The metabolism of dietary polyphenols ellagitannins by the gut-microbiota allows the human stratification in urolithin metabotypes depending on the final urolithins produced. Metabotype-A only produces urolithin-A, metabotype-B yields urolithin-B and isourolithin-A in addition to urolithin-A, and metabotype 0 does not produce urolithins. Metabotype-A has been suggested to be ‘protective’, and metabotype-B dysbiotic-prone to cardiometabolic impairments. We analyzed the gut-microbiome of 40 healthy women and determined their metabotypes and enterotypes, and their associations with anthropometric and gut-microbial changes after 3 weeks, 4, 6, and 12 months postpartum. Metabotype-A was predominant in mothers who lost weight (≥2 kg) (75%) versus metabotype-B (54%). After delivery, the microbiota of metabotype-A mothers changed, unlike metabotype-B, which barely changed over 1 year. The metabotype-A discriminating bacteria correlated to the decrease of the women’s waist while some metabotype-B bacteria were inversely associated with a reduction of body mass index (BMI), waist, and waist-to-hip ratio. Metabotype-B was associated with a more robust and less modulating microbial and anthropometric profiles versus metabotype-A, in which these profiles were normalized through the 1-year follow-up postpartum. Consequently, urolithin metabotypes assessment could be a tool to anticipate the predisposition of women to normalize their anthropometric values and gut-microbiota, significantly altered during pregnancy and after childbirth.

The maternal–infant transmission of several urolithins through breast milk and the gut colonization of infants by the urolithin-producing bacterium Gordonibacter during their first year of life were explored. Two trials (proof-of-concept study: n = 11; validation study: n = 30) were conducted, where breastfeeding mothers consumed walnuts as a dietary source of urolithin precursors. An analytical method was developed and validated to characterize the urolithin profile in breast milk. Total urolithins ranged from 8.5 to 176.9 nM, while they were not detected in breast milk of three mothers. The mothers’ urolithin metabotypes governed the urolithin profile in breast milk, which might have biological significance on infants. A specific quantitative polymerase chain reaction method allowed monitoring the gut colonization of infants by Gordonibacter during their first year of life, and neither breastfeeding nor vaginal delivery was essential for this. The pattern of Gordonibacter establishment in babies was conditioned by their mother’s urolithin metabotype, probably because of mother–baby close contact.

Inappropriate use or unintentional ingestion of naphazoline, especially in children, can quickly cause severe central nervous system depression and cardiovascular adverse effects [2,6].A five-year-old boy arrived at the Emergency Room 90 min after the ingestion of approximately 10 ml of Euboral Oftálmico solution (9.7 g of sodium-tetraborate, 0.1 g of naphazoline-chlorhydrate and 0.2 g of methylparaben for 1 l dilution, for topical use), prepared in a bottle without a label in a 0.02% concentration, which was twice that of the manufacturer's recommendation. During the physical examination, bradycardia (heart rate 45-50 bpm), hypothermia (35.5°C) and a blood pressure of 100/ 70 mmHg (blood pressure percentile 75th/90th) were observed. Gastric lavage and activated carbon administration were performed. A few minutes later, the patient presented somnolence, sweating, persistence of the bradycardia and hypothermia. Blood pressure and oxygen saturation were normal. At the EKG (electrocardiogram), sinusal bradycardia of 48 bpm was observed and laboratory parameters showed no abnormalities. Blood analysis of standard toxicological drugs was performed with negative results.Infusion therapy was started to force diuresis and the patient was admitted to the hospital in order to monitor vital parameters. Bradycardia lowest value (47 bpm) was observed 3 h after the ingestion. Somnolence and hypothermia (35.2°C) were maximum 7 h after the ingestion and sweating persisted until 12 h later. Blood pressure also returned to normal during this period without treatment; its highest value was 130/80 mmHg (blood pressure percentile >99th/99th) with no subsequent hypotension. The patient was discharged 20 h later.Naphazoline has a narrow therapeutic to toxic window and intoxication may occur at a dose of 0.05 mg/kg body weight [2]. Systemic side effects are observed rarely, despite frequent and uncontrolled use because of partial availability without doctor's prescription. They can progress potentially up to intoxication with vitally threatening cardiovascular symptoms (arterial hypertension with reflex bradycardia defined as a heart rate under 60 bpm and possible ischaemia of vital functions), pulmonary and central nervous symptoms. The central nervous system effects concern the reduction of vigilance ranging from drowsiness to coma, persisting cardiovascular hypotension and reduced respiration rate up to the Cheyne-Stokes breathing and possible pulmonary edema, hypothermia, mydriasis, hyperhydrosis and transient excitation hyperreflexia [1]. Our patient presented a large number of the symptoms described above, especially those affecting cardiovascular and central nervous systems. Blood analysis of standard toxicological drugs excluded alternative causes of intoxication.Because of rapid absorption, we wonder whether gastric lavage and carbon-activated administration are the suitable Eur J Pediatr (2006) 165:815-816