***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier . We have previously shown that a human intestinal floral strain , Lactobacillus GG ( ATCC 53103 ) , promotes local antigen-specific immune responses ( particularly in the IgA class ) , prevents permeability defects , and confers controlled antigen absorption . OBJECTIVE The aim of this study was to evaluate the clinical and immunologic effects of cow 's milk elimination without ( n = 14 ) and with ( n = 13 ) the addition of Lactobacillus GG ( 5 x 10(8 ) colony-forming units/gm formula ) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow 's milk allergy . The second part of the study involved 10 breast-fed infants who had atopic eczema and cow 's milk allergy . In this group Lactobacillus GG was given to nursing mothers . METHODS The severity of atopic eczema was assessed by clinical scoring . The concentrations of fecal alpha 1- antitrypsin , tumor necrosis factor-alpha , and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention . RESULTS The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG . The concentration of alpha 1-antitrypsin decreased significantly in this group ( p = 0.03 ) but not in the group receiving the whey formula without Lactobacillus GG ( p = 0.68 ) . In parallel , the median ( lower quartile to upper quartile ) concentration of fecal tumor necrosis factor-alpha decreased significantly in this group , from 709 pg/gm ( 91 to 1131 pg/gm ) to 34 pg/gm ( 19 to 103 pg/gm ) ( p = 0.003 ) , but not in those receiving the extensively hydrolyzed whey formula only ( p = 0.38 ) . The concentration of fecal eosinophil cationic protein remained unaltered during therapy . CONCLUSION These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy , and by alleviating intestinal inflammation , may act as a useful tool in the treatment of food allergy BACKGROUND Oral administration of live Lactobacillus casei strain GG is associated with the reduction of duration of diarrhea in children admitted to the hospital because of diarrhea . The purpose s of this work were to investigate the clinical efficacy of oral administration of Lactobacillus in children with mild diarrhea who were observed as out patients , and to see whether Lactobacillus GG can reduce the duration of rotavirus excretion . METHODS Duration of diarrhea was recorded in 100 children seen by family pediatricians and r and omly assigned to receive oral rehydration or oral rehydration followed by the administration of lyophilized Lactobacillus casei , strain GG .  Rotavirus was looked for in the stools of all children and in those in whom results were positive , stools were examined again 6 days after the onset of diarrhea . RESULTS In 61 children results were positive for rotavirus and in 39 results were negative . Duration of diarrhea was reduced from 6 to 3 days in children receiving Lactobacillus GG , with a similar pattern in rotavirus-positive and -negative children . Six days after the onset of diarrhea , stools in only 4 out of 31 children that received Lactobacillus GG were positive for rotavirus compared with positive findings in 25 out of 30 control subjects . CONCLUSIONS Oral administration of Lactobacillus GG is effective in rotavirus-positive and rotavirus-negative ambulatory children with diarrhea . Furthermore , it reduces the duration of rotavirus excretion A prospect i ve , placebo controlled , triple blind clinical trial was undertaken in Thail and to determine the effect of Lactobacillus GG on recovery from acute diarrhoea in children . Thirty-nine children ( mean age = 8 months ) were enrolled and following rehydration received either oral Lactobacillus GG ( n = 20 ) as a freeze-dried preparation or placebo ( n = 19 ) twice daily for 2 days . The clinical characteristics of the study groups were similar . There was no significant difference overall in clinical response detected between the study groups . When only those with acute non-bloody diarrhoea ( n = 26 ) were considered , the mean duration of diarrhoea was significantly shorter in the lactobacillus group ( 1.9 days ) than in the placebo group ( 3.3 days ) ( P < 0.055 ) . Stool frequency was less on the second day in the lactobacillus group ( P < 0.05 ) . The results suggest that Lactobacillus GG accelerates  recovery  from acute watery diarrhoea in young children in a tropical setting A placebo-controlled double-blind study was conducted on the efficacy of Lactobacillus GG in preventing  travellers ' diarrhoea . Altogether 820 persons travelling on holiday to southern Turkey to two destinations were r and omized into two groups receiving either Lactobacillus GG or placebo in identical sachets . On the return flight each participant completed a question naire indicating the incidence of diarrhoea and related symptoms during the trip . Of the original group 756 ( 92 % ) subjects completed the study acceptably . The overall incidence of diarrhoea was 43.8 % ( 331 cases ) . The total incidence of diarrhoea in the placebo group was 46.5 % and in the Lactobacillus GG 41.0 % indicating an overall protection of 11.8 % . Protection rates varied between two different destinations with the maximum protection rate reported as 39.5 % . Among older age groups there was significantly less diarrhoea when compared to younger travellers . Lactobacillus GG appeared to be effective in reducing the occurrence of travellers ' diarrhoea in one of the two destinations with no side effects OBJECTIVE Nosocomial diarrhea is a major problem in pediatric hospitals worldwide . We evaluated the efficacy of orally administered Lactobacillus GG ( LGG ) in the prevention of this disease in young children . STUDY DESIGN Eighty-one children aged 1 to 36 months who were hospitalized for reasons other than diarrhea were enrolled in a double-blind trial and r and omly assigned at admission to receive LGG ( n = 45 ) at a dose of 6 x 10(9 ) colony-forming units or a comparable placebo ( n = 36 ) twice daily orally for the duration of their hospital stay . RESULTS LGG reduced the risk of nosocomial diarrhea ( > or =3 loose or watery stools/24 h ) in comparison with placebo ( 6.7 % vs 33.3 % ; relative risk : 0.2 ; [ 95 % CI : 0.06 - 0.6 ] ; number needed to treat : 4 [ 95 % CI : 2 - 10 ] ) . The prevalence of rotavirus infection was similar in LGG and placebo groups ( 20 % vs 27.8 % , respectively ; relative risk : 0.72 ; 95 % CI : 0.33 - 1.56 ) . However , the use of LGG compared with placebo significantly reduced the risk of rotavirus gastroenteritis ( 1/45 [ 2.2 % ] vs 6/36 [ 16.7 % ] , respectively ; relative risk : 0.13 ; 95 % CI : 0.02 - 0.79 ; number needed to treat : 7 ; 95 % CI : 3 - 40 ) . CONCLUSIONS Prophylactic use of LGG significantly reduced the risk of nosocomial diarrhea in infants , particularly nosocomial rotavirus gastroenteritis BACKGROUND Addition of a medication to the World Health Organization protocol for treatment of acute diarrhea in children is controversial . In this trial , the clinical efficacy of a medication ( Lactéol Fort sachets ; Laboratoire du Lactéol du Docteur Boucard , Houdan France ) containing lyophilized heat-killed Lactobacillus acidophilus LB was assessed as an adjunct to oral rehydration therapy . METHODS Children aged 3 to 24 months with acute diarrhea and mild or moderate dehydration were enrolled in the study . Children received oral rehydration therapy for the first 4 hours . After this first rehydration phase , undiluted milk formula or breast milk was fed alternately with oral rehydration solution . Children were fed rice gruel as tolerated . They received either one sachet containing 10 billion of lyophilized heat-killed L. acidophilus LB or placebo at admission and at 12-hour intervals for five doses . RESULTS Seventy-three children ( 37 L. acidophilus LB , 36 placebo ) were enrolled , of whom 40 ( 17 L. acidophilus LB , 23 placebo ) received an antibiotic before inclusion . Rotavirus was identified in approximately 50 % of the children in each group . After 24 hours of treatment , the number of rotavirus-positive children with watery stools was significantly lower ( p = 0.012 ) in the L. acidophilus LB group . Mean duration of diarrhea was decreased ( p = 0.034 ) with L. acidophilus LB ( 43.4 hours ) versus placebo ( 57.0 hours ) . This decreased duration was particularly marked in children with no antibiotic therapy before inclusion ( 31.1 hours ) : 42.9 hours for the L. acidophilus LB group versus 74.0 hours for the placebo group ( p = 0.016 ) . CONCLUSIONS Addition of L. acidophilus LB to oral rehydration therapy was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea OBJECTIVE Lactobacillus GG ( L-GG ) , an acid- and bile-resistant strain that colonizes the intestinal mucosa , has been used to manage diarrhea in children . Our objective was to evaluate the prophylactic use of L-GG to prevent diarrhea in children at high risk from a developing country in a r and omized , placebo-controlled trial . STUDY DESIGN Two hundred four undernourished children 6 to 24 months old from an indigent peri-urban Peruvian town received either L-GG or placebo in flavored gelatin once daily , 6 days a week , for 15 months . Episodes of diarrhea were documented by daily home visits , and diagnostic studies were done in a subset of cases . Recovery of L-GG in stool from subjects and from family contacts was examined . RESULTS Subjects in the L-GG group had significantly fewer episodes of diarrhea ( 5.21 episodes diarrhea/child/year [ ' ecy ' ] L-GG group , 6 . 02 ecy placebo group ; P = .028 ) . The decreased incidence of diarrhea in the L-GG group was greatest in the 18- to 29-month age group ( P = . 004 ) and was largely limited to nonbreastfed children ( Breastfed : 6 . 59 ecy L-GG , 6.32 ecy placebo , P = .7 ; Nonbreastfed : 4.69 ecy L-GG , 5 . 86 ecy placebo , P = .005 ) . The duration of diarrhea episodes and the causes of diarrhea were similar in both groups , except adenovirus was more common in the placebo group . CONCLUSION L-GG supplementation may be useful as a prophylactic measure to control diarrhea in undernourished children at increased risk , especially nonbreastfed children in the toddler age group Background . Oral bacteriotherapy promotes recovery from acute childhood diarrhea , but few strains have been shown to have therapeutic potentials . We examined the effect of two newly identified probiotic Lactobacillus strains in acute childhood diarrhea .  Methods . Sixty-nine children were r and omized during hospitalization for acute diarrhea to receive a mixture of Lactobacillus rhamnosus 19070 - 2 and Lactobacillus reuteri DSM 12246 , 1010 colony-forming units of each strain or placebo twice daily for 5 days . Before selection of these stains their potential probiotic characteristics were demonstrated in vitro and in healthy volunteers . Results . In patients receiving probiotics , the diarrheal phase was reduced by 20 % . The duration of diarrhea was 82 h in the treatment group vs. 101 h in the control group ( not significant , P = 0.07 ) . However , 3 of 30 patients from the treatment group vs. 13 of 39 from the control group still had loose stools at the end of the study period ( P = 0.03 ) . In patients with diarrhea for < 60 h before start of treatment ( early intervention ) , a clear effect of the probiotics was demonstrated ( 80 h in the treatment group vs. 130 h in the control group , P = 0.003 ) . After early intervention , the length of hospitalization was reduced by 48 % ( 3.5 vs. 
    Output:
    
Probiotics are remarkably safe .
This was true no matter what probiotic was used .
Lactobacillus GG was the most extensively studied probiotic for this condition .
In conclusion , probiotics are safe and effective in the prevention and treatment of watery diarrhea .
They are especially effective in children under the age of 5 with Rotavirus infection .
Lactobacillus GG is the most extensively studied probiotic .