Intravaginal administration of gelatine capsules containing freeze-dried autochthonous lactobacilli: a double-blind, randomised clinical trial of safety.

Vaginal lactobacilli (LAB) in probiotic formulas constitute a promising alternative for microbiome reconstitution and for the prevention and treatment of urogenital infections. A double-blind, randomised clinical trial was conducted to assess the safety of LAB-gelatine capsules vaginally administered to healthy sexually active women. Participants were randomised into three groups: intervention A: Lactobacillus reuteri CRL1324, Lactobacillus gasseri CRL1263 and CRL1307; intervention B: Lactobacillus rhamnosus CRL1332, L. gasseri CRL1256 and CRL1320; and intervention C: placebo. In a survey and clinical evaluation, participants received a blister with 7 capsules to be administered 1 per day. A second sampling and a new survey were conducted 3-10 days after completing application. Colposcopy was performed to assess adverse effects on vaginal-cervical mucosa. Vaginal swabs were taken for Gram staining to determine the Nugent score, and obtainment of viable-cell cultures to quantify cultivable lactic acid bacteria and pathogens. The main outcomes evaluated were overall satisfaction and secondary effects, including discomfort, urogenital infection, inflammatory response or other symptoms. No significant differences were found in Nugent score or in leukocyte numbers in vaginal samples either before or after the three interventions. However, a tendency to decrease in both the Nugent score and in leukocyte numbers was observed after interventions A and B, though not after C. A significant increase in cultivable lactobacilli was determined after LAB interventions. No severe adverse events were detected. LAB-containing capsules were well tolerated by subjects, so they could be proposed as an adequate alternative to restore vaginal lactobacilli in sexually active women.

Effect of Milk Fermented with Lactic Acid Bacteria on Diarrheal Incidence, Growth Performance and Microbiological and Blood Profiles of Newborn Dairy Calves.

The effect of the administration of milk fermented with lactic acid bacteria to calves was evaluated. The strains included were: Lactobacillus murinus CRL1695, Lact. mucosae CRL1696, Lact. johnsonii CRL1693, and Lact. salivarius CRL1702, which were selected for their beneficial and functional properties and isolated from healthy calves in the northwestern region of Argentina. The trial was conducted on a dairy farm located in Tucumán (Holando-Argentino calves). A randomized controlled trial was performed in which 56 new-born animals were divided into two groups: the treated group (T) received the fermented milk for 60 days and the control group (C) only milk. The animals were fed a solid diet ad libitum. The treated group was given a daily dose of 1 × 109CFU of the probiotic fermented milk while the control group was fed milk. Body weight and biometrical parameters were recorded between 15 and 60 days of age, and average daily gain was calculated with three samplings per animal throughout the trial. Rectal swabs and fecal and blood samples were also collected. Results showed the efficacy of the probiotic: lower morbidity and mortality of calves (morbidity was 69.20% in animals without the probiotic, and 46.15% in probiotic-treated animals, with P = 0.09; mortality in C was 34.61 and 7.69% in animals fed with ferment milk; P = 0.02).The calves fed with probiotic evidenced an improvement in nutritional parameters, body condition and weight gain (health index P = 0.01; average daily gain P = 0.03).Viable bacterial numbers showed no differences between the two experimental groups. Hematological parameters and serum proteins were not modified by the treatment. The results suggest that the fermented milk containing lactic acid bacteria can be a viable veterinary product for young calves due to its beneficial effects on health and growth.

Does increased physical activity in school affect children's executive function and aerobic fitness?

This study seeks to explore whether increased PA in school affects children's executive function and aerobic fitness. The "Active school" study was a 10-month randomized controlled trial. The sample included 449 children (10-11 years old) in five intervention and four control schools. The weekly interventions were 2×45 minutes physically active academic lessons, 5×10 minutes physically active breaks, and 5×10 minutes physically active homework. Aerobic fitness was measured using a 10-minute interval running test. Executive function was tested using four cognitive tests (Stroop, verbal fluency, digit span, and Trail Making). A composite score for executive function was computed and used in analyses. Mixed ANCOVA repeated measures were performed to analyze changes in scores for aerobic fitness and executive function. Analysis showed a tendency for a time×group interaction on executive function, but the results were non-significant F(1, 344)=3.64, P=.057. There was no significant time×group interaction for aerobic fitness. Results indicate that increased physical activity in school might improve children's executive function, even without improvement in aerobic fitness, but a longer intervention period may be required to find significant effects.

Optimization of fermentation parameters to study the behavior of selected lactic cultures on soy solid state fermentation.

The use of solid fermentation substrate (SSF) has been appreciated by the demand for natural and healthy products. Lactic acid bacteria and bifidobacteria play a leading role in the production of novel functional foods and their behavior is practically unknown in these systems. Soy is an excellent substrate for the production of functional foods for their low cost and nutritional value. The aim of this work was to optimize different parameters involved in solid state fermentation (SSF) using selected lactic cultures to improve soybean substrate as a possible strategy for the elaboration of new soy food with enhanced functional and nutritional properties. Soy flour and selected lactic cultures were used under different conditions to optimize the soy SSF. The measured responses were bacterial growth, free amino acids and ß-glucosidase activity, which were analyzed by applying response surface methodology. Based on the proposed statistical model, different fermentation conditions were raised by varying the moisture content (50-80%) of the soy substrate and temperature of incubation (31-43°C). The effect of inoculum amount was also investigated. These studies demonstrated the ability of selected strains (Lactobacillus paracasei subsp. paracasei and Bifidobacterium longum) to grow with strain-dependent behavior on the SSF system. ß-Glucosidase activity was evident in both strains and L. paracasei subsp. paracasei was able to increase the free amino acids at the end of fermentation under assayed conditions. The used statistical model has allowed the optimization of fermentation parameters on soy SSF by selected lactic strains. Besides, the possibility to work with lower initial bacterial amounts to obtain results with significant technological impact was demonstrated.

Effect of physicochemical factors on glycerol production by simultaneous cultures of wine micro-organisms using the response surface method.

AIM: To evaluate the effect of temperature, pH and SO2 on growth and glycerol production improvement by Saccharomyces cerevisiae mc2, Kloeckera apiculata mF and Oenococcus oeni X2L using the response surface method (RSM). METHODS AND RESULTS: Multifactorial design of cultures with physicochemical factors variations was performed. The micro-organisms grew in all cultures conditions. Overall, after 6 days yeasts prevailed, especially S. cerevisiae (10(9) CFU ml(-1)), while O. oeni reached 10(7) CFU ml(-1). At initial fixed pH 5·5, metabolic behaviour of cultures showed a temperature-dependent response. Total malate consumption occurred at 26°C, 50 mg l(-1) SO2. Glucose and pentoses utilization was highly modified when varying SO2. Ethanol showed negative interaction with temperature-SO2 relationship. At low SO2, glycerol and acetate production increased when temperature enhanced. Predictive results of RSM indicate that 26°C, 60·24 mg l(-1) SO2 and pH 5·5 were the optimal conditions for glycerol and organic acids synthesis compatible with wine quality. CONCLUSIONS: We propose a predictive condition to improve the performance of mixed cultures for must fermentations. SIGNIFICANCE AND IMPACT OF THE STUDY: To optimize the culture conditions to design mixed starters containing autochthonous yeasts and O. oeni strains for winemaking and to obtain products with high glycerol content, low acidity and maintenance of regional characteristics.

Choice of psychological coping in laryngectomized, head and neck squamous cell carcinoma patients versus multiple sclerosis patients.

To be treated for cancer must be a frightening experience. Yet quality of life (QoL) of successfully treated cancer patients seems to be relatively similar in comparison with QoL of a general population, with psychological coping partly responsible for this finding. When measuring choice of coping, the nature of coping score levels constituting appropriate scores, and whether score levels rely on the context of the disease has not been settled. We have studied the COPE coping responses as related to disease in successfully treated head and neck squamous cell carcinoma (HNSCC) patient groups (general and laryngectomized), as well as compared to multiple sclerosis (MS) patients. The COPE response patterns have also been compared to the Beck depression inventory (BDI) scores. Age and gender of patients were not directly associated with choice of coping. Within the problem-focused coping indexes, the coping index "active coping" was reported to be most utilized among HNSCC patients, whereas "coping by suppression" and "coping by social support" were most utilized among MS patients. Emotional-focused coping was most prevalent among HNSCC patients and lowest among the MS patients. Level of avoidance coping was similar between the groups. The coping of the general HNSCC patients differed most from the MS patients. An association was shown between increased coping efforts and lowered mood. In particular, avoidance coping was associated with lowered mood. These associations were stronger among the MS patients than HNSCC patients. Drinking to cope was most prevalent among the laryngectomized group, and was correlated with BDI scores in all groups. Furthermore, adequate coping seems to be to limit avoidance coping and promote coping by acceptance. The response pattern of the COPE inventory seems to be valid among HNSCC and MS patients.

Coping with multiple sclerosis: a 5-year follow-up study.

OBJECTIVES: To examine how coping styles among patients with multiple sclerosis (MS) change over time and how patients' coping styles after 5 years are associated with disability pension. MATERIALS AND METHODS: Seventy-six MS patients and 94 healthy controls were included in this study. The patients were examined at baseline and 5 years later. This included a neurological examination and information on disability pension and a questionnaire assessing coping (the COPE scale). Controls were registered at baseline only. RESULTS: Compared to healthy controls, MS patients were more passive in coping with disease related distress. This was even more pronounced 5 years later. Disability pensioned patients employed more social support, venting of emotions and behavioural disengagement at follow-up. CONCLUSION: This study shows that patients with MS employ coping styles that may be inadequate and this is not improved by adaption over time. Although patients also use strategies to enhance their lives, these findings suggest that there may be a potential for improving the lives of patients with MS through interventions that may enhance adequate coping with the disease.

Depressive symptoms and coping in newly diagnosed patients with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic disease with unclear etiology, unpredictable clinical course, and no cure. Patients' ability to cope with MS moderates the adaptation to the disease. OBJECTIVES: To compare coping in patients recently diagnosed with MS and healthy controls and to study the association between depressive symptoms and patients' coping styles. METHODS: A sample of 86 recently diagnosed patients with definite or probable MS and 93 healthy population controls completed questionnaires assessing coping styles and depressive symptoms. RESULTS: Compared with healthy controls, patients with MS used significantly less the problem focused strategies including planning, restraint coping, and seeking social support for instrumental reasons, and they used less the emotion-focused strategies seeking social support for emotional reasons, focusing on and venting of emotions, and positive reinterpretation and growth. The mean Beck Depressive symptoms Inventory scores were 10.8 and 4.7 in patients and controls, respectively. In stress situations connected to MS, depressive symptoms in these patients were related to the problem-focused strategies of restraint coping and planning, the emotion-focused strategy of focusing on and venting of emotions, and the avoidance strategies of behavioral- and mental disengagements, and denial.

Summer influenza outbreak in a home for the elderly: application of preventive measures.

Influenza outbreaks occasionally occur in nursing homes (NHs) despite vaccination, but occurrence during summer is a rare event. We describe an influenza outbreak during a heatwave in 2005, and discuss the usefulness of rapid diagnosis in facilitating early intervention as well as appropriate infection control measures. An outbreak was observed in a single NH with 81 residents (mean age 88 years) and 48 healthcare workers (HCWs) and lasted seven days. Fever, cough and wheezing were reported as the main symptoms in 32 affected residents (39.5%) and 6 (12.5%) HCWs. Influenza was suspected and provisionally confirmed by a rapid diagnostic test performed on specimens from four patients. The outbreak was further confirmed by culture and reverse transcriptase-polymerase chain reaction in seven out of 10 residents. The strain was similar to the winter epidemic strain of the 2004-2005 season: H3N2A/New York/55/2004. As soon as the outbreak was confirmed, a crisis management team was set up with representatives of the local health authority and NH staff. A package of measures was implemented to control the outbreak, including patient isolation and the wearing of surgical masks by all residents and staff. A therapeutic course of oseltamivir was prescibed to 19/32 symptomatic patients and to 5/6 HCWs, and 47 residents and 42 remaining HCWs received a prophylactic post-exposure regimen. The outbreak ended within 48 h. Case fatality rate was 15.6% among residents. Pre-outbreak influenza vaccine coverage among the residents was 93.5% and 41.7% in HCWs. The rapid diagnostic test enabled prompt action to be taken, which facilitated infection control measures.

Patient information and coping styles in multiple sclerosis.

BACKGROUND: Patients with multiple sclerose (MS) live with their disease for many years. The cause of the disease is unknown and there are no curative therapies. Patients' adaption to chronic disease is dependent on the effectiveness of coping behaviour. OBJECTIVES: To explore the correlation between the quality of perceived disease information and to estimate the correspondance between the quality of perceived disease information and later coping styles applied by MS-patients in stress situations related to their disease. METHODS: Of a total of 108 patients recently diagnosed with MS, 93 agreed to participate in the study and 86 of these completed two different questionnaires, one assessing quality of the perceived information and the other asessing coping styles (the COPE scale). RESULTS: 43.2% of the patients were dissatisfied or very dissatisfied with the information by the time of diagnosis. MS-related coping styles were influenced by general coping styles and the most frequently employed strategies were ;positive reinterpretation and growth', ;planning' and ;restraint coping' while ;denial' was the most infrequently employed strategy. Patients who were satisfied with the information employed avoidance coping to a lesser extent and more actively both plan and seek information about the situation. CONCLUSION: Optimizing the information process in the early phase of the disease may induce coping styles that produce a better adaption to living with MS.

Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients.

OBJECTIVES: To study self-reported coping style by the COPE questionnaire and the association to tumour node distant metastasis (TNM) stage, received treatment and health-related quality of life (HRQoL) in a population of successfully treated head and neck squamous cell carcinoma (HNSCC) patients. DESIGN: Disease free HNSCC patients were interviewed during a regular outpatient visit to the Department. SETTING: All patients <80 years who had been diagnosed with HNSCC, in Western Norway, in the period from 1992 to 1997 and who were disease free in the year 2000 were included. MAIN OUTCOME MEASURES: The HNSCC patients were studied by the European organization for research and treatment of cancer quality of life (QoL) questionnaire and by the COPE questionnaire from which coping styles profiles were extracted. Clinical and socio-demographic variables were also gathered. RESULTS: Level of problem focused coping style was associated with the T stage and whether or not the patient was given neck radiotherapy. An avoidance-focused coping style was generally associated with lowered HRQoL. Employment of emotional focused coping was associated with low HRQoL among the patients treated with surgery only, and associated with increased HRQoL among patients treated with radiation therapy only. The associations between HRQoL and coping style levels were stronger for HRQoL indexes reflecting cognitive/emotional function than for HRQoL indexes reflecting physical function. CONCLUSIONS: In former HNSCC patients, level of problem focused coping style was associated with the T stage and if given neck radiotherapy. Level of avoidance coping was inversely associated with the HRQoL, and level of emotional coping was associated with HRQoL in a complex manner.

The personality and quality of life in HNSCC patients following treatment.

The aim of the present study was to investigate the association between self-reported quality of life (QoL) and personality in successfully treated primary head and neck squamous cell carcinoma (HNSCC) patients. We determined QoL using the European Organisation for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ) C30/H and N35, and personality by the Eysenck Personality Inventory (EPI). All patients younger than 80 years who had been diagnosed with HNSCC in Western Norway in the period from 1992 to 1997, and who had survived until 1999, were sampled. 96 patients (a 90% response rate) were included. Questionnaires were also mailed to all Norwegian laryngectomised patients; 104 patients returned the questionnaires (a 50% response rate). The neuroticism scores were test re-test reliable as determined by the neuroticism scores measured at the primary HNSCC diagnosis for a sub-sample (N=22) of the included patients. High neuroticism was associated with a low QoL in both patient samples. The neuroticism score was associated with the QLQ-C30 scales (common variance: 17-25%) and all QoL scores in the laryngectomised group (common variance: 11-25%), and the H and N35 symptom scores in the laryngectomised sample. The associations could still be shown when adjustments were made for gender, age, marital status, educational level, number of children and level of treatment. Extraversion was associated with general QoL, physical and emotional scores in the HNSCC patient sample. Radiation therapy in the HNSCC sample was associated with the H and N35 symptom scores, but different ones to those associated with neuroticism. In conclusion, high neuroticism, but not extraversion, is associated with a lowered QoL.

Influence of pH, temperature and culture media on the growth and bacteriocin production by vaginal Lactobacillus salivarius CRL 1328.

AIMS: To study the influence of pH, temperature and culture medium on the growth and bacteriocin production by vaginal Lactobacillus salivarius subsp. salivarius CRL 1328. METHODS AND RESULTS: The study was performed using a complete factorial experimental design. Lactobacillus salivarius was cultivated in LAPTg and MRS broths, adjusted to specific initial pH, and at different temperatures of incubation. The growth, which was evaluated by the Gompertz model, was higher in MRS broth than in LAPTg broth. The initial pH of the culture medium and the temperature had a dramatic effect on the production of bacteriocin. The optimal conditions for bacteriocin production were different to those for optimal growth. The decrease in the pH of the culture medium was parallel to the growth; pH had similar final values in both the MRS and the LAPTg broths. CONCLUSIONS: The optimal growth conditions were recorded in MRS broth, with an initial pH of 6.5 and a temperature of 37 degrees C. The maximum bacteriocin activity was obtained in LAPTg after 6 h at 37 degrees C, and at an initial pH of 6.5 or 8.0. SIGNIFICANCE AND IMPACT OF THE STUDY: The application of a complete factorial design, and the evaluation of the growth parameters through the Gompertz model, enabled a rapid and simultaneous exploration of the influence of pH, temperature and growth medium on both growth and bacteriocin production by vaginal Lact. salivarius CRL 1328.

Effect of Lactobacillus casei and yogurt administration on prevention of Pseudomonas aeruginosa infection in young mice.

Pseudomonas aeruginosa is an opportunistic pathogen that rarely causes pulmonary disease in normal hosts but one that is an important cause of acute pneumonia in immunocompromised patients, including neonates, and of chronic pneumonia in patients with cystic fibrosis. The aim of this work was to study the effect of oral administration of Lactobacillus casei and yogurt on prevention of P. aeruginosa lung infection in young mice (3 weeks old). This study demonstrates that oral administration of L. casei or yogurt to young mice enhanced lung clearance of P. aeruginosa and phagocytic activity of alveolar macrophages through a dose-dependent effect. There were, however, no significant differences in white blood cell (WBC) differential counts. Furthermore, it was observed that previous administration of L. casei or yogurt induced a significant increase in IgA and IgM levels in bronchoalveolar lavages (BALs) after a P. aeruginosa infection, although there was no relationship with the serum values.

Social relationships and mortality in patients with congestive heart failure.

The present study was undertaken to evaluate the possible effects of social relationships (perceived social support, and perceived social isolation) upon mortality risk among patients with congestive heart failure (CHF). Proportional hazard models were used to evaluate the effects of different social factors on mortality among 119 clinically stable patients (71.4% men; mean age 65.7+/-9.6 years) with symptomatic heart failure, recruited from an outpatient cardiology practice. Twenty deaths were registered during the 24-month period of data collection, all from cardiac causes. Results indicated that social isolation was a significant predictor of mortality (relative risk, 1.50, confidence interval (CI), 1.00 to 2.19; P<.038), controlling for depressive symptoms, heart failure severity, and functional status and age. Perceived intimate network support was marginally significantly associated with increased risk of mortality in this population of CHF patients (relative risk, 0.60, CI, 0.35-1.02; P<.06). However, the sample is small and caution in drawing conclusions should be exercised. Further research is required in order to either deny or confirm these findings, and to illuminate the mechanisms behind the relationships between social isolation and mortality.

Social support, negative life events and pupil misbehaviour among young Norwegian adolescents.

Relationships between negative life events, perceived social support and pupil misbehaviour were assessed in a national representative sample of 1057 Norwegian young adolescents aged 14 and 15. Negative life events were significantly associated with pupil misbehaviour among both male and female adolescents. Support from parents, friends and teachers was negatively associated with pupil misbehaviour.

Depressed mood and subjective health symptoms as predictors of mortality in patients with congestive heart failure: a two-years follow-up study.

OBJECTIVE: The present study was undertaken in order to evaluate the relationship between depressed mood (depression, emotional distress) and disease-specific subjective health symptoms upon mortality risk among patients with congestive heart failure (CHF). METHODS AND RESULTS: Proportional hazard models were used to evaluate the effects of selected biomedical, subjective health and psychological variables on mortality among 119 clinically stable patients (71.4% men; mean age 65.7 years +/- 9.6) with symptomatic heart failure, recruited from an outpatient cardiology practice. Twenty deaths were registered during the twenty-four-month period of data collection, all from cardiac causes. Results indicated that depressed mood was a significant predictor of mortality with a hazard ratio of 1.9, p .002. In contrast, subjective health was not a significant predictor of mortality in a Cox regression model that included depressed mood. The hazard ratio for a 1-point increase in Zung Depression Scale score was equal to 1.08 based on the multivariate model. CONCLUSIONS: Results indicate that depressed mood is significantly related to increased mortality risk among heart failure patients. This finding is of concern to clinicians and should have implications for treatment of patients with congestive heart failure.

Functional status and depression among men and women with congestive heart failure.

OBJECTIVE: The study was designed 1) to examine the prevalence of depression in patients with congestive heart failure (CHF); 2) to explore associations between the physician's rating of functional status (NYHA class) and patient's assessment of functional status (physical limitation, dyspnea) with symptoms of depression; and 3) to explore gender related differences in relation to physician's rating and patient's rating of function status, and symptoms of depression. METHOD: A sample of 119 clinically stable heart failure patients (85 males and 34 females) was recruited from an outpatient cardiology hospital practice. The patients underwent a physical examination and completed a set of questionnaires. Prevalence of depressive symptoms and the association of these symptoms with NYHA class and patient's perceived functional status was studied. RESULTS: Findings indicate that depressive symptoms were not predominant among this sample of CHF patients. Path analyses showed non-significant direct associations between NYHA class as well as patient's perception of dyspnea with depression. In contract, the subjective indicator of physical limitations was strongly associated with symptoms of depression among the males, but this relation was not significant among the females. CONCLUSIONS: Results suggest that men and women respond differently to the burden of heart failure. However, interpretation of the results from the present study should be considered as tentative and additional research is required to examine mechanisms that explain gender differences in response to heart failure.

Evolution in time of the relationship between occlusion and tooth absence.

The evolution in time of the relationship between occlusion tooth absence was studied in 204 people in Salamanca, in 1996. The data collected in an oral test (biting in maximal intercuspidation on articulating paper) were analysed using the method called expansion-contraction systems. The results show that the loss of occlusion through time is directly related to the absence of premolars and molars. Incisors and canines occlude more in elderly people. This supports the view of a polarization in the evolution of the occlusion towards canines and premolars whereas tooth absence is polarized towards molars.

Social support, social disability and their role as predictors of depression among patients with congestive heart failure.

The purpose of this study was to assess the effect of social support variables, personality, clinical variables (New York Heart Associations classification), and social disability upon depression. The sample consisted of 119 clinically stable patients (34 females, 85 males) with symptomatic heart failure, recruited from an outpatient hospital practice. The patients underwent a brief physical examination and completed a set of questionnaires. Descriptive statistics were used to characterise the patients' informal functional network. The analysis revealed that the intimate social network support (spouses) and primary social network support (close family) were rated as most supportive. Results from the path analysis showed that social disability was explained by the two personality factors, neuroticism and extraversion, and by the severity of disease (NYHA). No significant effects of the social support variables upon social disability were detected. Moreover, path-analyses showed that poor intimate network support, social disability and neuroticism were significantly positively associated with depression.