RESUMO
Probiotic-containing fermented dairy foods have the potential to benefit human health, but the importance of the dairy matrix for efficacy remains unclear. We investigated the capacity of Lacticaseibacillus casei BL23 in phosphate-buffered saline (BL23-PBS), BL23-fermented milk (BL23-milk), and milk to modify intestinal and behavioral responses in a Dextran Sodium Sulfate (DSS, 3% w/v) mouse model of colitis. Significant sex-dependent differences were found such that female mice exhibited more severe colitis, greater weight loss, and higher mortality rates. Sex differences were also found for ion transport ex vivo, colonic cytokine and tight junction gene expression, and fecal microbiota composition. Measurements of milk and BL23 effects showed BL23-PBS consumption improved weight recovery in females, while milk resulted in better body weight recovery in males. Occludin and Claudin-2 gene transcript levels indicated barrier function was impaired in males, but BL23-milk was still found to improve colonic ion transport in those mice. Pro-inflammatory and anti-inflammatory gene expression levels were increased in both male and female mice fed BL23, and to a more variable extent, milk, compared to controls. The female mouse fecal microbiota contained high proportions of Akkermansia (average of 18.1%) at baseline, and females exhibited more changes in gut microbiota composition following BL23 and milk intake. Male fecal microbiota harbored significantly more Parasutterella and less Blautia and Roseburia after DSS treatment, independent of BL23 or milk consumption. These findings show the complex interplay between dietary components and sex-dependent responses in mitigating inflammation in the digestive tract.
RESUMO
BACKGROUND: Simulation-based medical education has been shown to produce substantial educational benefits; however, the integration and effectiveness of high-fidelity simulation within the internal medicine (IM) clerkship remains largely unexplored. Investigators sought to determine the effectiveness of simulation in improving student confidence in acute coronary syndrome (ACS) and the Advanced Cardiac Life Support (ACLS) curriculum. Secondary goals included examining student perceptions of the role of simulation in medical education. METHODS: Investigators implemented a formative high-fidelity simulation curriculum in the IM clerkship at a large teaching institution. Third-year medical students enrolled in the IM clerkship between January and June 2014 attended a simulation course during their ambulatory block. Following a 2-hour session, participants completed a 17-item questionnaire. Descriptive statistical analyses and a thematic qualitative analysis were performed. Integration of high-fidelity simulation within the internal medicine clerkship remains largely unexplored RESULTS: The response rate was 100 per cent (n = 43). Students reported improvements in their ability to identify and manage ACS and ACLS before and after the simulation course: 93 per cent felt that simulation boosted their self-confidence in performing these tasks on a real patient; 86 per cent reported receiving useful feedback during the training sessions; 98 per cent agreed that their experience was enjoyable; and 95 per cent would recommend this course to other students. CONCLUSIONS: Internal medicine (IM) clerkship students participating in our pilot course demonstrated increased confidence in identifying and managing pathologies associated with ACS and arrhythmias. Students viewed simulation as an engaging and useful activity, desiring additional training sessions.
