Biotherapeutic agents and vaginal health.

Treatment of vaginal infection requires different drugs although the recurrence rate post treatment remains high due to adverse effects on the beneficial microbiota. Thus, there are clear clinical advantages for the use of biotherapeutic agents (prebiotics and/or probiotics) for treating these infections. Pre- and probiotic beneficial effects can be delivered topically or systemically. In general, both approaches have the potential to optimize, maintain and restore the ecology of the vaginal ecosystem. Specific carbohydrates provide a therapeutic approach for controlling infections by stimulating the growth of the indigenous lactobacilli but inhibiting the growth and adhesion of pathogens to the vaginal epithelial cells. Overall, little evidence exists to promote the prevention or treatment of vaginal disease with prebiotic carbohydrates in formulations such as pessaries, creams or douches. However, recent reports have promoted prebiotic applications in ecosystems other than the gut and include the mouth, skin and vagina. This review focuses on the utilization of pre- and probiotics for vaginal health.

Impact of prebiotics and probiotics on skin health.

This review discusses the role of pre- and probiotics with respect to improving skin health by modulating the cutaneous microbiota. The skin ecosystem is a complex environment covered with a diverse microbiota community. These are classified as either transient or resident, where some are considered as beneficial, some essentially neutral and others pathogenic or at least have the capacity to be pathogenic. Colonisation varies between different parts of the body due to different environmental factors. Pre- and probiotic beneficial effects can be delivered topically or systemically (by ingestion). The pre- and probiotics have the capacity to optimise, maintain and restore the microbiota of the skin in different ways. Topical applications of probiotic bacteria have a direct effect at the site of application by enhancing the skin natural defence barriers. Probiotics as well as resident bacteria can produce antimicrobial peptides that benefit cutaneous immune responses and eliminate pathogens. In cosmetic formulations, prebiotics can be applied to the skin microbiota directly and increase selectively the activity and growth of beneficial 'normal' skin microbiota. Little is known about the efficacy of topically applied prebiotics. Nutritional products containing prebiotics and/or probiotics have a positive effect on skin by modulating the immune system and by providing therapeutic benefits for atopic diseases. This review underlines the potential use of pre- and probiotics for skin health.

The use of konjac glucomannan hydrolysates to recover healthy microbiota in infected vaginas treated with an antifungal agent.

The aim of this study was to evaluate how konjac glucomannan hydrolysates (GMH) could support the healthy re-colonisation of vaginal microflora post infections. A total of 26 female patients (12 controls and 14 treatments) aged 18 to 25 suffering from vaginal infection were recruited for this study. Patients were assigned randomly into two groups to receive a standard antifungal treatment or a standard antifungal treatment plus pessary capsules containing 200 mg GMH (twice a week for thirty days). Patients were assessed on day zero, sixteen and thirty of the trial. Several parameters were determined including yeast and bacterial counts, the KOH test, pH, Gram staining and wet mount microscopic observations. The results showed that the counts of Candida were diminished completely with antifungal treatment for both groups. However, the total bacterial counts increased with time in the GMH pessary group unlike the control. The normalised average KOH scores were reduced sharply with time in both groups although in the control group scores started to increase after sixteen days. The normalised average white blood cell scores also decreased with time for both groups. Epithelial cell scores decreased only for the GMH pessary group while clue cells and yeast-like fungi decreased with time for both control and GMH pessary groups. These results indicate the improvement of vaginal health recovery (post antifungal treatment for Candida infection) and especially the presence of healthy microflora due to the introduction of GMH in the vagina. The data indicate that it would be worth examining further the health benefits of GMH in a vaginal health format with a view to employing the material as a prophylactic or therapeutic agent. It provides an alternative approach to reducing vaginal infections and promoting consumer health.

Effect of konjac glucomannan hydrolysates and probiotics on the growth of the skin bacterium Propionibacterium acnes in vitro.

The synbiotic ability of probiotic bacteria and konjac glucomannan hydrolysates (GMH) to inhibit acne-inducing bacterium, Propionibacterium acnes growth was studied in vitro. All probiotic bacteria strains tested were able to inhibit the growth of this species of skin bacterium where the inhibition was significantly (P < 0.01) enhanced by the presence of the GMH prebiotic. As the current treatment of acne is based on topical or systemic drugs, it is worth examining further the biotherapeutic activities of the GMH and selected probiotics with a view to future use as prophylactic or therapeutic synbiotics for treating acne infections.

Effect of lecithin and starch on alginate-encapsulated probiotic bacteria.

The effect of lecithin and starch on viability of alginate encapsulated probiotics was determined at different temperatures. Probiotic organisms (1% v/v>10Log CFU ml(-1)) were encapsulated using alginate (2% w/v), gelatinized starches (2% w/v) and lecithin (0-4% w/v) and stored in sealed containers at 4, 23 and 37 degrees C (to simulate shelf storage conditions). Incorporation of lecithin improved the entrapment efficiency (p < 0.05) and the viability of encapsulated bacteria (p = 0.02). Encapsulated Lactobacillus, Bifidobacterium species and Lactococcus lactis in lecithin containing freeze-dried beads had good survival stability (above 6Log CFU ml(-1)) at 23 degrees C for 12 weeks. The bacteria in the beads showed 6Log survival by the end of 2 weeks at 37 degrees C. Encapsulated L. casei in the alginate beads containing lecithin were also more stable in the yoghurt than the beads without lecithin. SEM analysis of the beads showed an irregular surface for the beads without lecithin.

Recurrent ectasia in corneal grafts and outcomes of repeat keratoplasty for keratoconus.

AIM: To analyse cases of recurrent ectasia in donor corneas after penetrating keratoplasty (PK) for keratoconus. METHODS: Data on 25 patients (36 eyes) with recurrent ectasia were retrospectively analysed in this study. The main outcome measures were time to development of recurrent ectasia after first PK for keratoconus, change in keratometric sphere and astigmatism between final suture removal and development of recurrent ectasia, status of regrafts for recurrent ectasia, and histopathology of grafts excised for recurrent ectasia. RESULTS: The age at first PK was 32.6 (SD 8.5) years, and ectasia developed 21.9 (7.0) years after PK. The mean keratometric sphere and cylinder increased by 4.2 D and 3.0 D, respectively, between final suture removal and diagnosis of recurrent ectasia. Ectasia was often preceded by thinning without bulging of the recipient stroma at the graft-host junction. Fifteen eyes (13 patients) were regrafted for recurrent ectasia, and histopathology of the excised grafts showed changes characteristic of keratoconus in the donor tissue in all cases. Two regrafts (two eyes of one patient) developed ectasia again, with one eye requiring a third PK to improve vision. CONCLUSIONS: Recurrent ectasia was diagnosed on average two decades after PK. Ectatic changes were often bilateral and occasionally recurred after regrafting, suggesting that host cellular and/or biochemical factors may be responsible. Repeat PK for recurrent ectasia is successful in the intermediate term.

A novel starch for the treatment of glycogen storage diseases.

OBJECTIVE: To determine whether a new starch offers better short-term metabolic control than uncooked cornstarch in patients with glycogen storage diseases (GSDs). STUDY DESIGN: A short-term double-blind cross-over pilot study comparing uncooked physically modified cornstarch (WMHM20) with uncooked cornstarch in patients with GSD types Ia, Ib and III. Twenty-one patients (ages 3-47, 9 female) were given 2 g/kg cornstarch or WMHM20 mixed in water. Blood glucose, lactate and insulin, and breath hydrogen and (13)CO2 enrichment were measured, at baseline and after each load. The hourly biochemical evaluations terminated when blood glucose was < or = 3.0 mmol/L, when the study period had lasted 10 h or when the patient wished to end the test. The alternative starch was administered under similar trial conditions a median of 10 days later. RESULTS: The median starch load duration was 9 h for WMHM20 versus 7 h for cornstarch. Glucose decreased more slowly (p = 0.05) and lactate was suppressed faster (p = 0.17) for WMHM20 compared with cornstarch. Peak hydrogen excretion was increased (p = 0.05) when cornstarch was taken. CONCLUSION: These data indicate longer duration of euglycaemia and better short-term metabolic control in the majority of GSD patients with WMHM20 compared to cornstarch.

Effects of storage temperatures and annealing conditions on the structure and properties of potato (Solanum tuberosum) starch.

Starches were extracted from freshly harvested potatoes (12 cultivars, grown in Perthshire) and the properties of the starches of six cultivars were compared with starches extracted from the same samples but stored at 5, 25 or 55 degrees C for 7 days before extraction. The amylose (total) content of the freshly extracted starches from tubers stored at 5, 25 or 55 degrees C was on average 27.9+/-2.3, 28.3+/-1.7, 29.2+/-2.2 and 28.8+/-1.5%, respectively, with corresponding phosphorus representing 60+/-16, 64+/-9, 61+/-5 and 63+/-9 mg 100 g(-1). The unit chain distribution by chromatography of the amylopectin molecules from the starches extracted from the different conditions was very similar with an average degree of polymerisation (DP) of 26+/-2 where the two major fractions (F1 and F2) represented 54+/-2 and 19+/-1, respectively. Peak gelatinisation temperatures (Tp) and enthalpies (DeltaH) for the freshly extracted starches and from tubers stored at 5 or 25 degrees C were very similar (63.3+/-1.5 degrees C and 18.6+/-0.8 J g(-1); 63.1+/-1.0 degrees C and 17.7+/-1.5 J g(-1) and; 62.9+/-0.7 degrees C and 18.7+/-1.1 J g(-1), respectively) although starches stored at 55 degrees C were annealed, where Tp represented 71.1+/-1.1 degrees C and DeltaH 18.1+/-1.4 J g(-1). These in situ-annealed starches were comparable in terms of gelatinisation characteristics to annealed freshly extracted starches where on average, T(p) represented 72.7+/-1.0 degrees C and DeltaH 20.8+/-1.0 J g(-1). Annealing of tubers in situ prior to processing might be beneficial with respect to developing new potato-based products.

Occurrence of aflatoxin M1 in randomly selected North African milk and cheese samples.

Forty-nine samples of raw cow's milk and 20 samples of fresh white soft cheese were collected directly from 20 local dairy factories in the north-west of Libya and analysed for the presence of aflatoxin M1 (AFM1). The samples were analysed using a high-performance liquid chromatography technique for toxin detection and quantification. Thirty-five of the 49 milk samples (71.4%) showed AFM1 levels between 0.03 and 3.13 ng ml(-1) milk. Multiple analyses of five milk samples free of AFM1 artificially contaminated with concentrations of AFM1 at 0.01, 0.05, 0.1, 1.0 and 3.0 ng ml(-1) showed average recoveries of 66.85, 72.41, 83.29, 97.94 and 98.25%, with coefficients of variations of 3.77, 4.11, 1.57, 1.29 and 0.54%, respectively. Fifteen of 20 white soft cheese samples (75.0%) showed the presence of AFM1 in concentrations between 0. 11 and 0.52 ng g(-1) of cheese. Multiple assays of five cheese samples free of AFM1 spiked with different concentration of AFM1 (0.1, 0.5, 1.0 and 3.0 ng g(-1)) showed average recoveries of 63.23, 78.14,83.29 and 88.68%, with coefficients of variation of 1.53, 9.90, 4.87 and 3.79%, respectively. The concentrations of AFM1 were lower in the cheese products than in the raw milk samples.

Dysphotopsia in phakic and pseudophakic patients: incidence and relation to intraocular lens type(2).

PURPOSE: To determine the relationship between various intraocular lens (IOL) types and the incidence of unwanted light images. SETTING: The Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. METHODS: A telephone questionnaire was administered to 302 postoperative patients who had received 1 of 6 commonly used IOLs between January and September 1998. Patients were included only if they had uneventful cataract surgery, no additional ocular pathology, and a postoperative best corrected visual acuity of 20/25 or better. A control group of 50 patients with the diagnosis of presbyopia only also participated in the questionnaire. Patients reported on incidence of glare, light sensitivity, and unwanted images. The data were analyzed for statistically significant relationships between incidence of photopsias and IOL type. RESULTS: The AcrySof 5.5 mm, AcrySof 6.0 mm, and SI-40 groups reported significantly more unwanted images than the control group (P =.0014). The 2 AcrySof groups also reported a greater incidence of light to the side causing a central flash, and the SI-40 group, a higher incidence of glare. The control group was more likely to experience symptoms of glare than any pseudophakic group. Overall, a mean of 49% of patients reported some light-related phenomenon postoperatively. The majority in all groups reported being satisfied with their eyesight despite the light-related problems. CONCLUSIONS: A significant number of pseudophakic patients reported symptoms of dysphotopsia. Patients who received an acrylic IOL with flattened edges were at increased risk of experiencing images associated with edge reflections. The SI-40 lens group, although less than the AcrySof groups, reported a higher incidence of glare than the non-AcrySof groups; however, it also had the highest number of patients still driving at night. The phakic population commonly experienced glare reported as more severe than several of the IOL groups.

Annealing of starch - a review.

Annealing processes, involving specific heating protocols, have been used by man for centuries to impart desirable properties to materials - especially metals and particularly tools and weapons. The terminology has also been applied to biopolymers such as starches, where the effects of the processing have been known for decades although the molecular basis has not been at all well understood. Because of the marked effect the annealing process has on starch functionality and consequently industrial applications, it is critical that the underlying molecular events are understood. This review is an attempt to clarify the process of starch annealing with an emphasis on data generated in the authors' laboratory.

Influence of growth conditions on barley starch properties.

Air equilibrated barley starch comprises amylopectin, amylose, lipid and water. The structure of amylose and amylopectin, and the proportion of amylose in granules is under genetic control and is therefore subject to genotypic variation. The amount of lipid (which is essentially all lysophospholipid) is similarly under genetic control. Environment and especially environmental temperature do, however, have a regulatory effect on the size of starch granules, the amylose to amylopectin ratio and the amount of lipid (which is essentially all complexed with amylose) within barley starch. High growth temperatures probably facilitate amylopectin crystallisation and increase gelatinisation temperatures, (and to some extent the enthalpy of gelatinisation), but delay the onset and depress the extent of swelling of granules when heated in water.