Identification of cancer inhibitors from Hystrix brachyura bezoar extracts using LC - MS multivariate data analysis and in silico evaluation on Bcl - 2, cyclin B/CDK1, VEGF and NM23 - H1 / Identificación de inhibidores de cáncer a partir de extractos de bezoar de Hystrix branchyura usando análisis multivariado LC - MS y evaluación in silico en Bcl - 2, cyclin B/CDK1, VEGF, y NM23 - H1

Hystrix brach yura bezoar is calcified undigested material found in the gastrointestinal tract known for various medicinal benefits including as an anticancer agent. However, the H. brachyura population has been declining due to its demand and is under Malaysian law pro tection. Therefore, present study aimed to identify bezoar anticancer active compounds through metabolomics and in - silico approaches. Five replicates of bezoar powder were subjected to extraction using different solvent ratios of methanol - water (100, 75, 5 0, 25, 0% v/v). Cytotoxicity and metabolite profiling using liquid chromatography - mass spectrometry were conducted. Putative compounds identified were subjected to in - silico analysis with targeted anticancer proteins namely, Bcl - 2, Cyclin B/CDK1 complex, V EGF and NM23 - H1. The correlation of LC - MS and cytotoxicity profile pinpointed two compounds, mangiferin and propafenone. In - silico study showed both compounds exerted good binding scores to all proteins with hydrophobic interaction dominating the ligand - pr otein complex binding, suggesting the ligands act as hydrophobes in the interactions.

El bezpar de Hystrix branchyura es material calcificado sin digerir encontr ados en el tracto gastrointestinal, conocido por sus variados beneficios médicos, incluyendo propiedades anticancerosas. De todas formas, la población de H. Branchyura ha ido declinando debido a su demanda y está bajo la protección de la ley de Malasia. Po r esto, este estudio busca identificar los componentes activos anticancerosos del bezoar mediante abordajes metabolómico e in silico. Cinco réplicas de polvo de bezoar fueron sometidos a extracción usando solventes con diferentes proporciones metanol - agua (100, 75, 50, 25, 0% v/v). Se hicieron perfiles de citotoxicidad y de metabolitos usando cromatografía líquida - espectrometría de masa ( LC - MS ). Se identificaron compuestos putativos yse sometieron a a nálisis in silico, buscando las proteínas anticancerosas B cl - 2, complejo Cyclin B/CDK1, VEGF, y NM23 - H1. La correlación LC - MS y el perfil de citotoxicidad identificaron dos compuestos: mangiferina y propafenona. El estudio in silico mostró que ambos compuestos tenían buenos índices de enlace con todas las proteín as con interacción hidrofóbica dominando el enlace complejo proteína - ligando, sugeriendo que los ligandos actúan como hidrófobos en las interacciones

Glucagon for Relief of Acute Esophageal Foreign Bodies and Food Impactions: A Systematic Review and Meta-Analysis.

Glucagon is frequently used for the relief of esophageal impactions. This systematic review and meta-analysis were performed to evaluate the efficacy and safety of glucagon for acute esophageal foreign body and food impactions. PubMed, CINAHL, Latin American and Caribbean Health Sciences Literature (LILACS), Scopus, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were searched from inception to March 1, 2018. Retrospective, observational, and randomized controlled trials assessing glucagon for the relief of acute esophageal foreign body and food impaction were included. There were no language or age restrictions. Only studies conducted on humans and with a comparator (e.g., control or placebo) were included. Study quality analysis was performed using the Cochrane Risk of Bias tool. Quality of evidence analysis was performed using the Grading of Recommendations, Assessment, Development and Evaluations approach. A total of 1988 studies were identified, and five studies with a total of 1185 subjects were included. Treatment success occurred in 213 of 706 (30.2%) patients in the glucagon group and 158 of 479 (33.0%) patients in the control group (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.69-1.17, p=0.42). There was minimal statistical heterogeneity (I2  = 14%, p=0.33). No publication bias was identified. Adverse events were identified in 24 (15.0%) patients in the glucagon group and 0 (0%) patients in the placebo group (risk difference [RD] 0.18, 95% CI 0.03-0.33, p=0.02). Vomiting events occurred more frequently in the glucagon group (17 of 160 [10.6%] vs 0 of 53 [0%]) but was not statistically significant (RD 0.07, 95% CI -0.03-0.17, p=0.19). Glucagon was not associated with a difference in treatment success but had a higher rate of adverse events for the treatment of esophageal foreign body and food impaction. Further controlled studies are needed to confirm the efficacy of glucagon with adequate power to assess adverse events.

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

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

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.

A case of gastric perforation caused by chestnut bezoars.

A 65-year-old man was admitted under emergency to our hospital because of abdominal pain. His current medication history did not include steroids or nonsteroidal antiinflammatory drugs. He had taken an eradication agent for Helicobacter pylori, and his serum was negative for H. pylori IgG antibody. Abdominal computed tomography indicated gastric perforation;therefore, emergency surgery was performed. Two weeks later, esophagogastroduodenoscopy revealed a gastric ulcer on the lesser curvature of the gastric angle and bezoars. The gastric perforation was thought to be caused by the bezoars. The bezoars were successfully treated with endoscopic therapy using Coca-Cola®. The bezoars included over 98% tannin, and the patient had frequently consumed chestnuts. We thus diagnosed a rare case of gastric perforation caused by chestnut bezoars.

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

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.

[Renal candidal bezoar: case report and review of the literature]. / Un cas de bézoard candidosique rénal.

Candida infection is a relatively common hematogenous nosocomial infection in immunocompromised patients. However, renal disease remains unusual. The mode of presentation in the case reported herein was lumbar pain with fever and hydronephrosis of the left kidney due to a fungal bezoar in the renal pelvis. Clinical and biological suspicion of this disease must quickly lead to ultrasound examination to confirm the diagnosis.

Gastric bezoar: a case of a patient treated with traditional Chinese medicine.

BACKGROUND: Gastric bezoar is a collection of indigestible material in the stomach. It is a relatively rare disease. In this case report, it is shown that Traditional Chinese Medicine (TCM) was effective in treating a patient with gastric bezoar. SUBJECT AND SETTING: A 47-year-old female patient who had undergone Billroth II gastrectomy for gastric cancer had been experiencing abdominal pain and distension for 1 month. She underwent gastroscopic examination at our outpatient department; the gastroscopy showed a bezoar (7×4×2 cm in size) in her remnant stomach. Treatment using a Chinese herbal decoction was suggested. RESULTS: The gastric bezoar dissolved after 2 weeks of regular therapy with San Jie Pai Shi decoction. No complications or adverse effects were noted during the TCM treatment. CONCLUSIONS: This case showed that TCM was an effective and alternative treatment option for patients with gastric bezoar.

Invasive fungal bezoar requiring partial cystectomy.

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.

Celulasa en el tratamiento de fitobezoares / Cellulase in the treatment of phytobezoars

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