Goals:
We performed a systematic review with meta-analysis to examine the efficacy and safety of oral fecal microbiota transplantation (FMT) capsules for recurrent Clostridioides difficile infection (rCDI).
Background:
FMT through colonoscopy is established as effective and safe in treating multiple recurrences of CDI, but consensus has not been established on delivery through oral capsules.
Study:
A systematic literature search was performed with multiple databases including MEDLINE and EMBASE to identify original studies including at least 10 patients that investigated the role of oral FMT capsules to treat rCDI. Cure rates were pooled by a random effects model and publication bias was assessed with the Egger test. Secondary analyses assessed for differences between capsule preparation (frozen vs. lyophilized stool) and delivery modality (capsule vs. colonoscopy).
Results:
Fifteen studies (12 case series and 3 randomized controlled trials) encompassing 763 patients were identified for inclusion. Significant variability existed in baseline patient characteristics and protocols. Meta-analysis of proportions showed efficacy of oral FMT capsules to be 0.821 (95% confidence interval: 0.762-0.874). No evidence for publication bias was found (P=0.51). Secondary analyses did not find significant differences in efficacy. Fourteen adverse events leading to death or hospitalization were noted, none of which were attributed to FMT.
Conclusions:
Oral FMT capsules for rCDI are promising because of ease of administration and noninvasive delivery. We found an overall efficacy of 82.1% with a low rate of serious adverse events. Further studies are needed to optimize protocols and outcomes.
Background: Quality of life (QoL) outcomes after paediatric tonsillectomy can be assessed with diseasespecific patient reported outcome measures. Our aim was to assess a modified T-14 Paediatric Throat Disorders Outcome Test in an Australian paediatric population undergoing tonsillectomy. Methods: A consecutive case series was conducted in children (aged 1-16 years) undergoing tonsillectomy over a period of 15 months. T-14 questionnaires administered to the caregivers of the child pre-operatively and post-operatively (n=45) within 6-8 weeks of the procedure were included for statistical analysis. Preand post-operative T-14 scores were compared and analysed according to surgical indication [either sleep disordered breathing (SDB), recurrent tonsillitis, or both] and complications with non-parametric tests. Results: Post-operative scores demonstrated a global improvement for SDB (n=22), recurrent tonsillitis (n=12) and for both (n=11) indications (P<0.0001 each). High compliance with the T-14 was obtained with parents completing the questionnaire pre-and post-operatively. T-14 scores did not improve in 2 patients who had rhinitis and otitis media at the time of post-operative testing. Conclusions: The modified T-14 questionnaire is suitable for measuring parental reported health outcomes for paediatric throat disorders in patients undergoing tonsillectomy in the Australian population. The T-14 questionnaire demonstrates improvement in parental perception of their child's symptoms after tonsillectomy. It is easy to administer producing a high compliance rate.
Two laryngeal transplants have been reported in the medical literature. Although both patients report improved quality of life relating to their ability to communicate with voice, further research is necessary to shape our understanding of this complicated operation, its indications, and its functional outcomes. Laryngoscope, 127:1861-1868, 2017.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.