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1.
Probiotics: Versatile Bioactive Components in Promoting Human Health.
Sharifi-Rad, J, Rodrigues, CF, Stojanović-Radić, Z, Dimitrijević, M, Aleksić, A, Neffe-Skocińska, K, Zielińska, D, Kołożyn-Krajewska, D, Salehi, B, Milton Prabu, S, et al
Medicina (Kaunas, Lithuania). 2020;(9)
Abstract
The positive impact of probiotic strains on human health has become more evident than ever before. Often delivered through food, dietary products, supplements, and drugs, different legislations for safety and efficacy issues have been prepared. Furthermore, regulatory agencies have addressed various approaches toward these products, whether they authorize claims mentioning a disease's diagnosis, prevention, or treatment. Due to the diversity of bacteria and yeast strains, strict approaches have been designed to assess for side effects and post-market surveillance. One of the most essential delivery systems of probiotics is within food, due to the great beneficial health effects of this system compared to pharmaceutical products and also due to the increasing importance of food and nutrition. Modern lifestyle or various diseases lead to an imbalance of the intestinal flora. Nonetheless, as the amount of probiotic use needs accurate calculations, different factors should also be taken into consideration. One of the novelties of this review is the presentation of the beneficial effects of the administration of probiotics as a potential adjuvant therapy in COVID-19. Thus, this paper provides an integrative overview of different aspects of probiotics, from human health care applications to safety, quality, and control.
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2.
An expanding spectrum of complications in isolated methylmalonic aciduria.
Forny, P, Grunewald, S
Journal of mother and child. 2020;(2):9-13
Abstract
Isolated methylmalonic acidurias represent a heterogeneous genetic group of inborn errors of propionate metabolism with the common biochemical hallmark of elevated methylmalonic acid present in tissues and body fluids. It was first described in the 1960s and over the years better understanding of the disease and its presentation, earlier diagnosis, and most importantly advances in treatment have resulted in extended survival of patients. With that an expanding spectrum of complications is emerging which requires attention and regular monitoring to facilitate early intervention and reduce disease burden.
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3.
Nutrition and gastroenterological support in end of life care.
Schütte, K, Middelberg-Bisping, K, Schulz, C
Best practice & research. Clinical gastroenterology. 2020;:101692
Abstract
Malnutrition and the broad spectrum of cancer cachexia frequently occur in patients with malignant disease of all tumour stages and impact on survival and quality of life of patients. Structured screening for the risk of malnutrition with validated tools and nutritional assessment are the prerequisite for adequate nutritional support in cancer patients. In patients receiving tumour directed therapy, the patients diet should meet the requirements to give optimal support, while later on comfort feeding is part of symptom focused palliation. The basis of nutritional support in a malnourished patient is nutritional counselling, and nutritional support can be offered within a step-up approach meeting the patient's needs. A combination of nutritional support with interventions targeting metabolic changes and physical exercise is suggested to treat cancer cachexia.
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4.
Risk Factors of Acute Gastrointestinal Failure in Critically Ill Patients With Traumatic Brain Injury.
Fu, W, Shi, N, Wan, Y, Mei, F, Qiu, B, Bao, Y, Zhang, Y, Hao, J, He, J, Peng, X
The Journal of craniofacial surgery. 2020;(2):e176-e179
Abstract
OBJECTIVE To assess the risk factors associated with acute gastrointestinal failure (AGF) in critically ill patients with traumatic brain injury (TBI). METHODS Prospective, observational study was conducted in NanFang Hospital, Southern Medical University. All patients admitted to the Department of Critical Care Medicine and Department of Neurosurgery from June 1, 2017 to December 1, 2018 with TBI were enrolled. RESULTS Overall, 199 patients were enrolled. About 62 episodes (31%) of AGF were diagnosed. In the multivariate analysis, women, severe Glasgow Coma Scale (GCS) classification, frontal lobe injury, abnormal serum sodium, pulmonary infection, and intracranial infection are significantly associated with developing AGF, independent of other prognostic factors. CONCLUSION The AGF occurs frequently in intensive care unit patients who are suffering from TBI. In critically ill patients with TBI, women, severe GCS classification, frontal lobe injury, abnormal serum sodium, pulmonary infection, and intracranial infection are independent risk factors for AGF.
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5.
Gastrointestinal involvement in children with SARS-COV-2 infection: An overview for the pediatrician.
Chiappini, E, Licari, A, Motisi, MA, Manti, S, Marseglia, GL, Galli, L, Lionetti, P
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. 2020;(Suppl 26):92-95
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Abstract
Gastrointestinal symptoms are common findings in children with SARS-CoV-2 infection. Diarrhea and vomiting have been reported in about 8%-9% of cases, reaching more than 20% in some studies. Children with gastrointestinal involvement appear to be younger than those without, but the severity of the disease seems to be similar between the two groups of subjects. Fecal shedding in children has been reported in 20%-30% of children and has been observed in both those with and those without overt gastrointestinal involvement. Moreover, prolonged fecal elimination, lasting several days after negativization of real-time polymerase chain reaction assay on respiratory swabs, has been reported with variable frequency in children with SARS-CoV-2 infection. These observations raise the question regarding the possibility of oral-fecal transmission and the possible role of children in spreading the infection, particularly when they appear asymptomatic or with gastrointestinal symptoms but with no respiratory involvement, as well as during their convalescent phase.
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6.
Evidence-Based Management of Diverticular Disease: What's New and What's Missing?
Flum, DR, Read, TE
Diseases of the colon and rectum. 2020;(6):715-717
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7.
Intracavitary contrast-enhanced ultrasonography in children: review with procedural recommendations and clinical applications from the European Society of Paediatric Radiology abdominal imaging task force.
Ključevšek, D, Riccabona, M, Ording Müller, LS, Woźniak, MM, Franchi-Abella, S, Darge, K, Mentzel, HJ, Ntoulia, A, Avni, FE, Napolitano, M, et al
Pediatric radiology. 2020;(4):596-606
Abstract
Contrast-enhanced ultrasonography (US) has become an important supplementary tool in many clinical applications in children. Contrast-enhanced voiding urosonography and intravenous US contrast agents have proved useful in routine clinical practice. Other applications of intracavitary contrast-enhanced US, particularly in children, have not been widely investigated but could serve as a practical and radiation-free problem-solver in several clinical settings. Intracavitary contrast-enhanced US is a real-time imaging modality similar to fluoroscopy with iodinated contrast agent. The US contrast agent solution is administered into physiological or non-physiological body cavities. There is no definitive list of established indications for intracavitary US contrast agent application. However, intracavitary contrast-enhanced US can be used for many clinical applications. It offers excellent real-time spatial resolution and allows for a more accurate delineation of the cavity anatomy, including the internal architecture of complex collections and possible communications within the cavity or with the surrounding structures through fistulous tracts. It can provide valuable information related to the insertion of catheters and tubes, and identify related complications such as confirming the position and patency of a catheter and identifying causes for drainage dysfunction or leakage. Patency of the ureter and biliary ducts can be evaluated, too. US contrast agent solution can be administered orally or a via nasogastric tube, or as an enema to evaluate the gastrointestinal tract. In this review we present potential clinical applications and procedural and dose recommendations regarding intracavitary contrast-enhanced ultrasonography.
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8.
Delivery of care for functional gastrointestinal disorders: A systematic review.
Basnayake, C, Kamm, MA, Salzberg, MR, Wilson-O'Brien, A, Stanley, A, Thompson, AJ
Journal of gastroenterology and hepatology. 2020;(2):204-210
Abstract
BACKGROUND A diverse range of treatments are available for the treatment of functional gastrointestinal disorders (FGIDs). Individual treatments, including drug therapies, behavioral therapy ("biofeedback"), psychological therapies, and dietary therapies, have been well validated in controlled, randomized trials and real-life case series. However, few studies have evaluated models of delivery of care for the whole population of referred patients with an FGID. This review evaluates models of specialist outpatient care for the management of FGIDs. METHODS A systematic review was performed of full-text articles published until October 2018 in Pubmed/Medline and Embase. Studies were included if they evaluated a model of outpatient care in a specialist setting for the treatment of adult patients with an FGID and included patient-reported outcomes comprising symptoms, quality of life, or psychological well-being. RESULTS Few studies have evaluated the delivery of care for the whole population of referred patients with an FGID, and there was one randomized comparison of different models of care. Two studies that evaluated the outcome of gastroenterologist-only clinics suggested poor long-term results. Two non-comparative case series reported the outcome of multidisciplinary care, including gastroenterologists and psychological therapists, suggesting improved patient quality of life and psychological well-being. CONCLUSIONS Despite the high prevalence and cost of treating FGIDs, and the availability of effective treatments, there are few data and limited randomized comparisons reporting the outcome of different types of specialist care. The few data available suggest that multidisciplinary care is superior to gastroenterologist-only care, but this needs to be validated in prospective comparative studies.
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9.
[Enkephalinases as a new pharmacological target in the treatment of gastrointestinal tract disorders].
Twardowska, A, Fichna, J, Binienda, A
Postepy biochemii. 2020;(3):263-269
Abstract
Enkephalinases, which belong to the family of zinc metalloproteases play a crucial role in modulation of the endogenous opioid system (EOS) activity. Enkephalinase inhibitors (EI) allow obtaining therapeutic concentrations of selected endogenous peptides. One of the first EIs, racecadotril possesses antidiarrheal properties. Moreover, there is evidence that racecadotril presents fewer adverse events compared to other medications used for the treatment of diarrhea, such as loperamide. Lower potency for developing serious adverse events may be the key to choosing EIs as the preferred therapy in patients with chronic diseases. Additionally, EOS is involved in pain modulation, hence EIs might also be used as potential medications in treatment of pain. This review discusses the use of EIs in the treatment of gastrointestinal diseases, including irritable bowel syndrome and inflammatory bowel disease.
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Impact of 24-h high and low fermentable oligo-, di-, monosaccharide, and polyol diets on markers of exercise-induced gastrointestinal syndrome in response to exertional heat stress.
Gaskell, SK, Taylor, B, Muir, J, Costa, RJS
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2020;(6):569-580
Abstract
The study aimed to determine the effects of 24-h high (HFOD) and low (LFOD) fermentable oligo-, di-, monosaccharide, and polyol (FODMAP) diets before exertional heat stress on gastrointestinal integrity, function, and symptoms. Eighteen endurance runners consumed a HFOD and a LFOD (double-blind crossover design) before completing 2 h of running at 60% maximal oxygen uptake in 35 °C ambient temperature. Blood samples were collected before and after exercise to determine plasma cortisol and intestinal fatty acid binding protein (I-FABP) concentrations, and bacterial endotoxin and cytokine profiles. Breath hydrogen (H2) and gastrointestinal symptoms (GIS) were determined pre-exercise, every 15 min during, and in recovery. No differences were observed for plasma cortisol concentration between diets. Plasma I-FABP concentration was lower on HFOD compared with LFOD (p = 0.033). A trend for lower lipopolysaccharide binding protein (p = 0.088), but not plasma soluble CD14 (p = 0.478) and cytokine profile (p > 0.05), responses on HFOD was observed. A greater area under the curve breath H2 concentration (p = 0.031) was observed throughout HFOD (mean and 95% confidence interval: HFOD 2525 (1452-3597) ppm·4 h-1) compared with LFOD (1505 (1031-1978) ppm·4 h-1). HFOD resulted in greater severity of GIS compared with LFOD (pre-exercise, p = 0.017; during, p = 0.035; and total, p = 0.014). A 24-h HFOD before exertional heat stress ameliorates disturbances to epithelial integrity but exacerbates carbohydrate malabsorption and GIS severity in comparison with a LFOD. Novelty Twenty-four-hour high FODMAP diet ameliorated disturbances to gastrointestinal integrity. Twenty-four-hour high FODMAP diet results in greater carbohydrate malabsorption compared with low FODMAP diet. Incidence of GIS during exertional heat stress were pronounced on both low and high FODMAP diets, but greater GIS severity was observed with high FODMAP diet.