Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected...Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:;"...<strong>Background:</strong><span style="font-family:Verdana;"> Bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> vaginosis is a complex pathogenic group of bacteria which can cause a wide range of symptoms in affected women in Obstetric and Gynaecological practice. Its occurrence usually indicates alteration in the normal vaginal flora expected in majority of the women of reproductive age. Amongst the maintenance agents of the vaginal health, lactobacilli occupy a prominent place. Asymptomatic bacterial vaginosis is postulated to be linked to the development of cervical intraepithelial neoplasia by some researchers while some differ in this regard. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To determine the rate of occurrence of asymptomatic bacterial vaginosis and associated factors in women who underwent cervical cytology for cervical cancer screening. </span><b><span style="font-family:Verdana;">Study Design</span></b><span style="font-family:Verdana;">: A cross sectional study involving microscopic examination of cervical smears of eligible clients presenting for routine Pap smear. </span><b><span style="font-family:Verdana;">Setting: </span></b><span style="font-family:Verdana;">The study was carried out in a </span></span><span style="font-family:Verdana;">well</span><span style="font-family:Verdana;"> woman’s facility established and manned by female medical doctors in Enugu state with the assistance of trained nursing staff. Various female cancers and other communicable and non</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">communicable disease screening are performed at the centre. The services are available to the general public including various parts of the state and other nearby states. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This preliminary study was carried out on women presenting for cervical cancer screening between February and July 2018 in a </span></span><span style="font-family:Verdana;">well</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> woman’s centre in Enugu. Information on the socio-demographic and gynaecological history of the study participants were obtained and recorded in designated proformas. Smears that showed changes suggestive of bacterial vaginosis on microscopy were set aside for further evaluation. Such changes included: a conspicuous absence of normal flora of lactobacilli;filmy background of coccobacilli replacing the lactobacilli, individual squamous cells covered by a layer of bacteria (clue cells);viable squamous cells showing reactive changes identified as increased nuclear size, perinuclear halo and binucleation. Data entry and analysis were done using statistical package for social sciences (SPSS) computer software version 21.0. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">285 eligible women had cervical smear done during the first six</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">month</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of the 2</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">year project at the centre. 50.9% were above reproductive age (>45</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">years), 38.2% were in second half of reproductive age (31</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">45), 10.9% were in the early reproductive age (15</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">30). 13% of the women were nulliparous, 51.9% were para</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">4, and 35.1% were grand</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">multiparous. Of the 285 Pap smear slides viewed, 31 had bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> vaginosis by the above criteria. This gave a prevalence of 10.8% in the reviewed cytological smears. There was an association of bacterial vaginosis with reproductive age. There was however, no association with age at coitarche and parity. There was also, no association of bacterial vaginosis with contraceptive use. There was no association between abnormal cervical cytology and asymptomatic bacterial vaginosis with absent lactobacilli. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prevalence of bacteria</span></span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis is significant in our study population who were asymptomatic. Cervical smear should be taken advantage of as a tool for both cervical pre-cancer and bacterial vaginosis screenings since same sample can simultaneously be used for both conditions during cytology. Bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis may be unlikely involved in pathogenesis of cervical intraepithelial neoplasia.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Recommendation: </span></b><span style="font-family:Verdana;">Researchers should harmonise the standards/criteria for the diagnosis of bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis because there are varied criteria for the diagnosis in the literature. Given, the dual advantage of pap smear in diagnosing cervical pre cancer stages and infections, more elaborate studies are needed to determine the usefulness of treatment or otherwise of bacterial vaginosis which constitute</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> significant incidental finding</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;">.</span>展开更多
The gut microbiota is currently considered an external organ of the human body that provides important mechanisms of metabolic regulation and protection.The gut microbiota encodes over 3 million genes,which is approxi...The gut microbiota is currently considered an external organ of the human body that provides important mechanisms of metabolic regulation and protection.The gut microbiota encodes over 3 million genes,which is approximately 150 times more than the total number of genes present in the human genome.Changes in the qualitative and quantitative composition of the microbiome lead to disruption in the synthesis of key bacterial metabolites,changes in intestinal barrier function,and inflammation and can cause the development of a wide variety of diseases,such as diabetes,obesity,gastrointestinal disorders,cardiovascular issues,neurological disorders and oncological concerns.In this review,I consider issues related to the role of the microbiome in the regulation of intestinal barrier function,its influence on physiological and pathological processes occurring in the body,and potential new therapeutic strategies aimed at restoring the gut microbiome.Herewith,it is important to understand that the gut microbiota and human body should be considered as a single biological system,where change of one element will inevitably affect its other components.Thus,the study of the impact of the intestinal microbiota on health should be considered only taking into account numerous factors,the role of which has not yet been fully elucidated.展开更多
Background:The transition period is a challenging period for high-producing dairy cattle.Cows in early lactation are considered as a group at risk of subacute ruminal acidosis(SARA).Variability in SARA susceptibility ...Background:The transition period is a challenging period for high-producing dairy cattle.Cows in early lactation are considered as a group at risk of subacute ruminal acidosis(SARA).Variability in SARA susceptibility in early lactation is hypothesized to be reflected in fecal characteristics such as fecal pH,dry matter content,volatile and odd-and branched-chain fatty acids(VFA and OBCFA,respectively),as well as fecal microbiota.This was investigated with 38 periparturient dairy cows,which were classified into four groups differing in median and mean time of reticular pH below 6 as well as area under the curve of pH below 6.Furthermore,we investigated whether fecal differences were already obvious during a period prior to the SARA risk(prepartum).Results:Variation in reticular pH during a 3-week postpartum period was not associated with differences in fecal pH and VFA concentration.In the postpartum period,the copy number of fecal bacteria and methanogens of unsusceptible(UN)cows was higher than moderately susceptible(MS)or susceptible(SU)cows,while the genera Ruminococcus and Prevotellacea_UCG-001 were proportionally less abundant in UN compared with SU cows.Nevertheless,only a minor reduction was observed in iso-BCFA proportions in fecal fatty acids of SU cows,particularly iso-C15:0and iso-C16:0,compared with UN cows.Consistent with the bacterial changes postpartum,the lower abundance of Ruminococcus was already observed in the prepartum fecal bacterial communities of UN cows,whereas Lachnospiraceae_UCG-001 was increased.Nevertheless,no differences were observed in the prepartum fecal VFA or OBCFA profiles among the groups.Prepartum fecal bacterial communities of cows were clustered into two distinct clusters with 70%of the SU cows belonging to cluster 1,in which they represented 60%of the animals.Conclusions:Inter-animal variation in postpartum SARA susceptibility was reflected in post-and prepartum fecal bacterial communities.Differences in prepartum fecal bacterial communities could alert for susceptibility to develop SARA postpartum.Our results generated knowledge on the association between fecal bacteria and SARA development which could be further explored in a prevention strategy.展开更多
BACKGROUND Lactose intolerance(LI)is commonly seen in East Asian countries.Several studies showed that lactose or milk loading has been used as a treatment for lactose malabsorption(LM)in Western countries,but there h...BACKGROUND Lactose intolerance(LI)is commonly seen in East Asian countries.Several studies showed that lactose or milk loading has been used as a treatment for lactose malabsorption(LM)in Western countries,but there have been no reports regarding this type of treatment in Japan.As lactose or milk loading requires ingestion of large amounts of lactose within a short period,this is considered to be too harsh for Japanese people because of their less habitual milk consumption(175 mL per day in average)than Western people.In this study,we demonstrated lactose tolerance acquisition in a suitable way for Japanese.AIM To examine the efficacy of lactose(cow’s milk)loading treatment in patients with LM.METHODS Individuals with abdominal symptoms induced by milk or dairy products(LI symptoms)were identified with a questionnaire.A 20 g lactose hydrogen breath test(LHBT)was carried out to confirm LM diagnosis and to evaluate co-existence of small intestinal bacterial overgrowth(SIBO).Respondents diagnosed with LM were selected as study subjects and were treated with incremental loads of cow’s milk,starting from 30 mL and increasing up to 200 mL at 4-7 d intervals.After the treatment,changes in symptoms and LM diagnostic value of 20 g LHBT were investigated.Stool samples pre-and post-treatment were examined for changes in intestinal microbiota using 16S rRNA sequencing.Informed consent was obtained prior to each stage of the study.RESULTS In 46 subjects with LI symptoms(10-68 years old,mean age 34 years old)identified with the questionnaire,35(76.1%)were diagnosed with LM by 20 g LHBT,and 6 had co-existing SIBO.The treatment with incremental cow’s milk was carried out in 32 subjects diagnosed with LM(14-68 years old,median age 38.5 years old).The mean period of the treatment was 41±8.6 d.Improvement of symptoms was observed in 29(90.6%;95%confidence interval:75.0%-98.0%)subjects.Although 20 g LHBT indicated that 10(34.5%)subjects had improved diagnostic value of LM,no change was observed in 16(55.2%)subjects.Analysis of the fecal intestinal microbiota showed a significant increase in Blautia in 7 subjects who became symptom-free after the treatment(P=0.0313).CONCLUSION LM was diagnosed in approximately 75%of the subjects who had LI.Incremental loads of cow’s milk is regarded as a useful treatment for LM without affecting everyday life.展开更多
基金supported by a research grant from the Office of the Vice-Chancellor for Research and Development,University of the Philippines-Diliman(Grant No.101007 PNSE)to W.L.R.and H.J.S
文摘Objective:To compare the sensitivity and specificity of direct fecal smear microscopy,culture,and polymerase chain reaction in the detection of Blastocystis sp.in human stool.Methods:Human stool samples were collected from a community in San Isidro,Rodriguez,Rizal,Philippines.These samples were subjected to direct fecal smear microscopy,culture and polymerase chain reaction to detect the presence of Blastocystis sp.Results:Of the 110 stool samples collected,28(25%)were detected positive for the presence of Blastocystis sp.by two or more tests.Culture method detected the highest number of Blastocystis-positive stool samples(n=36),followed by PCR of DNA extracted from culture(n=26),PCR of DNA extracted from stool(n=10),and direct fecal smear(n=9).Compared to culture,the sensitivity of the other detection methods were 66.7%for PCR from culture and 19.4%for both PCR from stool and direct fecal smear.Specificity of the methods was high,with PCR from culture and direct fecal smear having97.3%,while PCR from stool at 95.9%.Conclusions:In this study,in vitro culture is the best method for detecting Blastocystis sp.in human stool samples.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> vaginosis is a complex pathogenic group of bacteria which can cause a wide range of symptoms in affected women in Obstetric and Gynaecological practice. Its occurrence usually indicates alteration in the normal vaginal flora expected in majority of the women of reproductive age. Amongst the maintenance agents of the vaginal health, lactobacilli occupy a prominent place. Asymptomatic bacterial vaginosis is postulated to be linked to the development of cervical intraepithelial neoplasia by some researchers while some differ in this regard. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To determine the rate of occurrence of asymptomatic bacterial vaginosis and associated factors in women who underwent cervical cytology for cervical cancer screening. </span><b><span style="font-family:Verdana;">Study Design</span></b><span style="font-family:Verdana;">: A cross sectional study involving microscopic examination of cervical smears of eligible clients presenting for routine Pap smear. </span><b><span style="font-family:Verdana;">Setting: </span></b><span style="font-family:Verdana;">The study was carried out in a </span></span><span style="font-family:Verdana;">well</span><span style="font-family:Verdana;"> woman’s facility established and manned by female medical doctors in Enugu state with the assistance of trained nursing staff. Various female cancers and other communicable and non</span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""><span style="font-family:Verdana;">communicable disease screening are performed at the centre. The services are available to the general public including various parts of the state and other nearby states. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">This preliminary study was carried out on women presenting for cervical cancer screening between February and July 2018 in a </span></span><span style="font-family:Verdana;">well</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> woman’s centre in Enugu. Information on the socio-demographic and gynaecological history of the study participants were obtained and recorded in designated proformas. Smears that showed changes suggestive of bacterial vaginosis on microscopy were set aside for further evaluation. Such changes included: a conspicuous absence of normal flora of lactobacilli;filmy background of coccobacilli replacing the lactobacilli, individual squamous cells covered by a layer of bacteria (clue cells);viable squamous cells showing reactive changes identified as increased nuclear size, perinuclear halo and binucleation. Data entry and analysis were done using statistical package for social sciences (SPSS) computer software version 21.0. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">285 eligible women had cervical smear done during the first six</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">month</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of the 2</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">year project at the centre. 50.9% were above reproductive age (>45</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">years), 38.2% were in second half of reproductive age (31</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">45), 10.9% were in the early reproductive age (15</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">30). 13% of the women were nulliparous, 51.9% were para</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">4, and 35.1% were grand</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">multiparous. Of the 285 Pap smear slides viewed, 31 had bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> vaginosis by the above criteria. This gave a prevalence of 10.8% in the reviewed cytological smears. There was an association of bacterial vaginosis with reproductive age. There was however, no association with age at coitarche and parity. There was also, no association of bacterial vaginosis with contraceptive use. There was no association between abnormal cervical cytology and asymptomatic bacterial vaginosis with absent lactobacilli. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prevalence of bacteria</span></span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis is significant in our study population who were asymptomatic. Cervical smear should be taken advantage of as a tool for both cervical pre-cancer and bacterial vaginosis screenings since same sample can simultaneously be used for both conditions during cytology. Bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis may be unlikely involved in pathogenesis of cervical intraepithelial neoplasia.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Recommendation: </span></b><span style="font-family:Verdana;">Researchers should harmonise the standards/criteria for the diagnosis of bacteria</span><span style="font-family:Verdana;">l</span><span style="font-family:Verdana;"> vaginosis because there are varied criteria for the diagnosis in the literature. Given, the dual advantage of pap smear in diagnosing cervical pre cancer stages and infections, more elaborate studies are needed to determine the usefulness of treatment or otherwise of bacterial vaginosis which constitute</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> significant incidental finding</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;">.</span>
文摘The gut microbiota is currently considered an external organ of the human body that provides important mechanisms of metabolic regulation and protection.The gut microbiota encodes over 3 million genes,which is approximately 150 times more than the total number of genes present in the human genome.Changes in the qualitative and quantitative composition of the microbiome lead to disruption in the synthesis of key bacterial metabolites,changes in intestinal barrier function,and inflammation and can cause the development of a wide variety of diseases,such as diabetes,obesity,gastrointestinal disorders,cardiovascular issues,neurological disorders and oncological concerns.In this review,I consider issues related to the role of the microbiome in the regulation of intestinal barrier function,its influence on physiological and pathological processes occurring in the body,and potential new therapeutic strategies aimed at restoring the gut microbiome.Herewith,it is important to understand that the gut microbiota and human body should be considered as a single biological system,where change of one element will inevitably affect its other components.Thus,the study of the impact of the intestinal microbiota on health should be considered only taking into account numerous factors,the role of which has not yet been fully elucidated.
基金the financial support of Flanders Innovation&Entrepreneurship(VLAIOBelgium+3 种基金LA170830)the European Union’s Horizon 2020 research and innovation programme under grant agreement 101000213-Holo RuminantThe PhD research of Hong Yang and Xiaoping Jing was the Chinese Scholarship Council(CSC,China)the PhD research of Stijn Heirbaut was funded by a Ph D grant from the Special Research Fund of the Ghent University(Bijzonder Onderzoeksfonds,BOF,Belgium)。
文摘Background:The transition period is a challenging period for high-producing dairy cattle.Cows in early lactation are considered as a group at risk of subacute ruminal acidosis(SARA).Variability in SARA susceptibility in early lactation is hypothesized to be reflected in fecal characteristics such as fecal pH,dry matter content,volatile and odd-and branched-chain fatty acids(VFA and OBCFA,respectively),as well as fecal microbiota.This was investigated with 38 periparturient dairy cows,which were classified into four groups differing in median and mean time of reticular pH below 6 as well as area under the curve of pH below 6.Furthermore,we investigated whether fecal differences were already obvious during a period prior to the SARA risk(prepartum).Results:Variation in reticular pH during a 3-week postpartum period was not associated with differences in fecal pH and VFA concentration.In the postpartum period,the copy number of fecal bacteria and methanogens of unsusceptible(UN)cows was higher than moderately susceptible(MS)or susceptible(SU)cows,while the genera Ruminococcus and Prevotellacea_UCG-001 were proportionally less abundant in UN compared with SU cows.Nevertheless,only a minor reduction was observed in iso-BCFA proportions in fecal fatty acids of SU cows,particularly iso-C15:0and iso-C16:0,compared with UN cows.Consistent with the bacterial changes postpartum,the lower abundance of Ruminococcus was already observed in the prepartum fecal bacterial communities of UN cows,whereas Lachnospiraceae_UCG-001 was increased.Nevertheless,no differences were observed in the prepartum fecal VFA or OBCFA profiles among the groups.Prepartum fecal bacterial communities of cows were clustered into two distinct clusters with 70%of the SU cows belonging to cluster 1,in which they represented 60%of the animals.Conclusions:Inter-animal variation in postpartum SARA susceptibility was reflected in post-and prepartum fecal bacterial communities.Differences in prepartum fecal bacterial communities could alert for susceptibility to develop SARA postpartum.Our results generated knowledge on the association between fecal bacteria and SARA development which could be further explored in a prevention strategy.
基金Supported by Grants of J-milk(Japan Dairy Association)。
文摘BACKGROUND Lactose intolerance(LI)is commonly seen in East Asian countries.Several studies showed that lactose or milk loading has been used as a treatment for lactose malabsorption(LM)in Western countries,but there have been no reports regarding this type of treatment in Japan.As lactose or milk loading requires ingestion of large amounts of lactose within a short period,this is considered to be too harsh for Japanese people because of their less habitual milk consumption(175 mL per day in average)than Western people.In this study,we demonstrated lactose tolerance acquisition in a suitable way for Japanese.AIM To examine the efficacy of lactose(cow’s milk)loading treatment in patients with LM.METHODS Individuals with abdominal symptoms induced by milk or dairy products(LI symptoms)were identified with a questionnaire.A 20 g lactose hydrogen breath test(LHBT)was carried out to confirm LM diagnosis and to evaluate co-existence of small intestinal bacterial overgrowth(SIBO).Respondents diagnosed with LM were selected as study subjects and were treated with incremental loads of cow’s milk,starting from 30 mL and increasing up to 200 mL at 4-7 d intervals.After the treatment,changes in symptoms and LM diagnostic value of 20 g LHBT were investigated.Stool samples pre-and post-treatment were examined for changes in intestinal microbiota using 16S rRNA sequencing.Informed consent was obtained prior to each stage of the study.RESULTS In 46 subjects with LI symptoms(10-68 years old,mean age 34 years old)identified with the questionnaire,35(76.1%)were diagnosed with LM by 20 g LHBT,and 6 had co-existing SIBO.The treatment with incremental cow’s milk was carried out in 32 subjects diagnosed with LM(14-68 years old,median age 38.5 years old).The mean period of the treatment was 41±8.6 d.Improvement of symptoms was observed in 29(90.6%;95%confidence interval:75.0%-98.0%)subjects.Although 20 g LHBT indicated that 10(34.5%)subjects had improved diagnostic value of LM,no change was observed in 16(55.2%)subjects.Analysis of the fecal intestinal microbiota showed a significant increase in Blautia in 7 subjects who became symptom-free after the treatment(P=0.0313).CONCLUSION LM was diagnosed in approximately 75%of the subjects who had LI.Incremental loads of cow’s milk is regarded as a useful treatment for LM without affecting everyday life.
