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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 | On Strong Distance in Strong Oriented Graphs显示文摘 | Chartrand G Erwin D Raines M Zhang P | 1999 | Congr Numer1999，138，： | 1 |
| 3 | Biliary decompression promotes Kupffer cell recovery in obstructive jaundice显示文摘 | Clements MD McCaigue M Erwin P | 1996 | Gut1996，38，6： | 1 |
| 4 | Increased brain injury and vascular leakage after pretreatment with p38-inhibitor SB203580 in transient ischemia 显示文摘 | Lennmyr F Ericsson A C erwins P | 2003 | Acta Neurol Scand2003，108，5： | 1 |
| 5 | Cofquinome(HR 111V)in vitro evaluation of a broad-spectrum cephalosporin indicated for infections in animals显示文摘 | Meridith E Erwin and RonMd N Jones | 1994 | Diagnostic Microbiology and Infectious Disease1994，9，20： | 1 |
| 6 | Industrial Relations Climate,Attendance Behavior and the Role of Trade Unions显示文摘 | Deery S Erwin P Iverson R | | 0，，04： | 1 |
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| 8 | Genetic organization and heterogeneity of the iceA locus of Helicobacter pylori显示文摘 | Céu Figueiredo Wim G.V Quint Ricardo Sanna Erwin Sablon John P Donahue Qing Xu Geraldine G Miller Richard M Peek Martin J Blaser Leen-Jan van Doorn | 2000 | Gene2000，，1： | 1 |
| 9 | 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 |
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| 13 | The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection显示文摘 | Sheldon P Stone Ben S Cooper Chris C Kibbler Barry D Cookson Jenny A Roberts Graham F Medley Georgia Duckworth Rosalind Lai Shah Ebrahim Erwin M Brown Phil J Wiffen Peter G Davey | 2007 | The Lancet Infectious Diseases2007，，4： | 1 |
| 14 | Posttransplantation diabetes:a systematic review of the literature显示文摘 | Montori V M Basu A Erwin P J | 2002 | Diabetes Care2002，25，： | 1 |
| 15 | Radio antipodal colorings of cycles 显示文摘 | CHARTRAND G ERWIN D ZHANG P | 2000 | Congr Numer2000，144，： | 1 |
| 16 | Secure SCTP-A Versatile Secure Transport Protocol显示文摘 | Esbold Unurkhaan Erwin P Andreas Jungmaier | | 0，，03： | 1 |
| 17 | TGF-β Signaling in Renal Disease显示文摘 | Erwin P Ttinger BO Markus B | 2002 | J Am Soc Nephrol2002，13，10： | 1 |
| 18 | Nucleotide sequence of the bovine growth hormone chromosomal gene 显示文摘 | Gordon D F Quick D P Erwin C R | 1983 | Moleculer and Cellular Endocrinology1983，333，： | 1 |
| 19 | Cefquinome (HR 111 V) in vitro evaluation of a broad-spectrum cephalosporin indicated for infections in animals 显示文摘 | Murphy S P Erwin M E Jones R N | 1994 | Diagn Microbiol Infect Dis1994，20，1： | 1 |
| 20 | Do Decentralized Innovation Systems Promote Agricultural Technology Adoption? Experimental Evidence from Africa 显示文摘 | Haki P Erwin B | 2013 | Food Policy2013，12，9： | 1 |
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