The Journal of nutrition
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The Journal of nutrition · Mar 2010
ReviewGuidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics.
The rationale for the use of probiotics in the management of infectious diseases is supported by their potential to influence and stabilize the composition of gut microbiota, enhance colonization resistance, and modulate immune function parameters. A literature review was conducted to determine the efficacy of using probiotics in selected infections: 1) infectious diarrhea in infants and children, 2) traveler's diarrhea, 3) necrotizing enterocolitis in infants, 4) Helicobacter pylori infection, 5) respiratory tract infections in adults and children, 6) ear, nose, and throat infections, and 7) infectious complications in surgical and critically ill patients. The different types of infections that have been subject to clinical studies with different probiotics obviously prevent any generic conclusions. ⋯ Certain probiotics may also reduce the risk of various symptoms of respiratory tract infections in adults and children, including ear, nose, and throat infections, although data are currently far too limited to distill any clinical recommendations in this area. Positive but also negative results have been obtained in prevention of infectious complications in surgical and critically ill patients. For future studies it is recommended that researchers provide adequate power, identify pathogens, and report both clinical outcomes and immune biomarkers relating to putative underlying mechanisms.
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The Journal of nutrition · May 2009
Review Meta AnalysisProvision of multiple rather than two or fewer micronutrients more effectively improves growth and other outcomes in micronutrient-deficient children and adults.
Deficiencies of multiple micronutrients (MMN) usually coexist in developing countries, but supplements have usually provided only 1 or 2 micronutrients (MN). To inform policy, in this article we compared the relative benefits of supplying MMN vs. a placebo or 1 or 2 MN on the following: children's growth, health, and development; pregnancy outcome; nutritional status; and HIV/AIDS mortality and morbidity in adults. Sufficient data were available to perform random-effects meta-analyses of randomized controlled trials (RCT) for the effects of MMN on child growth and nutritional status. ⋯ There is some evidence that MMN supplementation improves CD4 counts and HIV-related morbidity and mortality in adults. The efficacy of MMN varies across trials, but overall there is evidence that outcomes are better than when providing < or =2 MN. The policy implications of these studies are discussed.
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Endogenous production of glutamine may become insufficient during critical illness. The shortage of glutamine is reflected as a decrease in plasma concentration, which is a prognostic factor for poor outcome in sepsis. Because glutamine is a precursor for nucleotide synthesis, rapidly dividing cells are most likely to suffer from a shortage. ⋯ This will give an indication for treatment as well as proper dosing. Most patients will have a normalized plasma glutamine concentration by adding 20-25 g/24 h. Furthermore, there are no reported adverse or negative effects attributable to glutamine supplementation.
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The Journal of nutrition · Jan 2006
ReviewTherapeutic use of branched-chain amino acids in burn, trauma, and sepsis.
Various experimental studies conducted in the 1970s demonstrated, at least in the physiological situation, the anabolic and/or anticatabolic properties of branched-chain amino acids (leucine, valine, isoleucine) or their ketoacid derivatives. This led to several clinical studies in the late 1970s and early 1980s that aimed to evaluate the potential benefits of BCAA supplementation in nutritional support of the critically ill. The data on burn, trauma, and sepsis are, however, far from convincing. ⋯ In contrast, more recently, leucine was demonstrated to positively affect protein synthesis in an experimental model of sepsis or burn. In parallel, 2 prospective controlled trials of BCAA supplementation in septic patients also demonstrated an improvement in patients' nutritional status and outcome. Thus, we should abandon the concept of BCAA-supplemented nutrition for a more promising leucine-supplemented nutrition that requires further evaluation.