Effects of a mixed additive based on Saccharomyces cerevisiae and Lactobacillus rhamnosus on broilers exposed to aflatoxin B1 by contaminated feed.

The objective of the present study was to explore the influence of dietary supplementation with a mixed additive (MA) containing a probiotic and anti-mycotoxin (Saccharomyces cerevisiae RC016 and Lactobacillus rhamnosus RC007) and its interaction on the performance and health (biochemistry and liver/intestine histopathology) of broilers fed diets contaminated with aflatoxin B1 (AFB1) at 506000±22.1ng/kg. The MA contained S. cerevisiae RC016 (1×107cells/g) and L. rhamnosus RC007 (1×108cells/g) in relation 1:1. A total of sixty-one-day-old Cobb broilers were randomly allocated into four treatment groups with three replicates of 5 birds each for a five-week-old feeding experiment. The experimental diet for each treatment (T) was formulated as follows: T1, a commercial diet (CD); T2, CD+AFB1; T3, CD+0.1% MA; T4, CD+AFB1+0.1% MA. The MA improved (p<0.01) production parameters (weight gain, conversion rate, and carcass yield) and reduced (p<0.01) the toxic effect of AFB1 on the relative weight of the livers. In addition, the macro and microscopic alterations of livers and the possible intestinal injury related to histological damage in the presence of mycotoxin were reduced. The use of probiotic MA based on S. cerevisiae RC016 and L. rhamnosus RC007 in animal feed provides greater protection against mycotoxin contamination and is safe for use as a supplement in animal feed, providing beneficial effects that improve animal health and productivity. This is of great importance at the economic level for the avian production system.

Symbiotic pectin microparticles with native Jerusalem artichoke (Helianthus tuberosus L.) enhance Lactobacillus paracasei subsp. tolerans survival.

The synergistic effect of microencapsulation in pectin microgels and inulin extracted from native crops of Jerusalem artichoke (JAI) was evaluated as a natural strategy to increase the survival of Lactobacillus paracasei subsp. tolerans F2 selected for its probiotic properties in Oncorhynchus mykiss. The strain was able to grow and ferment JAI in modified MRS broth, increasing cell population (∼+5 log units) with a net decrease in pH (6.2±0.2 to 4.0±0.5). Encapsulation of F2 in pectin microgels in the presence of JAI improved the survival of the strain not only during storage but also after exposure to simulated gastrointestinal conditions. Viable entrapped cells in the presence of the prebiotic were significantly higher (8.2-8.4log CFU/g) than without it (∼7.00log CFU/g) after 56 days at 4°C. These results encourage further implementation of these techniques for the formulation of functional feeds using natural alternative sources of inulin with greater viability on storage conditions and digestibility.

Gut microbes and health. / Microbiota intestinal y salud.

The human body is populated by myriads of microorganisms throughout its surface and in the cavities connected to the outside. The microbial colonisers of the intestine (microbiota) are a functional and non-expendable part of the human organism: they provide genes (microbiome) and additional functions to the resources of our species and participate in multiple physiological processes (somatic development, nutrition, immunity, etc.). Some chronic non-communicable diseases of developed society (atopias, metabolic syndrome, inflammatory diseases, cancer and some behaviour disorders) are associated with dysbiosis: loss of species richness in the intestinal microbiota and deviation from the ancestral microbial environment. Changes in the vertical transmission of the microbiome, the use of antiseptics and antibiotics, and dietary habits in industrialised society appear to be at the origin of dysbiosis. Generating and maintaining diversity in the microbiota is a new clinical target for health promotion and disease prevention.

Suplementos nutricionales para prevención de diabetes mellitus gestacional: lecciones aprendidas basadas en la evidencia.

INTRODUCTION: Gestational diabetes mellitus (GDM) affects between 5 and 40% of pregnant women. Recently different interventions with nutritional supplements have been evaluated for prevention of GDM. AIM: To perform a synthesis of the evidence on the efficacy of nutritional supplements (myo-inositol, probiotics, and vitamin D) in the prevention of GDM. METHODS: A systematic search in PubMed and Cochrane library was performed, including systematic reviews of randomized clinical trials (RCTs), published in English or Spanish until May 2020, using the keywords: "prevention", "gestational diabetes", "hyperglycemia and pregnancy", "supplementation", "probiotics", "myo-inositol" and "vitamin D". RESULTS: 10 systematic reviews that met the inclusion criteria were analyzed. Myo-inositol supplementation compared to placebo decreased the incidence of GDM (RR: 0.44 [0.27-0.87]; five RCTs), low quality of evidence. Although the supplementation with vitamin D or probiotics during pregnancy could reduce the incidence of GDM the evidence is limited. CONCLUSIONS: Myo-inositol supplementation is effective for prevention of GDM in high-risk women. Supplementation with vitamin D or probiotics probably decreases the incidence of GDM.

INTRODUCTION: La diabetes mellitus gestacional (DMG) afecta a entre el 5 y el 40% de mujeres embarazadas. Recientemente se han evaluado diferentes intervenciones con suplementos nutricionales para prevenir la DMG. OBJETIVO: Realizar una síntesis de la evidencia sobre eficacia de suplementos nutricionales (mioinositol, probióticos y vitamina D) para prevenir DMG. MÉTODO: Se realizó una búsqueda sistemática en PubMed y la biblioteca Cochrane, se incluyeron revisiones sistemáticas de estudios clínicos aleatorizados (ECAs), publicados en idioma inglés o español hasta mayo de 2020; se utilizaron las palabras clave: "prevención", "diabetes gestacional", "hiperglicemia y embarazo", "suplementación", "probióticos", "mio-inositol" y "vitamina D". RESULTADOS: Se analizaron 10 revisiones sistemáticas que cumplieron los criterios de inclusión. La suplementación con mioinositol comparado con placebo disminuyó la incidencia de DMG (RR: 0.44; IC 95%: 0.27-0.87; cinco ECAs). Si bien la suplementación con vitamina D o probióticos durante el embarazo podría disminuir la incidencia de DMG, la evidencia es limitada. CONCLUSIONES: La suplementación con mioinositol es efectiva para prevenir DMG en mujeres de alto riesgo. La suplementación con vitamina D o probióticos probablemente disminuye la incidencia de DMG.

Uso de mioinositol más Bifidobacterium lactis y Lactobacillus rhamnosus para la prevención de diabetes mellitus gestacional en mujeres mexicanas.

AIM: To compare the incidence of gestational diabetes mellitus (GDM) in women with three or more risk factor to developing GDM supplemented with myo-inositol plus probiotics versus women care without supplementation. METHODS: Retrospective cohort study, group 1, women with supplementation (myo-inositol 2g plus Bifidobacterium lactis and Lactobacillus rhamnosus 5x108 UFC, twice per day, from 12-14 to 28 weeks of gestation; group 2, women with prenatal care without supplementation, matched by age and body mass index (BMI). The primary outcome was the incidence of GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. RESULTS: Group 1 n=48, group 2 n=96. There were no significant baseline differences between groups in age, BMI and number of risk factors. The incidence of GDM in group 1 was n=14 (29.2%), and for group 2 n=46 (47.9%); RR: 0.61 (95% CI: 0.37-0.99; p = 0.03). CONCLUSIONS: Supplementation from 12-14 weeks of gestation with myo-inositol plus probiotics decrease the incidence of GDM in Mexican women.

OBJETIVO: Comparar la incidencia de diabetes mellitus gestacional (DMG) en mujeres con tres o más factores de riesgo para desarrollar DMG suplementadas con mioinositol más probióticos versus mujeres sin suplementación.­. MATERIAL Y ­MÉTODOS: Estudio de cohorte retrospectivo, grupo 1, mujeres con suplementación (mioinositol 2 g más Bifidobacterium lactis y Lactobacillus rhamnosus 5x108unidades formadoras de colonias, dos veces al día, de las 12-14 hasta las 28 semanas de gestación); grupo 2, mujeres con control prenatal habitual sin suplementación, pareadas por edad e índice de masa corporal (IMC). El resultado primario fue la incidencia de DMG utilizando los criterios de la Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo. RESULTADOS: Grupo 1, n = 48, y grupo 2 n = 96. No hubo diferencias significativas en características basales como edad, IMC, y numero de factores de riesgo entre los grupos. La incidencia de DMG en el grupo 1 fue n = 14 (29.2%) y en el grupo 2 n = 46 (47.9%); RR: 0.61 (IC 95%: 0.37-0.99; p = 0.03). CONCLUSIONES: La suplementación desde las 12-14 semanas de gestación con mioinositol más probióticos disminuye la incidencia de DMG en mujeres mexicanas.

Eradication of Helicobacter pylori infection with a new bismuth-based quadruple therapy in clinical practice. / Erradicación de la infección por Helicobacter pylori con una nueva terapia cuádruple basada en bismuto en la práctica clínica.

INTRODUCTION: The eradication of Helicobacter pylori infection represents a clinical challenge. OBJECTIVE: To evaluate the efficacy and safety of quadruple therapy with esomeprazole plus a 3-in-1 capsule containing bismuth subcitrate, metronidazole and tetracycline, plus probiotics in patients diagnosed with H. pylori infection in routine clinical practice. METHODS: A prospective, interventional, single-centre and open-label study in consecutive patients with a confirmed indication for eradication of H. pylori infection. Patients were treated with three capsules of Pylera® four times a day (breakfast, lunch, afternoon snack and dinner), plus 40mg of esomeprazole twice daily for 10 days (30min before breakfast and dinner) and probiotics for 30 days. Eradication of H. pylori infection was confirmed by labelled urea breath test performed at least 28 days after the end of treatment. RESULTS: A total of 100 patients were consecutively enrolled. Twenty-five patients (25.0%) had a prior history of treatment for their H. pylori infection. In the intention-to-treat population, eradication rates were 90.7% (68/75) and 80.0% (20/25) in patients treated with Pylera® as the first line or as rescue therapy, respectively. Eighteen patients (18%) had at least one adverse event, most of which (89%) were mild. CONCLUSION: Ten days of treatment with a quadruple regimen of bismuth, metronidazole and tetracycline plus esomeprazole and probiotics is an effective and safe strategy in patients with H. pylori infection.

Development and storage studies of high density macrocapsules containing Lactobacillus spp. strains as nutritional supplement in young calves.

The aim of this study was to evaluate different production methodologies of probiotic macrocapsules with high bacterial densities destined to lactating calves. Three types of capsules containing Lactobacillus casei DSPV318T and Lactobacillus plantarum DSPV354T were prepared from an overnight culture in whey medium: (1) mixing the culture with calcium alginate and then, reincubating the capsules in whey (RC); (2) concentrating the biomass by centrifugation and mixing the pellet with calcium alginate (CC) at different concentrations with respect to the initial culture (5X and 12.5X); (3) CC with cryoprotectants: whey permeate (Per) and glycerol (Gly). Chitosan coating was evaluated. Capsules were freeze-dried and viability was assessed before freezing, after freeze-drying and every two weeks for 84 days of storage at room temperature, 4°C and -20°C. CC showed higher cell densities than RC. Storage temperature affected viability: greater viability at lower temperature. Moreover, the effect of temperature was influenced by other factors, such as capsule coating, culture neutralization and cryoprotectants. Coating improved viability at room temperature; however no effect was observed at 4°C. Culture neutralization allowed greater survival during storage. Cryoprotectants improved viability during freezing, but they also generated a positive or negative effect depending on storage temperature. The best results were: at refrigeration Gly12.5X exhibited counts above 109CFU/capsule until day 70 and Per12.5X until day 56 of storage and at -20°C Gly12.5X showed counts above 109CFU/capsule until the end of the study (84 days). A 109CFU capsule is the daily dose per calf which would facilitate the administration of this probiotic inoculum to field animals.

Review of the role of probiotics in gastrointestinal diseases in adults. / Revisión del papel de los probióticos en la patología gastrointestinal del adulto.

BACKGROUND: Probiotics may act as biological agents that modify the intestinal microbiota and certain cytokine profiles, which can lead to an improvement in certain gastrointestinal diseases. OBJECTIVES: To conduct a review of the evidence of the role of probiotics in certain gastrointestinal diseases in adults. SEARCH METHODS: Review conducted using appropriate descriptors, filters and limits in the PubMed database (MEDLINE). SELECTION CRITERIA: The MeSH terms used were Probiotics [in the title] AND Gastrointestinal Diseases, with the following limits or filters: Types of study: Systematic Reviews, Meta-Analysis, Guideline, Practice Guideline, Consensus Development Conference (and Consensus Development Conference NIH), Randomized Controlled Trial, Controlled Clinical Trial and Clinical Trial; age: adults (19 or older); language: English and Spanish; in humans, and with at least one abstract. DATA COLLECTION AND ANALYSIS: Full texts of all the Systematic Reviews and meta-analyses directly related to the review's objective were obtained, as well as the Randomised Controlled Trials of the studies that were considered relevant and of sufficient quality for this review. MAIN RESULTS: Certain probiotics, different for each process, have proven to be effective and beneficial in cases of acute infectious diarrhoea, antibiotic-associated diarrhoea, Clostridium difficile-associated diarrhoea, pouchitis and Helicobacter pylori infection eradication. AUTHORS' CONCLUSIONS: Although some probiotics have not demonstrated any benefit, there are certain gastrointestinal diseases in which the use of probiotics, true biological agents, can be recommended.

[Inhibitory capacity of Lactobacillus spp. against pathogens involved in foodborne diseases]. / Efecto inhibitorio de Lactobacillus spp. sobre bacterias implicadas en enfermedades transmitidas por alimentos.

The genus Lactobacillus daily generates a growing interest among microbiologists and technologists, who try to discover new biotechnological applications and probiotic properties. The main goal of this study was to evaluate the inhibitory capacity of Lactobacillus spp. against pathogens (Escherichia coli O157:H7, Salmonella spp., Staphylococcus aureus) involved in foodborne diseases. For this purpose, samples were collected at different stages of the pork production chain. Seventy eight bacterial strains were isolated. Twenty seven (27) of these strains (37.18%) had genotypic and phenotypic characteristics corresponding to Lactobacillus spp. whereas 85.18% of them showed inhibitory capacity. These data showed that the studied strains represent a potential alternative to inactivate foodborne pathogens and thus provide safe food to consumers.

The Mexican consensus on probiotics in gastroenterology. / Consenso mexicano sobre probióticos en gastroenterología.

INTRODUCTION: Probiotics are frequently prescribed in clinical practice. Their efficacy in treating gastrointestinal disorders is supported by a significant number of clinical trials. However, the correct prescription of these agents is hampered due to a lack of knowledge of the scientific evidence and to the different presentations and microbial compositions of the probiotics that are currently available. AIM: To provide the clinician with a consensus review of probiotics and recommendations for their use in gastroenterology. MATERIALS AND METHODS: Controlled clinical trials, meta-analyses, and systematic reviews published up to 2015 were selected, using the MESH terms: probiotics, gastrointestinal diseases, humans, adults, AND children. The Delphi method was employed. Eighteen gastroenterologists treating adult patients and 14 pediatric gastroenterologists formulated statements that were voted on until agreement>70% was reached. The level of evidence based on the GRADE system was evaluated for each statement. RESULTS AND CONCLUSIONS: Eleven statements on the general concepts of probiotics and 27 statements on the use of probiotics in gastrointestinal diseases in both adults and children were formulated. The consensus group recommends the use of probiotics under the following clinical conditions: the prevention of diarrhea associated with antibiotics, the treatment of acute infectious diarrhea, the prevention of Clostridium difficile infection and necrotizing enterocolitis, the reduction of adverse events from Helicobacter pylori eradication therapy, relief from irritable bowel syndrome symptoms, the treatment of functional constipation in the adult, and the induction and maintenance of remission in patients with ulcerative colitis and pouchitis, and the treatment of covert and overt hepatic encephalopathy.

Colonic diverticular disease. Treatment and prevention.

Diverticular disease represents the most common disease affecting the colon in the Western world. Most cases remain asymptomatic, but some others will have symptoms or develop complications. The aims of treatment in symptomatic uncomplicated diverticular disease are to prevent complications and reduce the frequency and intensity of symptoms. Fibre, probiotics, mesalazine, rifaximin and their combinations seem to be usually an effective therapy. In the uncomplicated diverticulitis, outpatient management is considered the optimal approach in the majority of patients, and oral antibiotics remain the mainstay of treatment. Admission to hospital and intravenous antibiotic are recommended only when the patient is unable to intake food orally, affected by severe comorbidity or does not improve. However, inpatient management and intravenous antibiotics are necessary in complicated diverticulitis. The role of surgery is also changing. Most diverticulitis-associated abscesses can be treated with antibiotics and/or percutaneous drainage and emergency surgery is considered only in patients with acute peritonitis. Finally, patient related factors, and not the number of recurrences, play the most important role in selecting recipients of elective surgery to avoid recurrences.

[Characterization, influence and manipulation of the gastrointestinal microbiota in health and disease]. / Caracterización, influencia y manipulación de la microbiota gastrointestinal en salud y enfermedad.

The gastrointestinal tract harbors trillions of microorganisms that are indispensable for health. The gastrointestinal microbiota can be studied using culture and molecular methods. The applications of massive sequencing are constantly increasing, due to their high yield, increasingly accessible costs, and the availability of free software for data analysis. The present article provides a detailed review of a large number of studies on the gastrointestinal microbiota and its influence on human health; particular emphasis is placed on the evidence suggesting a relationship between the gastrointestinal microbial ecosystem and diverse physiological and immune/inflammatory processes. Discussion of the articles analyzed combines a medical approach and current concepts of microbial molecular ecology. The present revision aims to be useful to those interested in the gastrointestinal microbiota and its possible alteration to maintain, re-establish and enhance health in the human host.

[Probiotics in broilers' rearing: A strategy for intensive production models]. / Probióticos en pollos parrilleros: una estrategia para los modelos productivos intensivos.

The broiler industry has become an important economic activity in Argentina. Global production of broiler meat has been growing in Argentina faster than for any other meats, possibly due to declining poultry prices and increasing incomes. Modern rearing systems can produce broilers ready to slaughter in 50 days, with the required 2.7kg of weight and a feed conversion of about 1.6kg feed/kg of meat. Nevertheless, broilers raised under these intensive conditions are exposed to various stressors every day. For many years, feed supplementation with antibiotics was widely used to stabilize the gut flora, improve general parameters and prevent avian diseases. However, the utility of antibiotics has been questioned because of the emergence and spread of antibiotic-resistant bacteria in meat. Therefore, there is a renewed interest in finding viable alternatives to antibiotics. One potential method is the supplementation of broiler diets with probiotics. This review provides an updated summary of the use of probiotics to improve sanitary conditions and enhance performance in broilers, demonstrating the role of probiotics as a reliable option to replace antimicrobial growth promoters.

Evidence on the benefits of probiotics for preterm infants.

Introduction: This article reviews the evidence for the use of different strains of probiotics in the prevention of prevalent pathologies in premature neonates. A systematic review was conducted of the use of probiotics in neonates with less than 37 weeks of gestational age, based on a search for systematic reviews and observational and experimental studies performed during the period from January 2014 to February 2021. For this purpose, the PubMed, MEDLINE and Cochrane Library databases were consulted. The aim of this article was to review the existing data on the relationship between the administration of probiotics (with different strains and doses) and the risk of necrotising enterocolitis, mortality, late sepsis and other disease parameters in premature infants. The literature search obtained 240 articles, of which we selected 16, representing a total sample of over 200,000 premature infants. Analysis of the data obtained reveals statistical evidence that the combined administration of probiotics (especially of Lactobacillus and Bifidobacterium strains) reduces the incidence of grade II or higher necrotising enterocolitis, all-cause mortality, late sepsis, length of hospital stay and time until complete enteral nutrition is achieved. However, no benefits were apparent with respect to alleviating bronchopulmonary dysplasia, retinopathy of prematurity or intraventricular haemorrhage. Further research is needed to determine the most appropriate strains, doses and treatment duration for preterm infants to achieve the health benefits identified.

Introducción: En este artículo se revisa la evidencia del uso de las diferentes cepas de probióticos en la prevención de diversas patologías prevalentes en recién nacidos prematuros. Se ha realizado una revisión sistemática sobre el uso de probióticos en recién nacidos de menos de 37 semanas de edad gestacional, realizando una búsqueda de revisiones sistemáticas, estudios observacionales y experimentales desde enero de 2014 hasta febrero de 2021. Para ello se han utlizado motores de búsqueda como PubMed, MEDLINE y la biblioteca Cochrane. El objetivo de este artículo fue revisar los datos existentes sobre la relación entre la administración de probióticos (con diferentes cepas y dosis) y el riesgo de enterocolitis necrotizante, mortalidad, sepsis tardía, y otros parámetros de enfermedad en prematuros. En la búsqueda se obtuvieron 240 artículos, de los que seleccionamos 16, obteniendo más de 200.000 recién nacidos prematuros como muestra. En esta revisión se muestra con evidencia estadística, que la administración combinada de probióticos (espcialmente cepas de Lactobacillus y Bifidobacterium) reducen la incidencia de NEC en grado II o mayor, mortalidad por todas las causas, sepsis tardía, días de estancia hospitalaria y tiempo en lograr nutrición enteral completa. No se han podido evidenciar beneficios en cuanto a la displasia broncopulmonar, retinopatía de la prematuridad y hemorragia intraventricular. Se precisan nuevos estudios para conocer las cepas, dosis y tiempo de tratamiento más adecuados en neonatos prematuros para lograr beneficios en salud.

Evaluation of the efficacy of probiotics as treatment in irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a gastrointestinal functional disorder mainly characterised by abdominal pain, bloating and altered bowel habits. Dysbiosis might seem to be involved in the pathogenesis of the disease. Probiotics represent a potential treatment, since these could favour the functional microbiota and improve symptoms. The aim was to review the effectiveness of the use of probiotics in IBS symptomatology, analysing the influence of duration and dose. 18 articles were included. At the individual level, Lactobacillus, Bifidobacterium and Bacillus could be useful in the treatment of symptoms. Bifidobacterium bifidum reported the best results (1 × 109 CFU/day for 4 weeks). The most effective combination was 2 Lactobacillus strains, one of Bifidobacterium and one of Streptococcus (4 × 109 CFU/day for 4 weeks). Future clinical trials should confirm these results and analyse the difference between individual and combined treatments.

Effect of probiotics on cognitive function in adults with mild cognitive impairment or Alzheimer's disease: A meta-analysis of randomized controlled trials.

BACKGROUND: Recent clinical studies have yielded controversial results regarding the effect of probiotics on cognitive function in Alzheimer's disease (AD) or mild cognitive impairment (MCI) subjects. To clarify the efficacy of probiotics on cognition, we conducted a meta-analysis of randomized controlled trials (RCTs). METHODS: Instructions of the PRISMA 2020 statement were followed. Literature from the PubMed, Embase and Cochrane databases were systematically searched and manually screened for relevant published RCTs. We performed statistical analysis using RevMan, and assessed the risk of bias using the R software. RESULTS: A total of 12 studies comprising 852 patients with MCI or AD were identified. The results of meta-analysis showed that probiotics improved global cognitive function (SMD=0.67; 95% CI, 0.32, 1.02), recall/delayed memory (SMD=0.67; 95% CI: 0.32, 1.02), attention (SMD=0.31; 95% CI: 0.04, 0.58) and visuospatial/constructional (SMD=0.24; 95% CI: 0.06, 0.42) cognitive domain. CONCLUSION: This meta-analysis found that probiotic supplementation is associated with an improvement in cognitive performance among patients with AD and MCI. However, current evidence is limited, and more reliable large-scale RCTs with higher methodological quality are needed.

Treating asthma patients with probiotics: a systematic review and meta-analysis.

Introduction: Objective: To evaluate the role of probiotics in the treatment of asthma patients by meta-analysis. Methods: PubMed, Embase, The Cochrane Library, Web of Science, and other databases were searched by computer, and the relevant literature on the treatment of asthma by probiotics that met the inclusion criteria was screened by manual retrieval. Meta-analysis was performed using Revman 5.4 software and the combined effect was evaluated by odds ratio (OR) or mean difference (MD) and 95 % confidence interval (CI). Results: a total of ten references were included, all of which were randomized controlled studies, and a total of 1,101 people were investigated. Fractional exhaled nitric oxide (FeNO) (MD = -7.17, 95 % CI: -12.81, -1.54), asthma symptom severity (MD = -0.07, 95 % CI: -0.10, -0.04), Childhood Asthma Control Test (CACT) (MD = 2.26, 95 % CI: 1.14, 3.39), and the number of acute episodes of asthma (OR = 0.30, 95 % CI: 0.19, 0.47) in the probiotics group were better than those in the control group. There was no significant difference in forced expiratory volume in the first second (FEV1) (MD = 0.11, 95 % CI: -0.05, 0.26) and FEV1/FVC (%) (MD = 0.32, 95 % CI: -1.48, 2.12). Conclusion: the use of probiotics in patients with asthma can improve lung inflammation and asthma symptoms, reduce the number of asthma attacks, and have no effect on lung function.

Introducción: Objetivo: evaluar el papel de los probióticos en el tratamiento de pacientes con asma mediante metaanálisis. Métodos: se realizaron búsquedas informáticas en PubMed, Embase, The Cochrane Library, Web of Science y otras bases de datos, y se examinó la literatura relevante sobre el tratamiento del asma con probióticos que cumplía con los criterios de inclusión mediante recuperación manual. El metaanálisis se realizó con el software Revman 5.4 y el efecto combinado se evaluó mediante la razón de probabilidades (OR) o diferencia media (MD) y el intervalo de confianza (IC) del 95 %. Resultados: se incluyó un total de diez referencias, todas ellas estudios controlados aleatorios, y se investigó un total de 1.101 personas. El óxido nítrico exhalado (FeNO) (MD = -7,17, IC 95 %: -12,81, -1,54), la gravedad de los síntomas del asma (MD = -0,07, IC 95 %: -0,10, -0,04), la Prueba de Control del Asma (CACT-ACT) (MD = 2,26, IC 95 %: 1,14, 3,39) y el número de episodios agudos de asma (OR = 0,30, IC 95 %: 0,19, 0,47) en el grupo de probióticos fueron mejores que en el grupo de control. No hubo diferencia significativa en volumen espiratorio forzado en el primer segundo (FEV1) (DM = 0,11, IC 95 %: -0,05, 0,26) y FEV1/FVC (%) (DM = 0,32, IC 95 %: -1,48, 2,12). Conclusión: el uso de probióticos en pacientes con asma puede mejorar la inflamación pulmonar y los síntomas del asma, reducir el número de ataques de asma y no tener efecto sobre la función pulmonar.

Is there a relationship between oral hygiene and nutritional status in peritoneal dialysis patients?

Introduction: Brackground: in the early stages of kidney disease, oral manifestations (gingivitis and periodontitis) may cause premature tooth loss and limit food intake. There is scarce evidence of the relationship of oral hygiene and nutritional status in patients on Peritoneal Dialysis (PD). Objective: we aimed to assess the relationship of oral hygiene with nutritional, clinical, and physical performance parameters in PD patients. Methods: this cross-sectional study included outpatients aged 34-69 years. Oral health questionnaire, nutritional, functional, and clinical assessment tools such as Malnutrition Inflammation Score (MIS), Subjective Global Assessment (SGA), handgrip strength, and Gastrointestinal Symptoms Questionnaire (GSQ) were applied. Patients were divided according to debris, calculus, and Simplified Oral Hygiene Index (OHI-S) in two groups: "clean-slightly dirty" and "dirty-very dirty". Results: in total, 41 patients were included, those in the "dirty-very dirty" group had a worse nutritional status with higher scores on the MIS tool and worse nutritional diagnosis with SGA as compared to the "clean-slightly dirty" group. The handgrip strength was higher in patients in the best category of oral hygiene, and those with the worst hygiene presented greater severity of gastrointestinal symptoms. The risks of malnutrition in the three indices of oral hygiene with the worst category were statistically significant. Conclusion: poor oral hygiene was associated with poorer nutritional status, lower handgrip, and worse GSQ. Poor oral hygiene might be related to persistent inflammation status and catabolism that favored protein-energy wasting.

Introducción: Introducción: en las primeras etapas de la enfermedad renal, las manifestaciones orales (gingivitis y periodontitis) pueden causar la pérdida de dientes prematura y limitar la ingestión de los alimentos. Existe poca evidencia de la relación entre la higiene bucal y el estado de nutrición en los pacientes con Diálisis Peritoneal (PD). Objetivos: evaluar la relación de la higiene bucal con los parámetros nutricionales, clínicos y de funcionalidad física en pacientes con DP. Métodos: este es un estudio transversal que incluyó a pacientes ambulatorios de 34 a 69 años. Se aplicó un cuestionario de salud bucal, herramientas de evaluación nutricional, pruebas de funcionalidad y un cuestionario de síntomas gastrointestinales, con las herramientas MIS (Malnutrition Inflammation Score), SGA (Subjective Global Assessment); fuerza de prensión de mano y el cuestionario de síntomas gastrointestinales GSQ (Gastrointestinal Score Questionnaire). Los pacientes fueron agrupados de acuerdo con los índices de placa, cálculo y OHI-S (Simplified Oral Hygiene Index) en dos grupos: "limpio-ligeramente sucio" y "sucio-muy sucio". Resultados: se incluyeron 41 pacientes en total, aquellos en el grupo "sucio-muy sucio" presentaron un peor estado nutricional con mayores puntajes de la herramienta MIS y peor diagnóstico nutricional con la SGA comparado con el grupo "limpio-ligeramente sucio". La fuerza de prensión de mano fue mayor en los pacientes con la mejor categoría de higiene bucal, y aquellos con peor higiene presentaron mayor gravedad de síntomas gastrointestinales. El riesgo de desnutrición en los tres índices de higiene bucal con la peor categoría fueron estadísticamente significativos. Conclusiones: la mala higiene bucal se asoció con un peor estado nutricional, menor fuerza de prensión de la mano y peor GSQ. Una higiene bucal deficiente podría estar relacionada con un estado de inflamación y catabolismo persistentes favoreciendo el desgaste proteínico energético en pacientes en diálisis peritoneal.

The effect of probiotics on the serum lipid levels in non-obese healthy adults with hyperlipidemia: A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Introduction: probiotics might have a potential effect to manage serum lipid levels as nutraceuticals. Objective: this systematic review was conducted to explore whether probiotics have an efficient result in non-obese healthy adults with hyperlipidemia. Methods: PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials (from their commencement to January 2021). This meta-analysis was performed by Review Manager 5.3 and STATA 15.1. Changes in serum lipid levels after the intervention were used to evaluate the effect of the probiotics, which were expressed as the weighted mean difference (WMD) with a 95 % confidence interval (CI). Results: a total of 16 studies, which could be regarded as 21 independent trials with 1429 participants, were included in this meta-analysis following our inclusion criteria. It could be observed that probiotics could significantly lower total cholesterol (TC) (WMD: -0.34 mmol/L, 95 % CI: -0.45 to -0.23 mmol/L; p < 0.001, I2 = 73.9 %) and low-density lipoprotein cholesterol (LDL-C) (WMD: -0.26 mmol/L, 95 % CI: -0.36 to -0.17 mmol/L; p < 0.001, I2 = 79.0 %) levels in non-obese healthy adults with hyperlipidemia, while no significant effect between the probiotic intervention and control groups was observed on high-density lipoprotein cholesterol (HDL-C) (WMD: 0.00 mmol/L, 95 % CI: -0.02 to 0.02 mmol/L; p = 0.001, I2 = 56.6 %) and triglyceride (TG) (WMD: -0.08 mmol/L, 95 % CI: -0.18 to 0.01 mmol/L; p = 0.003, I2 = 52.4 %) levels. Conclusion: this systematic review showed that probiotics may provide a promising way to reduce serum lipid levels in non-obese healthy adults with hyperlipidemia, but their specific effect still needs more clinical experiments to be proven.

INTRODUCCIÓN: Introducción: los probióticos podrían tener efecto para controlar los niveles de lípidos séricos como nutracéuticos. Objetivo: esta revisión sistemática se realizó para explorar si los probióticos tienen un resultado eficiente en adultos sanos no obesos con hiperlipidemia. Métodos: se realizaron búsquedas de ensayos controlados aleatorios en PubMed, Embase, el Registro Cochrane Central de Ensayos Controlados y Web of Science (desde su inicio hasta enero de 2021). Este metanálisis fue realizado mediante Review Manager 5.3 y STATA 15.1. Los cambios de los niveles de lípidos séricos después de la intervención se utilizaron para evaluar el efecto de los probióticos, que se expresaron como la diferencia de medias ponderada (DMP) con un intervalo de confianza (IC) del 95 %. Resultados: en este metaanálisis se incluyeron un total de 16 estudios, que podrían considerarse 21 ensayos independientes con 1429 participantes, siguiendo nuestros criterios de inclusión. Se pudo observar que los probióticos podían reducir significativamente el colesterol total (CT) (DMP: -0,34 mmol/L, IC del 95 %: -0,45 a -0,23 mmol/L; p < 0,001, I2 = 73,9 %) y el colesterol de lipoproteínas de baja densidad (C-LDL) (DMP: -0,26 mmol/L, IC del 95 %: -0,36 a -0,17 mmol/L; p < 0,001, I2 = 79,0 %) en los adultos sanos no obesos con hiperlipidemia, mientras que no hubo efectos significativos entre los grupos de intervención y de control en el colesterol de lipoproteínas de alta densidad (HDL-C) (DMP: 0,00 mmol/L, IC del 95 %: -0,02 a 0,02 mmol/L; p = 0,001, I2 = 56,6 %) y los triglicéridos (TG) (DMP: -0,08 mmol/L, IC del 95 %: -0,18 a 0,01 mmol/L; p = 0,003, I2 = 52,4 %). Conclusión: esta revisión sistemática manifestó que los probióticos podrían suponer una forma prometedora de reducir los niveles de lípidos séricos en los adultos sanos no obesos con hiperlipidemia, pero se necesitan más experimentos clínicos para demostrar su efecto específico.

[Functional feeding to alleviate gastrointestinal disorders associated with autism spectrum disorders: A systematic review]. / Alimentación funcional para aliviar desórdenes gastrointestinales asociados a trastornos del espectro autista: Una revisión sistemática.

Introduction: Background: gastrointestinal disorders (GIDs) are common comorbidities in patients with autism spectrum disorders (ASD); treatments with gluten- and casein-free (LGLC) diets or prebiotic/probiotic supplements may reduce the severity of GIDs. Objective: to integrate and discuss the evidence on the effectiveness of LGLC diet therapies and prebiotic/probiotic supplements on GIDs in patients with ASD. Methodology: the guidelines for the publication of systematic reviews and meta-analyses (PRISMA) were used. Participant characteristics, dietary interventions, prebiotic/prebiotic supplementation, effects of interventions on GIDs, risk of bias, and safety of treatments were analyzed. Results: fifteen investigations were analyzed; the prevalence of GIDs among patients with ASD was high (58 %; range, 27-83 %). In more than 20 % of the patients managed with LGLC diets or supplements GID severity decreased (mainly constipation, diarrhea, and abdominal pain). Increases in the counts of beneficial bacteria and a decrease in the proportion of pathogenic bacteria were reported after supplement use. However, all these investigations had significant methodological biases. Conclusions: although reductions in the frequency and severity of some GIDs have been found, the effectiveness of these treatments has not been proven yet. Given the methodological differences in the investigations, the design of rigorous studies to evaluate the therapeutic effects of these treatments on gastrointestinal health in patients with ASD is warranted.

Introducción: Antecedentes: los trastornos gastrointestinales (TGI) son comorbilidades comunes en los pacientes con trastornos del espectro autista (TEA); los tratamientos con dietas libres de gluten y caseína (LGLC) o suplementos de prebióticos/probióticos podrían reducir la severidad de los TGI. Objetivo: integrar y discutir la evidencia sobre la efectividad de las terapias con dietas LGLC y suplementos de prebióticos/probióticos sobre los TGI en pacientes con TEA. Metodología: se utilizaron las guías para la publicación de revisiones sistemáticas y metaanálisis (PRISMA). Se analizaron las características de los participantes, las intervenciones dietéticas, la administración de suplementos de prebióticos/prebióticos, los efectos de las intervenciones sobre los TGI, el riesgo de sesgo de los estudios y la seguridad de los tratamientos. Resultados: se analizaron quince investigaciones; la prevalencia de los TGI entre los pacientes con TEA fue alta (58 %; rango, 27-83 %). En más del 20 % de los pacientes intervenidos con dietas LGLC o suplementos disminuyó la severidad de los TGI (principalmente estreñimiento, diarrea y dolor abdominal). Se reportaron aumentos en los conteos de bacterias benéficas y una disminución de la proporción de bacterias patógenas tras el uso de los suplementos. Sin embargo, todas estas investigaciones presentaron sesgos metodológicos importantes. Conclusiones: aunque se han encontrado reducciones en la frecuencia y severidad de algunos TGI, la efectividad de estos tratamientos aún no se ha comprobado. Dadas las diferencias metodológicas de las investigaciones, se justifica el diseño de estudios rigurosos para evaluar los efectos terapéuticos de estos tratamientos sobre la salud gastrointestinal en pacientes con TEA.