Age-dependent doses to members of the public from intake of radionuclides Part 4: Inhalation dose coefficients

Lactic acid bacteria (LAB) and their probio-active cellular substances exert many beneficial effects in the gastrointestinal tract. LAB prevent adherence, establishment, and replication of several enteric mucosal pathogens through several antimicrobial mechanisms. LAB also release various enzymes into the intestinal lumen and exert potential synergistic effects on digestion and alleviate symptoms of intestinal malabsoption. Consumption of LAB fermented dairy products with LAB may elicit antitumor effects. These effects are attributed to the inhibition of mutagenic activity; decrease in several enzymes implicated in the generation of carcinogens, mutagens, or tumor-promoting agents; suppression of tumors; and the epidemiology correlating dietary regimes and cancer. Specific cellular components in LAB strains seem to induce strong adjuvant effects including modulation of cell-mediated immune responses, activation of reticuloendothelial system, augmentation of cytokine pathways and regulation of interleukins, and tumor necrosis factors. Oral administration of LAB is well tolerated and proven to be safe in 143 human clinical trials and no adverse effects were reported in any of the total 7,526 subjects studied during 1961-1998. In an effort to decrease the reliance on synthetic antimicrobials and control the emerging immunocompromised host population, the time has come to carefully explore the prophylactic and therapeutic applications of probiotic LAB.

http://www.nterminus.com/sublinks/publications/(43)%20Probiotic%20LAB%20reprint.pdf

Probiotic Spectra of Lactic Acid Bacteria (LAB)

This update focuses on the bioavailability of dietary calcium for humans. Fundamentals of calcium metabolism, intestinal absorption, urinary excretion and balance are recalled. Dietary factors, especially lactose and other milk components, influencing calcium bioavailability at intestinal and renal levels are reviewed. A critical examination of all the methods used for evaluating calcium bioavailability is made. This includes in vitro assays, classical and isotopic balances, urinary excretion, isotope labeling in the urine, plasma and bones, long term evaluation of bone mineralization and the use of biological bone markers. Importance and advantages of animal models are discussed. The state of the art in the comparative bioavailability of calcium in foods is detailed including a comparison of sources of calcium (dairy products and calcium salts) in human studies and in some animal studies, casein phosphopeptides, proteins, lactose and lactase and their relation with calcium bioavailability (in humans and ...

The bioavailability of dietary calcium.

Heterotopic ossification is defined as the presence of lamellar bone at locations where bone normally does not exist. The condition must be distinguished from metastatic calcifications, which mainly occur in hypercalcaemia, and dystrophic calcifications in tumours. It is a frequent complication following central nervous system disorders (brain injuries, tumours, encephalitis, spinal cord lesions), multiple injuries, hip surgery and burns. In addition to this acquired form, hereditary causes also exist, such as fibrodysplasia ossificans progressiva, progressive osseous heteroplasia and Albright's hereditary osteodystrophy. Although these conditions are extremely rare, they can provide useful information on the physiopathology of heterotopic ossification, and thus lead to novel and causal treatment modalities. Heterotopic ossification is no trivial complication. A limitation of the range of joint motion may have serious consequences for the daily functioning of people who are already severely incapacitated because of their original lesion. Increased contractures and spasticity, pressure ulcers and increasing pain further compromise the patient's capabilities. Consequently, we feel that attention should be paid to the pathogenesis and particularly the prevention and treatment of this disorder.

/pdf/heterotopic-ossification-a-review-376ufydohs.pdf

Heterotopic ossification: a review.

Summary
Background Approximately 70% of the world population has hypolactasia, which often remains undiagnosed and has the potential to cause some morbidity. However, not everyone has lactose intolerance, as several nutritional and genetic factors influence tolerance.

Aims  To review current clinical practice and identify published literature on the management of lactose intolerance.

Methods  PubMed was searched using the terms lactose, lactase and diet to find original research and reviews. Relevant articles and clinical experience provided the basis for this review.

Results  Lactose is found only in mammalian milk and is hydrolysed by lactase in the small intestine. The lactase gene has recently been identified. ‘Wild-type’ is characterized by lactase nonpersistence, often leading to lactose intolerance. Two genetic polymorphisms responsible for persistence have been identified, with their distribution concentrated in north Europeans. Symptoms of lactose intolerance include abdominal pain, bloating, flatulence and diarrhoea. Diagnosis is most commonly by the lactose hydrogen breath test. However, most people with hypolactasia, if given appropriate advice, can tolerate some lactose-containing foods without symptoms.

Conclusion  In clinical practice, some people with lactose intolerance can consume milk and dairy foods without developing symptoms, whereas others will need lactose restriction.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2007.03557.x

Review article: lactose intolerance in clinical practice--myths and realities.

https://www.gastrojournal.org/article/0016-5085(83)90194-4/pdf

Effects of lactose on intestinal calcium absorption in normal and lactase-deficient subjects

1. Twelve cases of chronic POA and five cases of acute POA from clinical and radiologic onset were studied in the light of the following parameters: X-rays; lower limb angiographies with venous and arterial blood gas analysis; serial determinations of urine hydroxyproline; urine calcium, serum calcium and phosphorus; creatinephosphokinase; alkaline phosphatase; bone scans; skin temperatures; bone biopsies in evolving POA; light and electron microscopic studies; analysis of amorphous and crystalline components and fluorescent study of ectopic bone marked with tetracycline. 2. The most common localisation of heterotopic ossifications is periarticular; however, it may also be observed at some distance from the skeleton (cases 1 and 16). 3. Onset of POA is accompanied by angiographic modifications showing regression as the POA ages. However, one may not conclude from the persistance of angiographic modifications that the POA is not yet mature. Nor does normalisation of an initially pathological angiogram signify that the maturation of the ectopic bone formation is complete and the POA stabilised. The angiographic modifications associated with POA are secondary to the POA and not the cause. 4. Arteriovenous blood gas determinations correspond in general to the angiographic modifications and are of no value in judging the degree of maturity of the ectopic bone. 5. The development of POA may be associated with elevated urine Hyp. Normalisation of Hyp levels does not mean that the POA has stabilised; persistance of elevated values does not mean that the POA has not stabilised. Urine Hyp determinations do not permit any conclusion as to the degree of maturity of the POA lesion. 6. Elevation of serum alkaline phosphatase is a sign of the presence of pathologic growing bone, a contra-indication to POA surgery. Normalisation of this enzyme value does not constitute adequate proof of the stabilisation of the osteogenic process. 7. Infrequent isolated determinations of the alkaline phosphatase and of urine Hyp are of practically no value in following the evolution of POA. As for angiographies and bone scans, the dynamic picture produced by serial determinations gives a better idea of the status of the lesion. 8. Elevation of serum CPK suggests a participation of striated muscular tissue in the developing POA mass. 9. Determinations of serum calcium and phosphorus have been of no value in the diagnosis of POA, nor in the evaluation of the maturity of the ectopic mass. 10. In serial bone scans, a decrease in radionuclide uptake over a period of time seems to suggest a slowing of the disease process: an increase signifies active disease, a contraindication to surgery. 11. Multiple foci of osteogenesis of simultaneous onset do not necessarily evolve identically (case 2). 12. Serial bone scans seem to be the most reliable parameter for deciding when a POA is mature and may be operated. Although not constituting absolute proof of stabilisation of the osteogenic process, serial determinations of serum alkaline phosphatase are next in order of reliability. 13. POA may develop without any connection with muscular tissue but, most often, the POA develops in the muscular periphery, deriving from the interfascicular connective tissue, giving rise to a picture seen in some types of myositis ossificans, particularly the post-traumatic type. Histologic studies have shown that atrophic muscular fibres may occasionally be incorporated within the bony mass. 14. Light and electron microscopic examinations of 12 long standing POA (nine hips, two elbows, one knee) and of five recent POA (four hips, one knee) have shown that POA are the result of metaplasic osteogenesis, associated with some chondrogenesis, forming lamellar cortico-spongiosal bone. Therefore, the term ‘calcification’ does not apply to POA and may be abandoned. 15. The study of the ultrastructure and distribution of mineral salts in POA tissue, from early deposition to maturity, has shown that the sequence of transformation involves a progressive increase in the degree of mineralisation with a relative decrease of the amorphous phase and an enlargement in crystal size. After 30 months, the pattern in POA tissue approaches that of normal young adult bone. 16. Injury may certainly be a causative factor in the onset of POA, as shown by cases 2, 4, and 16, but other factors must be considered as well. The role of physiotherapy must be mentioned as a possible aetiologic factor, especially in association with marked spasticity (Hossack & King, 1967). Microscopic interstitial haemorrhages may result from too brisk a mobilisation. 17. If POA do occur more frequently in spastic patients, they may also take place in the absence of any spasticity, as shown by cases 1, 6, and 10. 18. Contrary to the views of Silver (1969), Stryker frames or turning beds, anticoagulant therapy and pressure sores do not appear to play an important role in the onset of POA. Cases 10 and 12 were not associated with any of these factors at any time during their treatment. 19. Eleven POA were resected in seven patients (nine hips, two elbows). There were recurrences in two patients attributed to lack of experience at the time these patients were operated. With the exception of one elbow with a recurrence, all other operated joints enjoyed a significant improvement in articular freedom. 20. This study has produced valuable parameters for the determination of POA maturation allowing for the correct timing of operation with minimal risk of recurrence. The question of the pathogenesis of POA has been answered only in part, and further study is needed, possibly with the help of bio- and histochemical techniques.

/pdf/current-facts-on-para-osteo-arthropathy-poa-4rxcatxbil.pdf

Current facts on para-osteo-arthropathy (POA)

Calcium absorption from milk in lactase-deficient subjects

https://www.gastrojournal.org/article/0016-5085(89)90900-1/pdf

A. Donath

Papers

Effects of lactose on intestinal calcium absorption in normal and lactase-deficient subjects

Current facts on para-osteo-arthropathy (POA)

Calcium absorption from milk in lactase-deficient subjects

Effect of absorbable and nonabsorbable sugars on intestinal calcium absorption in humans

A simple method for measurement of intestinal calcium absorption in humans by double-isotope technique.