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| 1 | Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections显示文摘Antibiotic-associated diarrhea(AAD) and Clostridum difficile infections(CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases Pub Med(June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications(required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar(discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics. | Lynne Vernice Mc Farland Metehan Ozen Ener Cagri Dinleyici Shan Goh | 2016 | World Journal of Gastroenterology2016，22，11： | 39 |
| 2 | Preventing pediatric antibiotic-associated diarrhea and Clostridium difficile infections with probiotics: A metaanalysis显示文摘AIM: To assess the efficacy and safety of probiotics for preventing pediatric:(1) antibiotic associated diarrhea and(2) Clostridium difficile(C. difficile) infections.METHODS: On June 3, 2013, we searched Pub Med(1960-2013), EMBASE(1974-2013), Cochrane Database of Systematic Reviews(1990-2013), CINAHL(1981-2013), AMED(1985-2013), and ISI Web of Science(2000-2013). Additionally, we conducted an extensive grey literature search including contact with National Institutes of Health Clinical Trials Registry, abstracts from annual infectious disease and gastroenterology meetings, experts in the field and correspondence with authors. The primary outcomes were the incidence of antibiotic-associated diarrhea(AAD) and C. difficile infections(CDI). Dichotomous outcomes(e.g., incidence of AAD or CDI) were pooled using a random-effects model to calculate the relative risk and corresponding 95% confidence interval(95%CI) and weighted on study quality. To explore possible explanations for heterogeneity, a priori subgroup analysis were conducted on probiotic strain type, daily dose, quality of study and safety of probiotics. The overall quality of the evidence supporting each outcome was assessed using the grading of recommendations, assessment, development and evaluation criteria.RESULTS: A total of 1329 studies were identified with 22 trials(23 treatment arms and 4155 participants) meeting eligibility requirements for our review of prevention of AAD and 5 trials(1211 participants) for the prevention of CDI. Trials in adult populations, trials of uncertain antibiotic exposure or studies which did not provide incidence of AAD were excluded. We found 12 trials testing a single strain of probiotic and 10 trials testing a mixture of probiotic strains. Probiotics(all strains combined) significantly reduced the incidence of pediatric AAD(pooled RR = 0.42, 95%CI: 0.33-0.53) and significantly reduced pediatric CDI(pooled RR = 0.35, 95%CI: 0.13-0.92). Of the two strains with multiple trials, both significantly reduced pediatric AAD: Saccharomyces boulardii lyo(pooled RR = 0.43, 95%CI: 0.32-0.60) and Lactobacillus rhamnosus GG(pooled RR = 0.36, 95%CI: 0.19-0.69). There was no significant effect by type of antibiotic, or by duration or dose of probiotic. No adverse events associated were found in the 22 controlled trials relating to the use of probiotics.CONCLUSION: This meta-analysis found that probiotics significantly prevented pediatric antibiotic associated diarrhea and pediatric CDI, but the efficacy varies significantly by the strain of the probiotic. | Lynne V Mc Farland Shan Goh | 2013 | World Journal of Meta-Analysis2013，1，3： | 8 |
| 3 | Retroperitoneal liposar- comas: the experience of a tertiary Asian center显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oneol2011，9，： | 1 |
| 4 | DNA base pair resolution by single molecule force spectroscopy显示文摘 | Sattin BD Pelling AE Goh MC | 2004 | Nucl Acids Res2004，32，16： | 1 |
| 5 | Potassium ion mediated collagen microfibril as- sembly on mica显示文摘 | Loo RW Goh MC | 2008 | Langmuir2008，24，13： | 1 |
| 6 | Retroperitoneal liposarcomas: the experience of a tertiary Asian center显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oncol2011，9，： | 1 |
| 7 | Retroperitoneal liposareonms: the experience of a tertiaD, Asian center显示文摘 | Lee SY Goh BK Ten MC | 2011 | World J Surg Oneol2011，9，： | 1 |
| 8 | Retroperitoneal liposar- comas: the experience of a tertiary Asian center显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oncol2011，9，： | 1 |
| 9 | Retroperitoneal liposarco- mas:the experience of a tertiary Asian center 显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oncol2011，9，： | 1 |
| 10 | Retroperitoneal liposarcomas: The experience of a tertiary Asian center显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oncol2011，9，： | 1 |
| 11 | British Ocular Syphilis Study (BOSS) : 2-year national surveillance study of intraoeular inflam- mation secondary to ocular syphilis 显示文摘 | Mathew RG Goh BT Westeott MC | 2014 | Invest Ophthalmol Vis Sei2014，55，8： | 1 |
| 12 | Retroperitoneal liposarcomas, the experience of a tertiary Asian center显示文摘 | Lee SY Goh BK Teo MC | 2011 | World J Surg Oncol2011，9，1： | 1 |
| 13 | Retroperitoneal liposarcomas:theexperience of a tertiary Asian center显示文摘 | Lee SY Goh BK Tee MC | 2011 | WorldJ Surg Oncol2011，9，： | 1 |
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