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Biomedical subjects

Martin H Floch

Publications and source records attributed to Martin H Floch.

15 recordsLinked to original sources

Recommendations for probiotic use.

Probiotics are live microbial organisms that are administrated as supplements or in foods to benefit the host. It is the recommendation that they may be helpful in the prevention and treatment of acute diarrhea in adults and children, the prevention of antibiotic-associated diarrhea in adults and children, and the maintenance of remission and prevention of pouchitis. Although early results indicate that probiotics may also be useful in immunologic modulation to prevent atopy, treatment of radiation intestinal disease, vaginosis, ulcerative colitis, and the irritable bowel syndrome, the studies available are not sufficient to say they are definitely helpful. Even fewer data are available to recommend probiotics for the treatment of H pylori and Crohn disease and for the prevention of cardiovascular risk factors or other degenerative diseases. Clearly, larger and better-designed studies of probiotics are necessary, including comparative and dose-ranging trials.

Cardiovascular Diseases↗

A hypothesis: is diverticulitis a type of inflammatory bowel disease?

It is accepted by epidemiologists that diverticula formation in the colon is related to a deficiency in dietary fiber intake, but the cause of acute diverticulitis remains unknown. A hypothesis is presented that acknowledges from the literature that fiber deficiency is also related to an altered intestinal microecology with a change in the bacterial flora. It is hypothesized that the change in the flora with a decrease in their influence on the immune process permits a low-grade chronic inflammation in the mucosa, which is the first step in developing an acute infection of diverticula or diverticulitis. There is some evidence that the low-grade chronic inflammation is present in subjects with diverticula, which is the forerunner of acute diverticulitis. This hypothesis is strengthened by early reports that anti-inflammatory mucosal agents such as mesalamine and immune process regulators such as probiotics may improve diverticulitis.

Bacteria↗

Information assimilation and distribution challenges and goals for real and virtual journals.

The distribution of biomedical information was transfigured over three centuries ago with the introduction of scientific journals. This enabled the widespread dissemination of data to global audiences and greatly facilitated not only the advance of science but amplified the interaction between investigators despite their different locations. This process continued to expand in a linear fashion prior to the emergence of the Internet. The latter system has prompted a phenomenal augmentation of information accessibility, and its ever-expanding use has resulted in an exponential increase in the demand for digital technology and online resources. This technology has achieved unprecedented acceptance in the scientific domain and enabled publishers to expeditiously produce and distribute journal contents online. Such unparalleled access to information has sparked incendiary debate within the scientific community and among journal publishers in regard to numerous issues. It is thus much debated as to who has the right to "own" or control intellectual property, whether information should be made freely available to the online global community, how to gauge the legitimacy and authenticity of published research, and the need to reexamine the feasibility and profitability of paper journals in consideration of the digital, online formats that continue to gain popularity. To assess the current status of the situation, a meeting of journal editors, research scientists, and publishing executives was held in Constance, Germany, on June 26, 2004, to discuss these issues and formulate strategies and recommendations for the future of biomedical publishing. Herewith we provide a summation (manifesto) of the meeting's proceedings and provide a consensus opinion with the aim of illuminating the subject and also proposing some putative solutions for the major challenges that currently confront the scientific and publishing community.

Forecasting↗

Probiotics used in human studies.

GOAL: To investigate the literature from 1980 to 2004 for the types of studies and organisms used as probiotics in human studies and diseases. METHODS: PubMed search for probiotic organisms used in studies from 1980 to August 2004. The data from those papers were evaluated for organisms used, dose, vehicle, frequency, and investigator's report of positive or negative results. RESULTS: A total of 185 manuscripts were identified. Investigators reported results of both single and multiple organisms in the same manuscript. A single organism was used in 125 reports, and multiple organisms, ranging from 2 to 9, were used in 60 reports. Positive results were reported in 239 clinical situations and negative results reported in 49 in a total of 288 clinical conclusions drawn by the respective investigators. The studies are tabulated in this review. CONCLUSION: There is a large literature available in credible journals that report benefit of probiotic administration using a wide range of doses, organisms, and clinical situations. Most of the studies are simple reports of a clinical situation and require additional evaluation.

Clinical Trials as Topic↗

Diet in the irritable bowel syndrome.

Patients with irritable bowel syndrome (IBS) often request dietary recommendations. They must eat, and they want to know what to eat. Present national guidelines recommend dietary treatment with fiber for IBS patients with constipation. Diet recommendations are made based on symptoms. There may be different dietary recommendations for constipation, diarrhea, and pain or bloating. This article reviews the relationship of foods to IBS and issues of food intolerances and hypersensitivities, and recommendations for diet therapy. The role of dietary fiber, both soluble and insoluble, is reviewed. Although there are few studies to substantiate exact diets, broad dietary plans are recommended for the different symptoms of IBS. In addition, the recent literature on probiotics and prebiotics pertinent to IBS is reviewed.

Abdominal Pain↗

The natural history of diverticulitis: fact and theory.

Epidemiological and anatomic evidence indicates that approximately 60% of humans of westernized societies living into the sixth decade will develop diverticulosis of the colon. The cause remains unknown, but epidemiological studies indicate it is a combination of decreased dietary fiber intake and increased intracolonic pressure. The intraluminal pressure exerted on the wall causes a diverticular outpocketing at any one of the three areas in which vessels enter the wall. In this paper, we advance a hypothesis that fiber deficiency not only leads to diverticula formation but also causes a change in the microecology that results in decreased colon immune response and permits a low-grade chronic inflammatory process that precedes a full-blown acute diverticulitis. Pathophysiologic studies reveal that complications do not occur until there is microperforation through the wall of the diverticulum into the pericolic tissue. The perforation might be small and cause a microabscess, or extend to a phlegmon, or extend to a large abscess formation. Free perforation occurs rarely, but fistulization does occur and most commonly to the bladder. The clinical findings vary. Most often, the clinical picture is one of fever, abdominal pain, a change in bowel habit, and localizing findings associated with leukocytosis. Computerized tomography scanning has become the procedure of choice to evaluate the symptoms since it is of less risk than a barium enema and obtains more information. The differential diagnosis may be difficult but usually can be made with accuracy. Medical treatment is preferred with appropriate antibiotic therapy and variations in fiber intake. When abscess occurs, percutaneous drainage may be tried, but when it is unsuccessful, surgical intervention is necessary. Sudden hemorrhage from a vessel in diverticula may also occur. It is estimated that approximately 20% of all patients that develop diverticula will have either inflammatory or bleeding episodes. In conclusion, fiber deficiency results in diverticular formation and a chronic inflammation that may progress to acute or chronic diverticulitis that can be treated medically but may require surgical intervention.

Anti-Bacterial Agents↗

Use of diet and probiotic therapy in the irritable bowel syndrome: analysis of the literature.

GOAL: The goal of this report is to review the use of dietary intake and probiotics in patients with irritable bowel syndrome (IBS) in published reports. BACKGROUND: Dietary factors can be important in inducing symptoms that occur in patients with the IBS. Dietary intolerances, dietary allergies, specific food metabolites, and regular diet contents all may act as triggers and aggravate the symptoms of IBS; but when any of these mechanisms can be proven to cause the symptoms, then their elimination results in the resolution of that patient's IBS. METHODS: Our previous review was updated. In addition, a careful Medline search was made for the years from 1975 to 2004 to evaluate human research reports on diet and probiotics in the IBS. Forty-six manuscripts were reviewed on diet and six were available on probiotic use in IBS. The most common dietary factor evaluated in the literature was bran, and the most common probiotic used was Lactobacillus plantarum. CONCLUSIONS: Although investigations have shown that bran may be helpful in some patients, a complete review of the literature does not reveal conclusive evidence that diet therapy is effective in IBS. From the limited reports on probiotics, there appears to be a trend to decreasing symptoms. It is clear that much more prospective research is needed to study both dietary factors and probiotics in these areas.

Diet↗