Refeeding syndrome in adults with celiac crisis: a case report.

BACKGROUND: Refeeding syndrome is a rare and life-threatening pathology with polyvisceral manifestations occurring in severely malnourished patients. It is rarely described in adults with celiac disease. CASE PRESENTATION: We report the case of a 28-year-old Tunisian woman followed up for celiac disease, who did not adhere to the gluten-free diet. She presented to our hospital with celiac crisis manifested by severe diarrhea, and metabolic and electrolyte disturbances. The treatment of electrolyte abnormalities, hydration, and nutritional support was marked by the occurrence on the fifth day of refeeding syndrome with psychomotor agitation followed by respiratory distress and a state of cardiogenic shock. CONCLUSIONS: Refeeding syndrome is still under-recognized. It should be systematically prevented for high-risk patients. Nutritional support in patients with celiac crisis should be monitored carefully since the risk of refeeding syndrome is very high with a poor prognosis.

Partial characterization of a novel amylase activity isolated from Tunisian Ficus carica latex.

CONTEXT: A large number of plants still need to be investigated through screening of amylases suitable for industry. In the present study, and for the first time, we describe the amylolytic activity of Saint Pedro Ficus carica L. (Moraceae) crude latex of Kahli and Bidhi varieties. OBJECTIVE: Effects of temperature, pH, metal ions, and inhibitors and compatibility with some commercial detergents were investigated for amylase activity. MATERIALS AND METHODS: Amylase activity was screened in crude latex using the DNS method and potato starch as a substrate. Analyses of amylolytic reaction products by thin-layer chromatography (TLC) and high-performance liquid chromatography (HPLC) were performed. RESULTS: Bidhi and Kahli amylases were active in optimal pH of 6.5 and 7 at 45°C, respectively, displaying a half life of 85 and 60 min, respectively, at 80°C, and they were very stable in a wide range of pH (4-12). Bidhi amylase activity increased to 260% by addition of 10(-3) mM Fe(2+) or 10(-2) mM Cu(2+), and was strongly inhibited by Mg(2+) and EDTA. In the presence of Ca(2+) and Mg(2+), Kahli amylase activity was dramatically enhanced by 220 and 260%, respectively. The compatibility of both amylases with certain commercial detergents was also shown to be good as enzymes retained up to 98% of their activities after 30 min of incubation at 80°C. DISCUSSION AND CONCLUSION: Analysis of amylolytic reaction products by TLC and HPLC suggested that Kahli amylase was an amyloglucosidase and Bidhi amylase was ß-fructose, α(1-4) glucose. Bidhi amylase is a good choice for application in starch, food, detergents and medical industries.

In vitro antimicrobial activity of four Ficus carica latex fractions against resistant human pathogens (antimicrobial activity of Ficus carica latex).

Methanolic, hexanoïc, chloroformic and ethyl acetate extracts of Ficus carica latex were investigated for their in vitro antimicrobial proprieties against five bacteria species and seven strains of fungi. The green fruit latex was collected from Chott Mariam Souse, Middle East coast of Tunisia. The antimicrobial activity of the extracts was evaluated and based respectively on the inhibition zone using the disc-diffusion assay, minimal inhibition concentration (MIC) for bacterial testing and the method by calculating inhibition percentage (I%) for fungi-inhibiting activities. The methanolic extract had no effect against bacteria except for Proteus mirabilis while the ethyl acetate extract had inhibition effect on the multiplication of five bacteria species (Enterococcus fecalis, Citobacter freundei, Pseudomonas aeruginosa, Echerchia coli and Proteus mirabilis). For the opportunist pathogenic yeasts, ethyl acetate and chlorophormic fractions showed a very strong inhibition (100%); methanolic fraction had a total inhibition against Candida albicans (100%) at a concentration of 500 microg/ml and a negative effect against Cryptococcus neoformans. Microsporum canis was strongly inhibited with methanolic extract (75%) and totally with ethyl acetate extract at a concentration of 750 microg/ml. Hexanoïc extract showed medium results.