Prophylactic strategies

The functionality and therefore definition of a probiotic is largely dependent on the animal production system in which it will be used. Fuller s widely cited definition of a probiotic as a live microbial feed supplement which beneficially affects the host animal by improving its intestinal balance (Fuller, 1989) is too narrow for aquaculture production systems because aquatic animals are intimately associated with their ambient environment. Hence, microbial-induced improvements to the host ectobiota or host external environments may also be considered probiotic (Verschuere et al, 2000). In their review, Irianto and Austin (2002) defined an aquaculture probiont as an entire or component(s) of a microorganism that is beneficial to the health of the host . This all-encapsulating definition includes probiotic action on both internal and external environments, and introduces the prospect of microbial components, such as peptidoglycan and lipopoly-saccharides, acting as immunostimulants (Smith et aL, 2003). 

Antagonism is a widespread trait among marine bacterial genera and is implicated in competitive interactions and ecological success of microorganisms (Kalinovskaya et al, 2003 Gram et al, 2010 Wietz et al, 2010  

There are many listings in the literature where antagonistic isolates or their products have conferred a protective benefit or enhanced survival of larval and post-larval crustaceans (Ravi et al, 2(X)7 Guo et al, 2009 Swain et al, 2009 Pai et al, 2010) and molluscs (Ruiz-Ponte et al, 1999 Riquelme et al, 2001 Longeon et al, 2(X)4 Kesarcodi-Watson et al, 2010). These studies indicate that a diversity of genera, including Alteromonas, Arthro-bacter. Bacillus, Enterococcus, Neptunomonas, Phaeobacter, Pseudomonas, Pseudoalteromonas, Roseobacter, Streptococcus, Thalassobacter and Vibrio, harbour strains with probiotic potential. 

The microbiota associated with larval hosts are good reservoirs of antagonistic bacteria (Hjehn et al, 20M FjeUheim et al, 2007) and represent logical micro-environments in which to conduct initial searches for 

Prebiotics are nutrients in the environment that simulate the growth and/ or activity of bacteria that are beneficial to the health of the host. It is now established, at least in humans, that specific areas of the body, such as skin, oral cavity, oesophagus and gastrointestinal tract, are micro-environments 

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Prevention of tumor lysis syndrome generally is achieved by increasing the urine output and preventing accumulation of uric acid. Prophylactic strategies should begin immediately on presentation, preferably 48 hours prior to cytotoxic therapy. Treatment modalities primarily increase uric acid solubility, address electrolyte disturbances, and support renal output. 

It is becoming increasingly evident that prevention of relapse, as well as adequate prophylactic strategies for patients with major mood disorders, are much more complicated than was originally assumed. Factors that contribute to this situation include the following ... 

M2. Marutsuka, T., Shimada, S., Shiomori, K., Hayashi, N., Yagi, Y., Yamane, T., et al.. Mechanisms of peritoneal metastasis after operation for non-serosa-invasive gastric carcinoma An ultrarapid detection system for intraperitoneal free cancer cells and a prophylactic strategy for peritoneal metastasis. Clin. Cancer Res. 9, 678-685 (2003). 

Steiert, A., Boyce, M., Sorg, H., 2013. Capsular contracture by silicone breast implants possible causes, bioeompatibility, and prophylactic strategies. Med. Devices (Auckl.) 6, 211-218. 

We would also suggest prophylactic concomitant bromocriptine for several weeks, with gradual tapering after that time period. Such prophylactic approaches during the retreatment phase have been attempted in a few patients, but there are no controlled studies. Nevertheless, it seems like a sensible strategy and poses little additional risk. 

For more than 40 years, lithium has been the standard drug therapy for bipolar disorder, primarily because of the quantity and the quality of evidence supporting its role as an effective maintenance and prophylactic treatment. This latter point is a very important consideration, given the recurrent nature of this disorder. Thus, clinicians must choose the optimal strategy for acute treatment with the realization that most patients will need to continue drug therapy indefinitely. In addition, there is support for maintenance lithium s beneficial impact on the suicide rate in bipolar patients ( 73, 74). The author of these reports notes that the lower suicide risk associated with lithium treatment may be due to the following ... 

The management of hyperthyroidism due to amiodarone has been reviewed in the light of the practices of 101 European endocrinologists (60). Most (82%) treat type I amiodarone-induced hyperthyroidism with thionamides, either alone (51%) or in combination with potassium perchlorate (31%) the preferred treatment for type II hyperthyroidism is a glucocorticoid (46%). Some initially treat all cases, before the type has been established, with a combination of thionamides and glucocorticoids. After restoration of normal thyroid function, 34% recommend ablative therapy in type I hyperthyroidism and only 8% in type II. If amiodarone therapy needs to be restarted, 65% recommend prophylactic thyroid ablation in type I hyperthyroidism and 70% recommend a wait-and-see strategy in type II. 

From the variety of experimental studies it becomes obvious that mucosal administration is a powerful tool for modulating immune responses. Apart from the importance to test the effectiveness and the mechanisms of action of any allergen of interest as a potential antiallergic agent or tolerogen in animal models, prophylactic treatment strategies could be of interest in patients with a known risk to develop allergy. 

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