Acceptance of brown-shelled eggs in a white-shelled egg market.

Brown eggs have gradually entered the traditional white-egg markets as a distinctive mode for packaging specialty eggs. A test was conducted at the Brigham Young University Sensory Laboratory (Provo, UT) to understand how consumers view attributes of the brown egg relative to the white egg. The objectives were to see how the consumer viewed properties of eggs by color and to examine the preference for brown color intensity. The 52 panelists were all women who routinely purchased and consumed eggs. Some women (53.8%) consumed eggs twice weekly, and 40.4% purchased them at least every 2 wk. Purchases included specialty eggs (14.6%) consisting of cage-free (50.0%), organic (28.6%), and n-3 enhanced (21.4%) eggs. The panelists preferred white eggs (90.4%). Though brown-shelled eggs did not exceed white eggs in preference, they were perceived positively (white-shelled %:brown-shelled %) as being more nutritious (65:29), having more flavor (27:14) and n-3 content (62:39), having a farm-flock origin (46:44), and being from organically fed hens (56:31) To test the preference for shade of brown eggs, a set of 6 eggs with varying intensities of brown color was evaluated for accepted appearance using a 9-point hedonic scale. The egg color intensities were measured using a Hunter Colorflex spectrophotometer (Hunter Associates Laboratory, Reston, VA) and the CIE system. The lightness (L*) values ranged from 83.2 for the white egg to 63.6 to 46.5 for the brown eggs. A significant (P < 0.05) preference was found for the 2 lighter shades of brown-shelled eggs (L* 63.6 and 57.5). Using the 9-point scale, panelists then compared brown eggs side by side with white eggs. Again, the 2 most light-tinted brown eggs were found most comparable with the white egg in acceptability and better (P < 0.05) than the darker brown eggs. In conclusion, white eggs were preferred over brown eggs; however, brown eggs gained in acceptance but did not exceed white as likely to be more nutritious or flavorful, fresher, organic, and of cage-free origin. Varying color shades in cartoned eggs was equally as acceptable as uniform colored eggs. Panelists preferred the appearance of the light-tinted brown eggs to that of darker brown eggs.

Systematic review: Helicobacter pylori and the risk of upper gastrointestinal bleeding risk in patients taking aspirin.

BACKGROUND: Aspirin is widely used to modify the risk of recurrent vascular events. It is, however, associated with increased upper gastrointestinal bleeding risk. The influence of Helicobacter pylori on this risk is uncertain. AIM: To determine the influence of H. pylori on upper gastrointestinal bleeding risk in patients taking aspirin. METHODS: MEDLINE and EMBASE databases were searched. All studies providing data regarding H. pylori infection in adults taking aspirin and presenting with upper gastrointestinal bleeding were included. RESULTS: A total of 13 studies that included 1 case-control, 10 cohort studies and 2 randomized-controlled trials (RCTs) were analysed. The case-control study (n = 245) determined H. pylori to be a significant independent risk factor for upper gastrointestinal bleeding. The cohort studies were heterogeneous, varying in inclusion criteria, doses and duration of aspirin used, mode of H. pylori testing and causative GI pathology considered. Comprising 5465 patients, H. pylori infection was tested for in 163 (0.03%) aspirin users with upper gastrointestinal bleeding. The RCTs yielded no significant results. CONCLUSIONS: The current data are not sufficient to allow meta-analyses. The widely held belief that H. pylori is a risk factor for upper gastrointestinal bleeding in regular aspirin users is not supported by the very limited evidence available.

Osteoma of paranasal sinuses in a horse with inspiratory dyspnoea.

We describe a case of osteoma in the frontal and maxillary sinuses of a 3-year-old Arabian mare, presented due to an inspiratory dyspnoea. The mare underwent two surgical procedures in order to excise the tumour. Twelve months after admission the mare was healthy with no signs of respiratory abnormalities. Sinus radiographs and endoscopy repeated at that time revealed some regrowth of the tumour in the maxillary sinus, however, twenty-two months following surgery the mare did not show clinical signs of upper airway disease.

Dog bite wounds in dogs and cats: a retrospective study of 196 cases.

The age, type, etc., time of injury, body areas injured, treatment modalities and mortality rates were reviewed in 185 dogs and 11 cats that were bitten by dogs. Male dogs were more frequently bitten than females, and small dogs (< or = 10 kg) were not only the most common victims but also were more likely to suffer multiple injuries. Mortality occurred only in cases with thoracic or abdominal injuries. Exploratory thoracotomy, performed in some of the cases presented with penetrating thoracic injury, did not prove to alter prognosis. Cats are not as frequently bitten as dogs, and are often younger than the mean age of cats in the overall hospital population.

The abdominal wall: an overlooked source of pain.

When abdominal pain is chronic and unremitting, with minimal or no relationship to eating or bowel function but often a relationship to posture (i.e., lying, sitting, standing), the abdominal wall should be suspected as the source of pain. Frequently, a localized, tender trigger point can be identified, although the pain may radiate over a diffuse area of the abdomen. If tenderness is unchanged or increased when abdominal muscles are tensed (positive Carnett's sign), the abdominal wall is the likely origin of pain. Most commonly, abdominal wall pain is related to cutaneous nerve root irritation or myofascial irritation. The pain can also result from structural conditions, such as localized endometriosis or rectus sheath hematoma, or from incisional or other abdominal wall hernias. If hernia or structural disease is excluded, injection of a local anesthetic with or without a corticosteroid into the pain trigger point can be diagnostic and therapeutic.

Typical antipsychotics exhibit inverse agonist activity at rat dopamine D1-like receptors expressed in Sf9 cells.

The baculovirus system has been used to express the rat dopamine D1 receptors in Spodoptera frugiperda (Sf9) cells. A panel of typical antipsychotics including, alpha-flupenthixol, fluphenazine and thioridizine were found to inhibit dopamine-dependent stimulation of adenylyl cyclase. However, these compounds were also found to inhibit adenylyl cyclase activity in the absence of agonist in Sf9 cells expressing dopamine D1-like receptors. Therefore, these nonselective dopamine receptor compounds displayed negative intrinsic or inverse agonist activity. None of the compounds tested were neutral antagonists.

Omphalocele in a foal.

An omphalocele was detected at birth in a male Arabian foal. The mass contained small intestine and after releasing a constricting band at the body wall, the contents slipped easily back into the abdomen. On the outside was the hairless pink membrane. The interior, now empty of small intestine, contained the umbilical arteries and vein, and a large urachus that extended from the bladder to the opening at the extremity of the mass. Six days after corrective surgery the foal was sent home and remained healthy.

Clinical features of hepatitis C-infected patients with persistently normal alanine transaminase levels in the Southwestern United States.

Approximately one third of patients with chronic hepatitis C virus (HCV) infection have normal alanine transaminase (ALT) levels. We studied the clinical, biochemical, virological, and histological features in patients with persistently normal ALT. A case-control study was conducted on 275 patients with chronic HCV infection, including 75 patients with persistently normal ALT and 200 patients with abnormal ALT. Persistently normal ALT was defined as 4 consecutive ALT values in each patient within a period of 12 months. The average age of the patients was 44 years (range 18 to 69 years). More non-Hispanic whites had persistently normal ALT. The mean serum ferritin level was significantly lower in patients with persistently normal ALT as compared with abnormal ALT (128 +/- 92 ng/mL and 224 +/- 128 ng/mL), respectively (P =.017). The mean HCV-RNA level was significantly lower in patients with persistently normal ALT as compared with abnormal ALT (12 x 10(5) +/- 2.8 x 10(6) copies/mL and 33 x 10(5) +/- 8.0 x 10(6)), respectively (P =.02). Histologically, patients with persistently normal ALT had less severe portal inflammation (P <.05), lobular inflammation (P =.003), piecemeal necrosis (P =.002), fibrosis (P <.05), lower prevalence of cirrhosis (P =.007), as well as a slower fibrosis progression rate (P <.001). Chronic hepatitis C patients with persistently normal ALT have low-activity grade and stage on liver biopsy. In these patients the hepatitis C RNA level was lower compared with abnormal ALT patients, which may explain the slower fibrosis progression rate.

Free skin grafting for treatment of distal limb skin defects in cats.

The technique and results of free skin grafts have been described in dogs, horses, rabbits, goats and mice. The procedure in cats is, however, described only indirectly in papers relating to dogs. A standard technique has been developed by the authors for use in cats, and is reported for 17 grafts in 16 cats with traumatic injury to the legs resulting in large areas of skin loss. This paper describes the preparation of the wound for grafting, the harvesting of the graft, graft placement, postoperative care and the results of the application of this technique. The success rate in this series of cases was high. This was attributed to proper preparation of the recipient site, collection of the graft and postoperative bandaging. The results suggest that the success rate of free skin grafts in cats is considerably higher than that achieved by the present authors in dogs, and reported for dogs by other surgeons in the literature.

Methotrexate in Crohn's disease: results of a randomized, double-blind, placebo-controlled trial.

BACKGROUND/AIMS: Immunosuppression with methotrexate may be useful in the treatment of Crohn's disease. We tested the efficacy of methotrexate in refractory Crohn's disease in a randomized, controlled trial. METHODOLOGY: Randomized, double-blind placebo-controlled trial of methotrexate in 33 patients with steroid-dependent Crohn's disease, 33% of whom had previously failed therapy with 6-mercaptopurine. Patients were given placebo or oral methotrexate 15 mg/week, or adjusted up to 22.5 mg/week, for up to 1 year or until treatment failure. Outcome was assessed by reduction in prednisone dosage, Crohn's Disease Activity Index, hospital admission, and laboratory parameters. RESULTS: Four patients were dropped from the study for non-compliance and one because of intercurrent illness, and 28 patients could be evaluated. Fewer methotrexate-treated patients (6/13 or 46%) had flares of Crohn's disease as compared to placebo-treated patients (12/15 or 80%), but this did not achieve statistical significance (p<0.1). There was a non-significant trend toward an increased number of significant side effects in the methotrexate-treated patients (3/13 or 23%) as compared to the placebo-treated patients (0/15 or 0%) (p<0.2). Laboratory indices of inflammation did not differ between the two groups. CONCLUSIONS: The methotrexate-treated group showed a trend toward fewer Crohn's disease flares, balanced by an increased number of significant side effects.

A case-control study of risk factors for sporadic hepatitis C virus infection in the southwestern United States.

OBJECTIVE: We performed a case-control study to evaluate risk factors and possible modes of transmission for hepatitis C virus (HCV) infection in patients with no history of blood transfusion or injection drug use. METHODS: Study subjects were selected from among patients seen in gastroenterology outpatient clinics at a university medical center in the southwestern United States. The study group consisted of 58 patients (12%) with chronic HCV infection who reported no history of transfusion or injection drug use, among a total of 477 patients evaluated for a positive HCV antibody test. These 58 patients were matched by age, ethnicity, and gender with 58 control patients diagnosed with gastroesophageal reflux attending the same clinics. Patients and controls were subjected to structured interviews and review of medical records. RESULTS: A variety of variables were significantly associated with increased risk of sporadic HCV infection, including a history of tattoos, needlestick exposure, a history of sexually transmitted disease, intercourse with an injection drug user, five or more lifetime sexual partners, intercourse during menses (for women), lower income, and heavy alcohol intake (>60 g/day). Multivariate analysis identified a history of sexually transmitted disease, heavy alcohol intake, and the presence of a tattoo as independent risk factors for sporadic HCV. In addition, six cases and one control had a history of needlestick exposure. Of the cases, 88% had at least one of these four risk factors, as compared with 26% of controls (odds ratio = 16.5; 95% confidence interval = 4.0-68.8). CONCLUSIONS: A history of sexually transmitted disease, heavy alcohol intake, the presence of tattoos, and a history of needlestick exposure were identified as risk factors for sporadic hepatitis C in this case-control study. If we include all patients with a history of blood transfusion or injection drug use, only 2% of the total 477 HCV patients had no identified risk factors.

Special considerations in interpreting liver function tests.

A number of pitfalls can be encountered in the interpretation of common blood liver function tests. These tests can be normal in patients with chronic hepatitis or cirrhosis. The normal range for aminotransferase levels is slightly higher in males, nonwhites and obese persons. Severe alcoholic hepatitis is sometimes confused with cholecystitis or cholangitis. Conversely, patients who present soon after passing common bile duct stones can be misdiagnosed with acute hepatitis because aminotransferase levels often rise immediately, but alkaline phosphatase and gamma-glutamyltransferase levels do not become elevated for several days. Asymptomatic patients with isolated, mild elevation of either the unconjugated bilirubin or the gamma-glutamyltransferase value usually do not have liver disease and generally do not require extensive evaluation. Overall hepatic function can be assessed by applying the values for albumin, bilirubin and prothrombin time in the modified Child-Turcotte grading system.

A case-control study of the factors associated with spontaneous resolution of hepatitis C viremia.

OBJECTIVE: Infection with the hepatitis C virus (HCV) becomes chronic in 85% of the infected individuals. We studied risk factors that may predict clearance of HCV. METHODS: A case-control study compared the association between risk factors and viral clearance. Viral clearance was defined as presence of a positive HCV antibody test plus negative HCV test by polymerase chain reaction (PCR). Forty-four cases and 214 controls with persistent viremia were identified in a database of patients evaluated at the Gastroenterology Clinic of the University of New Mexico. RESULTS: Of all 258 HCV-antibody-positive patients, 17% had a negative test by PCR. The multivariate logistic regression revealed that a history of parenteral exposure and a long time interval since the most recent exposure were both associated with an increased likelihood of persistent viremia, whereas subjects who had been monogamous for longer time periods were more likely to have cleared HCV from their serum. A low serum level of ferritin also conferred protection against persistent viremia. Case and control subjects did not differ with respect to their demographic characteristics, occurrence of comorbid disease, previous medical history, occurrence of sexually transmitted diseases, blood group, and risky health or sexual practices. CONCLUSIONS: These data suggest that route of exposure and time when exposure occurred are important in the development of persistent HCV infection.

CYP2E1 expression in human lymphocytes from various ethnic populations.

BACKGROUND: Monitoring CYP2E1 levels in alcoholic individuals holds inherent appeal because such determinations might indicate individuals at increased risk for alcoholic liver disease. We previously demonstrated that lymphocyte CYP2E1 expression reflects in vivo activity of the hepatic enzyme. METHODS: To further validate this approach, the current investigation compared lymphocyte CYP2E1 content and chlorzoxazone pharmacokinetics in 51 alcoholic and nonalcoholic White, Navajo, and Mexican American subjects. After an oral dose of chlorzoxazone, blood samples were collected and lymphocytes isolated. RESULTS: Alcoholics exhibited a 2-fold elevation in lymphocyte CYP2E1 messenger ribonucleic acid (mRNA) and protein compared to nonalcoholics. Chlorzoxazone clearance rates were 1.9-fold higher and area under the concentration curve (AUC) values 1.8-fold lower in alcoholic individuals compared to nonalcoholics. Furthermore, chlorzoxazone clearance rates correlated (r = 0.55, p < 0.01, n = 38) with lymphocyte CYP2E1 mRNA content, and transcript levels further correlated (r = 0.52, p < 0.001, n = 38) with CYP2E1 protein content. To compare phenotype with genotype, restriction fragment length polymorphism analyses on deoxyribonucleic acid samples were performed to identify polymorphisms in the CYP2E1 gene. No subjects were homozygous for rare alleles c2 or C. Nonetheless, 27% of the Navajos and 15% of the Mexican Americans were heterozygous for the c2 allele. Two White subjects appeared heterozygous (c1/c2) when RsaI was used to characterize CYP2E1 genotype but homozygous (c1/c1) at the PstI locus. Fifteen percent of Mexican American subjects, 20% of Navajo subjects, and 6% of White subjects were heterozygous for the C allele. Neither CD nor cl/c2 genotypes were associated with alcoholism. CONCLUSIONS: Human lymphocyte CYP2E1 mRNA levels may be useful predictors of alcohol-mediated alterations in hepatic CYP2E1 activity. Moreover, ethnicity does not appear to play a major role in the levels of expression of lymphocyte CYP2E1.

Gastric outlet obstruction with benign endoscopic biopsy should be further explored for malignancy.

BACKGROUND: Gastric outlet obstruction is commonly considered a complication of peptic ulcer disease. Malignancy accounts for up to 39% of gastric outlet obstruction. The object of this study was to evaluate the reliability of endoscopic biopsies in excluding malignancy as the cause of gastric outlet obstruction. METHODS: A retrospective study of 40 consecutive patients admitted with gastric outlet obstruction was conducted. Patient demographics, their use of H2-receptor antagonists or nonsteroidal anti-inflammatory drugs, and history of peptic ulcer disease were recorded. Histopathologic results of the endoscopic biopsy and surgical specimen were reviewed. The diagnosis based on the surgical specimen was considered the gold standard. RESULTS: Sixteen patients (40%) had malignant gastric outlet obstruction. Seven patients had gastric adenocarcinoma and nine had extragastric tumors. The patients with malignant obstruction were significantly older (> 55 years) (p = 0.03; odds ratio: 95% CI: 5.21 [1.05-23.49]). Gastric cancer patients had less frequently a history of peptic ulcer disease when compared with patients with benign gastric outlet obstruction (p = 0.04; odds ratio: 95% CI: 5 [1.04-38.13]). Endoscopic biopsy to detect malignant obstruction had poor sensitivity (i.e., 37%) when compared with biopsies of the surgical specimen. In three of seven patients with gastric cancer (40%), repeated jumbo biopsies were negative for malignancy. CONCLUSION: Patients with gastric outlet obstruction who had endoscopic biopsies negative for cancer should be explored surgically before embarking on medical therapy. The surgical exploration is especially important in gastric outlet obstruction patients who are considered at high risk for malignancy, that is, those who are older and have no history of peptic ulcer disease.