Acutely ill children (n = 129) aged 1-6 years receiving antibiotic therapy were randomized to receive a nutritional supplement with (PS) or without (P) synbiotics or a fruit-flavored drink (D) with their medications. Group PS had significantly greater weight gains (versus D) following antibiotic therapy. The percentages of subjects without bacterial illnesses 14 days following antibiotic therapy were as follows: 94.3% (PS), 87.8% (D), and 80.6% (P). PS (vs D) significantly increased fecal Lactobacillus in a subset of subjects. Oral supplements increase energy intake and promote weight gain in acutely ill children receiving antibiotics; synbiotics may confer additional benefits by increasing bifidobacteria levels.
::Children's Hospital U n i v e r s i t y o f Heidelberg, FRG This review focusses on a l t e r a t i o n s o f rheological properties o f bloo which might c o n t r i b u t e t o the development o f c i r c u l a r o t y d e t e r i o r a t i o l i n neonatal septicaemia. The f o l l o w i n g a1 t e r a t i o n s i n rheological properties have been shown i n septicaemia: 1. Decrease i n RBC deform a b i l i t y . RBC d e f o r m a b i l i t y i s determined by the shape and geometry ( i n p a r t i c u l a r , by the excess surface area) and by membrane and cytoplasma properties. W e have shown t h a t i n severe neonatal septicaemia RBC may l o s e membrane as we1 1 as c e l l water. This r e s u l t s i n decreased excess membrane surface and increased i n t e r n a l v i s c o s i t y . Moreover, endotoxin may markedly decrease RBC deformabili t y i n v i t r o and i n v ivo. This appears t o be due t o a l o s s i n membrane e l a s t i c i t y . A decrease i n RBC d e f o r m a b i l i t y may a l s o occur i n n e c r o t i z i n g e n t e r o c o l it i s as a r e s u l t o f e i t h e r endotoxin-mediated membrane destruction o r neuraminidase-induced l o s s o f membrane charge. 2. Increase i n RBC aggregation. RBC aggregation i s p r i n c i p a l l y caused by plasma macromolecules (e.g., f i b r i n o g e n ) . I n neonatal septicaemia, plasma f i b r inogen may increase. Moreover, i n neonates w i t h septicaemia RBC aggreg a t i o n i s more enhanced than expected from the r i s e i n plasma f i b r inogen. We have shown t h a t fibrin-monomer-f i b r i n o g e n complexes induce a marked r i s e i n RBC aggregation i n both neonatal and a d u l t blood. Since the complexes are formed as a r e s u l t o f endotoxinaemia, they might c o n t r i b u t e t o the increase i n RBC aggregation i n neonatal s e p t i -/ caenia . These data i n d i c a t e t h a t a1 tered rheological blood properties may c o n t r i b u t e t o c i r c u l a t o r y compromise i n septicaemia.
RHEOLOGICAL PROPERTIES OF ERYTHROCYTES IN PATIENTS WITH286 CONGENITAL DYSERYTHROPOETIC ANEMIA 11.
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