Probiotics for antibiotic-associated diarrhea:Do we have a verdict?

Probiotics use has increased tremendously over the past ten years.This was coupled with a surge of data relating their importance in clinical practice.Antibioticassociated diarrhea,whose frequency has risen recently,was one of the earliest targets with data published more than ten years ago.Unfortunately,available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors.Most published randomized controlled trials and subsequent meta-analyses suggest benefit for probiotics in the prevention of antibiotic-associated diarrhea.The same seems to also apply when the data is examined for Clostridium difficile-associated colitis.However,the largest randomized double-blind placebo-controlled trial to date examining the use of a certain preparation of probiotics in antibiotic-associated diarrhea showed disappointing results,but it was flawed with several drawbacks.The commonest species of probiotics studied across most trials is Lactobacillus;however,other types have also shown similar benefit.Probiotics have enjoyed an impeccable safety reputation.Despite a few reports of severe infections sometimes leading to septicemia,most of the available trials confirm their harmless behavior and show similaradverse events compared to placebo.Since a consensus dictating its use is still lacking,it would be advisable at this point to suggest prophylactic use of probiotics to certain patients at risk for antibiotic-associated diarrhea or to those who suffered previous episodes.

Hepatocellular carcinoma in Lebanon: Etiology and prognostic factors associated with short-term survival

瞄准：在黎巴嫩和早死亡预兆的预示的因素学习 HCC 的传染病学。方法：在一个五年的时期上诊断的 HCC 盒子的观察后续队研究被执行。Multivariate 分析被进行与肝意大利的程序(片断) 分数的癌症相比识别预示的因素。包括内在的肝疾病，病人的人口统计的特征，和孩子呸评估的肝疾病的严厉的病原学的多重变量得分被学习。肿瘤参数包括了小瘤，门静脉血栓的存在，和治疗形式的 HCC， alpha-fetoprotein 水平，数字和尺寸的诊断的时间。后续的死亡或损失被看作一个端点事件。结果：92 个病人(平均数 60.5 +/- 22.3 年) 被包括。内在的疾病的病原学分别地是在 67% ， 20% ，和 23.5% 的肝炎 B， C，和酒精。在诊断的孩子呸班分别地是在 34.8% ， 39.3% 和 25.8% 的 A， B，和 C。全面幸存分别地在 1， 2 和 3 年是 44.8% ， 32.8% 和 17.6%( 吝啬的 F/U 40.2 +/- 23.5 瞬间) 。Multivariate 分析识别了早死亡的三个预言者(【 6 瞬间) ：胆红素 】 3.2 mg/dL (P 【 0.01 ) ， HCC 作为肝疾病的第一个演讲(P = 0.035 ) ，并且肌酸酐 】 1 mg/dL (P = 0.017 ) 。一个分数由考克斯基于这些变量超过了片断分数比例的危险。巨鸟曲线显示了两个模型相等、中等精确。结论：HBV 是在黎巴嫩的 HCC 的领先的原因。早死亡的独立预言者是象疾病的第一表明的提高的胆红素，肌酸酐和 HCC。一个分数的未来的确认基于在预言短期的幸存的这些临床的参数被需要。