a on behalf of the Swiss IBDnet, an official working group of the Swiss Society of Gastroenterology

GoCARB is a computer vision-based smartphone system designed for individuals with Type 1 Diabetes to estimate plated meals’ carbohydrate (CHO) content. We aimed to compare the accuracy of GoCARB in estimating CHO with the estimations of six experienced dietitians. GoCARB was used to estimate the CHO content of 54 Central European plated meals, with each of them containing three different weighed food items. Ground truth was calculated using the USDA food composition database. Dietitians were asked to visually estimate the CHO content based on meal photographs. GoCARB and dietitians achieved comparable accuracies. The mean absolute error of the dietitians was 14.9 (SD 10.12) g of CHO versus 14.8 (SD 9.73) g of CHO for the GoCARB (p = 0.93). No differences were found between the estimations of dietitians and GoCARB, regardless the meal size. The larger the size of the meal, the greater were the estimation errors made by both. Moreover, the higher the CHO content of a food category was, the more challenging its accurate estimation. GoCARB had difficulty in estimating rice, pasta, potatoes, and mashed potatoes, while dietitians had problems with pasta, chips, rice, and polenta. GoCARB may offer diabetic patients the option of an easy, accurate, and almost real-time estimation of the CHO content of plated meals, and thus enhance diabetes self-management.

No abstract

A risk of cross-contamination exists when preparing a gluten-free (GF) meal in kitchen facilities that usually handle gluten-containing (GC) foods. Cross-contamination with gluten may occur during the preparation or cooking process; however, published data are lacking on gluten cross-contamination from kitchenware. This study was conducted to determine whether cross-contamination occurs through shared domestic kitchenware and, if so, which cleaning method is most reliable for avoiding this cross-contamination. Kitchenware (wooden spoon, colander, ladle, and knife) previously used to cook and/or prepare GC foods was used for the preparation of GF foods (bread and pasta). The gluten concentration of the GF foods was then determined using an established enzyme-linked immunosorbent assay. A PCR assay was also used to detect the presence of wheat ω-gliadin DNA in the food samples. Three cleaning methods were assessed to determine the concentrations of gluten and wheat DNA in GF foods cooked with utensils cleaned directly after the preparation of GC foods. Contrary to our expectations, gluten was not detected in relevant and quantifiable amounts in our samples (<20 mg/kg). The cleaning method used did not influence gluten concentrations: all samples contained <10 mg/kg. Based on PCR analyses, the only sample with lower cycle threshold ( C) values (i.e., higher concentration of wheat DNA) was from the contaminated ladle used to serve GF pasta. This outcome led to the hypothesis that shared ladles pose a higher risk for contamination of GF foods than do shared wooden spoons, colanders, or knives. Cross-contamination with gluten in a kitchen environment may occur, but kitchen utensils used for preparing GC pasta and for cutting GC bread should not pose a relevant problem to patients with celiac disease, at least in a domestic environment.

Zusammenfassung: Funktionelle Dyspepsie (FD) und Reizdarm-Syndrom (RDS), zwei häufige gastro-intestinale Entitäten mit überlappenden Symptomen, sollten nach den Rom-IV-Kriterien diagnostiziert werden. Dabei handelt es sich um eines oder mehrere der folgenden Symptome: bei FD um postprandiales Völlegefühl, frühes Sättigungsgefühl, Schmerzen oder Brennen epigastral; bei RDS um rezidivierende abdominale Schmerzen jeweils assoziiert mit Defäkation, Veränderungen der Stuhlfrequenz oder der Stuhlform. Zum Ausschluss struktureller Krankheiten ist auf Alarmsymptome zu achten. Für die Therapie bewährt sich bei beiden Krankheiten ein Stufenschema. Stufe 1: Arzt-Patienten-Gespräch mit Erläuterung von Diagnose und Prognose sowie Klärung der Therapieziele; Optimierung des Lebensstils; Einsatz von Phytotherapeutika; Stufe 2: Symptomorientierte Medikamente: bei FD Protonenpumpenhemmer bzw. Prokinetika; bei RDS Spasmolytika, Sekretagoga, Laxanzien, Gallensäurebinder, Antidiarrhoika, Antibiotika, Probiotika; Stufe. 3: viszerale Analgetika (Antidepressiva).