Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management

Recently, low-residue diets were removed from the American Academy of Nutrition and Dietetics’ Nutrition Care Manual due to the lack of a scientifically accepted quantitative definition and the unavailability of a method to estimate the amount of food residue produced. This narrative review focuses on defining the similarities and/or discrepancies between low-residue and low-fiber diets and on the diagnostic and therapeutic values of these diets in gastrointestinal disease management. Diagnostically, a low-fiber/low-residue diet is used in bowel preparation. A bowel preparation is a cleansing of the intestines of fecal matter and secretions conducted before a diagnostic procedure. Therapeutically, a low-fiber/low-residue diet is part of the treatment of acute relapses in different bowel diseases. The available evidence on low-residue and low-fiber diets is summarized. The main findings showed that within human disease research, the terms “low residue” and “low fiber” are used interchangeably, and information related to the quantity of residue in the diet usually refers to the amount of fiber. Low-fiber/low-residue diets are further explored in both diagnostic and therapeutic situations. On the basis of this literature review, the authors suggest redefining a low-residue diet as a low-fiber diet and to quantitatively define a low-fiber diet as a diet with a maximum of 10 g fiber/d. A low-fiber diet instead of a low-residue diet is recommended as a diagnostic value or as specific therapy for gastrointestinal conditions.     

Silent trauma

Abstract— Patients who present with discolored and/or symptomatic anterior teeth for which there are no obvious etiologic factors should be carefully questioned regarding their past surgical history. If the patient denies a history of trauma yet relates a recent, (2–5 years) history of undergoing general anesthesia, a differential diagnosis including trauma secondary to endotracheal intubation should be considered.     

Oculopharyngeal muscular dystrophy (OPMD) due to a small duplication in the PABPN1 gene

Oculopharyngeal muscular dystrophy (OPMD) is a late onset autosomal dominant muscle disorder. The OPMD-locus has been mapped to chromosome 14q11.2-q13. The polyadenylate binding protein nuclear 1 (PABPN1; PABP2) gene has been identified as the mutated gene. The mutation consists of a short meiotically stable trinucleotide repeat in the first exon of PABPN1 gene. We have investigated Dutch OPMD patients from four unrelated families and identified a new mutation in two of the four families. Instead of a repeat expansion we found a duplication in the first exon of the PABPN1 gene (c.27_28ins12, p.11_12insAAAA). The identification of this new mutation supports the theory of unequal crossing-over as molecular mechanism causing the mutation in the PABPN1 gene responsible for OPMD, and not the slippage model.     

The DFNB31 gene product whirlin connects to the Usher protein network in the cochlea and retina by direct association with USH2A and VLGR1

Mutations in the DFNB31 gene encoding the PDZ scaffold protein whirlin are causative for hearing loss in man and mouse. Whirlin is known to be essential for the elongation process of the stereocilia of sensory hair cells in the inner ear, though its complete spatial and temporal expression patterns remained elusive. Here, we demonstrate that, in embryonic development, the gene is not only expressed in the inner ear, but also in the developing brain and the retina. Various isoforms of whirlin are widely and differentially expressed, and we provide evidence that whirlin directly associates with USH2A isoform b and VLGR1b, two proteins that we previously reported to be part of the Usher protein interactome. These proteins co-localize with whirlin at the synaptic regions of both photoreceptor cells and outer hair cells in the cochlea. These findings indicate that whirlin is part of a macromolecular PDZ protein scaffold that functions in the organization of the pre- and/or postsynaptic side of photoreceptor and hair cell synapses. Whirlin might be involved in synaptic adhesion through interaction with USH2A and VLGR1b as well as in synaptic development as suggested by its spatial and temporal expression patterns. In addition, we demonstrate that whirlin, USH2A and Vlgr1b co-localize at the connecting cilium and the outer limiting membrane of photoreceptor cells and in spiral ganglion neurons of the inner ear. Our data show that whirlin is connected to the dynamic Usher protein interactome and indicate that whirlin has a pleiotropic function in both the retina and the inner ear.     

Silent trauma

Patients who present with discolored and/or symptomatic anterior teeth for which there are no obvious etiologic factors should be carefully questioned regarding their past surgical history. If the patient denies a history of trauma yet relates a recent, (2-5 years) history of undergoing general anesthesia, a differential diagnosis including trauma secondary to endotracheal intubation should be considered.     

Characterization and assembly of poliovirus-related 45 S particles

Using detergents, 45 S particles could be extracted from poliovirus-infected Vero and human embryonic kidney monolayer cells, but not from HeLa suspension cells. They were composed of the capsid proteins VP0, VP1, and VP3, devoid of RNA, and extremely sensitive to heat or to a slightly alkaline pH. The 45 S particles possessed neutralization epitopes of the N1 and N2 classes, as well as a VP3-linked epitope. The N2 epitopes were lost upon denaturation. In the presence of cell extracts 45 S particles were, like 14 S subunits, assembled to 71 S empty capsids expressing the N1 and N2 epitopes.     

Clinical profile of astemizole. A survey of 50 double-blind trials

From clinical-pharmacologic and clinical data involving over 2,800 patients, astemizole appears to be a very effective and well-tolerated antihistamine. It is superior to placebo and commonly used antihistamines for the relief of rhinitis, particularly rhinorrhea and sneezing. It has a pronounced effect on ocular itching and lacrimation in conjunctivitis and on pruritus and wheals in urticaria. This superiority is due to a very specific, almost complete and sustained histamine H1-blockade. The clinical data confirm the experimental data in relation to its lack of sedative effects.