The aim of our study was to develop a scoring system to predict whether diarrhea is of a bacterial origin and whether the diarrheal patients constitute a potential source of infection to others. Adults with acute diar...The aim of our study was to develop a scoring system to predict whether diarrhea is of a bacterial origin and whether the diarrheal patients constitute a potential source of infection to others. Adults with acute diarrhea （n=424） were enrolled in the study. Logistic regression and standard regression coefficients were used to formulate the Early Warning Infectivity Score System for Adults with Acute Bacterial Diarrhea （EWIS-ABD）. Four risk factors were identified by logistic regression, including body temperature （P〈0.01）, abdominal pain （P〈0.01）, leukocyte count in stool （P〈0.01）, and unclean dietary history （P〈0.01）. EWIS-ABD was thus developed, in which the value 〉5 points was set as an indicator of bacterial diarrhea. The incidence of bacterial diarrhea increased along with the elevated score. EWIS-ABD was more specific for bacterial diarrhea than for viral diarrhea. The accuracy and reliability of EWIS-ABD was high by prospective validation in 478 patients with acute diarrhea.展开更多
Dietary fiber is a non-digestible carbohydrate providing beneficial effects for bowel health. The aim of this study was to evaluate the clinical effects of fiber supplementation in enteral feeding on elderly patients ...Dietary fiber is a non-digestible carbohydrate providing beneficial effects for bowel health. The aim of this study was to evaluate the clinical effects of fiber supplementation in enteral feeding on elderly patients suffering from diarrhea. This study was conducted in 15 patients (7 men and 8 women, 79.0 ± 7.5 years) who had loose stools or diarrhea during enteral nutrition. The enteral formula was supplemented with soluble dietary fiber (5.2 g/day) for 3 weeks, which was then discontinued for 1 week to confirm its effects. The effects of soluble dietary fiber on stool frequency, the Bristol Stool Form Scale (which is designed to measure stool consistency), plasma diamine oxidase (DAO) activity, and concentrations of plasma short-chain fatty acids (SCFA) were evaluated. After supplementation with soluble dietary fiber, there were no significant differences in stool frequency but there was a significant improvement in stool consistency (P < 0.05). Furthermore, ingestion of soluble dietary fiber resulted in increased plasma DAO activity and significantly increased levels of plasma SCFA (P < 0.05). Supplementation with soluble dietary fiber may be beneficial for improving stool consistency in patients suffering from diarrhea during enteral nutrition. A further controlled trial is warranted to examine the preventive effects of soluble dietary fiber in patients suffering from diarrhea.展开更多
This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies...This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.展开更多
基金funded by the National Key Technology R&D Program during the Eleventh 5-year Plan Period[2007BAI24B06]
文摘The aim of our study was to develop a scoring system to predict whether diarrhea is of a bacterial origin and whether the diarrheal patients constitute a potential source of infection to others. Adults with acute diarrhea （n=424） were enrolled in the study. Logistic regression and standard regression coefficients were used to formulate the Early Warning Infectivity Score System for Adults with Acute Bacterial Diarrhea （EWIS-ABD）. Four risk factors were identified by logistic regression, including body temperature （P〈0.01）, abdominal pain （P〈0.01）, leukocyte count in stool （P〈0.01）, and unclean dietary history （P〈0.01）. EWIS-ABD was thus developed, in which the value 〉5 points was set as an indicator of bacterial diarrhea. The incidence of bacterial diarrhea increased along with the elevated score. EWIS-ABD was more specific for bacterial diarrhea than for viral diarrhea. The accuracy and reliability of EWIS-ABD was high by prospective validation in 478 patients with acute diarrhea.
文摘Dietary fiber is a non-digestible carbohydrate providing beneficial effects for bowel health. The aim of this study was to evaluate the clinical effects of fiber supplementation in enteral feeding on elderly patients suffering from diarrhea. This study was conducted in 15 patients (7 men and 8 women, 79.0 ± 7.5 years) who had loose stools or diarrhea during enteral nutrition. The enteral formula was supplemented with soluble dietary fiber (5.2 g/day) for 3 weeks, which was then discontinued for 1 week to confirm its effects. The effects of soluble dietary fiber on stool frequency, the Bristol Stool Form Scale (which is designed to measure stool consistency), plasma diamine oxidase (DAO) activity, and concentrations of plasma short-chain fatty acids (SCFA) were evaluated. After supplementation with soluble dietary fiber, there were no significant differences in stool frequency but there was a significant improvement in stool consistency (P < 0.05). Furthermore, ingestion of soluble dietary fiber resulted in increased plasma DAO activity and significantly increased levels of plasma SCFA (P < 0.05). Supplementation with soluble dietary fiber may be beneficial for improving stool consistency in patients suffering from diarrhea during enteral nutrition. A further controlled trial is warranted to examine the preventive effects of soluble dietary fiber in patients suffering from diarrhea.
文摘This article reviews the evidence for efficacy and safety of Saccharomyces boulardii(S.boulardii) for various disease indications in adults based on the peerreviewed,randomized clinical trials and pre-clinical studies from the published medical literature(Medline,Clinical Trial websites and meeting abstracts) between 1976 and 2009.For meta-analysis,only randomized,blinded controlled trials unrestricted by language were included.Pre-clinical studies,volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis,but included in the systematic review.Of 31 randomized,placebo-controlled treatment arms in 27 trials(encompassing 5029 study patients),S.boulardii was found to be significantly efficacious and safe in 84% of those treatment arms.A meta-analysis found a significant therapeutic efficacy for S.boulardii in the prevention of antibiotic-associated diarrhea(AAD)(RR = 0.47,95% CI:0.35-0.63,P < 0.001).In adults,S.boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea.Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Heliobacter pylori treatment-related symptoms.S.boulardii shows promise for the prevention of C.difficile disease recurrences;treatment of irritable bowel syndrome,acute adult diarrhea,Crohn's disease,giardiasis,human immunodeficiency virus-related diarrhea;but more supporting evidence is recommended for these indications.The use of S.boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.
