higher overall distension value than Metamucil, polyethylene glycol, and water by 0.88, 0.92, and 1.63 cm, respectively, with 95% confidence interval. The categorical multivariable logistic regression analysis showed that the lactulose group had greater odds of having more "useful" quadrants than the Metamucil, polyethylene glycol, and water groups, with odds ratios of 3.51, 2.68, and 9.19, respectively. CONCLUSION: Lactulose achieves better small bowel distension for CT enterography studies than the other 3 agents and, therefore, is the preferred oral regimen at our institution.

Differentiation of fresh and frozen/thawed fish, European sea bass (Dicentrarchus labrax), gilthead seabream (Sparus aurata), cod (Gadus morhua) and salmon (Salmo salar), using volatile compounds by SPME/GC/MS.

BACKGROUND: A simple method based on solid phase microextraction/gas chromatography/mass spectrometry (SPME/GC/MS) was applied for studying the volatile profiles of whole fish samples of European sea bass (Dicentrarchus labrax) and gilthead seabream (Sparus aurata) and fillets of cod (Gadus morhua) and salmon (Salmo salar) during frozen storage in order to be able to differentiate a fresh product from one that has been frozen. Analysis of volatile compounds was performed on these two product types, fresh and after freezing/thawing following storage at - 20 °C for 30 and 90 days. RESULTS: More than a hundred volatile compounds were found by SPME/GC/MS. Statistical processing by principal component analysis and ascending hierarchical classification was used to classify the samples into categories and verify the possibility of separating fresh samples from those that had been frozen and thawed. The compounds to be used as differentiators were identified. Four compounds were common to all species: dimethyl sulfide, 3-methylbutanal, ethyl acetate and 2-methylbutanal. Not only were they found in larger quantities after thawing but they also increased with the duration of storage at - 20 °C. CONCLUSION: These four compounds can therefore be considered as potential markers of differentiation between a fresh product and one that has been frozen.

Freshness characterisation of whiting (Merlangius merlangus) using an SPME/GC/MS method and a statistical multivariate approach.

BACKGROUND: The freshness of whiting was studied at five stages of ice storage by comparing the analysis of volatile compounds obtained through solid phase microextraction/gas chromatography/mass spectrometry (SPME/GC/MS) with two sensory methods. RESULTS: Of the volatile compounds identified, 38 were analysed using a statistical multivariate approach and classified according to their role in the estimation of freshness during storage as markers of freshness or spoilage. Regarding the evolution of the presence or absence of individual compounds, three categories were defined. For example, the volatile compounds propanal, hexanal, 1-penten-3-ol, pentanal, 2,3-pentanedione, 1-penten-3-one, heptanal, (E)-2-pentenal, 2,3-octanedione, (Z)-2-penten-1-ol, 1-pentanol, butanal, octanal, 3,5,5-trimethyl-2-hexene, 1-hexanol and 4,4-dimethyl-1,3-dioxane appeared highly relevant, because they are found throughout storage and can be divided into several categories that are directly related to the quality of fish. CONCLUSION: SPME/GC/MS combined with a statistical multivariate approach may be a useful method to identify volatile compounds and characterise fish freshness during storage.

Sensory and physicochemical evolution of tropical cooked peeled shrimp inoculated by Brochothrix thermosphacta and Lactococcus piscium CNCM I-4031 during storage at 8°C.

This study investigated the sensory quality and physicochemical evolution (pH, glucose, l-lactic acid, biogenic amine, free amino-acids and volatile compounds) during storage at 8°C of cooked peeled shrimp inoculated with the specific spoilage bacteria Brochothrix thermosphacta alone or mixed with the protective strain Lactococcus piscium CNCM I-4031. Growth of both bacteria was monitored at regular intervals during storage by microbial counts and the thermal temperature gradient gel electrophoresis (TTGE) technique. Bacterial counts showed that L. piscium and B. thermosphacta inoculated at 7 log CFU/g and 3 log CFU/g were well adapted to shrimp, reaching a maximum level of 9 log CFU/g after 4days and 10days respectively. In mixed culture, the growth of B. thermosphacta was reduced by 3.2±0.1 log CFU/g. The TTGE technique allowed monitoring the colonisation of the strains on the shrimp matrix and confirming the dominance of L. piscium in mixed culture throughout the experiment. Sensory analysis confirmed that B. thermosphacta spoiled the product after 11days, when its cell number attained 8 log CFU/g with the emission of strong butter/caramel off-odours. This sensory profile could be linked to the production of 2,3 butanedione, cyclopentanol, 3-methylbutanol, 3-methylbutanal, 2-methylbutanal, 4-methyl-3-chloro-3-pentanol and ethanol, which were produced in more significant quantities in the B. thermosphacta batch than in the batches in which the protective strain was present. On the contrary, TVBN and TMA were not suitable as quality indicators for B. thermosphacta spoilage activity. In the products where the protective L. piscium strain was present, no adverse effect on sensory quality was noted by the sensory panels. Moreover, biogenic amine assessment did not show any histamine or tyramine production by this strain, underlining its safety profile. Both strains produced lactic acid (1850mg/kg in L. piscium and B. thermosphacta batch on days 3 and 10 respectively; 3830mg/kg on day 7 in mixed culture) and the pH decrease from 6.6±0.0 to 5.9±0.1 was similar in all batches. Lactic acid production or competition for free amino-acid was not involved in the inhibition mechanism; however rapid glucose consumption by L. piscium could partially explain the growth limitation of the spoilage micro-organism. This study demonstrated the spoilage characteristic of B. thermosphacta and the usefulness of L. piscium as a bioprotective culture for tropical cooked peeled shrimp without any adverse effect on the sensory quality of the product.

Unusual presentation of a complication after pulmonary wedge resection for coccidioma.

We report an unusual presentation of a complication after pulmonary wedge resection. A patient with a history of pulmonary wedge resection for coccidioma presented postoperatively with dyspnea and severe hypoxemia. Cerebral infarctions were diagnosed less than 1 year later. Cardiac magnetic resonance imaging and pulmonary angiogram revealed a pulmonary arteriovenous fistula. Surgical resection of the pulmonary arteriovenous fistula led to improved oxygen saturation and discontinuation of home oxygen.