bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECT OF PROBIOTICS IN ABDOMINAL PAIN‐RELATED FUNCTIONAL GASTROINTESTINAL DISORDERS IN CHILDHOOD.
Authors: Weizman Z. 
Published: July 2016

Functional gastrointestinal disorders, associated with abdominal pain, are one of the most common complaints in childhood. Although benign in nature, these conditions are commonly associated with an excessive anxiety, unnecessary laboratory tests and a significant economic burden.According to the Rome III criteria these disorders may be classified into: functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain (FAP) and abdominal migraine. Several studies in adults have demonstrated some clinical benefit of particular probiotic agents, mostly in IBS.Pediatric literature data are scarce and controversial, as they present a wide variability of study design and type of microorganisms.The present lecture will outline our own data along a systematic literature review, demonstrating the evidence‐based data regarding the efficacy of probiotic agents in these conditions. Results are presented in the table below. Potential mechanisms, useful guidelines and future directions will be delineated as well.In conclusion, probiotic microorganisms may serve, to some extent, as a therapeutic aid in selected abdominal pain‐related functional gastrointestinal disorders in childhood, mainly FAP and IBS. These preliminary promising results should be validated in future well‐designed large‐scale trials.
FERMENTABLE OLIGOSACCHARIDES, DISACCHARIDES, MONOSACCHARIDES AND POLYOLS (FODMAP) AS A PREBIOTIC AND INTERACTION WITH MICROBIOME
Authors: Biesiekierski J. 
Published: July 2016

Reducing intake of a group of poorly absorbed, short‐chain carbohydrates, termed FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) has demonstrated symptom improvement in 75% of adult patients with irritable bowel syndrome (IBS). There are limited good quality randomised controlled trials of FODMAPs in children and current evidence is largely based on studies in adults.FODMAPs are found naturally in a range of foods and include fructose (in excess of glucose), lactose, polyols, fructans and galacto‐oligosaccharides. FODMAPs increase delivery of liquid and gas to the lumen, by virtue of their small molecular size, osmotic effect and rapid fermentability. This can lead to intestinal distension, which together with peripheral and central predisposing factors (e.g., visceral hypersensitivity) can generate gastrointestinal symptoms such as wind, bloating, abdominal pain and affect motility.FODMAPs, especially oligosaccharides, have shown positive effects on the colonic microenvironment and microbiota in healthy populations. Recent findings of changes in gut microbiota composition of IBS and healthy subjects with differing FODMAP intakes including changes in total bacteria abundance and altering the relative abundance of Bifidobacteria, raise caution to recommending the low FODMAP diet long‐term, and reinforce that the low FODMAP diet should not be recommended for asymptomatic populations.The use of the FODMAP diet in gastrointestinal disorders, including mechanisms of action, overview of the diet's structure and efficacy and further studies needed will be discussed, including limitations and what data exists within the paediatric population.
GUT MICROBIOTA AS A TARGET FOR FOOD ALLERGY
Authors: Canani Roberto Berni 
Published: July 2016

Evidence suggests a key pathogenetic role for gut microbiota modifications (dysbiosis) in food allergy development. Several factors responsible for dysbiosis have been associated with the occurrence of food allergy, such as caesarean delivery, lack of breast milk, drugs use (mainly antibiotics and gastric acidity inhibitors), antiseptic agents use, and low fibers/hight fat diet.No specific bacterial taxa have been consistently associated with food allergy, but evidence suggests that gut dysbiosis occurs even before food allergy signs and symptoms presentation.Data from animal and human studies highlight the ability of particular bacterial taxa to ferment dietary fibers for the production of short chain fatty acids (SCFAs) that affect host immunity and help to explain their health‐promoting role. Among SCFAs butyrate has a pivotal role in tolerance induction.Modulation of gut microbiota composition and/or function using selected probiotics strains represents a promising strategy for treatment and prevention of food allergy in childhood.
MICROBIOTA MANAGEMENT FOR THE PREVENTION OF RECURRENT EAR AND THORAT INFECTIONS
Authors: Gerritsen C. , Grahn‐Håkansson E. , Roos K. 
Published: July 2016

Upper respiratory tract infections (URTIs) are caused by an (acute) infection of a region in the upper respiratory tract. This commonly includes diseases like tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media and the common cold. URTIs can be caused by a variety of microorganisms including viruses and bacteria. Due to the combination of high colonization rates of potential pathogens and an immature immune system especially children are prone to the development of URTIs. Recurrent infections can have even more serious consequences, like hearing loss, and speaking‐ and learning disability. Treatments vary between countries and include to wait until the infections over, antibiotic prescription or in more severe cases surgery. A main disadvantage of traditional treatment options is that they only relieve the symptoms but do not address the underlying cause. The extensive use of antibiotic for acute otitis media (AOM) has obvious public health and economic consequences.Only very recently studies are being published researching the microbial communities that inhabit the (upper) respiratory tract. These studies show that the bacterial players in the respiratory tract are quite different to the key players in the gastro‐intestinal tract. Data indicate that just like the gastro‐intestinal tract, diversity in the microbiota seems to play an important role in the susceptibility to infections. Alternative therapies that support the commensal microbiota in the upper respiratory tract are highly desired. Recent studies have suggested that probiotics may reduce the risk of various symptoms of URTIs. The mechanisms behind the possible beneficial effect of probiotics on URTIs are not completely clear but may be related to colonization of the probiotic bacteria in the upper respiratory tract. At the moment we are looking into the possibilities to develop a probiotic formulation under the Ecologic®brand for upper respiratory tract infections. We have acquired a small collection of bacterial strains that already have shown their efficacy to be able to prevent the recurrence of ear and throat infection in several clinical trials (1–6). With these bacterial strains as a basis we are developing a probiotic formulation that stimulates the commensal upper respiratory tract microbiota and inhibits the specific pathogens involved in recurrent ear and throat infections.
Maternal Gut Microbiota Composition and Inflammatory Cytokines Before and After Delivery
Authors: Hermansson Henriina , Rautava Samuli , Isolauri Erika 
Published: July 2016

Introduction:The metabolic and immunologic changes during pregnancy endorse the growth and development of the foetus (1). The composition of the gut microbiota changes in parallel (2) but little is known about the significance of the gut microbiota in pregnancy and the pace of recovery after delivery.Methods:A nested case‐control study based on a prospective intervention trial (3) was conducted. Altogether 10 women who had delivered by elective caesarean section (CS) and 13 women with non‐elective CS were selected for this study. Women who had delivered vaginally (n = 23) were chosen as controls and matched for pre‐pregnancy BMI, probiotic intervention during pregnancy as well as antibiotic exposure during pregnancy and labour. Blood and faecal samples were collected at the third trimester of pregnancy and one month postpartum. The composition of the gut microbiota was assessed by qPCR. The concentrations of the cytokines IL‐1, IL‐6, IL‐8, IL‐10, MCP‐1, TNF‐α were measured from serum.Results:One month after delivery the gut microbiota composition had not changed from the situation at the third trimester. Against this trend, faecal Clostridium coccoides numbers were higher in mothers after vaginal delivery as compared to those who had delivered by CS (p = 0.0001). The serum concentrations pro‐inflammatory cytokines were higher one month postpartum than in the third trimester of pregnancy (Table 1).Discussion:Pregnancy alters the gut microbiota composition (1) and these pro‐inflammatory changes seen at the third trimester of pregnancy have not yet normalized one month after delivery. A parallel pro‐inflammatory tone was manifested in the serum cytokine profile indicating that the inflammatory state continues after pregnancy. The mode of delivery plays little role in these phenomena. Therefore probiotic intervention in attempt to reduce the risk of inflammatory conditions may need extension beyond the perinatal period.
Effects of Probiotics on Performance, Carcass Yield and Internal Organs in Broilers
Authors: Yalçin Suzan , Eser Handan , Yalçin Sakine 
Published: July 2016

Introduction:Probiotics have been used increasingly in poultry diets after the ban on the use of antibiotic growth promoters in the EU. Probiotics include beneficial microorganisms that may have positive effects on the intestinal tract of poultry. This study was aimed to determine the effects of dietary probiotics on performance, carcass yield and internal organs in broilers.Methods:A total of 300 Ross 308 broiler male chicks aged one day were divided into one control group and two treatment groups each group containing 100 chicks. Each group was divided into 5 replicates, as subgroups, each comprising 20 chicks. Feed and water were provided for ad libitum consumption and the diets were presented in mash form. The experimental period lasted 39 days. Basal diet was supplemented with the probiotics (Nafoil forte, Bacillus subtilis, Lactobacillus plantarum, Saccharomyces cerevisiae, Biotem Ltd Company). Probiotics were added at 0.1 and 0.2% to the first and second treatment groups, respectively. Body weight and feed intake were recorded. Body weight gain and feed conversion ratio were calculated. At the end of the experiment (d 39) 10 broilers from each group were weighed and slaughtered by severing the jugular vein. Hot carcass weights were determined and carcass yield was calculated. Absolute and proportional weights of abdominal fat, liver, heart, spleen, gizzard and Bursa of Fabricius were also determined.Results:Dietary supplementation of probiotics containing Bacillus subtilis, Lactobacillus plantarum, Saccharomyces cerevisiae didn't affect the final body weight, body weight gain, feed intake and feed efficiency during the 39 days of experimental period. Probiotics supplementation increased carcass yield (P < 0.05) and decreased abdominal fat percentages (P < 0.05). Relative weights of liver, heart, gizzard, spleen and Bursa of Fabricius were not affected from the usage of probiotics.Discussion:Dietary probiotics supplementation improved carcass yield and decreased the abdominal fat significantly without changing other performance parameters in broilers. As a conclusion dietary probiotics supplementation might be beneficial additives for broilers.
Shelf acetabuloplasty for reconstructive or salvage surgical treatment in Legg-Calvé-Perthes disease
Authors: Paulson Andrea , Mielke Cary 
Published: July 2016

Background:
Treatment for Legg-Calvé-Perthes (LCP) disease remains controversial. When containment is not possible, salvage procedures have been used to treat symptomatic LCP disease.

Methods:
The purpose of this study was to assess the effectiveness of shelf acetabuloplasty (SA) for treatment of patients with symptomatic Legg-Calvé-Perthes (LCP) disease. A retrospective review of 17 patients with LCP disease treated by SA was conducted. The mean age at diagnosis was 7 yr, the mean age at SA was 9 yr, and the mean age at final follow-up was 14 yr. Surgery was offered to provide femoral head coverage and pain relief. Preoperative range of motion (ROM) and radiographs were evaluated. Radiographs, ROM, and Adolescent (parent report) Outcomes Data Collection Instrument (PODCI) outcomes were done at final follow-up. The lateral pillar classification of Herring was assessed preoperatively. The Stulberg classification was determined at final follow-up.

Results:
Preoperatively, 10 patients were Herring B, two were Herring B/C, and five were Herring C. Significant improvement was seen at final follow-up in all radiographic parameters that document improved femoral head coverage. No change was seen in the lateral acetabular shape (LAS) or the articulotrochanteric distance (ATD). Six hips at final visit were Stulberg 1 or 2 (35%), six hips were Stulberg 3 (35%), and five hips were Stulberg 4 or 5 (30%). All PODCI outcomes were slightly below normal, except happiness rated slightly above normal. Sixteen of 17 patients would recommend SA to others.

Conclusions:
SA remains a viable option for successful treatment during any stage of symptomatic LCP disease.
Analysis of surgeon experience and impact of comorbidities on early discharge after mini-open transforaminal lumbar interbody fusion
Authors: Chan Ferdinand J. , Stelma Sarah , Cho Woojin , Krystal Jonathan , Sharan Alok D. 
Published: July 2016

Background:
Mini-open transforaminal lumbar interbody fusion (TLIF) has emerged as an alternative to open lumbar fusion. Currently, there is a limited amount of literature concerning the learning curve and perioperative variables of mini-open TLIF despite literature suggesting its overall advantage over open procedures. The objectives of this study were to evaluate the learning curve associated with mini-open TLIF and to identify factors affecting length of stay (LOS).

Methods:
Retrospective review of one surgeon’s first 100 mini-open TLIF cases was performed to evaluate operative time, LOS, estimated blood loss (EBL), Oswestry Disability Index (ODI), visual analog pain scores (VAS), and fusion status. Operative time and LOS data were used to determine a proficiency point. Additional patient factors were collected and their impact on LOS was determined.

Results:
Operative time was found to be significantly less after 21 patients and LOS shorter after 22 patients. No significant differences were found when the first 22 patients were compared to the last 78 patients for ODI, VAS, and fusion status. Factors associated with decreased LOS include shorter operative time, lower EBL, later point on the learning curve of the surgeon, and patient factors including lower body mass index, being married or living with a significant other, and having a prior lumbar surgery.

Conclusions:
A significant learning curve is associated with mini-open TLIF. Similar follow-up outcomes suggest satisfactory outcomes even during the learning curve period.
Autologous platelet-rich plasma injection in tennis elbow and plantar fasciitis
Authors: Gupta S.K.Venkatesh , Bandari Divya 
Published: July 2016

Background:
The introduction of platelet rich plasma (PRP) as a possible adjunct to conservative and operative treatment has motivated significant research into this topic. PRP is a set of autologous platelet products used to accelerate recovery from injury by bringing to the site of injury a set of molecules that will accelerate the functional recovery of the tissue by trying to regenerate it rather than merely repair with scar tissue. In this prospective study, we evaluate the results of PRP in tennis elbow and plantar fasciitis.

Methods:
During October 2013 to March 2015, 100 patients, 60 with tennis elbow and 40 plantar fasciitis, who visited our center with failed conservative treatment were treated with PRP, and results were evaluated with VAS, DASH and FHSQ scores.

Results:
Among 60 patients with tennis elbow (24 males and 36 females) post-PRP injection significant differences were observed between VAS and DASH score at baseline and after 4 wk and 8 wk (P<0.001). Among 40 patients with plantar fasciitis (16 males and 24 females) post-PRP injection significant results were observed between VAS and FHSQ scores at baseline and after 4 wk and 8 wk (P<0.001).

Conclusions:
PRP when given with proper care appears to be helpful in tennis elbow and plantar fasciitis. It is safe and a significant improvement has been observed in VAS and DASH scores for tennis elbow and VAS and FHSQ for plantar fasciitis.
First Place Award Multidisciplinary care of the hip fracture patient: a case control analysis of differing treatment protocols
Authors: Noticewala Manish S. , Swart Eric , Shah Roshan P. , Macaulay William , Geller Jeffrey A. 
Published: July 2016

Background:
Recent evidence has suggested that geriatric patients with osteoporotic hip fractures may benefit from comanagement with a multidisciplinary care team. We evaluated the effect that establishment of a comprehensive multidisciplinary care team had on time to surgery, length of hospital stay, postoperative complications, and morbidity on geriatric hip fracture patients.

Methods:
This study was a retrospective comparative cohort study of 267 patients admitted for geriatric hip fractures at an academic trauma center and a community hospital. Patients at the academic hospital were treated by a unilateral orthopaedic team, while patients at the community hospital were treated by a comprehensive multidisciplinary team (MDT), with both hospitals served by the same group of rotating physicians and ancillary staff. Outcomes included time to surgery (TTS), length of stay (LOS), postoperative complications, and mortality rates.

Results:
One hundred and twenty-nine hip fractures were treated by the MDT and 138 by the non-MDT. The MDT cohort was older (84.5 vs. 79.9 yr, P<0.001) and had a larger percentage of women (79.8% vs. 67.4%, P=0.03) than the non-MDT cohort. Patients in the MDT cohort experienced a shorter TTS (1.7 vs. 2.4 days, P<0.001) and LOS (8.2 vs. 10.7 days, P=0.024) than those in the non-MDT cohort. There were no differences in complication or mortality rates between the two cohorts.

Conclusions:
Treatment of patients with hip fractures by a comprehensive multidisciplinary team may lead to improved clinical processes shown by decreased time to surgery and shorter LOS but did not significantly decrease individual complication or mortality rates.
Third Place Award Off-label versus on-label outcomes of total joint arthroplasty
Authors: Liu Jane , Small Travis , Masch Jessica , Goldblum Andrew , Klika Alison , Barsoum Wael 
Published: July 2016

Background:
Original indications for knee and hip arthroplasty implants were developed decades ago and categorized conditions, such as obesity and developmental dysplasia, as contraindications, rendering their use in these patients “off-label”. The objective of this pilot study was to determine the prevalence of off-label use at our institution and test for differences in clinical and functional outcomes between patients with implants used on- and off-label.

Methods:
Primary knee or hip arthroplasty patients treated between January 2010 and June 2010 were studied. Revision rate, University of California Los Angeles (UCLA) activity level, functional (i.e., Hip Disability and Osteoarthritis Outcome Score or Knee Disability and Osteoarthritis Outcome Score) and Short Form-12 General Health Status were compared.

Results:
Two hundred and twenty five (81.5%) patients responded to the survey (92 hips and 133 knees), 154 (68.4%) of which had off-label use of an implant. There were no differences detected between groups.

Conclusions:
This study suggests that on-label and off-label patients have similar short-term outcomes.
Emerging biomarkers in systemic sclerosis
Authors: Manetti Mirko 
Published: July 2016

Purpose of reviewThe severity of each organ involvement, natural course, and response to therapies are extremely heterogeneous among patients with systemic sclerosis (SSc). The discovery and validation of biomarkers can help identify disease risk, improve early diagnosis and prognosis, better design clinical trials and assess response to treatment, and further elucidate the underlying pathogenic mechanisms of this disease. The goal of this review is to summarize recent advances into the field of SSc biomarker development.Recent findingsThe use of both traditional and next-generation techniques, including large-scale transcriptomic, epigenomic, and proteomic technologies, has yielded a slew of new candidate biomarkers that correlate with different SSc clinical phenotypes. Recent evidence indicates that skin gene expression-based pharmacodynamic biomarkers have the potential to be employed as surrogate measures of clinical endpoints (i.e. modified Rodnan skin thickness score) providing objective assessment of response in clinical trials.SummarySeveral promising biomarkers addressing key unmet needs related to the evaluation and management of SSc patients have been recently proposed. Nevertheless, these biomarkers still require rigorous validation in prospective studies and have yet to make their way into clinical practice and therapeutic development. Robust biomarkers, ideally mechanistic ones, are needed to enable precision medicine in SSc.
Risk Factors for Early ACL Reconstruction Failure in Pediatric and Adolescent Patients: A Review of 561 Cases
Authors: Ho Brian , Edmonds Eric W. , Chambers Henry G. , Bastrom Tracey P. , Pennock Andrew T. 
Published: July 2016

Background:
Anterior cruciate ligament (ACL) reconstruction failure is relatively common in young high-risk athletes. The purpose of this study was to examine a single center’s 10-year experience with ACL reconstructions in pediatric and adolescent patients to better define short-term failure rates and risk factors for revision ACL surgery.

Methods:
This institutional review board-approved retrospective study included all patients who underwent a primary ACL reconstruction between 2002 and 2013. Chart and radiographic review was performed to assess patient demographic, injury, and surgical data including growth plate status, concomitant ligament/meniscus/cartilage injury, surgical procedures, femoral drilling technique, graft source and type, femoral and tibial fixation devices, and graft size. Graft failures had to be confirmed both with clinical examination and magnetic resonance imaging or the patient had to undergo a revision ACL reconstruction. Potential factors associated with failure were evaluated using either parametric or nonparametric analysis as appropriate.

Results:
A total of 561 ACL reconstructions were performed that met our inclusion criteria. The average patient age was 15.4 years (range, 5 to 19 y) and 53% of the patients were male. In all, 54 failures were identified for a 9.6% failure rate. Soft tissue grafts were twice as likely to fail compared with patellar tendon grafts (13% vs. 6%; P<0.001). Multivariate analysis revealed that graft choice (soft tissue vs. patellar tendon) was the primary variable predictive of failure (P<0.05), with interactions/mediating effects contributed by maturity (growth plate status) and ACL technique (P<0.05). The average time to failure was 13.6 months and hamstring grafts and anatomic femoral tunnels were both found to fail earlier (P<0.05). During the study period, approximately 8% of patients sustained a contralateral ACL injury.

Conclusions:
ACL failure rates in adolescent and pediatric patients vary based on patient age, graft selection, and surgical technique. Bone patellar tendon bone autografts had the lowest failure rate in this high-risk population.

Level of Evidence:
Level IV—retrospective case series.