Administration of Bifidobacterium animalis subsp. lactis BB-12 and xylitol with a novel pacifier in early childhood

Probiotic bifidobacteria are used in the prevention and treatment of childhood diseases. On the other hand, these bacteria are also connected to dental caries. The purpose of the present work was to test a food supplement containing Bifidobacterium animalis subsp. lactis BB-12 (B. lactis BB-12) and xylitol, and to investigate its health effects, properties and safety when used in a novel pacifier in early childhood. In a double-blind, placebo-controlled trial, newborn infants (n=163) were assigned randomly to receive B. lactis BB-12, xylitol, or sorbitol from the age of 1– 2 monthsto 2 years with a pacifier or a spoon. Children were followed up to four years of age. A part of the parents participating in the clinical trial evaluated the feasibility of the novel administration method. The pattern of tablet release from the pouch of the pacifier was tested in adults. The food supplement tablet containing B. lactis BB-12 and xylitol could be delivered in a safe and controlled way with the novel pacifier. The early administration of B. lactis BB-12 did not result in permanent oral colonization of this probiotic or affect the colonization of mutans streptococci in early childhood. Moreover, B. lactis BB-12 did not increase the occurrence of caries. Controlled administration of B. lactis BB-12 significantly reduced the incidence of respiratory infections during the first eight months of life in a Finnish population with breastfed infants. To conclude, administration of B. lactis BB-12 in early childhood is safe with regard to the future dental health of the child. In addition, B. lactis BB-12 may add to the protection against respiratory infections provided by human breast milk in infancy.

Endoscopic biliary procedures: studies on cannulation and stenting

Deep cannulation is a prerequisite for successful endoscopic retrograde cholangiopancreatography (ERCP) procedures. Of the biliary procedures, stenting is one of the most common. This study was carried out to investigate current and controversial issues regarding biliary cannulation and stenting. The double guidewire (DGW) technique was studied to analyze its safety and feasibility in biliary cannulation as a single procedure and as a part of the novel three-step cannulation protocol. Female gender was evaluated in regard to difficult cannulation. The use of an angled and a straight tipped guidewire in biliary cannulation was studied in a prospective, randomized trial. Additionally, the patency of the novel antireflux plastic biliary stent was compared to the patency of the conventional plastic biliary stent in a prospective, randomized setting. The DGW method seems safe and feasible as an alternative cannulation technique in biliary cannulation. Female gender was not associated significantly with difficult biliary cannulation in our study, although the cannulation times seemed to be longer and the alternative cannulation techniques seemed to be needed more often in females than males. According to the results of this thesis, an angled tipped guidewire may facilitate biliary cannulation. In controversy to the previous result presented in the literature, the antireflux plastic biliary stent tested herein should not be used, as the patency of the stent was significantly shorter compared to the conventional plastic stent.