Supplementation with probiotics can improve a person’s gut health, but the benefits are often fleeting, and colonization by the probiotic’s good microbes usually doesn’t last. Breast milk may help sustain those colonies in the long run, say researchers at the University of California, Davis.
In a study they report that breastfeeding babies who received a three-week course of a probiotic that consumes human milk still had colonies of those beneficial gut microbes 30 days after the end of probiotic treatment.
The study is the first to show that a combination of breast milk and a probiotic organism can lead to lasting changes in the gut microbiome, says neonatologist Mark Underwood, who led the study.
“Even though we stopped giving the probiotic on day 28 of life, the particular organisms we gave stayed in their fecal community out to 60 days and even longer,” he says. “They were surviving and dominating, and that’s something we really have not seen before.”
For the study, Underwood and his colleagues recruited 66 breastfeeding mothers. In one group, 34 mothers fed their newborns a three-week course of Bifidobacterium longum subspecies infantis EVC001, a probiotic supplement. In the other group, the mothers did not administer probiotics. Analyses of fecal samples from the infants, collected during the first 60 days of life, revealed stark differences.
Genetic sequencing, PCR analysis, and mass spectrometry revealed larger populations of B. infantis, which improves gut health, in the infants who received supplementation than in the infants who did not. Those colonies persisted for at least 30 days after the end of supplementation, suggesting that the changes were durable, say the researchers. They hypothesize that because the benefit is linked directly to breastfeeding, once the infant stops breastfeeding the colonies will diminish.
Underwood says he and his group suspected B. infantis would pair well with the sugars in breastmilk to shape the gut microbiota. “Compared to all the bugs we’ve tested, this one is a really good consumer of milk oligosaccharides,” he says. “It’s able to use the sugar molecules in mom’s milk better than any other gut microbe, including commensal and pathogenic bugs.” Accordingly, the study’s analysis showed that infants who received supplementation had lower levels of human milk oligosaccharides in their feces, which meant more had been consumed by B. infantis.
Studies conducted over the last decade or so have shown deep connections between disease and dysbiosis, which is an imbalance in gut microbial populations. Disruption of the microbiota, particularly early in life, may increase risk for many diseases both inside and outside the gut, including diabetes, allergies and asthma, irritable bowel syndrome, and some cancers, says Underwood. Finding ways to colonize an infant’s intestines with beneficial bacteria might lower those lifelong risks.
Further comparisons of the two groups of infants showed other benefits. Fecal samples from infants who received supplementation had lower numbers of potential pathogens and higher levels of lactate and acetate, which are beneficial products of fermentation of human milk sugars by B. infantis.
Underwood says formula could be developed to include oligosaccharides , which might extend the benefits to children who aren’t breastfed as well. “If mom can’t breastfeed for whatever reason, our hypothesis would be if you give that baby a 3-week course of this probiotic and a formula with added human milk oligosaccharides, colonization should happen and persist as long as they’re on that formula,” he says.

The American Society for Microbiologyhttps://tinyurl.com/y7yntxhm

A growing number of individuals of all ages are surviving intensive care unit hospitalization, however their mental and physical health problems persist. A new study from Regenstrief Institute and Indiana University researchers reports that a care model they originally developed for older adults with dementia could benefit ICU survivors of all ages.
ICU survivors have high rates of persistent cognitive impairment similar to Alzheimer’s disease due to a combination of critical illness, medications administered during hospitalization, and physiological aspects of delirium that are not well understood.
The Critical Care Recovery Center (CCRC) care model developed by the Regenstrief Institute and IU Center for Aging Research scientists is the first collaborative care concept in the US focusing on the extensive cognitive, physical, and psychological recovery needs of intensive care unit survivors and decreasing the likelihood of serious illness after discharge from an ICU. The CCRC is an outpatient clinic with an interdisciplinary care team working closely with family caregivers as well as the ICU survivors themselves after hospital or rehabilitation facility discharge.
The 51 ICU survivors in the new study were the initial patients seen in the first CCRC — the Eskenazi Health Critical Care Recovery Center. They ranged in age from 40 to 70 with an average age of 55. Prior to the trauma or illness that had brought them to the ICU, nearly all were psychiatrically normal and functionally independent.
During their ICU stay more than three-quarters of the study participants had required mechanical ventilation and almost half were given antipsychotic medications for delirium. Following ICU discharge 88 percent had cognitive impairment and 60 percent experienced depression, recognized upon their subsequent follow-up as outpatients in the CCRC.
“The ICU survivor population is very heterogeneous which makes it a complicated population to understand and serve,” said Sophia Wang, MD, an implementation scientist at the Center for Health Innovation and Implementation Science and assistant professor of clinical psychiatry at the IU School of Medicine who led the study. “ICU survivors of all ages have high rates of persistent cognitive impairment similar to Alzheimer’s disease. Their complex needs match the traditional complexity of geriatric syndromes.”
According to Dr. Wang, the problems encountered after ICU discharge, known as Post Intensive Care Syndrome or PICS, should be viewed as a multifaceted disorder of cognitive, psychiatric, and physical impairment. Because the CCRC model is equipped to handle those complexities, it is a good fit for the ICU survivor population, regardless of the individual’s age.
“In this study we have demonstrated how novel concepts initially used to create a successful model of collaborative care for dementia were successfully applied to create the CCRC providing innovative collaborative care for ICU survivors,” she said. “We will be conducting future studies of how the CCRC meets the complex needs of ICU survivors and the healthcare systems they navigate.”
Regenstrief Institutehttps://tinyurl.com/y7ld8kjv

Esaote, one of the world leaders in the manufacturing of medical imaging equipment, and Barco, a global leader in healthcare imaging, have combined their expertise to offer unparalleled ultrasound imaging performance in radiology.

MyLabTM9, the flagship ultrasound system in radiology and shared services recently launched by Esaote, defines a new standard in increasing the value of your investment. At the core of the system design stands a new concept of clarity in image quality, together with performance and workflow improvement for more efficient and informed healthcare.

The new MyLabTM9 evo 2.0 was presented in preview at the ECR 2018 in Vienna, February 28th ‐ March 4th.

“We are keen to keep investing in delivering the best quality with no compromise: that’s why we selected Barco, one of the most accredited partners in radiology to boost performance in the Esaote’s MyLabTM9 top-end product,” said Luca Bombino, Global Product Marketing Manager.

In addition to new advanced features and hi‐tech transducers, the new system configuration includes the latest state‐of‐the‐art 24” Eonis® display engineered by Barco ‐ which reflects Esaote’s continuous investment in radiology.

The high‐quality Eonis display presents sharp, bright images and exceptional colours with high contrast for perfect visualization of ultrasound images.

The display’s unique front consistency sensor automatically aligns the image quality every time the display is switched on and maintains the luminance for consistent image quality and brightness.

“Our partnership with Esaote is a clear demonstration of our mission to co‐create technology solutions for integrated care. By combining our expertise in diagnostic visualization with the skillset of partners such as Esaote, we are convinced we can enable better health outcomes for more people,” said Mark Bultinck, VP Sales EMEA for Barco Healthcare.

Developed to provide ultra‐quality ultrasound technology to hospitals, clinics and private practices, the MyLabTM9 offers smart upgradability, remote serviceability, long‐term maintenance options and transducer compatibility.

Flushing the bladder with a common chemotherapy drug immediately after surgery significantly reduces the chances of bladder cancer returning, according to a major study by SWOG, an international clinical trials network funded by the National Cancer Institute.
The research was led by Edward M. Messing, MD, a SWOG investigator and professor of urology, and a professor of oncology and pathology, at the University of Rochester School of Medicine and Dentistry and a physician at the Wilmot Cancer Institute.
The study notes this may be the first phase III trial in the U.S. to show a benefit from this treatment strategy in two decades. European and Canadian urologists have been using it for years, with their own clinical trial data to support the procedure.
“The real importance of this study is that we now have a readily available drug that’s fairly inexpensive, well-tolerated, and effective,” Messing said. “One of the biggest issues with low-grade bladder cancer is that it frequently returns. I know some patients who have to undergo four surgeries a year, and if we can cut down on these recurrences, we will save a lot of people a lot of pain, money, and time lost to recovery.”
The study says the findings “support using this therapy,” but adds that further research is needed to compare various chemotherapy agents for their effectiveness. About 80,000 Americans a year are diagnosed with bladder cancer, and the low-grade non-muscle invasive form makes up about half of the new cases annually. A JAMA editorial on the work states: "The thoughtfully designed, executed, and interpreted study by Messing et al provides important results for patients and physicians alike, to the extent that the investigators focused on a problem with meaningful implications for individual patients, population health, and the value of care."
The SWOG team conducted the randomized, double-blind clinical trial involving 406 eligible patients at 23 cancer centers.
Surgeons removed all cancerous tissue with a procedure known as TURBT, or transurethral resection of bladder tumour. Then, 201 patients received the chemotherapy drug, gemcitabine, mixed with saline, administered via catheter to the bladder area within three hours after surgery. Gemcitabine works by blocking new DNA and killing any dividing cells. It’s used to treat several other cancers, including advanced bladder cancer, but had not been studied in this setting among low-grade cancer patients. The second group of 205 patients received saline alone.
Researchers followed all patients for four years — the time period when most bladder cancers return — seeking to discover which treatment strategy worked better. The results were clear: A 34 percent reduction in the risk of recurrence for patients receiving the gemcitabine infusion. Sixty-seven patients in the gemcitabine group, or 35 percent, experienced a recurrence, compared with 91 patients in the saline group, or 47 percent.

SWOGwww.swog.org/news-events/news/2018/05/08/simple-step-reduces-bladder-cancer-recurrence