| 1 | Probiotics for antibiotic-associated diarrhea:Do we have a verdict?显示文摘Probiotics use has increased tremendously over the past ten years.This was coupled with a surge of data relating their importance in clinical practice.Antibioticassociated diarrhea,whose frequency has risen recently,was one of the earliest targets with data published more than ten years ago.Unfortunately,available trials suffer from severe discrepancies associated with variability and heterogeneity of several factors.Most published randomized controlled trials and subsequent meta-analyses suggest benefit for probiotics in the prevention of antibiotic-associated diarrhea.The same seems to also apply when the data is examined for Clostridium difficile-associated colitis.However,the largest randomized double-blind placebo-controlled trial to date examining the use of a certain preparation of probiotics in antibiotic-associated diarrhea showed disappointing results,but it was flawed with several drawbacks.The commonest species of probiotics studied across most trials is Lactobacillus;however,other types have also shown similar benefit.Probiotics have enjoyed an impeccable safety reputation.Despite a few reports of severe infections sometimes leading to septicemia,most of the available trials confirm their harmless behavior and show similaradverse events compared to placebo.Since a consensus dictating its use is still lacking,it would be advisable at this point to suggest prophylactic use of probiotics to certain patients at risk for antibiotic-associated diarrhea or to those who suffered previous episodes. | Iyad Issa Rami Moucari | 2014 | World Journal of Gastroenterology2014，20，47： | 17 |
| 2 | Extraperitoneal robot-assisted radical prostatectomy: Comparison with transperitoneal technique显示文摘AIM: To determine peri-operative, oncological, functional and safety profiles of extraperitoneal robot-assisted radical prostatectomy(e RARP) vs transperitoneal robot-assisted radical prostatectomy(t RARP) in a single centre.METHODS: A total of 120 consecutive patients underwent 50 e RARP and 70 e RARP operations respectively by the same surgical team. Peri-operative and post-operative outcomes including blood loss, hospitalization, complications(Clavien grade), positive surgical margin(PSM) rates, continence and erectile function were compared. The performance of e RARP required several technical modifications. These included developmentof Retzius' space by balloon insufflation, laparoscopic dissection of lateral extensions of this area; caudal port positioning; cranial digital stripping of peritoneum for sucker port and lodging the bagged prostate specimen adjacent to the lateral assistant port to permit space for urethro-vesical anastomosis.RESULTS: Robotic console times were shorter with e RARP vs t RARP(145.1 min vs 198.3 min, P < 0.0001). There were no significant differences in blood loss, PSM rates(e RARP 17.7% vs t RARP 22%) or complications(e RARP 8.5% vs t RARP 8%). A drain was used in all patients after t RARP and in 25/70 e RARP cases. Length of hospital stay was shorter after e RARP(mean 1.94 d vs 3.6 d, P < 0.0002). There were no differences between techniques in continence or potency at 6 mo. e RARP required several technical modifications: development of Retzius' space by balloon insufflation, laparoscopic dissection of lateral extensions of this area; caudal port positioning; and lodging the bagged prostate specimen adjacent to the lateral assistant port to permit space for urethro-vesical anastomosis.CONCLUSION: e RARP demonstrated advantages in surgical times, hospital stay and equivalence in PSM rates, complications and functional outcomes. e RARP is a useful alternative to t RARP especially in patients with adhesions, pre-existing inguinal hernias, or those unable to withstand steep Trendelenburg position. | Chris Anderson Ben Ayres Rami Issa Matthew Perry Evangelos Liatsikos Jens-Uwe Stolzenburg Khurshid R Ghani | 2013 | World Journal of Clinical Urology2013，2，2： | 1 |
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