Revisión sistemática de intervenciones de fisioterapia respiratoria y sus efectos en la función pulmonar en pacientes obesos intervenidos de cirugía bariátrica / Systematic review of Respiratory Physiotherapy interventions and their effects on lung function in obese patients operated of bariatric surgery

Introducción La incidencia de obesidad alcanza casi un tercio de la población mundial. En España habrá más de 27 millones de personas con obesidad para 2030, suponiendo una enorme carga socioeconómica, obligando a realizar intervenciones como la cirugía bariátrica (CB) que también tiene sus complicaciones. En los últimos años ha existido un avance de técnicas de fisioterapia respiratoria (FR) por ejemplo, empleando ejercicios respiratorios o utilizando presión positiva (PP). Objetivo Revisar sistemáticamente las intervenciones de FR en CB centrándonos en el tipo de intervención, momento y sus efectos sobre la función pulmonar. Metodología Se realizó la búsqueda en las bases PubMed, CINAHL y PEDro hasta marzo del 2022. Se incluyeron estudios de intervenciones de FR, que midieran la función pulmonar, en contexto pre-posquirúrgico de CB. Se excluyeron los trabajos que no aportaran datos originales, intervención no realizada por fisioterapeutas o que no miden función respiratoria. La calidad metodológica de los estudios se evaluó con la escala PEDro y JBI cheklist for cohort studies. Resultados Fueron incluidos 16 documentos, 20% presentó excelente calidad metodológica y 50% buena. El tamaño muestral varió entre 24 y 148, al igual que la edad (entre 18-60 años) incluso alcanzando 75 años en algún estudio, predominando el género femenino. El tipo de intervenciones (manuales, instrumentales o educacionales), momento de aplicación (pre y posquirúrgicas) y resultados evaluados fueron muy heterogéneos. Conclusiones Existe gran variabilidad de intervenciones de fisioterapia en CB, la mayoría (75%) mejoran la función pulmonar, otras indican falta de eficacia y algunas no indican cambios (AU)

Introduction The incidence of obesity reaches almost a third of the world population. In Spain, there will be more than 27 million people with obesity in 2030. Assuming an enormous socioeconomic burden, forcing interventions such as bariatric surgery, whit their complications. In recent years, there has been an advance in Respiratory Physiotherapy (RP) techniques, for example, using breathing exercises or using positive pressure (PP). Objective To systematically review RP interventions in bariatric surgery, focusing on the type of intervention, timing, and its effects on lung function. Methodology PubMed, CINAHL and PEDro databases were searched until March 2022. RP emergency studies were included, which measured lung function, in the pre-post-surgical context of bariatric surgery. Studies that did not provide original data, intervention not performed by physiotherapists or that did not measure respiratory function were excluded. The methodological quality of studies was evaluated with the PEDro scale and the JBI checklist for cohort studies. Results 16 documents were included, 20% presented excellent methodological quality and 50% good. The sample size varied between 24 and 148 and age (between 18-60 years), even reaching 75 years in some studies, with the female gender predominating. The type of outbreak (manual, instrumental or educational), time of application (pre and post-surgery) and results evaluated were very heterogeneous. Conclusions There is a high variability in physiotherapy interventions used in bariatric surgery, most (75%) improve lung function, others indicate lack of efficacy and some do not indicate changes (AU)

Effects of Lactobacillus fermentum CECT5716 Lc40 on infant growth and health: a randomised clinical trial in nursing women.

The breast milk microbiota has been described as a source of bacteria for infant gut colonisation. We studied the effect of Lactobacillus fermentum CECT5716 (Lc40) on growth and infection incidence of the infants, when the probiotic is administrated to the mothers. Moreover, whether such effects might depend on the interaction between the mother or infant microbiota and the probiotic administration. A total of 291 mother-infant pairs were studied for 16 weeks in a randomised double-blinded placebo-controlled multicentre trial. The Lc40 group (n=139) received 1 capsule/day containing 3×109 cfu Lc40; the control group (n=152) received 1 placebo (maltodextrin) capsule/day. A positive and significant correlation of the Staphylococcus load between breast milk and infant faeces was only observed in control group. Additionally, the weight z-score of the infants whose mothers had higher values of Lactobacillus in their breast milk were significantly higher for the Lc40 group. We observed a significant lower incidence of conjunctivitis in the infants whose mothers received Lc40. A higher load of Staphylococcus in infant faeces significantly increased the risk of respiratory infections. Such incidence, under an absent or low Staphylococcus load in the faeces, was significantly 36 times higher in the infants in the control group than in the infants in the Lc40 group. However, the protective effect of Lc40 was gradually reduced as the Staphylococcus load of the milk increased. The administration of Lc40 to nursing women might influence infant growth and health but it seems to depend on its interactions with mother or infant microbiota. Registered in the US Library of Medicine (www.clinicaltrials.gov): NCT02203877.

Mercury and selenium binding biomolecules in terrestrial mammals (Cervus elaphus and Sus scrofa) from a mercury exposed area.

Mercury (Hg) is likely bound to large biomolecules (e.g. proteins) in living organisms, and in order to assess Hg metabolic pathways and possible toxicological effects, it is essential to study these Hg containing biomolecules. However, the exact nature of most metal binding biomolecules is unknown. Such studies are still in their infancy and information on this topic is scarce because the analysis is challenging, mainly due to their lability upon digestion or extraction from the tissue. New analytical methods that allow complex Hg-biomolecules to be analysed intact are needed and only few very recent studies deal with this approach. Therefore, as an initial step towards the characterization of Hg containing biomolecules, an analytical procedure has been optimised using size-exclusion chromatography (SEC) with inductively coupled plasma mass spectrometry (ICP-MS) detection. We applied this technique to elucidate the distribution and elution profile of Hg and Se, and some physiological important elements such as Fe, Ni, Zn and Cu, to assess metal binding profiles in liver and kidney samples of red deer (Cervus elaphus) and wild boar (Sus scrofa) who roam freely within the largest Hg mining district on Earth, Almadén in Spain. Elemental fractionation profiles of the extracts from different tissues were obtained using two different SEC columns (BioSep-SEC-S2000 GL 300-1kDa and Superdex 75 10/300 GL 70-3kDa). Similar profiles of Hg were observed in red deer and wild boar; however, significant differences were evident for liver and kidney. Moreover, the profiles of Se showed a single peak at high-medium molecular weight in all investigated tissues, while co-elution of Hg with Fe, Ni, Zn and Cu was observed.

Mercury species accumulation and trophic transfer in biological systems using the Almadén mining district (Ciudad Real, Spain) as a case of study.

The impact of mercury (Hg) pollution in the terrestrial environments and the terrestrial food chains including the impact on human food consumption is still greatly under-investigated. In particular, studies including Hg speciation and detoxification strategies in terrestrial animals are almost non-existing, but these are key information with important implications for human beings. Therefore, in this work, we report on Hg species (inorganic mercury, iHg, and monomethylmercury, MeHg) distribution among terrestrial animal tissues obtained from a real-world Hg exposure scenario (Almadén mining district, Spain). Thus, we studied Hg species (iHg and MeHg) and total selenium (Se) content in liver and kidney of red deer (Cervus elaphus; n = 41) and wild boar (Sus scrofa; n = 16). Similar mercury species distribution was found for both red deer and wild boar. Major differences were found between tissues; thus, in kidney, iHg was clearly the predominant species (more than 81%), while in liver, the species distribution was less homogeneous with a percentage of MeHg up to 46% in some cases. Therefore, Hg accumulation and MeHg transfer were evident in terrestrial ecosystems. The interaction between total Se and Hg species has been evaluated by tissue and by animal species. Similar relationships were found in kidney for both Hg species in red deer and wild boar. However, in liver, there were differences between animals. The possible underlying mechanisms are discussed.

Mercury speciation analysis in terrestrial animal tissues.

No previous analytical procedures are available and validated for mercury speciation analysis in terrestrial animal tissues. This analysis is a difficult task both because the expected concentrations are low, since important accumulation process are not likely to occur, and also because there are not commercially available certified reference material. Thus, an analytical methodology has been developed and validated for mercury speciation for the specific case of terrestrial animal tissues. The proposed method is based on the quantitative extraction of the species by closed-vessel microwave assisted heating with an alkaline reagent, followed by ethylation. The ethylated derivatives were then submitted to head-space solid phase microextraction with a 100 µm polidimethylsiloxane-coated fiber, and desorbed onto a gas chromatograph coupled to atomic fluorescence detection via pyrolysis unit (HS-SPME-GC-pyro-AFS). Procedural detection limits were 31.8 ng g(-1) and 52.5 ng g(-1) for CH(3)Hg(+) and Hg(2+), respectively, for liver and 35.3 ng g(-1) and 58.1 ng g(-1) for CH(3)Hg(+) and Hg(2+), respectively, for kidney. These limits of detection are 5.5 and 6 times better than the obtained without solid phase microextraction for CH(3)Hg(+) and Hg(2+), respectively. The methodology was found linear up to 120 µg L(-1) and reproducible from one day to the following. It was validated with certified reference materials NCS ZC 71001 (beef liver) and BCR No 186 (pig kidney) for total mercury, calculated as the sum of species, and with spiked red deer liver and kidney for speciation. Finally, it was applied to the analysis of samples of red deer liver, red deer kidney and wild boar kidney coming from the Almadén's mercury mining area (Ciudad Real, Spain), the longest and largest producer of mercury in the world until its closure in 2002.

Comparison of gas chromatographic hyphenated techniques for mercury speciation analysis.

In this study, we evaluate advantages and disadvantages of three hyphenated techniques for mercury speciation analysis in different sample matrices using gas chromatography (GC) with mass spectrometry (GC-MS), inductively coupled plasma mass spectrometry (GC-ICP-MS) and pyrolysis atomic fluorescence (GC-pyro-AFS) detection. Aqueous ethylation with NaBEt(4) was required in all cases. All systems were validated with respect to precision, with repeatability and reproducibility <5% RSD, confirmed by the Snedecor F-test. All methods proved to be robust according to a Plackett-Burnham design for 7 factors and 15 experiments, and calculations were carried out using the procedures described by Youden and Steiner. In order to evaluate accuracy, certified reference materials (DORM-2 and DOLT-3) were analyzed after closed-vessel microwave extraction with tetramethylammonium hydroxide (TMAH). No statistically significant differences were found to the certified values (p=0.05). The suitability for water samples analysis with different organic matter and chloride contents was evaluated by recovery experiments in synthetic spiked waters. Absolute detection and quantification limits were in the range of 2-6 pg for GC-pyro-AFS, 1-4 pg for GC-MS, with 0.05-0.21 pg for GC-ICP-MS showing the best limits of detection for the three systems employed. However, all systems are sufficiently sensitive for mercury speciation in environmental samples, with GC-MS and GC-ICP-MS offering isotope analysis capabilities for the use of species-specific isotope dilution analysis, and GC-pyro-AFS being the most cost effective alternative.

Mercury speciation in fish tissues from a Mediterranean River basin: the Tagus River (central Spain) as a case study.

An assessment of mercury (Hg) accumulation in fish from the Tagus River aquatic system (central Spain), which has been influenced by pollution from industrial and urban development, was performed. Total Hg (THg), inorganic Hg (IHg), and monomethylmercury (MMHg) were determined in muscle and liver of different fish species, including Cyprinus carpio, Ameiurus melas, and Chondrostoma miegii, sampled from three locations. Although concentrations of THg and Hg species showed wide variability among the fish species, they were also found to be considerably dependent on location and fish tissue. Relative contents of MMHg to THg in muscle varied from 60 to 88%, whereas those found in liver ranged from 7 to 59%. Mean THg concentrations ranged from 126 to 810 ng/g (dry weight [dw]) in liver and from 159 to 1057 ng/g dw in muscle. Therefore, the mean THg concentration in all fish muscle samples was far lower than the maximum residue level recommended by the European Union for fishery products. Nevertheless, the concentrations of Hg in fish muscle reported in this study were somewhat increased compared with other areas geographically distant from most major anthropogenic Hg sources and, in some cases, even greater than those previously reported elsewhere in more polluted areas. In contrast, Hg contents in liver were lower than those found in Hg-contaminated areas, but they were within the range found in other areas exposed to diffuse sources of pollution by Hg. Thus, this article provides an overview of the concentration and distribution of Hg species in fish muscle and liver tissues samples taken from a freshwater system in the Mediterranean River basin.

Asociación entre el gen del transportador de la serotonina y rasgos de personalidad en pacientes con trastorno límite de la personalidad evaluados mediante el Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) / Association between the serotonin transporter gene and personality traits in borderline personality disorder patients evaluated with Zuckerman-Kuhlman Personality Questionnaire (ZKPQ)

Introduction. The serotoninergic system seems to be implicated in characteristic symptoms of borderline personality disorder (BPD) such as affective instability, impulsivity or suicide. Some studies suggest an association between serotonin transporter gene (5-HTT) polymorphisms and some BPD symptoms. Short allele (S) of the 5-HTTLPR polymorphism in the promoter region has been shown to be associated with impulsivity, aggressive behavior, anxiety and neuroticism. Of the variable number of tandem repeat (VNTR) polymorphism in intron 2, BPD patients showed higher frequencies of the allele with the 10 repeats. The aim of this study was to determine the association between 5-HTTLPR and VNTR polymorphism of 5-HTT and personality traits in borderline personality disorder. Method. A total of 65 BPD patients diagnosed by means of semi-structured interviews SCID-II and DIB-R were included. Two common polymorphisms of 5-HTT were genotyped: the 5-HTTLPR in the promoter region and VNTR in intron 2. Personality traits were assessed by the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Results. Patients with L allele (L/S or L/L) in the 5-HTTLPR polymorphism showed lower scores on the subscale of liking parties and friends. Patients with the allele with 10 repeat of the VNTR polymorphism, showed lower scores in impulsivity, sensation seeking and in the subscale liking of parties and friends. Conclusions. The results suggest a significant association between the 5-HTT gene and some personality traits in BPD. This gene may play a role in the etiology of borderline personality disorder

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Association between the serotonin transporter gene and personality traits in borderline personality disorder patients evaluated with Zuckerman-Zuhlman Personality Questionnaire (ZKPQ).

INTRODUCTION: The serotoninergic system seems to be implicated in characteristic symptoms of borderline personality disorder (BPD) such as affective instability, impulsivity or suicide. Some studies suggest an association between serotonin transporter gene (5-HTT) polymorphisms and some BPD symptoms. Short allele (S) of the 5-HTTLPR polymorphism in the promoter region has been shown to be associated with impulsivity, aggressive behavior, anxiety and neuroticism. Of the variable number of tandem repeat (VNTR) polymorphism in intron 2, BPD patients showed higher frequencies of the allele with the 10 repeats. The aim of this study was to determine the association between 5- HTTLPR and VNTR polymorphism of 5-HTT and personality traits in borderline personality disorder. METHOD: A total of 65 BPD patients diagnosed by means of semi-structured interviews SCID-II and DIB-R were included. Two common polymorphisms of 5-HTT were genotyped: the 5-HTTLPR in the promoter region and VNTR in intron 2. Personality traits were assessed by the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). RESULTS: Patients with L allele (L/S or L/L) in the 5-HTTLPR polymorphism showed lower scores on the subscale of liking parties and friends. Patients with the allele with 10 repeat of the VNTR polymorphism, showed lower scores in impulsivity, sensation seeking and in the subscale liking of parties and friends. CONCLUSIONS: The results suggest a significant association between the 5-HTT gene and some personality traits in BPD. This gene may play a role in the etiology of borderline personality disorder.

Safety assessment of the human milk-isolated probiotic Lactobacillus salivarius CECT5713.

The potential probiotic bacteria Lactobacillus salivarius CECT5713 has recently been isolated from human milk and characterized. The objective of the present study was to evaluate the oral toxicity of this potential probiotic bacteria in mice. With this aim, 50 Balb/C mice were divided in 5 groups (n = 10). Three of these groups were treated orally with different doses of L. salivarius CECT5713: 5 x 10(8), 2 x 10(9), or 10(10) cfu/mouse per d for 28 d. One additional group was administered the vehicle alone and was used as a control. The last group were injected intraperitoneally with 10(8) cfu/mouse in a single dose and killed 2 (n = 5) and 5 (n = 5) d after intraperitoneal injection. Food intake, body weight, bacterial translocation, serum alpha-amyloid protein, and different biochemical parameters were analyzed. Oral administration of L. salivarius CECT5713 to mice had no adverse effects on mouse body weight or food intake. No bacteremia was shown and there was no treatment-associated bacterial translocation to the liver or spleen. Intraperitoneal administration caused a significant bacterial translocation to the liver and spleen, but not to the blood. However, this translocation was not related to illness or death at either d 2 or d 5, although an increase in plasma serum alpha-amyloid protein was observed at d 2. These results suggest that the strain L. salivarius CECT5713 is nonpathogenic for mice, even in doses 10,000 times higher (expressed per kilograms of body weight) than those normally consumed by humans. Thus, this strain is likely to be safe for human consumption.

Two Lactobacillus strains, isolated from breast milk, differently modulate the immune response.

AIMS: The ability of two different Lactobacillus strains (Lactobacillus salivarius CECT5713 and Lactobacillus fermentum CECT5716), isolated from human breast milk, to modulate the immune response was examined. METHODS AND RESULTS: In rodent bone-marrow-derived macrophages (BMDM), the presence of Lact. fermentum CECT5716 induced pro-inflammatory cytokines, in contrast to the activation of IL-10 induced by Lact. salivarius CECT5713. Although both strains reduced the lipopolysaccharide (LPS)-induced inflammatory response in BMDM, the effect of Lact. salivarius CECT5713 was more efficient, probably because of the production of higher amounts of IL-10 cytokine. In vivo assays in mice showed similar results; the consumption of Lact. fermentum CECT5716 enhanced the production of Th1 cytokines by spleen cells and increased the IgA concentration in faeces. However, the consumption of Lact. salivarius CECT5713 induced IL-10 production by spleen cells. CONCLUSION: Therefore, in general, the effect of Lact. fermentum CECT5716 is immunostimulatory in contrast to the anti-inflammatory effect of Lact. salivarius CECT5713. SIGNIFICANCE AND IMPACT OF THE STUDY: The results of this study show that two Lactobacillus strains isolated from breast milk can exert different and even opposing effects on immune response demonstrating the specificity of each strain.

Antimicrobial potential of four Lactobacillus strains isolated from breast milk.

AIMS: The antimicrobial potential of four lactobacilli (Lactobacillus salivarius CECT5713, Lactobacillus gasseri CECT5714, L. gasseri CECT5715 and Lactobacillus fermentum CECT5716), isolated from fresh human breast milk, was evaluated in this study and compared with Lactobacillus coryniformis CECT5711, a reuterin-producing strain isolated from an artisan goat's cheese. METHODS AND RESULTS: Agar diffusion tests, competitive adhesion assays and mucin expression assays were carried out in order to value the antibacterial properties of the lactobacilli strains. The antibacterial capability of the strains was tested in vivo by using a murine infection model with Salmonella choleraesuis. The results revealed that all the strains studied, displayed antibacterial properties against pathogenic bacteria. However, the antibacterial potential varied among the lactobacilli tested and, in fact, L. salivarius CECT5713 showed not only the best in vitro antibacterial activity, but also the highest protective effect against a Salmonella strain in the murine infection model. CONCLUSION: The four breast-milk lactobacilli, and particularly L. salivarius CECT5713, possess potent antibacterial activities that result in a higher protection against S. choleraesuis CECT4155 in a mouse infection model. SIGNIFICANCE AND IMPACT OF THE STUDY: These results suggest that lactobacilli from breast milk could contribute to an anti-infective protection in neonates and would be excellent candidates for the development of infant probiotic products.

The consumption of two new probiotic strains, Lactobacillus gasseri CECT 5714 and Lactobacillus coryniformis CECT 5711, boosts the immune system of healthy humans.

Orally ingested probiotic bacteria are able to modulate the immune system. However, differences exist in the immunomodulatory effects of different probiotic strains. Moreover, different regulatory effects, which depend on the health status of the consumer, have been identified. This work describes a randomized, double-blind, placebo-controlled human clinical trial to investigate the immune effects on healthy people of a fermented product containing two new probiotic strains, Lactobacillus gasseri CECT 5714 and Lactobacillus coryniformis CECT 5711, which was compared with another fermented product, a standard yogurt. Consumption of either the new product or yogurt increased the proportion of phagocytic cells, including monocytes and neutrophils, as well as their phagocytic activity. However, combination of the product containing the strains L. gasseri CECT 5714 and L. coryniformis CECT 5711 also induced an increase in the proportion of natural killer (NK) cells and in IgA concentrations. The effects were higher after two weeks of treatment than after 4 weeks, which suggests regulation of the immune system. In addition, the new product enhanced immunity in the participants to a greater extent than did the control standard yogurt.

The consumption of two new probiotic strains, Lactobacillus gasseri CECT 5714 and Lactobacillus coryniformis CECT 5711, boosts the immune system of healthy humans / El consumo de dos nuevas cepas probióticas, Lactobacillus gasseri CECT 5714 y Lactobacillus coryniformis CECT 5711, estimula el sistema inmunitario de individuos sanos

Orally ingested probiotic bacteria are able to modulate the immune system. However, differences exist in the immunomodulatory effects of different probiotic strains. Moreover, different regulatory effects, which depend on the health status of the consumer, have been identified. This work describes a randomized, double-blind, placebo-controlled human clinical trial to investigate the immune effects on healthy people of a fermented product containing two new probiotic strains, Lactobacillus gasseri CECT 5714 and Lactobacillus coryniformis CECT 5711, which was compared with another fermented product, a standard yogurt. Consumption of either the new product or yogurt increased the proportion of phagocytic cells, including monocytes and neutrophils, as well as their phagocytic activity. However, combination of the product containing the strains L. gasseri CECT 5714 and L. coryniformis CECT 5711 also induced an increase in the proportion of natural killer (NK) cells and in IgA concentrations. The effects were higher after two weeks of treatment than after 4 weeks, which suggests regulation of the immune system. In addition, the new product enhanced immunity in the participants to a greater extent than did the control standard yogurt (AU)

La ingestión oral de bacterias probióticas puede modular el sistema inmunitario. Sin embargo, existen diferencias en los efectos inmunomoduladores de diferentes cepas probióticas. Además, se han identificado distintos efectos reguladores, que dependen del estado de salud del consumidor. Este trabajo describe un ensayo clínico aleatorizado, con ocultación doble (double blind) y con control de placebo llevado a cabo en humanos para estudiar los efectos inmunitarios del consumo de un producto fermentado que contiene dos nuevas cepas probióticas, Lactobacillus gasseri CECT 5714 y Lactobacillus coryniformis CECT 5711, comparados con los efectos producidos por otro producto fermentado, un yogurt clásico. El consumo del nuevo producto o del yogurt clásico aumentó la proporción de células fagocitarias, como monocitos y neutrófilos, así como su actividad fagocitaria. Sin embargo, la combinación del producto que contenía las cepas L. gasseri CECT 5714 y L. coryniformis CECT 5711 indujo además un aumento en la proporción de linfocitos citolíticos natuales (células NK) y en las concentraciones de IgA. Estos efectos fueron más acusados después de dos semanas de tratamiento que después de 4 semanas, lo que sugiere una regulación del sistema inmunitario. Además, el nuevo producto reforzó la inmunidad en las personas que participaron en el ensayo más que el yogur clásico usado como control (AU)

Oral administration of two probiotic strains, Lactobacillus gasseri CECT5714 and Lactobacillus coryniformis CECT5711, enhances the intestinal function of healthy adults.

Modifications in gastrointestinal parameters, intestinal colonization and tolerance are some of the main goals claimed for probiotics. However, although healthy people are the common target for these new functional food products, the number of clinical trials analysing the effects of probiotics in gastrointestinal parameters of healthy subjects is very scarce. A randomized, double blind, placebo-controlled human clinical trial involving 30 healthy adults was performed to investigate the effect of a fermented product containing two probiotic strains, Lactobacillus gasseri CECT5714 and Lactobacillus coryniformis CECT5711, on several blood and fecal parameters, most of them related to the host intestinal function. The volunteers were randomly distributed into two groups, one receiving a standard yogurt and the other a similar dairy fermented product in which the Lactobacillus delbreuckii subsp. bulgaricus yogurt strain had been replaced by a combination of the probiotic strains L. gasseri CECT5714 and L. coryniformis CECT5711. The volunteers that received the probiotic strains reported no adverse effects and the strains could be isolated from their feces at a relatively high level. In fact, the concentration of fecal lactic acid bacteria significantly increased in the probiotic group. Additionally, the oral administration of the probiotic strains led to an improvement of parameters such as the production of short chain fatty acids, the fecal moisture and the frequency and volume of the stools. As a result, the volunteers assigned to the probiotic group perceived a clear improvement in their intestinal habits. The study revealed that probiotics may exert a positive effect on healthy adults.

Effect of miglitol administration to non-insulin-dependent diabetic rats.

1. The effect of the acute or chronic oral administration of miglitol (Bay M 1099 alpha-glucosidase inhibitor) to non-insulin-dependent diabetic rats was studied. 2. The acute oral administration of miglitol (10 mg/kg b.w.) reduced significantly the increment of blood glucose after oral maltose (2 g/kg b.w.) overload (364 +/- 58 and 205 +/- 12 mmol/90 min, without and with miglitol respectively; P < 0.05). 3. Under chronic oral administration of miglitol (10 mg/kg b.w.), two days after the start of treatment the blood glucose dropped from 7.53 +/- 9.59 to 4.40 +/- 5.50 mmol/l. The plasma insulin, cholesterol, or triglycerides levels were not modified. 4. A significant reduction (P < 0.01) in water and food intake was observed. Normal rats values were not affected by miglitol treatment.

In vitro study of the effect of miglitol on carbohydrate digestion and intestinal metabolism in normal and non-insulin-dependent diabetic rats.

The effect of miglitol was studied (20 mg/kg body weight), administered intraduodenally alone or together with maltose, on the absorption and intestinal metabolism of glucose during its translocation from the lumen of the intestine to the blood, using in vitro perfused preparations of complete small intestine-pancreas, proximal small intestine alone, or distal small intestine alone, isolated from normal and non-insulin-dependent diabetic rats. In the absence of a luminal administration of maltose in normal rats, the glucose uptake from the vascular perfusate was greater in the presence (0.52 +/- 0.04 mmol/h) than in the absence (0.39 +/- 0.02 mmol/h) of miglitol (p < 0.05). In diabetic rats, no significant variations were observed in glucose uptake from the vascular perfusate as an effect of miglitol, but the glucose uptake in the presence of this drug was significantly less (p < 0.05) than that observed in normal rats. Portal lactate was significantly greater (p < 0.05) in diabetic than in normal rats and, after administration of miglitol, rose in both normal and diabetic rats, the rise being significantly greater in normal than in diabetic rats (p < 0.01). When maltose was administered luminally (2 g/kg body weight), the values of portal glucose in both normal and diabetic rats were significantly less in the presence of miglitol in the complete as well as in the distal and proximal small intestine preparations (p < 0.05); the glucose uptake from luminal administered maltose was greater in the presence of miglitol in diabetic (p < 0.05) and in normal (p < 0.05) rats except in the complete small intestine of normal rats; and no significant differences were observed in portal lactate levels between normal and diabetic rats in the presence of miglitol. In conclusion, our results show that miglitol administered luminally at the doses employed here, as well as reducing the transport of glucose from the lumen of the intestine into the blood supply, significantly stimulate intestinal glucose metabolism.