Obstructive Bezoars of the Small Bowel Treated with Coca-Cola Zero through a Long Intestinal Tube and Endoscopic Manipulation.

PubMed

Endo, Kei; Kakisaka, Keisuke; Suzuki, Yuji; Matsumoto, Takayuki; Takikawa, Yasuhiro

2017-11-15

An 82-year-old Japanese man visited our hospital with abdominal fullness accompanied by lower abdominal pain. He presented with small bowel obstruction due to multiple diospyrobezoars. The bezoars were successfully removed without any surgical intervention by the administration of Coca-Cola Zero through a long intestinal tube and subsequent endoscopic manipulation. Such a combination may be the treatment of choice for small bowel obstruction due to bezoars.

Obstructive Bezoars of the Small Bowel Treated with Coca-Cola Zero through a Long Intestinal Tube and Endoscopic Manipulation

PubMed Central

Endo, Kei; Kakisaka, Keisuke; Suzuki, Yuji; Matsumoto, Takayuki; Takikawa, Yasuhiro

2017-01-01

An 82-year-old Japanese man visited our hospital with abdominal fullness accompanied by lower abdominal pain. He presented with small bowel obstruction due to multiple diospyrobezoars. The bezoars were successfully removed without any surgical intervention by the administration of Coca-Cola Zero through a long intestinal tube and subsequent endoscopic manipulation. Such a combination may be the treatment of choice for small bowel obstruction due to bezoars. PMID:28943577

Small-bowel obstruction secondary to bezoar impaction: a diagnostic dilemma.

PubMed

Ho, Thomas W; Koh, Dean C

2007-05-01

Gastrointestinal bezoar (GIB) is uncommon and is reported to occur in 4% of all admissions for small-bowel obstruction (SBO). Because of a lack of diagnostic features, it is often associated with a delay in treatment, with increased morbidity. In this article, we report our experience with managing bezoar-induced SBO and the role of early computed tomography (CT) imaging in establishing the diagnosis. We retrospectively reviewed all cases of bezoar-induced SBO treated in our unit between 1999 and 2005. There were 43 patients, of whom 2 had a recurrence, giving a total of 45 episodes. The frequency of bezoar in our patients presenting with SBO was 4.3%. All patients were of Asian origin: 41 Chinese, 1 Indian, and 1 Malay. Twenty-eight (65%) patients had previous abdominal surgery of which 26 were gastric surgery. Thirty-eight (88%) patients were edentulous. Forty-one (91%) underwent serial abdominal radiography, whereas only 4 patients (9%) had either CT imaging or contrast study alone. Only 11 (24%) cases had a correct diagnosis of bezoar impaction made preoperatively by CT imaging. The diagnostic accuracy of CT imaging in our series was 65%, with six cases of misdiagnosis. Overall, CT led to a change in management of 76% (13 in 17). The median time to surgery from admission was 2 (0-10) days. There were 2 cases of ischemic bowel that necessitated bowel resection. The median length of hospital stay was 11 (5-100) days. Ten patients (22%) had postoperative complications, and there was one death. Bezoar-induced SBO is uncommon and remains a diagnostic and management challenge. It should be suspected in patients with an increased risk of formation of GIB, such as previous gastric surgery, poor dentition, and a suggestive history of increased fibre intake. We advocate that CT imaging be performed early in these at-risk patients and in patients presenting with SBO with or without a history of abdominal surgery in order to reduce unnecessary delays before appropriate surgical intervention.

An unusual cause of small bowel obstruction in children: lentil soup bezoar

PubMed Central

Plataras, Christos; Sardianos, Nektarios; Vlatakis, Stephanos; Nikas, Konstantinos

2014-01-01

Bezoars are an unusual cause of acute intestinal obstruction in children. Most cases are trichobezoars in adolescent girls who swallow their hair. Lactobezoars are another unusual but occasionally reported cause of intestinal obstruction in neonates. Phytobezoars and food bolus bezoars are the least common types of intestinal obstruction that have been reported in children. Of the few paediatric cases that have been described, the majority involve persimmons. Moreover, all of these cases involve the ingestion of raw fibres or fruit that have not been cooked. We report a case of a girl who presented with acute ileal obstruction because of lentil soup bezoar. Given the wide use of this otherwise nutritional foodstuff, we highlight the danger from its inappropriate preparation to the health of children. This is the first reported case of intestinal obstruction caused by lentils in children and we hope to raise concern among paediatricians regarding this matter. PMID:24692381

The tethered bezoar as a delayed complication of laparoscopic Roux-en-Y gastric bypass: a case report.

PubMed

Pratt, Janey S A; Van Noord, Michael; Christison-Lagay, Emily

2007-05-01

Known complications of Roux-en-Y gastric bypass causing abdominal pain and obstructive symptoms include biliary colic, anastomotic ulcer, anastomotic stenosis, or internal hernia. This case report describes a new complication in a patient 15 months post-bypass: a bezoar at the gastrojejunal anastomosis, the nidus of which was a length of permanent suture material which had eroded through the gastric wall. We include endoscopic images of the bezoar, a review of the related gastric bypass literature, and describe the changes made in our practice as a result of this complication.

Cellulase, Coca-Cola®, pancreatin and ursodeoxycholic acid in the dissolution of gastric bezoars: why not all together?

PubMed

Cerezo Ruiz, Antonio; Domínguez Jiménez, José Luis; Uceda-Vaño, Antonio

2018-06-14

Two cases of a chemical dissolution of gastric phytobezoars are presented. The novel approach of that management is the pharmacological mixture than completely made disappear the bezoars in patients fated to surgery removal.

Endoscopic Removal of a Giant Gastric Bezoar in a Gastric pouch Diverticulum

DTIC Science & Technology

2017-08-15

hair ), pharmacobezoars (medications), mid laclobezoars (milk). This is a case of a giant phytobezoar. requiring endoscopic rein oval. 1S. SUBJECT...classified into four types, depending on the material constituting the indigestible mass of the bezoar: phytobezoars (plants), trichobezoars ( hair

[A 67-year old man with epigastric pain].

PubMed

Greger, A; Hamelmann, W; Konermann, M

2017-11-01

A 67-year-old man suffering from epigastric pain showed a phytobezoar in the endoscopy. Therapy with Coca Cola® and enzymes was initiated. The (partial) lysis led to a migration of the bezoar into the ileum, resulting in a small bowel obstruction. After removal of the remaining bezoar via ileotomy a secondary pneumatosis intestinalis occurred. As a rare finding the (phyto-)bezoar should be considered as a differential diagnosis of abdominal pain - especially considering the rising numbers of bariatric surgery, which is a potential risk factor. Furthermore, intestinal obstruction after migration has to be considered as a relevant complication of treatment.

Invasive fungal bezoar requiring partial cystectomy.

PubMed

Sundi, Debasish; Tseng, Kenneth; Mullins, Jeffrey K; Marr, Kieren A; Hyndman, Matthew Eric

2012-02-01

A 67-year-old man developed dysuria and position-dependent obstructive voiding symptoms after undergoing holmium laser ablation of the prostate (HOLAP) for benign prostatic hypertrophy. A large fungal (candidal) ball adherent to the bladder wall was removed by loop excision, but the bezoar recurred in 2 weeks despite systemic fluconazole and intravesical amphotericin B. A second attempt at endoscopic removal with ultrasonic lithotripsy, endoscopic graspers, and fulguration was also unsuccessful. The patient underwent open partial cystectomy to remove his invasive fungal bezoar. Convalescence was unremarkable. Urinalysis, culture, and follow-up cystoscopy after partial cystectomy demonstrated successful definitive treatment of the fungal ball. Copyright © 2012 Elsevier Inc. All rights reserved.

[Two cases of phytobezoars treated by adminsitration of Coca-Cola by oral route].

PubMed

Lee, Hyun Jai; Kang, Hyoun Goo; Park, Se Young; Yi, Chea Yong; Na, Gyoung Jun; Lee, Tae Yeong; Kim, Sang Hyun; Song, Chul Soo

2006-12-01

Bezoars are concretions of foreign bodies found in the gastrointestinal tract. In the past, most common method for the treatment of bezoar was surgical management. However, the current treatment methods include chemical dissolution and endoscopic mechanical lithotripsy. There were few reports on the treatment of phytobezoars by nasogastric Cola lavage. However, there was no report succeeded by oral route alone. In our two cases, phytobezoars were treated by oral administration of Coca-Cola. Our patients drank 700-800 mL of Coca-Cola daily, and after two months, complete dissolutions of bezoars were achieved. We report two cases of phytobezoars completely treated by drinking Coca-Cola.

Renal fungal bezoar owing to Geotrichum candidum

PubMed Central

Yegneswaran Prakash, Peralam; Seetaramaiah, Venkatesh K; Thomas, Joseph; Khanna, Vinay; Rao, Sugandhi P

2012-01-01

Geotrichum candidum is yeast like fungi that cause infections in immunocompromised patients. We report a case of renal fungal ball with Geotrichum candidum in a 27 yr. old women post-partum. This case to our knowledge is the first case of renal fungal bezoar due to Geotrichum candidum reported in India. PMID:27330935

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum – Report of a case

PubMed Central

Pergel, Ahmet; Yucel, Ahmet Fikret; Aydin, Ibrahim; Sahin, Dursun Ali

2012-01-01

INTRODUCTION Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. PRESENTATION OF CASE The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5 cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. DISCUSSION Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. CONCLUSION For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases. PMID:22659120

Successful endoscopic treatment of gastric phytobezoar: A case report.

PubMed

Ugenti, Ippazio; Travaglio, Elisabetta; Lagouvardou, Elpiniki; Caputi Iambrenghi, Onofrio; Martines, Gennaro

2017-01-01

Gastric bezoars are a rare condition associated with situations of gastric dysmotility and prior gastric surgery, though sometimes they can present without any risk factor. We describe the first successful treatment in medical literature of a large gastric bezoar in the outpatient setting through endoscopic fragmentation. A 76-year-old man was referred to our outpatient endoscopy clinic because of dyspepsia and epigastric pain. Upper GI endoscopy with a standard endoscope revealed a 10-cm-diameter gastric phytobezoar with necrotic pressure ulcer of the angulus. We fragmentized the bezoar into smaller pieces, with complete dissolution and without any complication. The patient was then promptly discharged home with a medical therapy. Follow-up endoscopy at 6 months showed the total disappearance of any residual fibers. Different types of bezoars are described in literature, of which phyto- and trychobezoars are the most frequent. They can be absolutely asymptomatic or can arise with epigastric pain, pressure ulcer bleeding, gastrointestinal perforation or small bowel obstruction. The treatment is debated though endoscopic removal or fragmentation with the help of Coca-Cola lavages has showed the best success rate. The main experiences in literature concern hospitalized patients or describe treatment techniques which require overnight stays. An effective and rapid treatment in the outpatient setting is described in our experience, without short- or long-term complications. The endoscopic fragmentation of large gastric bezoars in the outpatient setting is safe with a good clinical course. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Coconut matting bezoar identified by a combined analytical approach.

PubMed Central

Levison, D A; Crocker, P R; Boxall, T A; Randall, K J

1986-01-01

A rare type of bezoar composed of coconut matting was found in the stomach of a caucasian man. The exact identity of the fibres was established by scanning electron microscopy, x-ray energy spectroscopy, and microscopic infrared spectroscopy. This report illustrates the importance of these techniques for identifying the nature of foreign material. Images PMID:3950038

Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola.

PubMed

Chung, Y W; Han, D S; Park, Y K; Son, B K; Paik, C H; Jeon, Y C; Sohn, J H

2006-07-01

A diospyrobezoar is a type of phytobezoar that is considered to be harder than any other types of phytobezoars. Here, we describe a new treatment modality, which effectively and easily disrupted huge gastric diospyrobezoars. A 41-year-old man with a history of diabetes mellitus was admitted with lower abdominal pain and vomiting. Upper gastrointestinal endoscopy revealed three huge, round diospyrobezoars in the stomach. He was made to drink two cans of Coca-Cola every 6 h. At endoscopy the next day, the bezoars were partially dissolved and turned to be softened. We performed direct endoscopic injection of Coca-Cola into each bezoar. At repeated endoscopy the next day, the bezoars were completely dissolved.

Laparoscopic treatment of a phytobezoar in the duodenal diverticulum - Report of a case.

PubMed

Pergel, Ahmet; Yucel, Ahmet Fikret; Aydin, Ibrahim; Sahin, Dursun Ali

2012-01-01

Primer small intestine bezoar is seen rarely. It frequently arises from underlying small intestine pathologies (diverticle, tumor, stricture etc.). We report a very rare case of disopyrobezoar in the duodenal diverticulum, a kind of phytobezoar caused by persimmons, which was treated laparoscopically. The 47-year-old patient applied to polyclinic with complaints of epigastric tenderness, occasional distension, and acid regurgitation. In endoscopical examination, impacted bezoar was determined in the diverticulum in the duodenum. Because it is too hard, it was unable to remove endoscopically. On the abdominal tomography, a smooth-bounded non-homogeneous mass including gas and soft tissue areas in the 2nd portion of the duodenum was detected. A barium meal confirmed the presence of a 5cm diameter diverticulum on the lateral wall of the second portion of the duodenum. It also showed an intraluminalfilling defect as well as the mottled appearance of the bezoar. Learned from history of the patient, that the patient consumed over persimmon in childhood. Generally, duodenal diverticles are asymptomatic. Surgical treatment is rarely necessary because of complications such as bleeding, perforation, abdominal pain, bezoar formation. As well as using methods such as gastric lavage, enzymatic dissolution, endoscopical fragmentation in the treatment of phytobezoar, their chances of success are low because its structure is rigid. Usually, surgical intervention is required. For the treatments of bezoar cases located in the small intestine, laparoscopic surgical method is a safe and feasible method in selected cases. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Efferent limb of gastrojejunostomy obstruction by a whole okra phytobezoar: Case report and brief review

PubMed Central

Zin, Thant; Maw, Myat; Pai, Dinker Ramananda; Paijan, Rosaini Binti; Kyi, Myo

2012-01-01

A phytobezoar is one of the intraluminal causes of gastric outlet obstruction, especially in patients with previous gastric surgery and/or gastric motility disorders. Before the proton pump inhibitor era, vagotomy, pyloroplasty, gastrectomy and gastrojejunostomy were commonly performed procedures in peptic ulcer patients. One of the sequelae of gastrojejunostomy is phytobezoar formation. However, a bezoar causing gastric outlet obstruction is rare even with giant gastric bezoars. We report a rare case of gastric outlet obstruction due to a phytobezoar obstructing the efferent limb of the gastrojejunostomy site. This phytobezoar which consisted of a whole piece of okra (lady finger vegetable) was successfully removed by endoscopic snare. To the best of our knowledge, this is the first case of okra bezoar-related gastrojejunostomy efferent limb obstruction reported in the literature. PMID:22624073

How good is cola for dissolution of gastric phytobezoars?

PubMed

Lee, Beom-Jae; Park, Jong-Jae; Chun, Hoon-Jai; Kim, Ji-Hoon; Yeon, Jong-Eun; Jeen, Yoon-Tae; Kim, Jae-Seon; Byun, Kwan-Soo; Lee, Sang-Woo; Choi, Jae-Hyun; Kim, Chang-Duck; Ryu, Ho-Sang; Bak, Young-Tae

2009-05-14

To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars. A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola. After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent complete dissolution (P = 0.006). Gender, symptom duration, size of bezoar and method of cola administration were not significantly different between the two groups. Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation. The rate of complete dissolution with three liters of cola was 23.5%, but no case of diospyrobezoar was completely dissolved using this method. However, pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.

How good is cola for dissolution of gastric phytobezoars?

PubMed Central

Lee, Beom Jae; Park, Jong-Jae; Chun, Hoon Jai; Kim, Ji Hoon; Yeon, Jong Eun; Jeen, Yoon Tae; Kim, Jae Seon; Byun, Kwan Soo; Lee, Sang Woo; Choi, Jae Hyun; Kim, Chang Duck; Ryu, Ho Sang; Bak, Young-Tae

2009-01-01

AIM: To evaluate the efficacy of cola treatment for gastric phytobezoars, including diospyrobezoars. METHODS: A total of 17 patients (range: 48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed. Three liters of cola lavage (10 cases) or drink (7 cases) were initially used, and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare. The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola. RESULTS: After 3 L of cola lavage or drinking, a complete dissolution of bezoars was achieved in four patients (23.5%), while 13 cases (76.5%) were only partially dissolved. Phytobezoars (4 of 6 cases) were observed more frequently than diospyrobezoars (0 of 11) in the group that underwent complete dissolution (P = 0.006). Gender, symptom duration, size of bezoar and method of cola administration were not significantly different between the two groups. Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation. CONCLUSION: The rate of complete dissolution with three liters of cola was 23.5%, but no case of diospyrobezoar was completely dissolved using this method. However, pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars. PMID:19437568

Differentiation of various traditional Chinese medicines derived from animal bile and gallstone: simultaneous determination of bile acids by liquid chromatography coupled with triple quadrupole mass spectrometry.

PubMed

Qiao, Xue; Ye, Min; Pan, De-lin; Miao, Wen-juan; Xiang, Cheng; Han, Jian; Guo, De-an

2011-01-07

Animal biles and gallstones are popularly used in traditional Chinese medicines, and bile acids are their major bioactive constituents. Some of these medicines, like cow-bezoar, are very expensive, and may be adulterated or even replaced by less expensive but similar species. Due to poor ultraviolet absorbance and structural similarity of bile acids, effective technology for species differentiation and quality control of bile-based Chinese medicines is still lacking. In this study, a rapid and reliable method was established for the simultaneous qualitative and quantitative analysis of 18 bile acids, including 6 free steroids (cholic acid, chenodeoxycholic acid, deoxycholic acid, lithocholic acid, hyodeoxycholic acid, and ursodeoxycholic acid) and their corresponding glycine conjugates and taurine conjugates, by using liquid chromatography coupled with tandem mass spectrometry (LC/MS/MS). This method was used to analyze six bile-based Chinese medicines: bear bile, cattle bile, pig bile, snake bile, cow-bezoar, and artificial cow-bezoar. Samples were separated on an Atlantis dC₁₈ column and were eluted with methanol-acetonitrile-water containing ammonium acetate. The mass spectrometer was monitored in the negative electrospray ionization mode. Total ion currents of the samples were compared for species differentiation, and the contents of bile acids were determined by monitoring specific ion pairs in a selected reaction monitoring program. All 18 bile acids showed good linearity (r² > 0.993) in a wide dynamic range of up to 2000-fold, using dehydrocholic acid as the internal standard. Different animal biles could be explicitly distinguished by their major characteristic bile acids: tauroursodeoxycholic acid and taurochenodeoxycholic acid for bear bile, glycocholic acid, cholic acid and taurocholic acid for cattle bile, glycohyodeoxycholic acid and glycochenodeoxycholic acid for pig bile, and taurocholic acid for snake bile. Furthermore, cattle bile, cow-bezoar, and artificial cow-bezoar could be differentiated by the existence of hyodeoxycholic acid and the ratio of cholic acid to deoxycholic acid. This study provided bile acid profiles of bile-based Chinese medicines for the first time, which could be used for their quality control. Copyright © 2010 Elsevier B.V. All rights reserved.

A Large-Sized Phytobezoar Located on the Rare Site of the Gastrointestinal Tract

PubMed Central

Yang, Jee Eun; Kim, Gi Ae; Kim, Ga Hee; Yoon, Da Lim; Jeon, Sung Jin; Jung, Hwoon-Yong; Kim, Jin-Ho

2013-01-01

Bezoars are concretions of undigested material and are most often observed in the stomach. They can occur at any site in the gastrointestinal tract; however, duodenal localization is very rare. We report the case of a 71-year-old male who had undergone subtotal gastrectomy with gastroduodenostomy and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. An approximately 7×8 cm-sized mass was found on an abdominal computed tomography scan. On following endoscopy, a large bezoar was revealed in the duodenum and was removed using an endoscopic removal technique, assisted by a large amount of Coca-Cola infusion. PMID:23964339

Foam bezoar: resection of perforated terminal ileum in a 17-year-old with sickle β+ thalassemia and pica.

PubMed

Altepeter, Tara; Annes, John; Meller, Janet

2011-07-01

Children and adolescents with sickle cell disease demonstrate an increased incidence of pica. Pica involving polyurethane foam has been previously reported, but effective management of such cases remains unclear. We present the case of a 17-year-old African American adolescent girl with sickle β+ thalassemia who presented with a long history of foam rubber pica resulting in intestinal obstruction. Conservative management was unsuccessful, and the patient ultimately required operative intervention. We advocate for a low threshold for early operation in cases of foam rubber bezoar. Copyright © 2011 Elsevier Inc. All rights reserved.

Treatment of gastric phytobezoars with Coca-Cola given via oral route: a case report.

PubMed

Ertuğrul, Gökhan; Coşkun, Murat; Sevinç, Mahsuni; Ertuğrul, Fisun; Toydemir, Toygar

2012-01-01

A 43-year-old female patient presented with a chief complaint of upper abdominal pain. As her complaints had lasted for 1 month, an upper gastrointestinal system endoscopy was performed and discovered a bezoar in the stomach. The bezoar was quite hard and light green-yellow in color. Pathological examination revealed phytobezoar. The patient was hospitalized and given oral Coca-Cola(®) Zero for seven days at a dose of 500 mL three times daily. The upper gastrointestinal system endoscopy performed at the end of 7 days showed that the phytobezoar had softened and become smaller. The phytobezoar was broken into pieces with biopsy forceps and washing was applied, so the phytobezoar pieces could pass through the pylorus. The patient was discharged after the procedure without problem.

Treatment of gastric phytobezoars with Coca-Cola® given via oral route: a case report

PubMed Central

Ertuğrul, Gökhan; Coşkun, Murat; Sevinç, Mahsuni; Ertuğrul, Fisun; Toydemir, Toygar

2012-01-01

Background A 43-year-old female patient presented with a chief complaint of upper abdominal pain. As her complaints had lasted for 1 month, an upper gastrointestinal system endoscopy was performed and discovered a bezoar in the stomach. Case presentation The bezoar was quite hard and light green-yellow in color. Pathological examination revealed phytobezoar. The patient was hospitalized and given oral Coca-Cola® Zero for seven days at a dose of 500 mL three times daily. Conclusion The upper gastrointestinal system endoscopy performed at the end of 7 days showed that the phytobezoar had softened and become smaller. The phytobezoar was broken into pieces with biopsy forceps and washing was applied, so the phytobezoar pieces could pass through the pylorus. The patient was discharged after the procedure without problem. PMID:22393302

Gastro-intestinal phytobezoars in Zimbabwean Africans.

PubMed

Stein, C M; Gelfand, M

1985-01-01

The clinical features of 10 African patients with gastro-intestinal phytobezoars are described. These were similar to those described with persimmon bezoars and we postulate that the fruit of locally found trees, also of the genus Diospyros, are responsible.

The goat domestication process inferred from large-scale mitochondrial DNA analysis of wild and domestic individuals

PubMed Central

Naderi, Saeid; Rezaei, Hamid-Reza; Pompanon, François; Blum, Michael G. B.; Negrini, Riccardo; Naghash, Hamid-Reza; Balkız, Özge; Mashkour, Marjan; Gaggiotti, Oscar E.; Ajmone-Marsan, Paolo; Kence, Aykut; Vigne, Jean-Denis; Taberlet, Pierre

2008-01-01

The emergence of farming during the Neolithic transition, including the domestication of livestock, was a critical point in the evolution of human kind. The goat (Capra hircus) was one of the first domesticated ungulates. In this study, we compared the genetic diversity of domestic goats to that of the modern representatives of their wild ancestor, the bezoar, by analyzing 473 samples collected over the whole distribution range of the latter species. This partly confirms and significantly clarifies the goat domestication scenario already proposed by archaeological evidence. All of the mitochondrial DNA haplogroups found in current domestic goats have also been found in the bezoar. The geographic distribution of these haplogroups in the wild ancestor allowed the localization of the main domestication centers. We found no haplotype that could have been domesticated in the eastern half of the Iranian Plateau, nor further to the east. A signature of population expansion in bezoars of the C haplogroup suggests an early domestication center on the Central Iranian Plateau (Yazd and Kerman Provinces) and in the Southern Zagros (Fars Province), possibly corresponding to the management of wild flocks. However, the contribution of this center to the current domestic goat population is rather low (1.4%). We also found a second domestication center covering a large area in Eastern Anatolia, and possibly in Northern and Central Zagros. This last domestication center is the likely origin of almost all domestic goats today. This finding is consistent with archaeological data identifying Eastern Anatolia as an important domestication center. PMID:19004765

Phytobezoar: A Brief Report with Surgical and Radiological Correlation

PubMed Central

Robertson, Faith C.; Khurana, Bharti; Gates, Jonathan D.

2018-01-01

Gastrointestinal bezoars, collections of incompletely digested material within the alimentary tract, can present as a diagnostic challenge and should be considered in the differential diagnosis and management of small bowel obstruction, ischemic bowel, or bowel perforation. We present a case of a 37-year-old man with a distant history of laparotomy for superior mesenteric artery thrombosis requiring partial small bowel resection of the jejunum who presented with worsening abdominal pain, nausea, vomiting, and hematemesis. An abdominal computed tomography revealed dilated loops of small bowel with a transition point at the ileum, distal to his prior bowel anastomosis. He was managed initially nonoperatively, but persistent vomiting and worsening distention necessitated urgent exploratory laparotomy. During the procedure, a 4 cm by 3 cm phytobezoar was discovered at the midjejunum. The patient had an unremarkable postoperative course with no further symptoms at 1-year follow-up. Timely diagnosis and treatment of bezoar is essential to minimize patient complications. PMID:29780655

Bowel obstruction: Differential diagnosis and clinical management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Welch, J.P.

1987-01-01

This book presents a practical guide to the diagnosis and management of obstruction, both mechanical and organic, of the large and small bowel. Obstruction is a common problem for surgeons, and this text emphasizes differential diagnosis and the use of all radiologic modalities. It presents the surgical and medical considerations involved with gallstones, bezoars, parasites, tumors, inflammation, trauma, intussusception, more.

Diabetic gastroparesis-associated bezoar resolution via "cola-lysis".

PubMed

Whitson, Bryan A; Asolati, Massimo; Kandaswamy, Raja; Sutherland, David E R

2008-01-01

Phytobezoars associated with diabetic gastroparesis are often sources of diminished quality of life for patients. Poor blood sugar control has been associated with increasing gastroparesis. For recipients of pancreas transplants to correct diabetes, phytobezoar treatment post-transplant can typically be limited to invasive procedures and prokinetic agents. We present the case of an alternative treatment to phytobezoar, cola libation, i.e., "cola-lysis."

Systematic review: Coca-Cola can effectively dissolve gastric phytobezoars as a first-line treatment.

PubMed

Ladas, S D; Kamberoglou, D; Karamanolis, G; Vlachogiannakos, J; Zouboulis-Vafiadis, I

2013-01-01

Gastric phytobezoars represent the most common bezoars in patients with poor gastric motility. A variety of dissolution therapies and endoscopic fragmentation techniques have been evaluated as conservative treatment so as to avoid surgery. To investigate the effectiveness of Coca-Cola for gastric phytobezoars dissolution. We performed a systematic search to identify publications on gastric phytobezoars to assess the efficacy of Coca-Cola as a dissolution therapy. Diospyrobezoars, formed after persimmon ingestion, are a distinct type of phytobezoars characterized by their hard consistency. Thus, these two subgroups of bezoars were compared in terms of successful dissolution. Over a 10-year period (2002-2012), 24 papers including 46 patients have been published. In 91.3% of the cases, phytobezoar resolution with Coca-Cola administration was successful, either as a single treatment (50%) or combined with further endoscopic techniques, whereas only 4 patients underwent surgery. Phytobezoars were more likely to dissolve after initial attempt with Coca-Cola compared with diospyrobezoars (60.6% vs. 23%, P = 0.022). Coca-Cola alone is effective in gastric phytobezoar dissolution in half of the cases and, combined with additional endoscopic methods, is successful in more than 90% of them. © 2012 Blackwell Publishing Ltd.

Acute Intestinal Obstruction Caused by a Persimmon Phytobezoar after Dissolution Therapy with Coca-Cola

PubMed Central

Ha, Seung Soo; Lee, Hyun Suk; Jung, Min Kyu; Cho, Chang Min; Kim, Sung Kook; Choi, Yong Hwan

2007-01-01

Bezoars are concretions or hard masses of foreign matter that are found in the gastrointestinal tract. Recent reports have demonstrated the efficacy of Coca-Cola administration for the dissolution of phytobezors. Here we report on a 73-year-old man with a very large gastric persimmon diospyrobezoar, and this caused small intestinal obstruction after partial dissolution with oral and injected Coca-Cola. PMID:18309693

Acute intestinal obstruction caused by a persimmon phytobezoar after dissolution therapy with Coca-Cola.

PubMed

Ha, Seung Soo; Lee, Hyun Suk; Jung, Min Kyu; Jeon, Seong Woo; Cho, Chang Min; Kim, Sung Kook; Choi, Yong Hwan

2007-12-01

Bezoars are concretions or hard masses of foreign matter that are found in the gastrointestinal tract. Recent reports have demonstrated the efficacy of Coca-Cola administration for the dissolution of phytobezors. Here we report on a 73-year-old man with a very large gastric persimmon diospyrobezoar, and this caused small intestinal obstruction after partial dissolution with oral and injected Coca-Cola.

[Poisons and antidotes according to Gunyetü'l Muhassilin and an 18th century Ottoman pamphlet].

PubMed

Tug, R

2000-01-01

This study deals with the chapter on poisons (Sümum) of Gunyetü'l-Muhassilin, a translation, and a pamphlet on antidotes called Panzehir, by Ahmed Sani,one of the most prominent figures of the Ottoman physicians. As a foreword, the terminology related with the subject; and an introduction to the Islamic medical theory, the basis of the subject, is discussed. The main topics on poison are; protection against and treatment of poisons; being poisoned by the sting of insects, snakes etc. and diseases such as rabies, as a result of bites of animals and their treatment; treatment of poisoned suppuration; insecticide drugs and measures; and common drugs against all kinds of poisons. Immunization and nutrition with respect to being poisoned; and preventive measures against insects; and mineral and organic antidotes are also discussed. The classification of diseases and treatment are evaluated on the humoral theory basis. The treatment of insect poisoning is viewed from the perspective of its symptoms. The pamphlet named Panzehir is about a special antidote, the bezoar stone. This antidote is divided into two, of the mineral and the animal origin; and the uses of the bezoar are discussed.A vocabulary is added to help readers to understand the terminology.

[Poisons and antidotes according to Gunyetü'l Muhassilin and an 18th century Ottoman pamphlet].

PubMed

Tuğ, R

2000-01-01

This study deals with the chapter on poisons (Sümum) of Gunyetü'l-Muhassilin, a translation, and a pamphlet on antidotes called Panzehir, by Ahmed Sani, one of the most prominent figures of the Ottoman physicians. As a foreword, the terminology related with the subject; and an introduction to the Islamic medical theory, the basis of the subject, is discussed. The main topics on poisons are; protection against and treatment of poisons; being poisoned by the sting of insects, snakes etc. and diseases such as rabies, as a result of bites of animals and their treatment; treatment of poisoned suppuration; insecticide drugs and measures; and common drugs against all kinds of poisons. Immunization and nutrition with respect to being poisoned; and preventive measures against insects; and mineral and organic antidotes are also discussed. The classification of diseases and treatment ase evaluated on the humoral theory basis. The treatment of insect poisoning is viewed from the perspective of its symptoms. The pamphlet named Panzehir is about a special antidote, the bezoar stone. This antidote is divided into two, of the mineral and the animal origin and the uses of the bezoar are discussed. A vocabulary is added to help readers to understand the terminology.

Small bowel obstruction due to phytobezoar formation within meckel diverticulum: CT findings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frazzini, V.I. Jr.; English, W.J.; Bashist, B.

1996-05-01

Intestinal obstruction due to a phytobezoar within a Meckel diverticulum is exceedingly rare, with only seven reported cases in the surgical literature. The most important precipitating factor is the ingestion of agents high in fiber and cellulose. Small bowel obstruction in all but one case was due to retrograde propagation of the bezoar into the small bowel lumen. We report the clinical and CT findings in such a patient following a vegetarian diet. 14 refs., 2 figs.

The factors influencing urinary arsenic excretion and metabolism of workers in steel and iron smelting foundry.

PubMed

Shuhua, Xi; Qingshan, Sun; Fei, Wang; Shengnan, Liu; Ling, Yan; Lin, Zhang; Yingli, Song; Nan, Yan; Guifan, Sun

2014-01-01

In order to evaluate the degree of arsenic (As) exposure and the factors influencing urinary As excretion and metabolism, 192 workers from a steel and iron smelting plant, with different type of work in production such as roller, steel smelting, iron smelting and metallic charge preparation, were recruited. Information about characteristics of each subject was obtained by questionnaire and inorganic As (iAs), monomethylarsonic acid (MMA), dimethylarsinic acid (DMA) in urine were determined. The results showed that steel smelters had significantly higher concentrations of DMA and total As (TAs) than rollers and metallic charge preparation workers, and iron and steel smelters had a higher value of primary methylation index and lower proportion of the iAs (iAs%) than rollers and metallic charge preparation workers. In steel smelters, urinary As level exceeded the biological exposure index (BEI) limit for urinary As of 35 μg/l by 65.52%, and higher than metallic charge preparation workers (35.14%). The individuals consumed seafood in recent 3 days had a higher TAs than the individuals without seafood consumption. Multivariate logistic regression analysis showed that different jobs, taken Chinese medicine of bezoar and seafood consumption in recent 3 days were significantly associated with urinary TAs exceeded BEI limit value 35 μg/l. Our results suggest that workers in steel and iron smelting plant had a lower level of As exposure, and seafood consumption and taking Chinese medicine of bezoar also could increase the risk of urinary TAs exceeded BEI limit value.

Association between the Prevalence of Indigestible Foreign Objects in the Gastrointestinal Tract of Slaughtered Cattle and Body Condition Score

PubMed Central

Nongcula, Vikhaya Vincent; Zhou, Leocadia

2017-01-01

Simple Summary The South African national cattle herd has increased from 6 million head since the 1970s to 14 million and more than two-thirds of the 14 million cattle in South Africa reside in the Eastern Cape Province (ECP), yet the Province has one of the highest poverty indexes. While this improvement is commendable, there are still many challenges to efficient livestock production notably infectious and non-infectious diseases. Many non-infectious diseases of the fore-stomach, such as rumenitis, rumen parakeratosis, traumatic reticuloperitonitis and poly bezoars, are rarely reported, but are known to obstruct the digestive functions of the fore-stomach, causing a marked reduction in animal weight, reproduction, feed absorption and productivity, and death. The pathogenesis of these diseases often begins with the consumption of indigestible foreign objects (IFOs). Animal husbandry in the ECP is mostly communal, with an extensive system of rearing animals as the most popular production system. This system of rearing animals exposes them to consumption of litter, especially when there is drought. This study provides knowledge on the prevalence, type and effect of the indigestible foreign object on the body condition score of animals slaughtered in the ECP. Abstract It is estimated that South Africa’s population will be above 65 million in 2050. Thus, food production needs to triple to alleviate poverty and food insecurity. However, infectious and non-infectious diseases affect livestock productivity, thereby hampering food supply. Non-infectious disease/conditions caused by the consumption of solid waste material are rarely reported. Hence, this study investigates the occurrence and type of indigestible foreign objects (IFOs) in the stomach of slaughtered cattle in two high-throughput abattoirs (n = 4424) in the Eastern Cape Province of South Africa. The study revealed that metallic and non-metallic indigestible objects had an overall prevalence of 63% in cattle slaughtered in Queenstown abattoir (QTA, (n = 1906)) and 64.8% at the East London abattoir (ELA, (n = 2518)). Most of the IFOs were found in the rumen (64.2% and 70.8%) and reticulum (28.5% and 20.6%) at QTA and ELA respectively. The leading IFOs in the stomach of cattle at QTA were plastics (27.7%), poly bezoars (10.7%) and ropes (10.7%), while poly bezoars (19.8%), ropes (17.6%) and stones (10.7%) were the main IFOs seen in cattle at ELA. The study showed a statistical significance (p < 0.05) between body condition score and the prevalence of indigestible objects in cattle. The study concluded that litter and waste containing IFOs could pose a threat to livestock health and productivity. The practice of good animal husbandry and efficient solid waste management will mitigate the problem of animals consuming IFOs. PMID:29084136

Presence-absence surveys of prey and their use in predicting leopard (Panthera pardus) densities: a case study from Armenia.

PubMed

Khorozyan, Igor G; Malkhasyan, Alexander G; Abramov, Alexei V

2008-12-01

It is important to predict how many individuals of a predator species can survive in a given area on the basis of prey sufficiency and to compare predictive estimates with actual numbers to understand whether or not key threats are related to prey availability. Rugged terrain and low detection probabilities do not allow for the use of traditional prey count techniques in mountain areas. We used presence-absence occupancy modeling and camera-trapping to estimate the abundance and densities of prey species and regression analysis to predict leopard (Panthera pardus) densities from estimated prey biomass in the mountains of the Nuvadi area, Meghri Ridge, southern Armenia. The prey densities were 12.94 ± 2.18 individuals km(-2) for the bezoar goat (Capra aegagrus), 6.88 ± 1.56 for the wild boar (Sus scrofa) and 0.44 ± 0.20 for the roe deer (Capreolus capreolus). The detection probability of the prey was a strong function of the activity patterns, and was highest in diurnal bezoar goats (0.59 ± 0.09). Based on robust regression, the estimated total ungulate prey biomass (720.37 ± 142.72 kg km(-2) ) can support a leopard density of 7. 18 ± 3.06 individuals 100 km(-2) . The actual leopard density is only 0.34 individuals 100 km(-2) (i.e. one subadult male recorded over the 296.9 km(2) ), estimated from tracking and camera-trapping. The most plausible explanation for this discrepancy between predicted and actual leopard density is that poaching and disturbance caused by livestock breeding, plant gathering, deforestation and human-induced wild fires are affecting the leopard population in Armenia. © 2008 ISZS, Blackwell Publishing and IOZ/CAS.

Effect of the combination of ginseng, oriental bezoar and glycyrrhiza on autonomic nervous activity and immune system under mental arithmetic stress.

PubMed

Zheng, Aisong; Moritani, Toshio

2008-06-01

Stress reduces physical and mental tolerances (immune potential) of humans and it induces progression of existing illness or causes latent disorders to become active. Thus, the control and suppression of stress plays an important role in the improvement of quality of life and prevention of diseases. Ginseng, oriental bezoar and glycyrrhiza have been used for Kampo (herbal treatment) for thousand years and a number of pharmacological and clinical studies have reported their effects. However, it has not been previously described how the combination of these most commonly used herbs affect mental stress. This is a randomized, double-blind, placebo-controlled experiment to examine the effectiveness of reducing stress response by taking Kampo. Ten healthy males (mean age 27+/-1) participated in the study. The effectiveness of stress reduction was assessed by measuring ECG, salivary chromogranin A (CgA), blood glucose, WBC, granulocytes, lymphocytes, NK cell activity, etc. Salivary and blood measurement values of pre- and post-mental arithmetic stress were compared. In addition, ECG measurement values of pre- and mid-mental arithmetic stress were compared. we observed a higher HF power and a lower SNS index, HR, CgA, WBC and granulocytes in the Kampo trial than those in the placebo trial. The HR, HF power and SNS index were changed significantly (p<0.05) and CgA, WBC and granulocytes tended to show some differences between the two trials (p<0.1). However, blood glucose, lymphocytes, and NK cell activity showed no significant differences between the Kampo and placebo trials. The result suggests that the Kampo should be useful in reducing mental stress.

Primarily Proximal Jejunal Stone Causing Enterolith Ileus in a Patient without Evidence of Cholecystoenteric Fistula or Jejunal Diverticulosis.

PubMed

Abtar, Houssam Khodor; Mneimneh, Mostapha; Hammoud, Mazen M; Zaaroura, Ahmed; Papas, Yasmina S

2016-01-01

Stone formation within the intestinal lumen is called enterolith. This stone can encroach into the lumen causing obstruction and surgical emergency. Jejunal obstruction by an enterolith is a very rare entity and often missed preoperatively. To our knowledge, most cases of jejunal obstruction, secondary to stone, were associated with biliary disease (cholecystoenteric fistula), bezoar, jejunal diverticulosis, or foreign body. Hereby we present a rare case report of small bowel obstruction in an elderly man who was diagnosed lately to have primary proximal jejunal obstruction by an enterolith without evidence of a cholecystoenteric fistula or jejunal diverticulosis. This patient underwent laparotomy, enterotomy with stone extraction, and subsequent primary repair of the bowel.

An Unusual Cause of Duodenal Obstruction: Persimmon Phytobezoar.

PubMed

Fan, Shengxian; Wang, Jing; Li, Yousheng

2016-12-01

Duodenal phytobezoar, an unusual cause of acute duodenal obstruction, is rarely seen. The most common cause of this type of bezoar is persimmon. It frequently arises from underlying gastrointestinal tract pathologies (gastric surgery, etc.). Here, we report the case of a 66-year-old man who had undergone distal gastrectomy with Billroth I reconstruction for gastric cancer and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. The abdominal computed tomography scan showed a large-sized mass in the horizontal portion of the duodenum. On following endoscopic examination, a large phytobezoar was revealed in the duodenum. He was treated with endoscopic fragmentation combined with nasogastric Coca-Cola. The patient tolerated the procedure well and resumed a normal oral diet 3 days later.

Medicinal use of wild fauna by mestizo communities living near San Guillermo Biosphere Reserve (San Juan, Argentina).

PubMed

Hernandez, Jorge; Campos, Claudia M; Borghi, Carlos E

2015-01-21

Wild and domestic animals and their by-products are important ingredients in the preparation of curative, protective and preventive medicines. Despite the medicinal use of animals worldwide, this topic has received less attention than the use of medicinal plants. This study assessed the medicinal use of animals by mestizo communities living near San Guillermo MaB Reserve by addressing the following questions: What animal species and body parts are used? What ailments or diseases are treated with remedies from these species? To what extent do mestizo people use animals as a source of medicine? Is the use related to people's age? We conducted semi-structured interviews with 171 inhabitants (15-93 years old) of four villages close to the Reserve: Tudcúm, Angualasto, Malimán and Colangüil. We calculated the informant consensus factor and fidelity level to test homogeneity of knowledge and to know the importance of different medicinal uses for a given species. The medicinal use of animals was reported by 57% of the surveyed people. Seven species were mentioned: Rhea pennata, Lama guanicoe, Puma concolor, Pseudalopex sp., Lama vicugna, Lepus europaeus and Conepatus chinga. Several body parts were used: fat, leg, bezoar-stone, stomach, feather, meat, blood, feces, wool, and liver. The fat of R. pennata was the most frequently used animal part, followed by the bezoar stone and the leg of L. guanicoe. Animals were used to treat 22 ailments, with respiratory and nervous system disorders being the most frequently treated diseases with a high degree of consensus. Old people used animals as remedies more frequently than young residents, showing some differences among villages. A low number of animal species was mentioned as used for medicinal purposes, which could be explained by the perception of strong control related the legislation that bans hunting and the erosion of traditional knowledge produced by mestizaje. However, the presence of a traditional medicine is deeply rooted in the community culture. Management strategy for protected areas should focus not only on the conservation and sustainability of biological resources, but also on the ancestral knowledge of local communities, such as the medicinal use of animals.

Edible seeds from Cucurbitaceae family as potential functional foods: Immense promises, few concerns.

PubMed

Patel, Seema; Rauf, Abdur

2017-07-01

Cucurbitaceae family members such as pumpkin and watermelon have seeds that are discarded as the by-products of food processing. However, they have been discovered to contain a rich repertoire of nutrients such as proteins, unsaturated fatty acids, phenolic acids, carotenoids, tocopherol, phytosterol, squalene etc. Biological assays have proven the seed extracts to exert antioxidative, hypoglycemic, anticancer, antihypertensive, cardioprotective, antilipemic, gynoprotective, and anthelmintic properties. Further, the seeds do not contain any major anti-nutrients. Phytoestrogens like β-sitosterol occur, which might be acting as agonists or antagonists of estrogen and testosterone, given their validated role in gyenic and prostate health. Few instances of intestinal bezoar, and allergy, following pumpkin seeds consumption have emerged. After the risk-benefit analysis though exhaustive literature search, it can be suggested that these seeds are underutilized and they can be used to formulate a myriad of nutraceuticals. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Convergent genomic signatures of domestication in sheep and goats.

PubMed

Alberto, Florian J; Boyer, Frédéric; Orozco-terWengel, Pablo; Streeter, Ian; Servin, Bertrand; de Villemereuil, Pierre; Benjelloun, Badr; Librado, Pablo; Biscarini, Filippo; Colli, Licia; Barbato, Mario; Zamani, Wahid; Alberti, Adriana; Engelen, Stefan; Stella, Alessandra; Joost, Stéphane; Ajmone-Marsan, Paolo; Negrini, Riccardo; Orlando, Ludovic; Rezaei, Hamid Reza; Naderi, Saeid; Clarke, Laura; Flicek, Paul; Wincker, Patrick; Coissac, Eric; Kijas, James; Tosser-Klopp, Gwenola; Chikhi, Abdelkader; Bruford, Michael W; Taberlet, Pierre; Pompanon, François

2018-03-06

The evolutionary basis of domestication has been a longstanding question and its genetic architecture is becoming more tractable as more domestic species become genome-enabled. Before becoming established worldwide, sheep and goats were domesticated in the fertile crescent 10,500 years before present (YBP) where their wild relatives remain. Here we sequence the genomes of wild Asiatic mouflon and Bezoar ibex in the sheep and goat domestication center and compare their genomes with that of domestics from local, traditional, and improved breeds. Among the genomic regions carrying selective sweeps differentiating domestic breeds from wild populations, which are associated among others to genes involved in nervous system, immunity and productivity traits, 20 are common to Capra and Ovis. The patterns of selection vary between species, suggesting that while common targets of selection related to domestication and improvement exist, different solutions have arisen to achieve similar phenotypic end-points within these closely related livestock species.

Abdominal pain in children with sickle cell disease.

PubMed

Rhodes, Melissa M; Bates, David Gregory; Andrews, Tina; Adkins, Laura; Thornton, Jennifer; Denham, Jolanda M

2014-02-01

The differential diagnosis of abdominal pain is broad in any child, and further complicated in children with sickle cell disease (SCD). Acute causes of abdominal pain may require emergent surgery, such as for appendicitis or obstruction caused by a bezoar. Rapid intervention is necessary and life-saving in children with SCD and acute splenic or hepatic sequestration. The majority of children with SCD presenting to the physician's office or emergency department will have subacute reasons for their abdominal pain, including but not limited to constipation, urinary tract infection, peptic ulcer disease, and cholecystitis. Vaso-occlusive pain often presents in children as abdominal pain, but is a diagnosis of exclusion. The case of a 10-year-old girl with intermittent abdominal pain is used as a starting point to review the pathophysiology, diagnosis, and treatment of the most acute and common causes of abdominal pain in children with SCD.

Death of a Female Prostitute Due to Intestinal Obstruction by an Unknown Substance.

PubMed

Dokoupil, Marek; Marecová, Klára; Handlos, Petr; Březina, Petr

2018-05-16

A young adult black female, known to be a prostitute and suspected of smuggling narcotics, was found dead in her apartment in a state of early decomposition. Oval-shaped gray-white masses of exogenous origin protruded from the anus. The autopsy showed dilatation of the folds of the large intestine, which were almost completely filled with these oval-shaped gray-white masses of foreign material. The uterus was enlarged with multiple large leiomyomas. Toxicological tests of blood and the foreign material revealed no toxicologically relevant substances. Kaolin was detected in a sample of the foreign material from the large intestine. The immediate cause of death was intestinal obstruction due to the formation of a kaolin bezoar with simultaneous compression of the large intestine by the enlarged myomatous uterus. Subsequent revelation of a habit the deceased had brought from her native country led to the conclusion that this exotic custom was responsible for her death. © 2018 American Academy of Forensic Sciences.

A new technique for endoscopic treatment of gastric phytobezoars: fragmentation using guidewire.

PubMed

Senturk, O; Hulagu, S; Celebi, A; Korkmaz, U; Duman, A E; Dindar, G; Bozkurt, N; Yilmaz, H; Ozturkler, M; Can, B; Batman, A

2014-12-01

Bezoars result from accumulation of indigestible materials in the gastrointestinal tract and often occur in the stomach. In this study, we evaluated the use of guidewires in patients with gastric phytobezoars (PBs) as a new method for PB removal and examined the safety of the procedure. Between February 2009 and January 2013, we analyzed data from 11 patients with gastric PBs. We fitted a transparent cap to a standard endoscope (EG450WR5, Fujinon), and a 0.025 inch guidewire was passed through the standart endoscope. PBs were surrounded by a loop in the guidewire and destroyed. After 2 weeks of treatment, patients were re-evaluated for effectiveness. PB fragmentation time was 5-11 minutes. In five patients with a history of gastric surgery, we needed an additional 16-28 minutes for removal of the fragments. In six patients additionally treated with enzymatic degradation after the breaking procedure, PBs completely disappeared within 2 weeks. There were no complications during the procedure. The guidewire and fragmentation procedure for PBs is an efficient and reliable method. When combined with enzymatic degradation, PBs can be managed quickly and effectively.

DNA barcoding commercially important aquatic invertebrates of Turkey.

PubMed

Keskin, Emre; Atar, Hasan Hüseyin

2013-08-01

DNA barcoding was used in order to identify aquatic invertebrates sampled from fisheries bycatch and discards. A total of 440 unique cytochrome c oxidase sub unit I (COI) barcodes were generated for 22 species from three important phyla (Arthropoda, Cnidaria, and Mollusca). All the species were sequenced and submitted to GenBank and Barcode of Life Database (BOLD) databases using 654 bp-long fragment of mitochondrial COI gene. Two of them (Pontastacus leptodactylus and Rapana bezoar) were first records of the species for the BOLD database and six of them (Carcinus aestuarii, Loligo vulgaris, Melicertus kerathurus, Nephrops norvegicus, Scyllarides latus, and Scyllarus arctus) were first standard (>648 bp) COI barcode records for the GenBank database. COI barcodes were analyzed for nucleotide composition, nucleotide pair frequencies, and Kimura's two-parameter genetic distance. Mean genetic distance among species was found increasing at higher taxonomic levels. Neighbor-joining trees generated were congruent with morphometric-based taxonomic classification. Findings of this study clearly demonstrate that DNA barcodes could be used as an efficient molecular tool in identification of not only target species from fisheries but also bycatch and discard species, and so it could provide us leverage for a better understanding in monitoring and management of fisheries and biodiversity.

A Dig into the Past Mitochondrial Diversity of Corsican Goats Reveals the Influence of Secular Herding Practices

PubMed Central

Hughes, Sandrine; Fernández, Helena; Cucchi, Thomas; Duffraisse, Marilyne; Casabianca, François; Istria, Daniel; Pompanon, François; Vigne, Jean-Denis; Hänni, Catherine; Taberlet, Pierre

2012-01-01

The goat (Capra hircus) is one of the earliest domesticated species ca. 10,500 years ago in the Middle-East where its wild ancestor, the bezoar (Capra aegagrus), still occurs. During the Neolithic dispersal, the domestic goat was then introduced in Europe, including the main Mediterranean islands. Islands are interesting models as they maintain traces of ancient colonization, historical exchanges or of peculiar systems of husbandry. Here, we compare the mitochondrial genetic diversity of both medieval and extant goats in the Island of Corsica that presents an original and ancient model of breeding with free-ranging animals. We amplified a fragment of the Control Region for 21 medieval and 28 current goats. Most of them belonged to the A haplogroup, the most worldwide spread and frequent today, but the C haplogroup is also detected at low frequency in the current population. Present Corsican goats appeared more similar to medieval goats than to other European goat populations. Moreover, 16 out of the 26 haplotypes observed were endemic to Corsica and the inferred demographic history suggests that the population has remained constant since the Middle Ages. Implications of these results on management and conservation of endangered Corsican goats currently decimated by a disease are addressed. PMID:22299033

A dig into the past mitochondrial diversity of Corsican goats reveals the influence of secular herding practices.

PubMed

Hughes, Sandrine; Fernández, Helena; Cucchi, Thomas; Duffraisse, Marilyne; Casabianca, François; Istria, Daniel; Pompanon, François; Vigne, Jean-Denis; Hänni, Catherine; Taberlet, Pierre

2012-01-01

The goat (Capra hircus) is one of the earliest domesticated species ca. 10,500 years ago in the Middle-East where its wild ancestor, the bezoar (Capra aegagrus), still occurs. During the Neolithic dispersal, the domestic goat was then introduced in Europe, including the main Mediterranean islands. Islands are interesting models as they maintain traces of ancient colonization, historical exchanges or of peculiar systems of husbandry. Here, we compare the mitochondrial genetic diversity of both medieval and extant goats in the Island of Corsica that presents an original and ancient model of breeding with free-ranging animals. We amplified a fragment of the Control Region for 21 medieval and 28 current goats. Most of them belonged to the A haplogroup, the most worldwide spread and frequent today, but the C haplogroup is also detected at low frequency in the current population. Present Corsican goats appeared more similar to medieval goats than to other European goat populations. Moreover, 16 out of the 26 haplotypes observed were endemic to Corsica and the inferred demographic history suggests that the population has remained constant since the Middle Ages. Implications of these results on management and conservation of endangered Corsican goats currently decimated by a disease are addressed.

Goat domestication and breeding: a jigsaw of historical, biological and molecular data with missing pieces.

PubMed

Amills, M; Capote, J; Tosser-Klopp, G

2017-12-01

Domestic goats (Capra hircus) are spread across the five continents with a census of 1 billion individuals. The worldwide population of goats descends from a limited number of bezoars (Capra aegagrus) domesticated 10 000 YBP (years before the present) in the Fertile Crescent. The extraordinary adaptability and hardiness of goats favoured their rapid spread over the Old World, reaching the Iberian Peninsula and Southern Africa 7000 YBP and 2000 YBP respectively. Molecular studies have revealed one major mitochondrial haplogroup A and five less frequent haplogroups B, C, D, F and G. Moreover, the analysis of autosomal and Y-chromosome markers has evidenced an appreciable geographic differentiation. The implementation of new molecular technologies, such as whole-genome sequencing and genome-wide genotyping, allows for the exploration of caprine diversity at an unprecedented scale, thus providing new insights into the evolutionary history of goats. In spite of a number of pitfalls, the characterization of the functional elements of the goat genome is expected to play a key role in understanding the genetic determination of economically relevant traits. Genomic selection and genome editing also hold great potential, particularly for improving traits that cannot be modified easily by traditional selection. © 2017 Stichting International Foundation for Animal Genetics.

[The importance of conservation of rare domestic animal breeds using the example of Arc Warder].

PubMed

Frölich, Kai; Jandowsky, Anabell

2017-02-09

The domestic animals descend from various wild ancestors. Thus, for example, of the wolf, the dog (15  000 BC), of the Bezoar goat the goat (10  000 BC), of the Asian mouflon the sheep (10  000 BC), of the wild boar the pig (8000 BC) and of the aurochs the cattle (7000 BC). Domestication has dramatically changed our culture and led to a great diversity of animal breeds. This is a unique cultural and historical treasure, which we have to preserve for future generations. The zoological park Arc Warder is Europe's largest center for rare and endangered domestic animal breeds. Arc Warder is more than a zoo; it is a landscape park, a conservation venture for genetic resources and furthermore a research project. Five principles guide the conservation efforts of Arc Warder: 1. Conservation through preservation. The breeding program will improve the quality of the genetic reservoir of breeds. 2. Conservation through the establishment of satellite stations. These pastures outside the park allow to increase the gene pool and ensure the protection of breeds against epidemics. 3. Conservation through high level education. 4. Protection by networking with national and international institutions. 5. Protection through research. Arc Warder is actively involved in close scientific cooperation with various universities and other research institutions on a number of scientific projects concerning the biological characteristics of old breeds.

Trichophytobezoar duodenal obstruction in New World camelids.

PubMed

Sullivan, Eileen K; Callan, Robert J; Holt, Timothy N; Van Metre, David C

2005-01-01

To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. Retrospective study. Alpacas (7) and 1 llama. Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.

Gastrogastric Fistula: an Unusual Cause for Severe Bile Reflux Following Conversion of Sleeve Gastrectomy to One Anastomosis Gastric Bypass.

PubMed

Haddad, Ashraf; Bashir, Ahmad; Nimeri, Abdelrahman

2018-05-04

One anastomosis gastric bypass/mini-gastric bypass (OAGB/MGB) was first described in 2001 as a safe and effective procedure. It has been gaining popularity worldwide. Multiple authors have reported the need to re-operate on patients for bile reflux. We report a patient with severe bile reflux after laparoscopic conversion of sleeve gastrectomy (LSG) to OAGB/MGB. A 33-year-old patient underwent a LSG in 2014. Postoperatively, she developed severe gastroesophageal acid reflux. In 2016, she underwent conversion of LSG to OAGB/MGB at the original institution for the treatment of her reflux symptoms. In 2017, she presented to us with epigastric pain, worsening reflux symptoms, steatorrhea, hypoproteinemia (6 g/dl), and body mass index of 25 kg/m 2 . Preoperative endoscopy revealed bile reflux, suture bezoar, and ulceration at the anastomosis. Laparoscopic exploration started by identifying the anatomy and measuring the lengths of the biliopancreatic limb (350 cm) and the common channel (450 cm). Upon dissecting the pouch, a gastrogastric fistula extending from the antrum to the pouch was encountered. This was confirmed with intraoperative endoscopy with bile refluxing to the pouch. The fistula, antrum, and part of the pouch were resected. The patient was converted to Roux-en-Y gastric bypass. She had an uneventful postoperative recovery. At 3 months of follow-up, her weight was stable and her steatorrhea resolved. Patients with bile reflux after OAGB/MGB need a high index of suspicion to detect unusual causes. Gastrogastric fistula is an unusual etiology of bile reflux that was never reported in the literature previously.

Assessing the Role of Livestock in Big Cat Prey Choice Using Spatiotemporal Availability Patterns

PubMed Central

Ghoddousi, Arash; Soofi, Mahmood; Kh. Hamidi, Amirhossein; Lumetsberger, Tanja; Egli, Lukas; Khorozyan, Igor; Kiabi, Bahram H.; Waltert, Matthias

2016-01-01

Livestock is represented in big cat diets throughout the world. Husbandry approaches aim to reduce depredation, which may influence patterns of prey choice, but whether felids have a preference for livestock or not often remains unclear as most studies ignore livestock availability. We assessed prey choice of the endangered Persian leopard (Panthera pardus saxicolor) in Golestan National Park, Iran, where conflict over livestock depredation occurs. We analyzed leopard diet (77 scats) and assessed wild and domestic prey abundance by line transect sampling (186 km), camera-trapping (2777 camera days), double-observer point-counts (64 scans) and questionnaire surveys (136 respondents). Based on interviews with 18 shepherds, we estimated monthly grazing time outside six villages with 96 conflict cases to obtain a small livestock (domestic sheep and goat) availability coefficient. Using this coefficient, which ranged between 0.40 and 0.63 for different villages, we estimated the numbers of sheep and goats available to leopard depredation. Leopard diet consisted mainly of wild boar (Sus scrofa) (50.2% biomass consumed), but bezoar goat (Capra aegagrus) was the most preferred prey species (Ij = 0.73), whereas sheep and goats were avoided (Ij = -0.54). When absolute sheep and goat numbers (~11250) were used instead of the corrected ones (~6392), avoidance of small livestock appeared to be even stronger (Ij = -0.71). We suggest that future assessments of livestock choice by felids should incorporate such case-specific corrections for spatiotemporal patterns of availability, which may vary with husbandry methods. Such an approach increases our understanding of human-felid conflict dynamics and the role of livestock in felid diets. PMID:27064680

The surgical treatment of chronic gastric atony following Roux-Y diversion for alkaline reflux gastritis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vogel, S.B.; Woodward, E.R.

1989-06-01

Symptoms of severe nausea, vomiting, abdominal pain, and frequent bezoars, as well as objective gastric retention, can occur following Roux-Y biliary diversion for alkaline reflux gastritis. Medical therapy and prokinetic drugs have proven ineffective. This review evaluates 37 patients who underwent further gastric resection from 1979 to 1987 to improve gastric emptying and resolve symptoms. Fifteen patients underwent perioperative radionuclide solid-food gastric emptying studies. Seventy-three per cent (27 of 37 patients) of the patients who underwent further gastric resection (70% to 95%) had a satisfactory postoperative response. Twenty patients were graded Visick 1 or 2 and 7 Visick-3 patients, althoughmore » much improved, still had some symptoms of gastroparesis. Twenty-seven per cent (10 of 37 patients) failed to improve and underwent completion total gastrectomy. Overall, 70% of this group had almost complete resolution of their symptoms. Three of 10 patients were considered ''failures'' due to postprandial pain in 1 and early vasomotor dumping in 2. Of the 10 patients who failed initial revisional surgery, 7 underwent a 70% to 80% subtotal gastric resection (STG) and 3 patients underwent 85% to 95% extensive resection (EXT.G.). Of the 15 patients who underwent perioperative radionuclide evaluation, a mean two-hour gastric retention of 61.4% +/- 4% (SEM) decreased to 25% +/- 4% following further gastric resection. Eight patients were in the STG group and seven patients were in the EXT.G group. Following STG, mean two-hour gastric retention of 58.2% +/- 3.5% decreased to 38% +/- 3% (p less than 0.05). In seven patients who underwent EXT.G, mean two-hour retention of 65% +/- 4% decreased to 10% +/- 2.5% (p less than 0.005). EXT.G resulted in normal gastric emptying and few late failures.« less

SIMPLIFIED LAPAROSCOPIC GASTRIC BYPASS WITH GASTROJEJUNAL LINEAR MECHANICAL ANASTOMOSIS: TECHNICAL ASPECTS.

PubMed

Palermo, Mariano; Serra, Edgardo

Gastric bypass is a restrictive and malabsorptive surgery. The restrictive part consists in the creation of a small gastric pouch. The gastrointestinal bypass serves as the malabsorptive element. To describe a simplified gastric bypass approach for morbid obese patients, showing our results, and also remarking the importance of this technique for reducing the learning curve. The patient is positioned in a split legs position and carefully strapped to the operating room table, with the surgeon between the patient's legs. Five trocars are inserted after pneumoperitoneum at the umbilicus. Dissection of the esophagogastric angle and lesser curvature is mandatory before the gastric pouch manufacturing. This pouch is done with two blue load staplers. Using a blue load linear stapler inserted only half way into the hole in the pouch is used to perform the gastrojejunal anastomosis and in order to create an anastomosis that is about 2 cm in length. A side-to-side jejunojejunostomy is done with a white load linear stapler. The last step of the gastric bypass consists in the cut of the jejunum between the two anastomosis with a white load linear stapler. Blue test is performed in order to detect leaks. From January 2012 to December 2015, 415 simplified RYGB were performed. Gender: 67% female and 33 % males. Average of BMI 44.7. Mean age was 42 years old. Mean operative time 79 min. 39 % of this sample had T2 diabetes. Regarding complications were observed, one fistula, one gastrojejunal stenosis and one obstruction due to a bezoar. The described technique is a simplified approach in which all the anastomosis are performed in the upper part of the abdomen, allowing the surgeons to be more systematized and avoiding them to make mistakes in the confection of the Roux-en-Y anastomosis. This simplified gastric bypass is a safe and reproducible technique. Bypass gástrico é cirurgia restritiva e malabsortiva. A parte restritiva consiste na criação de uma pequena bolsa gástrica. O bypass gastrointestinal serve como o elemento malabsortivo. Descrever uma abordagem de bypass gástrico simplificado para pacientes obesos mórbidos, mostrando os resultados, e também destacando a importância desta técnica para reduzir a curva de aprendizagem. O paciente é posicionado em posição de pernas abertas e cuidadosamente amarrado à mesa da sala de operação com o cirurgião entre as pernas. Cinco trocárteres são inseridos após pneumoperitônio no umbigo. Dissecção do ângulo esofagogástrico e curvatura menor é obrigatória antes da realização da bolsa gástrica. Esta bolsa é feita com dois grampeadores de carga azuis. Usando um grampeador carga linear azul inserido apenas a meio caminho para dentro do orifício na bolsa é executada a anastomose gastrojejunal a fim de criar anastomose de cerca de 2 cm de comprimento. Jejunojejunostomia laretolateral é feita com um grampeador carga linear branca. A última etapa do bypass gástrico consiste no corte do jejuno entre as duas anastomoses com um grampeador carga linear branco. Teste de azul é realizado de modo a detectar vazamentos. De janeiro de 2012 a dezembro de 2015, foram realizadas 415 RYGB simplificadas. Gênero: 67% homens e 33% mulheres. A média do IMC foi de 44,7 e a de idade 42 anos. A média de tempo operatório foi de 79 min. 39% desta amostra tinha diabete melito tipo 2. Quanto às complicações foram observadas uma fístula, uma estenose gastrojejunal e uma obstrução devido à bezoar. A técnica descrita é uma abordagem simplificada, na qual todas as anastomoses são realizadas na parte superior do abdome, permitindo aos cirurgiões serem mais sistematizados e evitando cometerem erros na confecção da anastomose em Y-de-Roux. Este bypass gástrico simplificado é técnica segura e reprodutível.

Revision of the Metallactus kollari species-group with a new diagnosis of the genus (Coleoptera: Chrysomelidae: Cryptocephalinae).

PubMed

Sassi, Davide

2018-04-20

The genus Metallactus has been controversial since its introduction due to the ambiguous nature of the original diagnosis. This has caused some confusion in the taxonomy of Neotropical Pachybrachina. In this work the morphology of endophallus, which is useful for the characterization of species groups in several groups of Coleoptera, including Cryptocephalinae, has been analyzed. This has proven to be a good resource also in the taxonomic treatment of the species belonging to the genus Metallactus. After a careful survey on most of the species described so far, the endophallus shape in Metallactus turned out to be remarkably distinctive and very promising in the delimitation of species groups. The present work includes: a) a new diagnosis of the genus Metallactus on the basis of the aedeagal anatomy; b) the designation of the type species of the nominal genus; c) the revision of a first species-group of the genus, including the type species, hereinafter called Metallactus kollari species-group. Before this revision, catalogues had been reporting 13 species attributable to this group, in the present work three species have been synonymized and seven have been described as new to science. Therefore, the group includes 17 species. The species described as new are: Metallactus rileyi n. sp., M. bellatrix n. sp., M. longicornis n. sp.; M. londonpridei n. sp., M. regalini n. sp., M. bezoar n. sp., M. guarani n. sp. The new synonymies are as follows: Metallactus albipes Suffrian, 1866 (= M. nigrofasciatus Suffrian, 1866 n. syn.), M. albifrons Suffrian, 1866 (= M. flavofrontalis Jacoby, 1907 n. syn.), M. dodecastictus Suffrian, 1866 (= Griburius nigritarsis Jacoby, 1907 n. syn.). The lectotypes of all previously described species have been designated. The new synonymies, the name-bearing type fixations and designations and the nomenclatural acts have been critically discussed. An identification key for the species-group is also provided.

Effects of in-vitro cultured calculus bovis on learning and memory impairments of hyperlipemia vascular dementia rats.

PubMed

Zhong, Xiao-Ming; Ren, Xue-Cong; Lou, Ye-Liang; Chen, Meng-Jing; Li, Guan-Ze; Gong, Xue-Yuan; Huang, Zhen

2016-11-04

In-vitro cultured calculus bovis (ICCB) is a quality substitute for natural bezoar which is used for the therapeutic purpose of treating encephalopathy. ICCB has been authorized to use on clinic. The aim of the study is to evaluate the effects and the potential mechanisms of in-vitro cultured calculus bovis (ICCB) on learning and memory impairments of hyperlipemia vascular dementia (HVD) rats. The HVD model was established by permanent occlusion of bilateral common carotid arteries based on hyperlipemia rats. Learning and memory abilities were evaluated by morris water maze test and shuttle box test. Ultraviolet-visible spectrophotometry (UV-vis) was employed to determine the SOD, MDA and NO in cerebral tissue, as well as the TG in serum. HE staining and toluidine blue staining were employed to evaluate cone cells damage in hippocampus CA1. An immunohistochemistry was used to measure the Bax and Bcl-2 expressions in cerebral tissue. Compared with control group, the abilities of spatial learning and memory and conditional memory were decreased significantly in HVD group (P<0.01, P<0.05). MDA content in cerebral tissue was remarkably increased while the SOD activity and NO content were both decreased (P<0.01). TG content in serum was increased remarkably (P<0.01). And the cone cells in hippocampus CA1 were damaged obviously. Compared with HVD group, ICCB treatment improved the abilities of learning and memory, elevated the SOD activity (P<0.01, P<0.05), reduced the MDA content (P<0.01) as well as the TG content in serum (P<0.01), increased the NO content (P<0.01), improved the damaged cone cells in hippocampus CA1, increased the number of cones cells (P<0.01), decreased the Bax expression, and increased the Bcl-2 expression (P<0.01). ICCB could improve the abilities of learning and memory in HVD rats. It might be related to anti-oxidative, regulation of Bax and Bcl-2 expressions, and the alleviation of cone cells damage. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Dietary fiber in management of diabetes.

PubMed

Vinik, A I; Jenkins, D J

1988-02-01

Current evidence suggests that high-fiber diets, especially of the soluble variety, and soluble fiber supplements may offer some improvement in carbohydrate metabolism, lower total cholesterol and low-density lipoprotein (LDL) cholesterol, and have other beneficial effects in patients with non-insulin-dependent diabetes mellitus (NIDDM). Diets enriched with wheat bran and guar gum induce 10-20% reductions in serum cholesterol and LDL in both normo- and hypercholesterolemic subjects and have the ability to blunt the hypertriglyceridemic effects of diets high in carbohydrate and low in fiber. In insulin-dependent diabetes mellitus (IDDM) the situation is less clear, but a decrement of the circadian glucose profile has been shown. Americans, in general, consume too little fiber. With the need to restrict fat and reduce protein, an increase in carbohydrates is mandatory. A practical goal would be to establish the present level of fiber intake (15-30 g/day) and to gradually increase it. An intake of up to 40 g of fiber per day or 25 g/1000 kcal of food intake appears beneficial; in many individuals on weight-reducing diets higher levels may be unacceptable because of gastrointestinal side effects. The level of maximum benefit has not been determined. Fiber supplementation appears beneficial only if given with a diet comprising approximately half of the calories as carbohydrate. Foods should be selected with moderate to high amounts of dietary fiber from a wide variety of choices to include both soluble and insoluble types of fiber. Insufficient data are available on the long-term safety of high-fiber supplements. People at risk for deficiencies, such as postmenopausal women, the elderly, or growing children, may require supplements of calcium and trace minerals. People with upper gastrointestinal dysfunction are at risk of bezoar formation and cautioned against a diet high in fiber of the leafy vegetable type. Careful attention must be paid to insulin dose because hypoglycemia can result if there is a radical change in fiber intake and insulin dose is not reduced appropriately. Care must be exercised in the use of "novel" fibers, including the wood celluloses, because little is known of their safety and efficacy.