The Potential of Probiotics to Eradicate Gut Carriage of Pathogenic or Antimicrobial-Resistant Enterobacterales

Probiotic supplements have been used to decrease the gut carriage of antimicrobial-resistant Enterobacterales through changes in the microbiota and metabolomes, nutrition competition, and the secretion of antimicrobial proteins. Many probiotics have shown Enterobacterales-inhibiting effects ex vivo and in vivo. In livestock, probiotics have been widely used to eradicate colon or environmental antimicrobial-resistant Enterobacterales colonization with promising efficacy for many years by oral supplementation, in ovo use, or as environmental disinfectants. In humans, probiotics have been used as oral supplements for infants to decease potential gut pathogenic Enterobacterales, and probiotic mixtures, especially, have exhibited positive results. In contrast to the beneficial effects in infants, for adults, probiotic supplements might decrease potentially pathogenic Enterobacterales, but they fail to completely eradicate them in the gut. However, there are several ways to improve the effects of probiotics, including the discovery of probiotics with gut-protection ability and antimicrobial effects, the modification of delivery methods, and the discovery of engineered probiotics. The search for multifunctional probiotics and synbiotics could render the eradication of “bad” Enterobacterales in the human gut via probiotic administration achievable in the future.

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue

Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients’ functional status and quality of life.

From the Cochrane Library: Dietary supplements for established atopic eczema (Preprint)

UNSTRUCTURED Atopic eczema is a chronic inflammatory skin condition, affecting 5% to 20% of people worldwide, with no current cure. While there are many available treatment options that help improve atopic eczema, patients in whom these treatments did not work or who fear their long-term effects may look to diet for solutions. Nutritional supplements are a vast and growing industry, and patients often turn to oral supplements as complementary or alternative treatment options for a variety of health conditions. Nutritional supplements are not required to prove efficacy or safety before becoming available to consumers, as they are regulated by the FDA as foods instead of drugs. Given their growing popularity and industry characteristics, it is important for physicians to be knowledgeable about these ingredients in order to counsel patients. A 2012 Cochrane review, “Dietary supplements for established atopic eczema” offers a comprehensive review of evidence regarding popular dietary supplements used in atopic eczema.

In a Randomized, Placebo-Controlled Cross-Over Study, Administration of 6 and 12 G Fortetropin® Does Not Reduce Serum Myostatin in Healthy Adult Dogs Over 72-Hours

Objective: To evaluate the effect of a single administration of 6 and 12 g of Fortetropin compared to placebo on serum myostatin in healthy, adult dogs over a 72-h period.Methods: Prospective, placebo-controlled, randomized, double-blind, crossover study. Ten hospital-employee-owned healthy adult dogs aged 2 to 8 years old were enrolled in the study. Blood samples were collected prior to and then 12-, 24-, 36-, 48-, and 72-h following administration of the test agent (6 and 12 g) or placebo. Serum samples were processed according to manufacturer's guidelines for canine serum using GDF-8/Myostatin Quantikine ELISA kit (R&D Systems). Analysis-of-variance (ANOVA) analyses were carried out where P < 0.05 was deemed significant.Results: Mean serum myostatin was not significantly lower in treatment groups of either low or high dose compared to placebo at any time point. Baseline mean serum myostatin in low and high dose treatment groups was 29,481 (SD = 5,224) and 32,214 pg/mL (SD = 7,353), respectively. Placebo group low and high dose baseline mean serum myostatin was 30,247 (SD = 5,875) and 28,512 (SD = 5,028).Conclusion: The results of this study indicate that administration of single 6 or 12 g dose of Fortetropin does not reduce serum myostatin in healthy adult dogs over a 72-h period.Clinical Importance: Oral supplements, like Fortetropin, require further studies to determine the efficacy and bioavailability in order to guide clinical use in dogs.

Effects of Oral Supplementation of TrichovitalsTM on Human Skin, Hair and Nail Physiology

In this study, Microcore’s oral supplements of TrichovitalsTM contains Collagen type (I,III,V,X), elastin, ellagic acid, Sabbery b glucogallin, Biotin, Curcumin C3 reduct ODN and Murraya koenigii. ESM ingestion is associated with significant impact on hair thickness, reduction in hair breakage and improvement in hair growth. This study leads to evaluate the impacts of a nutritional intervention as compared to control group (without oral supplements intake) on the appearances of hair, skin, and nails in healthy middle-aged adults. Two pilot studies were run to assess TrichovitalsTM on skin parameter. 1. Self-assessment questionnaire intended to perform an assessment on skin, hair, and nail health after 12 weeks of treatment for a group of 25 female volunteers 2. Evaluated the efficacy of TrichovitalsTM effect of 5-week treatment on hydration of skin by corneometry, on elasticity with the cutometer, and on pigmentation with themexameteron for a group of 7 female volunteers, Microscopic studies of hair strength and nail growth. In study 1-Participants were predominantly satisfied with the effects obtained on general face (100% volunteers satisfied) and (94% volunteers satisfied) body skin condition and skin properties (100% volunteers satisfied) with facial skin softness, 95% ith facial skin hydration, 63% of facial skin brightness and 89% with body skin hydration and significant effects on hair damages (100% volunteers satisfied), hair falls (95% volunteers satisfied) and hair growth (96% volunteers satisfied) and nail appearance (80% volunteers satisfied) and improvement in brittle nails. In this open-label 5 weeks study, Oral Microcore’s TrichovitalsTM ingestion was associated with a significant improvement in skin appearance such as increase skin hydration and skin elasticity, reduces skin pigmentation after 5 weeks treatment and facial skin tone, with significant impact on hair thickness, reduces split ends, hair loss, hair breakage and improvement in hair growth after 5 weeks treatment, increase of 80% nail growth rate and a decrease of 42% brittle nails after 6 weeks. Microcore’s TrichovitalsTM achieved significant change improvement in skin, hair and nail appearance (thickness/density) than control group (without oral supplements intake) by week 12 of the study. From the result analysis, Microcore’s TrichovitalsTM is deemed to be one of the most effective anti-aging products in cosmetic sector and overall physical appearance. Oral supplementation of 500mg/day of Microcore’s TrichovitalsTM for 12 weeks is associated with significant improvement in the appearance of facial skin, hair and nail. Increases in skin hydration and skin elasticity with reduced pigmentation on skin were observed after 5 weeks treatment, which is a very important marker for skin aging. Also significant impact on hair thickness reduces split ends, hair loss, hair breakage and improvement in hair growth and healthy development of nails after 5 weeks treatment.

Effects of Oral Supplementation of Muttaijow complexTM on Human Skin, Hair and Nail Physiology

In this study, Microcore’s oral supplements of Muttaijow ComplexTM obtained from the egg shell that contains naturally occurring collagen Type (I, V, X), Elastin (Desmosine and isodesmosine), Hyaluronic acid, Glucosamine, Chondroitin, Glycosaminoglycans or Muco-polysaccharides, Membrane bound protein molecules, and Calcium are used in a group of volunteers. This study leads to evaluate the impacts of a nutritional intervention as compared to control group (without oral supplements intake) on the appearances of hair, skin, and nails in healthy middle-aged adults. Two pilot studies were run to assess Muttaijow ComplexTM on skin parameter. 1. Self-assessment questionnaire intended to perform an assessment on skin, hair, and nail health after 12 weeks of treatment for a group of 25 female volunteers 2. Evaluated the efficacy of Muttaijow ComplexTM effect of 5-week treatment on hydration of skin by corneometry, on elasticity with the cutometer, and on pigmentation with themexameteron for a group of 7 female volunteers, Microscopic studies of hair strength and nail growth. In study 1-Participants were predominantly satisfied with the effects obtained on general face (100% volunteers satisfied) and body (94% volunteers satisfied) skin condition and skin properties (100% volunteers satisfied with facial skin softness, 95% with facial skin hydration, 83% of facial skin brightness and 89% with body skin hydration) and partly with effects on hair (65-70%volunteers satisfied) and nail appearance (70% volunteers satisfied) and improvement in brittle nails. In this open-label 5 weeks study, Oral Microcore’s Muttaijow ComplexTM ingestion was associated with a significant improvement in skin appearance such as increase skin hydration and skin elasticity, reduces skin pigmentation after 5 weeks treatment and facial skin tone, with significant impact on hair thickness, reduces split ends, hair loss, hair breakage and improvement in hair growth after 5 weeks treatment, increase of 12% nail growth rate and a decrease of 42% brittle nails after 6 weeks. Microcore’s Muttaijow ComplexTM achieved significant change improvement in skin, hair and nail appearance (thickness/density) than control group (without oral supplements intake) by week 12 of the study. From the result analysis, Microcore’s Muttaijow ComplexTM is deemed to be one of the most effective anti-aging products in cosmetic sector and overall physical appearance. Oral supplementation of 500mg/day of Microcore’s Muttaijow ComplexTM for 12 weeks is associated with significant improvement in the appearance of facial skin, hair and nail. Increases in skin hydration and skin elasticity with reduced pigmentation on skin were observed after 5 weeks treatment, which is a very important marker for skin aging. Also, significant impact on hair thickness, reduces split ends, hair loss, hair breakage and improvement in hair growth and healthy development of nails after 5 weeks treatment.

27 Oral Supplementation for Burn Patients: Would YOU Eat That?

Introduction The metabolic demands of burn injury often require that patients consume a high-calorie diet. For patients taking nutrition solely by the oral route, this can be challenging, and supplementation is necessary. The burn team is sometimes frustrated at patients’ inability or perceived unwillingness to consume the daily prescribed supplementation. The purpose of this study was to expose the burn team to the various nutritional supplements offered to patients, and to gain a better understanding of the palatability those supplements. Methods Nine volunteers from the burn team participated in this blinded study: an attending surgeon; surgical residents (2); students (1); therapists (2); and nurses (3). Samples of 9 different nutritional supplements were placed in numbered cups, with the contents known only to the dietitians. The supplements consisted of: “milkshake” consistency drinks (#1,4,6,7, 9); gelatin (#2); frozen custard (#3); clear thin liquid (#5); and pudding (#8). Each participant received one cup of each supplement and was asked to rate the contents on a scale of 1 to 10, with 10 being tastiest. Mean, trimmed mean, and median taste scores were noted. Data were analyzed by t-test and by regression to assess for differences based on protein content. Results The highest mean and trimmed mean scores (7.3 and 7.4) were given to product #8. Product #1 had slightly lower scores (6.4 and 6.1). Product #9 received the lowest mean score (2.2); the trimmed mean was even lower (1.7). Median scores for the products upheld these results, and most of the remainder of the products received median scores of 4 or 5. T-test analysis showed significant differences in preference for products 1 and 8 versus the rest of the products (with means of 2.2 to 5.3). Regression analysis suggests that taste scores tend to be higher for products with a lower percentage of calories from protein, while the higher protein products fare less well in taste (a decline of roughly 0.47 in mean taste score for every 10-percentage point increase in percentage of calories from protein). Conclusions A blinded taste test of commonly offered supplements revealed that most products are, at best, moderately acceptable (median score 4–5). This suggests two potential changes in the approach to oral supplementation. First, the burn team should be sympathetic to the challenges that patients face with oral supplements, particularly the high-protein versions. Second, the burn team may need to be innovative. Chilling the drinks, offering different flavors, mixing flavors, or mixing with other liquids may help patients to take oral supplements more enthusiastically. Sampling these oral supplements has helped our team to understand better what we ask our patients to do to achieve their nutritional goals.

Refractory Hypocalcemia Following Stomach Intestinal Pylorus-Sparing Bariatric Surgery and Thyroidectomy: Successful Management With Creation of a Proximal Roux-en-Y Gastric Bypass

Some forms of bariatric surgery make patients susceptible to calcium malabsorption, and the parathyroid hormone (PTH) axis is important for maintaining normocalcemia in these patients. Injury to the parathyroid glands due to anterior neck surgery commonly causes PTH axis disruption and can result in severe hypocalcemia in bariatric surgery patients. Herein, we present a case of a patient with a history of stomach intestinal pylorus-sparing bariatric surgery who developed refractory hypocalcemia requiring daily intravenous (IV) calcium 2 years after thyroidectomy. PTH levels were inappropriately normal during episodes of hypocalcemia, and urinary calcium level was <3.0 mg/dL following large oral doses of calcium, suggesting that both inadequate PTH response and malabsorption contributed to her severe hypocalcemia. In order to enhance calcium absorptive capacity while minimizing the risk of weight regain, she was surgically treated with a Roux-en-Y gastric bypass proximal to the prior operation. The surgery successfully improved blood calcium levels; the patient was successfully weaned from IV calcium and was able to maintain normocalcemia with oral supplements. We discuss the case in the context of available literature and provide our recommendations.

Quem Nutre? Uma pesquisa sobre as EMTNs do Brasil

Introduction: The excellence of Nutritional Therapy (NT) for hospitalized patients requires the existence of a Multiprofessional Nutrition Therapy Team (EMTN). The implementation of a EMTN in Brazilian hospitals is mandatory according to the National Health Surveillance Agency (ANVISA), since the publication of Ordinance 272 of 1998. The EMTN must be constituted by at least one doctor, one dietitian, one nurse and one pharmacist, qualified and with specific training in NT. Despite all efforts to develop NT in Brazil, the prevalence of malnutrition remains high. NT when performed by EMTN is associated with reduced complications and costs. The presence of EMTN still does not seem to be the reality of all Brazilian hospitals. Objective: The present study aims, by means of an electronic questionnaire, to determine the existence and the current situation of the EMTN in public and private hospitals in Brazil and to define the profile of the professionals who work in the EMTN. Methods: Study carried out using a survey-type electronic questionnaire. The REDCap program was used to record responses. Results: 115 Brazilian hospitals participated, of which 80% declared having EMTN, being present in all regions of the country, with greater prevalence in the Southeast region and in large hospitals. Regarding the use of NT, it was found that institutions with EMTN have a higher average use of Enteral NT (31.9 patients) and Parenteral NT (4.3 patients). There was also a greater use of oral supplements in hospitals with EMTN (37 patients) when compared to hospitals without EMTN (18.4 patients).In almost half of the institutions, work at EMTN is not the exclusive activity of these professionals. Conclusion: EMTN are not yet a reality in all large hospitals in Brazil. A broader study can help to clarify this scenario and propose strategies for the strengthening of NTMS and NT.

A Systemic Review on Topical Marketed Formulations, Natural Products, and Oral Supplements to Prevent Androgenic Alopecia: A Review

Androgens have an intense consequence on the human scalp and body hair. Scalp hair sprouts fundamentally in awol of androgens whereas the body hair hike is vulnerable to the activity of androgens. Androgenetic alopecia (AGA) invoked as males emulate Alopecia due to the cause of the dynamic reduction of scalp hair. Androgens are medium of terminus growth of hair although the body. Local and system androgens convert the extensive terminal follicles into lesser vellus like structure. The out start of this type of alopecia is intensely irregular and the reason behind this existence of enough circulating steroidal hormones androgens and due to genetic predisposition. Effective treatments are available in the market as well as under clinical and preclinical testing. Many herbal formulations are also available but not FDA approved. Different conventional and NDDS formulations are already available in the market. To avoid various systemic side effects of both Finasteride and Minoxidil, topical formulations and natural products (nutrients, minerals, vitamins) now a days are being widely used to treat Androgenic alopecia. CAM (complementary and alternative medicine) provides the option to elect favorable, low-risk, adjuvant and alternative therapies. Herein, we offer a widespread review of topical marketed formulations, natural products, and CAM treatment options for AGA. Graphic Abstract