Background: functional gastrointestinal disorders (FGID) are common conditions in children and adults, often associated with abnormalities of whole gut transit. Currently, transit tests can be performed using several imaging methods, including tracking of radiopaque markers, gamma scintigraphy with the use of radioisotopes, magnetic tracking methods, tracking of movement of wireless motility capsules, and emerging magnetic resonance imaging (MRI) approaches. Objectives: to review recent literature on diagnostic imaging techniques used to investigate whole gut transit in FGIDs. Methods: a systematic review was carried out. The different techniques are described briefly, with particular emphasis on contemporary literature and new developments, particularly in the field of MRI. Conclusions: emerging MRI capsule marker methods are promising new tools to study whole gut transit in FGIDs.
Background: Functional constipation in children is common. Management of this condition can be challenging and is often based on symptom reports. Increased, objective knowledge of colonic volume changes in constipation compared to health could provide additional information. However, very little data on paediatric colonic volume is available except from methods that are invasive or require unphysiological colonic preparations. Objectives: (1) To measure volumes of the undisturbed colon in children with functional constipation (FC) using magnetic resonance imaging (MRI) and provide initial normal range values for healthy controls, and (2) to investigate possible correlation of colonic volume with whole gut transit time (WGTT). Methods: Total and regional (ascending, transverse, descending, sigmoid, and rectum) colon volumes were measured from MRI images of 35 participants aged 7–18 years (16 with FC and 19 healthy controls), and corrected for body surface area. Linear regression was used to explore the relationship between total colon volume and WGTT. Results: Total colonic volume was significantly higher, with a median (interquartile range) of 309 mL (243–384 mL) for the FC group than for the healthy controls of 227 mL (180–263 mL). The largest increase between patients and controls was in the sigmoid colon–rectum region. In a linear regression model, there was a positive significant correlation between total colonic volume and WGTT (R = 0.56, p = 0.0005). Conclusions: This initial study shows increased volumes of the colon in children with FC, in a physiological state, without use of any bowel preparation. Increased knowledge of colonic morphology may improve understanding of FC in this age group and help to direct treatment.
Background: 99mTc-sestamibi single photon emission tomography (SPECT) method is widely used for imaging coronary artery disease (CAD). 82-Rubidium-PET is an alternative method that can be used to perform the same purpose. Purpose/Aim: This study aims to determine whether 82-Rubidium-PET can offer extra value over 99mTc-sestamibi SPECT in imaging CAD. Methods: To achieve the study aim, a systematic review of the literature for the 2 tracers were conducted. The aim of the systemic review was to find every related previous study that corresponded to well-defined scientific criteria. The analysis of the results was restricted to peer-reviewed papers in order to avoid any selective outcome reports. Besides, extra analysis was carried out to curb or avoid any ascertainment bias. The qualified studies selected for this research were then assessed for the risk of bias. Furthermore, the details of the methods were rechecked to ensure that they were comparable, before synthesizing the results. Results: Eighteen original studies were selected and included in the final analysis out of 803 articles identified at the initial research. Overall, the mean value of sensitivity and specificity for diagnosis of CAD was 84.3% and 75.4%, respectively for technetium 99m sestamibi (99mTc-MIBI). On the other hand, for 82-Rubidium-PET, the mean value of sensitivity and specificity for diagnosis of CAD was 81% and 81%, respectively. The accuracy of diagnostics of these imaging modalities was dependent on the radiotracers and stress agent used in these studies, with 99mTc-MIBI achieving the highest diagnostic value. Conclusion: This study concludes that 99mTc-MIBI-SPECT has higher diagnostic value for diagnosing CAD compared to 82-Rubidium-PET. This indicates that 99mTc-MIBI-SPECT is a more valuable technique for predicting CAD. Besides, for the stress agents used to stimulate the heart and increase workload, this research/study recommends the use of adenosine for the SPECT and the use of dipyridamole for positron emission tomography. However, it suggests the need for more systemic and theoretical studies to assess the real value of 82-Rubidium-PET and the value of stress agents.
Milk structural assemblies (e.g., casein micelles) occur naturally and can be altered during processing, and this may influence the milk’s nutritional properties. Heat treatment of dairy ensures microbiological safety and extends shelf-life. Both pasteurisation and ultra-high temperature (UHT) processing are known to alter natural structural assemblies, but despite widespread use, only four human studies have addressed how heat treatment affects nutrient delivery. In vitro, animal, and human models have all shown more rapid nutrient release or appearance from UHT vs. pasteurised milk, with altered gastric emptying rate proposed as a mechanism. We hypothesised that differences in bovine milk structural assemblies arising from different processing methods would speed up gastric emptying and nutrient delivery following consumption of UHT relative to pasteurised milk. A randomised double-blind crossover trial assessed gastric emptying rate (using magnetic resonance imaging measuring gastric content volume) over 3 h and plasma amino acid appearance (using ultra-performance liquid chromatography) over 5 h following 500 mL of each milk in healthy women (n = 20). Gastric electrical activity was measured using body surface gastric mapping, and abdominal distension using stretch sensors. The time to empty 25% of the stomach contents was greater following UHT vs. pasteurised milk (45 ± 4 vs. 33 ± 4 min p < 0.05). While gastric content remained greater for longer following UHT milk, the incremental area under the curve of plasma essential amino acids was greater than pasteurised milk (55324 ± 3809 vs. 36598 ± 5673 μmol·min·L−1p < 0.05). The greater amino acid appearance following UHT milk aligns with more rapid release of proteins from the gastric curd observed in vitro, yet the greater gastric content volume implies gastric content composition (e.g., solid vs. liquid) is an important determinant of nutrient release. Dairy processing using different heat treatments, which induced structural modifications, impacted gastric emptying and plasma amino acid appearance, with implications for appetite regulation and nutrient utilisation for metabolism.