Biogenic amine formation and microbial spoilage in chilled garfish (Belone belone belone)--effect of modified atmosphere packaging and previous frozen storage.

AIMS: To evaluate biogenic amine formation and microbial spoilage in fresh and thawed chilled garfish. METHODS AND RESULTS: Storage trials were carried out with fresh and thawed garfish fillets at 0 or 5 degrees C in air or in modified atmosphere packaging (MAP: 40% CO2 and 60% N2). During storage, sensory, chemical and microbial changes were recorded and histamine formation by isolates from the spoilage microflora was evaluated at 5 degrees C. Photobacterium phosphoreum was responsible for histamine formation (>1000 ppm) in chilled fresh garfish. The use of MAP did not reduce the histamine formation. Strongly histamine-producing P. phosphoreum isolates formed 2080-4490 ppm at 5 degrees C, whereas below 60 ppm was formed by other P. phosphoreum isolates. Frozen storage inactivated P. phosphoreum and consequently reduced histamine formation in thawed garfish at 5 degrees C markedly. CONCLUSIONS: Photobacterium phosphoreum can produce above 1000 ppm of histamine in chilled fresh garfish stored both in air and in MAP. Freezing inactivates P. phosphoreum, extends shelf life and markedly reduces histamine formation in thawed MAP garfish during chilled storage. SIGNIFICANCE AND IMPACT OF THE STUDY: At 5 degrees C, more than 1000 ppm of histamine was formed in garfish; thus even when it is chilled this product represents a histamine fish-poisoning risk.

Microbial spoilage and formation of biogenic amines in fresh and thawed modified atmosphere-packed salmon (Salmo salar) at 2 degrees C.

AIMS: To evaluate the microbial spoilage, formation of biogenic amines and shelf life of chilled fresh and frozen/thawed salmon packed in a modified atmosphere and stored at 2 degrees C. METHODS AND RESULTS: The dominating microflora, formation of biogenic amines and shelf life were studied in two series of storage trials with naturally contaminated fresh and thawed modified atmosphere-packed (MAP) salmon at 2 degrees C. Photobacterium phosphoreum dominated the spoilage microflora of fresh MAP salmon at more than 10(6) cfu g(-1) and the activity of this specific spoilage organism (SSO) limited the shelf life of the product to ca 14 and 21 d in the two experiments. Despite the high levels of P. phosphoreum, less than 20 mg kg(-1) histamine was observed in fresh MAP salmon prior to sensory spoilage. Freezing eliminated P. phosphoreum and extended the shelf life of MAP salmon at 2 degrees C by 1-2 weeks. Carnobacterium piscicola dominated the spoilage microflora of thawed MAP salmon and probably produced the ca 40 mg kg(-1) tyramine detected in this product at the end of its shelf life. CONCLUSIONS: Photobacterium phosphoreum dominated the spoilage microflora of fresh MAP salmon but produced only small amounts of biogenic amines in this product. The elimination of P. phosphoreum by freezing allowed this bacteria to be identified as the SSO in fresh MAP salmon. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification of P. phosphoreum as the SSO in fresh MAP salmon facilitates the development of methods to determine and predict the shelf life of this product, as previously shown with fresh MAP cod.

Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia.

The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory failure requiring MV amongst patients with PCP treated in the era of adjunctive corticosteroid therapy. Furthermore, we studied factors associated with survival in relation to MV. Of 170 consecutive patients with AIDS-related PCP, 18 (11%) required MV. Thirteen of 18 ventilated patients died (72%). In a logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short-term mortality remained high after the introduction of adjunctive corticosteroid therapy. BAL neutrophilia may be a useful prognostic marker to identify patients at high risk of requiring mechanical ventilation.

[Treatment of hepatic encephalopathy with flumazenil]. / Flumazenil til behandling af hepatisk encefalopati.

Hepatic encephalopathy (HE) is the neuropsychiatric syndrome that occurs as a complication to liver failure in patients with acute or chronic liver disease. Mental status in this syndrome can range from subtle deficits to coma, with respiratory insufficiency and aspiration to the lungs. The mortality is high. The pathogenesis of HE is not clearly understood. One theory is that it reflects a metabolic disorder of the brain, developed from neuroactive nitrogenous metabolites in the gut that accumulate in plasma when there is an impaired hepatocellular extraction or porto-systemic shunting. Transient improvement of the condition is seen in a subgroup of patients after administration of flumazenil, a specific benzodiazepine antagonist. The group of patients with a positive response to flumazenil therapy may have a better prognosis. Flumazenil may be used in patients in the pretransplantation phase.

[Long-term oxygen therapy in chronic respiratory insufficiency]. / Langtidsbehandling med ilt ved kronisk respirationsinsufficiens.

The aim of this retrospective study was to investigate the accordance between the indications used for prescription of continuous domiciliary oxygen and the guidelines recommended by the Danish Society of Pulmonary Medicine. Sixty-two patients with chronic hypoxic respiratory insufficiency in chronic domiciliary oxygen therapy were investigated. Only one patient fulfilled all the prescribed recommendations and, in general, there were no registrations of compliance or of follow-ups in the patient records.