Adjunctive efficacy of Bifidobacterium animalis subsp. lactis XLTG11 in alleviating functional constipation in children

According to a recent study, the administration of XLTG11 at a dosage of 1 × 1010 CFU per day to children resulted in an elevation in fecal frequency, brought about favorable alterations in gut microbiota, and effectively regulated short-chain fatty acid (SCF) genes and genes associated with methane metabolism. This study’s results were published in the Brazilian Journal of Microbiology. 
In this double-blinded, randomized trial, eligible children were divided into two groups: the intervention group (n = 65) received conventional treatment with probiotics, and the control group (n = 66) received conventional treatment without probiotics. The primary outcome measure focused on fecal frequency. To predict gene family abundances based on 16S information, fecal gut microbiota analysis and PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) were utilized.
During the treatment period, there was a significant increase in the weekly frequency of feces in each group (F = 41.97, p < 0.001). The frequency of feces (times/week (t/w)) in the intervention group was notably higher compared to the control group post-intervention (3.69 ± 2.62 t/w versus 3.18 ± 1.43 t/w for the first week, 4.03 ± 2.54 t/w versus 2.89 ± 1.39 t/w for the second week, 3.74 ± 2.36 t/w versus. 2.94 ± 1.18 t/w for the third week, and 3.45 ± 1.98 versus 3.17 ± 1.41 t/w for the fourth week) (F = 7.60, p = 0.0067). The dominant species shifted to Bifidobacterium breve, Bifidobacterium longum, and Escherichia coli in the group that received the intervention. The genes associated with short-chain fatty acid metabolism were upregulated, while methane metabolism was downregulated.
The above study demonstrated that giving children XLTG11 at a daily dose of 1 × 1010 CFU resulted in more frequent bowel movements, brought about positive changes in gut microbiota, and effectively controlled SCFs genes and genes associated with methane metabolism.
 

Nomogram predicts cancer-specific survival for patients with primary gastrointestinal melanoma

According to a recent study, it was validated that nomogram can predict cancer-specific survival and develop a risk stratification system for patients with primary gastrointestinal melanoma. The findings of the study were published in The Turkish Journal of Gastroenterology.
Results from a database of 433 patients with primary gastrointestinal melanoma were included in the study after randomly dividing the participants into training and validation cohorts (8:2). The nomogram was constructed based on the risk factors identified in the multivariate Cox regression analysis. Based on the nomogram, a risk stratification system was developed. Time-dependent receiver operating characteristic, calibration curve, and decision curve analysis were performed.
All cases were randomly divided into either the training (n = 347, 80%) or validation cohort (n = 86, 20%). For all patients, the median cancer-specific survival (CSS) time was 18.0 months (95% CI: 14.7-21.3). The median CSS was 18.0 months (95% CI: 14.5-21.5) and 18.0 months (95% CI: 10.7-25.3) in the training and validation cohorts, respectively (log-rank test, P = .241).
It was found that CSS under the curves of the nomogram for 6-, 12-, and 18-month were 0.789, 0.757, and 0.726 for internal validation, and 0.796, 0.763, and 0.795 for the external validation. Furthermore, the patients were divided into 2 risk sub-groups to study the risk stratification, low-risk (point: 0-182) and high-risk (point: 183-333). The median CSS was 31.0 months (95% CI: 24.5-37.5) in the low-risk subgroup and 8.0 months (95% CI: 6.2-9.8) in the high-risk subgroup. The Kaplan-Meier analysis and the log-rank test demonstrated that the risk stratification was well-differentiated in patients with varying risks of cancer-specific survival.
Thus, it can be concluded that the nomogram prediction model may be practical for validation of cancer-specific survival and development of a risk stratification system in patients with primary gastrointestinal melanoma.
 

3 L split-dose PEG regimen superior to 2 L PEG regimen for colonoscopic bowel preparation

A recent study demonstrated that 3 L split-dose polyethylene glycol (PEG) is superior to 2 L polyethylene glycol for colonoscopic bowel preparation in individuals with relatively high BMI. This study was published in the journal, BMC Gastroenterology.

This was a multicenter randomized controlled trial that included 710 individuals with high BMIs (≥ 24 kg/m2), who were scheduled to undergo colonoscopy. The participants were randomly assigned into the 3 L split-dose polyethylene glycol (PEG) group (n=353) and the 2 L PEG group (n=357).  The primary outcome of the study was the rate of adequate bowel preparation, and the secondary outcomes included the Boston Bowel Preparation Scale (BBPS) score, polyp detection rate, cecal intubation rate, and adverse reactions during bowel preparation. Additionally, the study had exploratory subgroup analyses for adequate bowel preparation.

After enrollment, 15 participants did not undergo colonoscopy, only 345 participants received 3 L split-dose PEG regimen, and 350 participants received 2 L PEG regimen for colonoscopic bowel preparation. It was shown that the rate of adequate bowel preparation was superior in the 3 L split-dose PEG regimen (81.2%) compared to the 2 L PEG regimen (74.9%). Additionally, it was found that the BBPS score (6.71±1.15 vs. 6.37±1.31) and the rate of polyp detection (62.0% vs. 52.9%) were better with the 3 L split-dose PEG regimen compared to the 2 L PEG regimen. In the subgroup analysis, the 3 L split-dose PEG regimen performed better than the 2 L PEG regimen in the overweight individuals (BMI 25-29.9 kg/m2).

These findings suggest that a 3 L split-dose PEG regimen is superior to a 2 L PEG regimen for colonoscopic bowel preparation in individuals with high BMI (25-29.9 kg/m2).

Antibiotic prophylaxis results in lower risk of infectious complications before ERCP in patients with biliary obstruction

A recent study suggests that incidence of postendoscopic retrograde cholangiopancreatography (ERCP) infections was significantly lower with antibiotic prophylaxis in patients with biliary obstruction. The study's findings were published in The American Journal of Gastroenterology.

This double-blind, placebo-controlled, randomized trial included 378 patients who were randomly assigned in a 1:1 ratio to receive either a single dose of 1 g intravenous cefoxitin (n=189) or normal saline (n=189; placebo), 30 minutes before undergoing ERCP. The incidence of infectious complications after ERCP comprised the primary outcome of this trial.

At the end of the study, it was found that the risk of infectious complications after ERCP was 2.8% and 9.8% in the antibiotic prophylaxis group and placebo group, respectively. The incidence rates of bacteremia in the antibiotic prophylaxis and placebo groups were 2.3% and 6.4%, respectively. Finally, the incidence rate of cholangitis was 1.7% in the antibiotic prophylaxis group and 6.4% in the placebo group.

Based on the above results, it can be concluded that before ERCP, antibiotic prophylaxis resulted in a significantly lower risk of infectious complications, especially cholangitis, in patients with biliary obstruction.