[Peroral toxicological assessment of bentonite nanoclay used in the food industry].

Bentonite nanoclay (NC) manufactured from the natural sedimentary mineral bentonite contains more than 90% montmorillonite. Currently, it is widely used in food industry as processed aids - adsorbents for the purification of vegetable oils and beverages. Clay minerals have also applications as food additives and components in composite package materials. In vitro studies have shown that various forms of NC exerted cytotoxicity in many cell lines, whereas in vivo evidence of NC oral toxicity is contradictory. Therefore, this study aimed to assess the acute oral toxicity of NC and to evaluate its toxicological characteristics in a subacute 92-day experiment on Wistar rats with a daily oral administration in doses of 1, 10, and 100 mg/kg body weight (bw). Material and methods. The NC acute toxicity was evaluated in 8 male and 8 female rats with the initial bw 236±10 and 203± 10 g, respectively. NC was administered as an aqueous dispersion intragastrically at a dose of 5 g/kg bw. On the 14th day (end of the experiment), an autopsy of the chest and abdominal organs was performed. The subacute experiment was carried out on 64 male rats with an average initial bw of 117±7 g. During the experiment the levels of anxiety and memory function were evaluated using the test "Conditional reflex of passive avoidance". On the 90th day of the experiment, diurnal urinary excretion of creatinine and selenium was evaluated. At the end of the experiment, the integral parameters, the state of the intestinal wall permeability were assessed. Hematological and biochemical parameters were examined in blood, the content of non-protein thiols and the number of cells in apoptosis were determined in liver, and the state of cultivated microbiome populations was studied in cecum. Results. The results of the determination of NC acute toxicity showed the absence of rat's mortality and specific pathological changes in the internal organs at a dose as large as 5000 mg/kg bw, which allowed attributing NC to the V hazard class. Nevertheless, under the conditions of the 92-day experiment, NC caused some adverse biological effects on rat's organism. So, even at an NC dose of 1 mg/kg bw, there was a sharp inhibition of the symbiotic bifidobacterium growth, an increase in platelet count, in LDL and the LDL/HDL ratio, together with the presence of hypertriglyceridemia. At a dose of 10 mg/kg bw, an increase in spleen mass and a decrease in the de Ritis coefficient (AsAT/AlAT) were established. At a dose of 100 mg/kg bw there were shifts in the leukocyte blood count, an excessive enterococci growth in the cecum, significantly increased animal bw, along with the decrease of AsAT/AlAT and the level of serum nitrogen metabolites, indirectly indicating inhibition of catabolic processes. However, at the highest dose of NC, intestinal absorption of the protein antigen - ovalbumin, was apparently completely blocked. Conclusion. The data obtained have shown that NC has potentially adverse effects on the rats mainly at a dose of 100 mg/kg bw, nevertheless, its NOAEL in the 92-day daily oral exposure experiment is probably less than 1 mg/kg bw.

Submersion in Industrial Powders That Lead to Tracheal Impaction and an Unusual Intubation.

BACKGROUND: Silica, also known as quartz, is a naturally occurring compound that has many common uses, such as for glass, pottery, and concrete. Similarly, bentonite, another natural compound found in many clays, has been used for a variety of purposes from cat litter to bulk laxatives. Both are known for their fluid-absorptive properties. The long-term effects of exposure such as developing silica pneumoconiosis are well studied; acute inhalational injuries of similar substances are also documented. CASE REPORT: We discuss the difficult airway case of a 32-year-old man who presented to the emergency department (ED) in cardiac arrest after he was buried in a mound of powdered silica and bentonite due to an industrial accident. The combination of the naturally fluid-absorptive properties of silica and bentonite, and the moist environment of the oropharynx, led to a unique circumstance. Most foreign bodies in the airway can be remedied, at least in part, by standard irrigation for decontamination. However, irrigation of dry bentonite and silica would produce a clay-like substance that could occlude the trachea, leading to an avoidably more difficult airway presentation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The difficulties experienced with his intubation can serve as a learning point to other providers who encounter a similar presentation. In the event that the inhaled substance is known to be fluid-absorptive, deviation from standard irrigation for decontamination may permit avoidance of a tracheal impaction, and facilitate establishment of a definitive airway. When there is suspicion for the potential of tracheal impaction, proceeding with bronchoscopy either in the ED or operating room as quickly as possible rather than continuing attempts at intubation may deliver the patient a definitive airway in a more timely fashion.

Excess of dietary montmorillonite impairs growth performance, liver function, and antioxidant capacity in starter pigs.

Montmorillonite (MMT) is widely used as a mycotoxin adsorbent in animal feeds, but its safety remains unclear. This study was conducted to investigate the safety of MMT supplementation in diets fed to starter pigs. A total of 120 32-d-old piglets (initial weight, 8.0 ± 0.9 kg) were randomly allotted into dietary treatments with graded MMT levels (0 [FS 0], 0.5% [FS 0.5], 1.0% [FS 1.0], 2.5% [FS 2.5], and 5.0% [FS 5.0]) with 6 replicate pens per treatment and 4 pigs per pen. All diets were fed for 28 d. As the MMT level increased, ADG and G:F changed in a linear and quadratic manner, while ADFI was linearly decreased ( > 0.05). Compared with FS 0, ADG, ADFI, and G:F of pigs in FS 1.0 increased ( < 0.05). However, the ADFI in pigs of FS 5.0 was lower than that in pigs of FS 0 ( < 0.05). The relative liver weight activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) changed in a linear and quadratic manner ( < 0.05). Compared with FS 0, pigs in FS 2.5 and FS 5.0 had a greater serum ALT ( < 0.05), while AST activity significantly increased in pigs of FS 5.0 ( < 0.05). Dietary MMT supplementation decreased serum Mg content in a linear and quadratic manner ( < 0.05), while Zn and Cu contents were linearly decreased ( < 0.05). Serum Zn and Cu contents of pigs in FS 0.5, FS 2.5, and FS 5.0 groups were lower than those in the control. Pigs fed with 2.5% and 5% MMT showed hepatic histopathological changes, including swelling, granular and vesicular degeneration, and apparent vacuolar degeneration. In addition, the content of serum total antioxidant capacity (T-AOC) and activity of glutathione peroxidase (GSH-PX) decreased in a linear and quadratic manner ( < 0.05). Compared to the control, 5.0% MMT significantly increased piglets' serum malondialdehyde (MDA) concentration and decreased GSH-PX activity ( < 0.05). T-AOC concentration in the pigs fed 2.5% and 5.0% MMT was lower than that in the control group ( < 0.05). Serum superoxide dismutase (SOD) activity changed in a quadratic manner ( < 0.05). Piglets in FS 1.0 showed a higher SOD activity when compared with the control ( < 0.05). These results indicate that supplementation of MMT higher than 1.0% can negatively affect liver structure and serum mineral content, and 5.0% MMT supplementation would also decrease feed intake, aggravate liver damage, and reduce the antioxidant capacity of starter pigs. Therefore, excess supplementation of MMT is not safe in starter pigs.

Evaluation of the efficacy, acceptability and palatability of calcium montmorillonite clay used to reduce aflatoxin B1 dietary exposure in a crossover study in Kenya.

Acute aflatoxin exposure can cause death and disease (aflatoxicosis) in humans. Aflatoxicosis fatality rates have been documented to be as high as 40% in Kenya. The inclusion in the diet of calcium silicate 100 (ACCS100), a calcium montmorillonite clay, may reduce aflatoxin bioavailability, thus potentially decreasing the risk of aflatoxicosis. We investigated the efficacy, acceptability and palatability of ACCS100 in a population in Kenya with recurring aflatoxicosis outbreaks. Healthy adult participants were enrolled in this double-blinded, crossover clinical trial in 2014. Following informed consent, participants (n = 50) were randomised to receive either ACCS100 (3 g day-1) or placebo (3 g day-1) for 7 days. Treatments were switched following a 5-day washout period. Urine samples were collected daily and assessed for urinary aflatoxin M1 (AFM1). Blood samples were collected at the beginning and end of the trial and assessed for aflatoxin B1-lysine adducts from serum albumin (AFB1-lys). AFM1 concentrations in urine were significantly reduced while taking ACCS100 compared with calcium carbonate placebo (ß = 0.49, 95% confidence limit = 0.32-0.75). The 20-day interval included both the placebo and ACCS100 treatments as well as a washout period. There were no statistically significant differences in reported taste, aftertaste, appearance, colour or texture by treatment. There were no statistically significant differences in self-reported adverse events by treatment. Most participants would be willing to take ACCS100 (98%) and give it to their children (98%). ACCS100 was effective, acceptable and palatable. More work is needed to test ACCS100 among vulnerable populations and to determine if it remains effective at the levels of aflatoxin exposure that induce aflatoxicosis.

Intervention trial with calcium montmorillonite clay in a south Texas population exposed to aflatoxin.

South Texas currently has the highest incidence of hepatocellular carcinoma (HCC) in the United States, a disease that disproportionately affects Latino populations in the region. Aflatoxin B1 (AFB1) is a potent liver carcinogen that has been shown to be present in a variety of foods in the United States, including corn and corn products. Importantly, it is a dietary risk factor contributing to a higher incidence of HCC in populations frequently consuming AFB1-contaminated diets. In a randomised double-blind placebo controlled trial, we evaluated the effects of a 3-month administration of ACCS100 (refined calcium montmorillonite clay) on serum AFB1-lysine adduct (AFB-Lys) level and serum biochemistry in 234 healthy men and women residing in Bexar and Medina counties, Texas. Participants recruited from 2012 to 2014 received either a placebo, 1.5 g or 3 g ACCS100 each day for 3 months, and no treatment during the fourth month. Adverse event rates were similar across treatment groups and no significant differences were observed for serum biochemistry and haematology parameters. Differences in levels of AFB-Lys at 1, 3 and 4 months were compared between placebo and active treatment groups. Although serum AFB-Lys levels were decreased by month 3 for both treatment groups, the low dose was the only treatment that was significant (p = 0.0005). In conclusion, the observed effect in the low-dose treatment group suggests that the use of ACCS100 may be a viable strategy to reduce dietary AFB1 bioavailability during aflatoxin outbreaks and potentially in populations chronically exposed to this carcinogen.

In vivo bone formation by and inflammatory response to resorbable polymer-nanoclay constructs.

The development of synthetic bone grafts with requisite mechanical and morphological properties remains a key challenge in orthopaedics. Supercritical carbon dioxide (scCO2)-processed nanocomposites consisting of organically-modified montmorillonite clay dispersed in poly-d-lactide (PDLA) have shown structural and mechanical properties similar to corticocancellous bone. Using quantitative undecalcified histology and micro-computed tomography (µCT), time and material-dependent influences on in vivo bone formation, and inflammatory response were characterized. This represents the first in vivo evidence of the ability of scCO2-processed PDLA-nanoclay constructs to support osteogenesis, while eliciting an inflammatory response comparable to PDLA-hydroxyapatite materials. Histologic analyses demonstrated that the in vivo performance of nanoclay-containing PDLA constructs was similar to pure PDLA constructs, though nanocomposites demonstrated more radiodense bone at all time points (µCT analysis), and higher bone volume at 6 weeks. Taken with previous structural and mechanical studies, these in vivo analyses suggest that scCO2-processed, polymer-clay nanocomposites may be suitable structural bone graft materials. FROM THE CLINICAL EDITOR: With advances in science, orthopedic researchers have devoted significant amount of time in developing synthetic bone graft materials. Many of which are indeed currently in clinical use. In their previous studies, the authors described and studied supercritical carbon dioxide (scCO2)-processed nanocomposites consisting of organically modified montmorillonite clay dispersed in poly-D-lactide (PDLA) in in-vitro experiments. Here, in-vivo experiments were performed to investigate if this new material had improved mechanical properties, as well as the induction of inflammatory response. The overall positive findings may mean that this material could be used for future bone graft substitute applications.

Short-term safety and efficacy of calcium montmorillonite clay (UPSN) in children.

Recently, an association between childhood growth stunting and aflatoxin (AF) exposure has been identified. In Ghana, homemade nutritional supplements often consist of AF-prone commodities. In this study, children were enrolled in a clinical intervention trial to determine the safety and efficacy of Uniform Particle Size NovaSil (UPSN), a refined calcium montmorillonite known to be safe in adults. Participants ingested 0.75 or 1.5 g UPSN or 1.5 g calcium carbonate placebo per day for 14 days. Hematological and serum biochemistry parameters in the UPSN groups were not significantly different from the placebo-controlled group. Importantly, there were no adverse events attributable to UPSN treatment. A significant reduction in urinary metabolite (AFM1) was observed in the high-dose group compared with placebo. Results indicate that UPSN is safe for children at doses up to 1.5 g/day for a period of 2 weeks and can reduce exposure to AFs, resulting in increased quality and efficacy of contaminated foods.

Aspect ratio dependent cytotoxicity and antimicrobial properties of nanoclay.

Nanoclays may enter human body through various routes such as through the respiratory and gastrointestinal tract, skin, blood, etc. There is dearth of such studies evaluating the interaction of clay nanoparticles with human cells. In particular, the interaction of proteins and nucleic acids with nanoparticles of different aspect ratio remains a domain that is very poorly probed and understood. In the present study, we address the issue of cytotoxicity and antimicrobial attributes of two distinct nanoclay platelets namely, laponite (diameter = 25 nm and thickness = 1 nm) and montmorillonite (MMT, diameter = 300 nm and thickness = 1 nm), having different aspect ratio (25:1 vs 300:1). Cytotoxicity was assessed in both prokatyotes: Escherichia coli, eukaryotes-human embryonic kidney (HEK), and cervical cancer SiHa cell lines, and a comparative size-based analysis of the toxicity were made at different exposure time points by MTT assay. The antimicrobial activity of the nanoclays was evaluated by disc diffusion method (Kirbey-Bauer protocol). Laponite exhibited maximum efficacy as an antimicrobial agent against E. coli. Comparatively smaller size laponite could preferentially enter the cells, leading to relatively wider or larger zone of inhibition. On contradictory; laponite showed 74.67 % survival while MMT showed 89.02 % survival in eukaryotic cells at 0.00001 % (w/v) concentration. In summary, both MMT and laponite indicated cytotoxicity at 0.05 % concentration within 24 h of exposure on HEK and cervical cancer (SiHa) cell lines. The toxicity was possibly dependent on size, aspect ratio, and concentration.

Respiratory disease related mortality and morbidity on an island of Greece exposed to perlite and bentonite mining dust.

A morbidity and mortality study took place, focused on Milos Island, where perlite and bentonite mining sites are located. Official data concerning number and cause of deaths, regarding specific respiratory diseases and the total of respiratory diseases, for both Milos Island and the Cyclades Prefecture were used. Standardized Mortality Ratios (SMRs) were computed, adjusted specifically for age, gender and calendar year. Tests of linear trend were performed. By means of a predefined questionnaire, the morbidity rates of specific respiratory diseases in Milos, were compared to those of the municipality of Oinofita, an industrial region. Chi-square analysis was used and the confounding factors of age, gender and smoking were taken into account, by estimating binary logistic regression models. The SMRs for Pneumonia and Chronic Obstructive Pulmonary Disease (COPD) were found elevated for both genders, although they did not reach statistical significance. For the total of respiratory diseases, a statistically significant SMR was identified regarding the decade 1989-1998. The morbidity study revealed elevated and statistically significant Odds Ratios (ORs), associated with allergic rhinitis, pneumonia, COPD and bronchiectasis. An elevated OR was also identified for asthma. After controlling for age, gender and smoking, the ORs were statistically significant and towards the same direction.

Alginate/quaternized carboxymethyl chitosan/clay nanocomposite microspheres: preparation and drug-controlled release behavior.

Drug-delivery systems, using natural drug carriers, have become increasingly important because of their nontoxicity and biodegradability. In this study, firstly, quaternized carboxymethyl chitosan (QCMC) was intercalated into the interlayer of organic montmorillonite (OMMT) to obtain the QCMC/OMMT nanocomposites, their structure, morphology, and thermal stability were investigated. Next, crosslinked alginate/QCMC/OMMT (AQCOM) microsphere was obtained by crosslinking with CaCl2, and the drug-controlled release behavior was evaluated with bovine serum albumin (BSA) as model drug. The results suggested that, carboxyl groups in alginate and QCMC crosslinked with Ca(2+), quaternary ammonium groups in QCMC or OMMT electrostatically interacted with carboxyl groups in alginate, and there was stable three-dimensional network in AQCOM microsphere. The swelling ratio of AQCOM microspheres decreased with the increase of OMMT content, the lowest one was only about 45% compared to the microsphere without OMMT of 197%. Besides, the in vitro release results for BSA indicated that the AQCOM microsphere displayed more excellent encapsulation and controlled release capacities than the microsphere without OMMT. The in vitro active cutaneous anaphylaxis test was carried out on Guinea pigs, which revealed that AQCOM microsphere did not cause anaphylaxis. Therefore, QCMC/OMMT nanocomposites from natural materials are considerably suitable to apply as drug-controlled release carriers.

NovaSil clay does not affect the concentrations of vitamins A and E and nutrient minerals in serum samples from Ghanaians at high risk for aflatoxicosis.

To assess the potential interference of NovaSil (NS) clay with micronutrients in humans, vitamins A and E and minerals (15 nutrient and 15 non-nutrient minerals) were measured in serum samples from a 3-month intervention trial with NS. Participants (n = 177) were randomly divided into three groups that received 3.0 g NS day(-1) (high dose, HD), 1.5 g NS day(-1) (low dose, LD), or placebo (PL). Levels of vitamins A and E in serum were comparable among the three study groups at baseline, 1 month and 3 months of NS intervention. Gender-stratified non-parametric mixed-effect model analysis showed no significant effects of dose and dose-time interaction for levels of vitamins A and E. A significant time effect was detected; however, it was limited to an increase in vitamin E in the male participants over the course of the study. No significant differences were found in levels of the nutrient and non-nutrient minerals between the HD and PL groups at baseline and 3 months of NS intervention, except for strontium levels. Strontium was significantly increased (p < 0.001) in the HD group (male = 113.65 +/- 28.00 microg l(-1); female = 116.40 +/- 24.26 microg l(-1)) compared with the PL group (male = 83.55 +/- 39.90 microg l(-1); female = 90.47 +/- 25.68 microg l(-1)) following the 3-month intervention with NS. These results, combined with safety and efficacy data, confirm that NS clay is highly effective in reducing aflatoxin exposure and acts as a selective enterosorbent that does not affect the serum concentrations of important vitamins and nutrient minerals in humans.

Severe hypokalemia caused by oral and rectal administration of bentonite in a pediatric patient.

BACKGROUND: Bentonite is a clay substance that has been used as a homeopathic cathartic. Oral ingestion of bentonite in large quantities has the potential to cause gastrointestinal obstruction and electrolyte abnormalities. We present a case of severe hypokalemia in a pediatric patient who received both oral and rectal administrations of bentonite. CASE: A 3-year-old girl presented with a chief complaint of vomiting, constipation, lethargy, and weakness over several days. On initial evaluation, the child was mildly dehydrated and had a serum potassium of 0.9 mmol/L. Electrocardiographic findings were also consistent with hypokalemia. Upon further questioning, the parents reported that they had been administering a home remedy, containing colloidal bentonite, both orally and rectally as treatment for persistent constipation. The child received intravenous antibiotics, a normal saline bolus, and multiple boluses of potassium chloride, resulting in eventual normalization of her electrolyte abnormalities. CONCLUSION: Ingestion of large quantities of clay substances, such as bentonite, can result in gastrointestinal binding of essential electrolytes and possible obstruction. Symptoms and laboratory values often resolve with replacement of electrolytes and cessation of bentonite intake. Although cases of oral ingestion of clay-like substances resulting in electrolyte abnormalities have been reported, there are no previously reported human cases of hypokalemia caused specifically by bentonite administration. This may be due to the unique rectal administration seen in this child, which has not previously been described.

Chronic toxicological evaluation of dietary NovaSil clay in Sprague-Dawley rats.

NovaSil (NS) clay, a common anti-caking agent in animal feeds, has been shown to sorb aflatoxins in the GI tract and diminish their bioavailability and adverse effects in short-term animal studies. Based on this evidence, it is hypothesized that clay-based enterosorption of aflatoxins may be a useful strategy for the prevention of aflatoxicosis in human populations. However, the potential toxicity of long-term dietary exposure to NS has not been determined. In this research, 5-6-week-old male and female Sprague-Dawley rats were fed rations containing 0, 0.25, 0.5, 1.0, or 2.0% (w/w) levels of NS for 28 weeks. Analysis of the NS showed negligible levels of dioxin and furan contaminants. Total feed consumption, cumulative feed consumption, body weight, total body weight gain, feed conversion efficiency, cumulative feed conversion efficiency, and relative organ weights were unaffected in either sex at the doses tested. No NS-dependent differences in relative organ weights or gross or histopathological changes were observed. Analysis of hematological parameters, clinical chemistry, and selected vitamin and mineral levels revealed isolated significant differences between some treatments and control groups (mean corpuscular hemoglobin, serum Ca, serum vitamin A, and serum Fe). However, the differences observed in each case were not dose-dependent. These results suggest that dietary inclusion of NS at levels as high as 2.0% (w/w) does not result in overt toxicity. These findings (as well as others) support the use of NS clay for dietary intervention studies in human populations at high risk for aflatoxicosis.

Short-term safety evaluation of processed calcium montmorillonite clay (NovaSil) in humans.

NovaSil clay (NS) provides significant protection from the adverse effects of aflatoxins (AFs) in multiple animal species by decreasing bioavailability from the gastrointestinal tract. It is postulated that NS clay can be safely added to human diets to diminish exposure and health risks from AF contaminated food. To determine the safety and tolerance of NS in humans and establish dosimetry protocols for long-term efficacy studies, a randomized and double-blinded phase I clinical trial was conducted. Volunteers (20-45 yr in age), were clinically screened for confirmation of their health status. Fifty subjects (23 males and 27 females) were randomly divided into two groups: The low-dose group received nine capsules containing 1.5 g/day, and the high-dose group received nine capsules containing 3.0 g/day for a period of 2?wk. NS capsules were manufactured in the same color and size and were distributed to each participant three times a day at designated sites where follow-up was taken to record any side effects and complaints. Blood and urine samples were collected before and after the study for laboratory analysis. All participants completed the trial and compliance was 99.1%. Mild GI effects were reported in some participants. Symptoms included abdominal pain (6%, 3/50), bloating (4%, 2/50), constipation (2%, 1/50), diarrhea (2%, 1/50), and flatulence (8%, 4/50). No statistical significance was found between the two groups for these adverse effects (p > 0.25). No significant differences were shown in hematology, liver and kidney function, electrolytes, vitamins A and E, and minerals in either group. These results demonstrate the relative safety of NS clay in human subjects and will serve as a basis for long-term human trials in populations at high risk for aflatoxicosis.

Symptomatic efficacy of beidellitic montmorillonite in irritable bowel syndrome: a randomized, controlled trial.

BACKGROUND: Beidellitic montmorillonite is a purified clay containing a double aluminium and magnesium silicate. AIM: To assess the efficacy and the safety of beidellitic montmorillonite (3 g, t.d. for 8 weeks) in patients with irritable bowel syndrome (IBS). METHODS: A multicentre, double-blind, placebo-controlled, randomized study with parallel groups, was performed in IBS patients selected according to ROME I criteria. Patients were included after a 1-week washout period to confirm that abdominal pain and/or discomfort was rated at least 2 on a 0-4 graded Likert scale. Patients were then randomized and stratified according to their predominant bowel habit profile into three groups. The use of rescue medication was allowed: polyethylene glycol 4000 (10-20 g/day) as a laxative agent in case of stool absence for three consecutive days, phloroglucinol (80 to a maximum of 320 mg/day) as a spasmolytic agent for no more than 8 days. The main end-point was the improvement of abdominal pain and/or discomfort by at least 1 point on the Likert scale. RESULTS: A total of 524 patients constituted the overall intent-to-treat population (ITT), 263 were assessed in the beidellitic montmorillonite group, i.e. 93 diarrhoea-predominant IBS (D-IBS), 83 constipation-predominant IBS (C-IBS), 87 alternating constipation/diarrhoea-IBS (A-IBS); 261 in the placebo group, i.e. 81 D-IBS, 92 C-IBS and 88 A-IBS. Initial analysis in the ITT population demonstrated a higher rate of success with beidellitic montmorillonite (51.7%) when compared with the placebo group (45.2%); however, the difference was not statistically significant. Improvement was significant in C-IBS both in ITT (beidellitic montmorillonite group = 49.4%, placebo group = 31.5%, P < 0.016) and per protocol populations (59.4% vs. 37.8%) (P < 0.01). The time to improvement of abdominal pain and/or discomfort (log Rank test) was also significantly in favour of beidellitic montmorillonite, (P < 0.04). The average number of stools per day was not different from baseline, either in all patients or in C-IBS patients. Spasmolytic and laxative agent intakes were not different between the two groups. Subjective evaluation by patients of treatment efficacy and visual analogue scale test of treatment efficacy by investigators were significantly better in the beidellitic montmorillonite group (P < 0.05). Tolerance of beidellitic montmorillonite was considered optimal without any significant adverse event. CONCLUSIONS: Although pain or discomfort was not significantly improved in the entire IBS population treated with beidellitic montmorillonite in comparison with placebo, this study demonstrates that beidellitic montmorillonite is efficient for C-IBS patients (P < 0.016). This effect of beidellitic montmorillonite on pain cannot be explained by changes in bowel habits. The efficacy of this well-tolerated therapy warrants further confirmatory therapeutic trials in C-IBS patients.

Fuller's earth (montmorillonite) pneumoconiosis.

A fuller's earth worker developed signs of pneumoconiosis. Pathological examination of the lung tissues showed interstitial collections of dust laden macrophages associated with mild fibrosis. Mineralogical analysis showed a high content of montmorillonite. This study shows that a pneumoconiosis can result from prolonged heavy exposure to calcium montmorillonite (fuller's earth) in the absence of quartz. The disease is relatively mild and associated with little clinical disability.

Effect of bentonite incorporated in a feed ration with tilmicosin in the prevention of induced Mycoplasma gallisepticum airsacculitis in broiler chickens.

A factorial arrangement of tilmicosin and bentonite was evaluated for efficacy in broiler chickens infected with Mycoplasma gallisepticum and correlated to tilmicosin recovery in a feed assay method. Tilmicosin at 300-500 g/ton prevented development of airsacculitis. The addition of 2% bentonite to the ration caused tilmicosin at 300 g/ton to be ineffective in controlling air-sac lesions, whereas 400 and 500 g/ton were moderately effective. Six percent bentonite rendered tilmicosin completely ineffective at all dose levels. There was a direct correlation between the percentage of bentonite in the feed rations, the percentage of the tilmicosin recovered in the assay procedure, and the increased incidence of air-sac lesions.