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| 1 | Effect of fiber supplementation on the microbiota in critically ill patients显示文摘AIM:To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and fermentation.METHODS:Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were studied.The study was divided into 2 parts:first,short-term (3-9 d)clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid(SCFA)concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid;second,4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR)of microbial 16S rRNA genes and Human Intestinal Tract Chip(HITChip)microarray analysis.Nearly all patients were receiving antibiotics(10/13)and acid suppressants(11/13)at some stage during the studies.RESULTS:In group 1,tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence(P=0.008 and P<0.0001,respectively)of increased fermentation with no exacerbation of abdominal symptoms and resolution of diarrhea in 2 of 4 patients.In group 2 before supplementation,fecal microbiota mass and their metabolites,SCFA,were dramatically lower in patients compared to healthy volunteers.From qPCR and HITChip analyses we calculated that there was a 97%reduction in the predominant potential butyrate producers and starch degraders.Following 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA(acetate 28.4±4.1μmol/g to 42.5±3.1μmol/g dry weight,P=0.01;propionate 1.6±0.5 vs 6.22±1.1,P=0.006 and butyrate 2.5±0.6 vs 5.9±1.1,P=0.04)and microbial counts of specific butyrate producers,with resolution of diarrhea in 3 of 4 patients.CONCLUSION:Conventional management of critically ill patients,which includes the use of elemental diets and broad-spectrum antibiotics,was associated with gross suppression of the colonic microbiota and their production of essential colonic fuels,i.e.,SCFA.Our investigations show that fiber supplementation of the feeds has the potential to improve microbiota mass and function,thereby reducing the risks of diarrhea due to dysbiosis. | Stephen JD O'Keefe Junhai Ou James P DeLany Scott Curry Erwin Zoetendal H Rex Gaskins Scott Gunn | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 3 |
| 2 | Nucleus pulposus notoehord cells secrete connective tissue growth factor and up-regulate proteoglycan expression by intervertebral disc chondrocytes显示文摘 | Erwin WM Ashman K O'Donnel P | 2006 | Arthritis Rheum2006，54，12： | 1 |
| 3 | Effect of Internal Clearance on Load Distribution and Life of Radially Loaded Ball and Roller Bearings 显示文摘 | Fred B O Erwin V Z Joseph V P | 2012 | Tribology Trans- actions2012，55，2： | 1 |
| 4 | Epidermal growth factor is critical for intestinal adaptation following small bowel resection 显示文摘 | Stem L E Erwin C R O'Brien D P | 2000 | Microsc Res Tech2000，51，2： | 1 |
| 5 | Sorghum and salinity: L response of growth, water relations, and ion accumulation to NaCI salinity显示文摘 | Godfrey W N John C O Erwin B | 2004 | Crop Science2004，44，： | 1 |
| 6 | European multi-centre study of the Nucleus Hybrid L24 cochlear implant显示文摘 | Thomas Lenarz Chris James Domenico Cuda Alec Fitzgerald O&rsquo Connor Bruno Frachet Johan H.M. Frijns Thomas Klenzner Roland Laszig Manuel Manrique Mathieu Marx Paul Merkus Emmanuel A.M. Mylanus Erwin Offeciers Joerg Pesch Angel Ramos-Macias Alain Robier | 2013 | International Journal of Audiology2013，，12： | 1 |
| 7 | Epidermal growth factor is critical for intestinal adaptation following small bowel resection 显示文摘 | Stern LE Erwin CR O Brien DP | 2000 | Microsc Res Tech2000，51，2： | 1 |
| 8 | Observation of second-phase particles in bulk zirconium alloys using synchrotron radiation显示文摘 | ERWIN K T DELAIRE O MOTTA A T CHU Y S MANCINI D C BIRTCHER R C | 2001 | J Nucl Mater2001，294，： | 1 |
| 9 | Basic types of submarine slope curvature显示文摘 | Erwin W A Sehlager O | 2000 | Journal of Sedimentary Research2000，70，4： | 1 |
| 10 | Efficiency and Equity in Private and Public Education: A Nonparametric Comparation显示文摘 | LAURENSC KRISTOF D W ERWIN O | 2010 | European Journal of Operation Research2010，202，2： | 1 |
| 11 | Isolated noncompaction of the left ventricular myocardium in the adult is an autosomal dominant disorder in the majority of patients显示文摘 | Klaassen SS Brenda GB Erwin O | 2003 | American Journal of Medical Genetics2003，119，： | 1 |
| 12 | Epidermal growth factor is critical for intestinal adaptation following small bowel resection显示文摘 | Stern LE Erwin CR O' Brien DP | 2000 | Microsc Res Tec2000，51，： | 1 |
| 13 | Replication and dissemination of a cancer education model for African American women显示文摘 | Erwin D O Ivory J Stayton C | 2003 | Cancer Control2003，10，5： | 1 |
| 14 | Spacecraft tracking using sampled-data Kalman filters显示文摘 | Teixeira B O S Santillo M A Erwin R S | 2008 | Control Systems Magazine2008，28，4： | 1 |
| 15 | A symbi- ont-independent endo-1, 4-β-Xylanase from the plant- parasitic nematode Meloidogyne incognita 显示文摘 | Makedonka M D Erwin R Hein O | 2006 | Mole- cular Plant-Microbe Interactions2006，19，5： | 1 |
| 16 | Training lay health workers to promote post-treatment breast cancer surveillance in African American breast cancer survivors : development and implementation of a curricu-lum显示文摘 | Thompson H S Edwards T Erwin D O | 2009 | J Cancer Educ2009，24，4： | 1 |
| 17 | Nucleus pulposus notochord cells secrete connective tissue growth factor and up-regulate proteoglycan expression by intervertebral disc chondrocytes显示文摘 | Erwin WM Ashman K O'Donnel P | 2006 | Arthritis Rheum2006，54，： | 1 |
| 18 | Complete genome sequence of Pseudomonas aeruginosa PA01, an opportunistic pathogen 显示文摘 | Stover C K Pham X O Erwin A | 2000 | Nature2000，406，6799： | 1 |
| 19 | Sustainable tree biomass production显示文摘 | Folke O Andersson G?ran I ?gren Erwin Führer | 2000 | Forest Ecology and Management2000，，1： | 1 |
| 20 | Why do some trauma patients die while others survive?A matched-pair analysis based on data from Trauma Register DGU(R)显示文摘Purpose:The mortality rate for severely injured patients with the injury severity score(ISS)>16 has decreased in Germany.There is robust evidence that mortality is influenced not only by the acute trauma itself but also by physical health,age and sex.The aim of this study was to identify other possible influences on the mortality of severely injured patients.Methods:In a matched-pair analysis of data from Trauma Register DGU(R),non-surviving patients from Germany between 2009 and 2014 with an ISS_>16 were compared with surviving matching partners.Matching was performed on the basis of age,sex,physical health,injury pattern,trauma mechanism,conscious state at the scene of the accident based on the Glasgow coma scale,and the presence of shock on arrival at the emergency room.Results:We matched two homogeneous groups,each of which consisted of 657 patients(535 male,average age 37 years).There was no significant difference in the vital parameters at the scene of the accident,the length of the pre-hospital phase,the type of transport(ground or air),pre-hospital fluid management and amounts,ISS,initial care level,the length of the emergency room stay,the care received at night or from on-call personnel during the weekend,the use of abdominal sonographic imaging,the type of X-ray imaging used,and the percentage of patients who developed sepsis.We found a significant difference in the new injury severity score,the frequency of multi-organ failure,hemoglobine at admission,base excess and international normalized ratio in the emergency room,the type of accident(fall or road traffic accident),the pre-hospital intubation rate,reanimation,in-hospital fluid management,the frequency of transfusion,tomography(whole-body computed tomography),and the necessity of emergency intervention.Conclusion:Previously postulated factors such as the level of care and the length of the emergency room stay did not appear to have a significant influence in this study.Further studies should be conducted to analyse the identified factors with a view to optimising the treatment of severely injured patients.Our study shows that there are significant factors that can predict or influence the mortality of severely injured patients. | Dan Bieler Thomas Paffrath Annelie Schmidt Maximilian V(o)llmecke Rolf Lefering Martin Kulla Erwin Kollig Axel Franke Sektion NIS of the German Trauma Society | 2020 | Chinese Journal of Traumatology2020，23，4： | 0 |
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