***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 Alterations in the intestinal bacterial flora are believed to be contributing factors to many chronic inflammatory and degenerative diseases including rheumatic diseases . While microbiological fecal culture analysis is now increasingly used , little is known about the relationship of changes in intestinal flora , dietary patterns and clinical outcome in specific diseases . To clarify the role of microbiological culture analysis we aim ed to evaluate whether in patients with rheumatoid arthritis ( RA ) or fibromyalgia ( FM ) a Mediterranean diet or an 8-day fasting period are associated with changes in fecal flora and whether changes in fecal flora are associated with clinical outcome . Methods During a two-months-period 51 consecutive patients from an Integrative Medicine hospital department with an established diagnosis of RA ( n = 16 ) or FM ( n = 35 ) were included in the study . According to predefined clinical criteria and the subjects ' choice the patients received a mostly vegetarian Mediterranean diet ( n = 21 ; mean age 50.9 + /-13.3 y ) or participated in an intermittent modified 8-day fasting therapy ( n = 30 ; mean age 53.7 + /- 9.4 y ) . Quantitative aerob and anaerob bacterial flora , stool pH and concentrations of secretory immunoglobulin A ( sIgA ) were analysed from stool sample s at the beginning , at the end of the 2-week hospital stay and at a 3-months follow-up . Clinical outcome was assessed with the DAS 28 for RA patients and with a disease severity rating scale in FM patients . Results We found no significant changes in the fecal bacterial counts following the two dietary interventions within and between groups , nor were significant differences found in the analysis of sIgA and stool ph . Clinical improvement at the end of the hospital stay tended to be greater in fasting vs. non-fasting patients with RA ( p = 0.09 ) . Clinical outcome was not related to alterations in the intestinal flora . Conclusion Neither Mediterranean diet nor fasting treatments affect the microbiologically assessed intestinal flora and sIgA levels in patients with RA and FM . The impact of dietary interventions on the human intestinal flora and the role of the fecal flora in rheumatic diseases have to be clarified with newer molecular analysis techniques . The potential benefit of fasting treatment in RA and FM should be further tested in r and omised trials Background Chronic fatigue syndrome ( CFS ) is characterized by profound fatigue , which substantially interferes with daily activities , and a characteristic symptom complex . Patients use a variety of prescribed and self-administered medications , vitamins , and supplements for relief of their symptoms . The objective of this study was to describe utilization of medications and supplements by persons with CFS and non-fatigued individuals representative of the general population of Wichita , Kansas . Methods We used a r and om-digit  dialing telephone survey to identify persons with CFS in the general population of Wichita , Kansas . Subjects who on the basis of telephone interview met the CFS case definition , and r and omly selected non-fatigued controls , were invited for a clinic evaluation that included self-reported use of medications and supplements . Sex-adjusted odds ratios and 95 % confidence interval were estimated to measure the association between CFS and use of various drug categories . Results We clinical ly evaluated and classified 90 subjects as CFS during the study and also collected clinical data on 63 who never described fatigue . Subjects with CFS reported using 316 different drugs compared to 157 reported by non-fatigued controls . CFS subjects were more likely to use any drug category than controls ( p = 0.0009 ) .  Pain relievers and vitamins/supplements  were the two most common agents listed by both groups . In addition CFS persons were more likely to use pain relievers , hormones , antidepressants , benzodiazepines , gastro-intestinal , and central nervous system medications ( Sex-adjusted odds ratios range = 2.97 – 12.78 ) . Conclusion Although the reasons for increased use of these agents were not eluci date d , the data indicated the CFS patients ' need for symptom relief Objective : The impact on mood and memory of consuming a probiotic containing milk drink , or a placebo , was examined as , previously , a poor mood has been found to correlate with the frequency of constipation . Design : A double-blind placebo-controlled trial with r and om allocation of subjects . Setting : Subjects went about their normal life in the community apart from three visits to the laboratory . Subjects : One hundred and thirty-two healthy members of general population , mean age 61.8 years , volunteered in response to local media coverage . One hundred and twenty-four finished the trial . Intervention : For a 3-week period , either a probiotic containing milk drink , or a placebo , were consumed daily . Mood and cognition were measured at baseline , and after 10 and 20 days of consumption . Results : At baseline those who reported themselves to be less frequently constipated were more clearheaded , confident and elated . Although the taking of the probiotic did not generally change the mood , this appeared to be a reflection of the generally good mood in this sample . When those in the bottom third of the depressed/elated dimension at baseline were considered , they selectively responded by reporting themselves as happy rather than depressed after taking the probiotic . The intervention did not , however , influence the reported frequency of defaecation , probably a reflection of the initially low incidence of constipation . An unexpected and possibly chance finding was that the consumption of probiotics result ed in a slightly-poorer performance on two measures of memory . Conclusions : The consumption of a probiotic-containing yoghurt improved the mood of those whose mood was initially poor . This improvement in mood was not , however , associated with an increased frequency of defaecation . Sponsorship : Funded by Yakult , Japan In a previous clinical study , a probiotic formulation ( PF ) consisting of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 ( PF ) decreased stress-induced gastrointestinal discomfort . Emerging evidence of a role for gut microbiota on central nervous system functions therefore suggests that oral intake of probiotics may have beneficial consequences on mood and psychological distress . The aim of the present study was to investigate the anxiolytic-like activity of PF in rats , and its possible effects on anxiety , depression , stress and coping strategies in healthy human volunteers . In the pre clinical study , rats were daily administered PF for 2 weeks and subsequently tested in the conditioned defensive burying test , a screening model for anti-anxiety agents . In the clinical trial , volunteers participated in a double-blind , placebo-controlled , r and omised parallel group study with PF administered for 30 d and assessed with the Hopkins Symptom Checklist ( HSCL-90 ) , the Hospital Anxiety and Depression Scale ( HADS ) , the Perceived Stress Scale , the Coping Checklist ( CCL ) and 24 h urinary free cortisol ( UFC ) . Daily subchronic administration of PF significantly reduced anxiety-like behaviour in rats ( P < 0·05 ) and alleviated psychological distress in volunteers , as measured particularly by the HSCL-90 scale ( global severity index , P < 0·05 ; somatisation , P < 0·05 ; depression , P < 0·05 ; and anger-hostility , P < 0·05 ) , the HADS ( HADS global score , P < 0·05 ; and HADS-anxiety , P < 0·06 ) , and by the CCL ( problem solving , P < 0·05 ) and the UFC level ( P < 0·05 ) . L. helveticus R0052 and B. longum R0175 taken in combination display anxiolytic-like activity in rats and beneficial psychological effects in healthy human volunteers Background & objectives : Small intestinal bacterial overgrowth ( SIBO ) leads to several gastrointestinal ( GI ) problems and complications leading to malabsorption . The effectiveness of probiotics in the treatment of SIBO syndrome has not been well studied . This pilot study was aim ed to assess the efficacy of a probiotic consisting of lactobacilli in the treatment of SIBO . Methods : In this study , 30 cases suffering from chronic abdominal pain or diarrhoea and with a positive hydrogen breath test were r and omized in a double-blind manner into two groups : probiotic drug user and control group . After an initial 3-week aggressive therapy with broad-spectrum antibiotics , a 15-day maintenance antibiotic therapy with lactol was administered for the study group and the same regimen without lactol for the control group . After six months the HBT result and the GI symptoms were analyzed and compared between the two groups . Results : The result of hydrogen breath test and the clinical symptoms in patients receiving the maintenance regimen with lactol probiotic showed a better response . The hydrogen breath test turned negative in 93.3 per cent of those receiving lactol compared to 66.7 per cent of the controls . In all the cases receiving lactol , the abdominal pain disappeared completely ( P=0.002 ) . In addition , other GI problems including flatulence , belching and diarrhoea significantly improved in the study group ( P<0.05 ) . Interpretation & conclusions : Based on the preliminary data it seems that adding lactol probiotic to the maintenance therapy of small intestinal bacterial overgrowth patients on routine antibiotic therapy will be beneficial in preventing the complications of this syndrome Certain therapeutic microbes , including Bifidobacteria infantis ( B. infantis ) 35624 exert beneficial immunoregulatory effects by mimicking commensal-immune interactions ; however , the value of these effects in patients with non-gastrointestinal inflammatory conditions remains unclear . In this study , we assessed the impact of oral administration of B. infantis 35624 , for 6‒8 weeks on inflammatory biomarker and plasma cytokine levels in patients with ulcerative colitis ( UC ) ( n = 22 ) , chronic fatigue syndrome ( CFS ) ( n = 48 ) and psoriasis ( n = 26 ) in three separate r and omized , double-blind , placebo-controlled interventions . Additionally , the effect of B. infantis 35624 on immunological biomarkers in healthy subjects ( n = 22 ) was assessed . At baseline , both gastrointestinal ( UC ) and non-gastrointestinal ( CFS and psoriasis ) patients had significantly increased plasma levels of C-reactive protein ( CRP ) and the pro-inflammatory cytokines tumor necrosis factor α ( TNF-α ) and interleukin-6 ( IL-6 ) compared with healthy volunteers . B. infantis 35624 feeding result ed in reduced plasma CRP levels in all three inflammatory disorders compared with placebo . Interestingly , plasma TNF-α was reduced in CFS and psoriasis while IL-6 was reduced in UC and CFS . Furthermore , in healthy subjects , LPS-stimulated TNF-α and IL-6 secretion by peripheral blood mononuclear cells ( P BMC s ) was significantly reduced in the B. infantis 35624-treated groups compared with placebo following eight weeks of feeding . These results demonstrate the ability of this microbe to reduce systemic pro-inflammatory biomarkers in both gastrointestinal and non-gastrointestinal conditions . In conclusion , these data show that the immunomodulatory effects of the microbiota in humans are not limited to the mucosal immune system but extend to the systemic immune system Background Lactic acid-producing bacteria ( LAB ) probiotics demonstrate immunomodulating and anti-inflammatory effects and the ability to lessen the symptoms of  arthritis in both animals and humans . This r and omized , double-blind , placebo-controlled , parallel- design , clinical pilot trial was conducted to evaluate the effects of the LAB probiotic preparation , Bacillus coagulans GBI-30 , 6086 , on symptoms and measures of functional capacity in patients with rheumatoid arthritis ( RA ) in combination with pharmacological anti-arthritic medications . Methods Forty-five adult men and women with symptoms of RA were r and omly assigned to receive Bacillus coagulans GBI-30 , 6086 or placebo once a day in a double-blind fashion for 60 days in addition to their st and ard anti-arthritic medications .  Arthritis activity was evaluated by clinical examination , the American College of Rheumatology ( ACR ) criteria , the Stanford Health Assessment Question naire Disability Index ( HAQ-DI ) , and laboratory tests for erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) . Results Subjects who received Bacillus coagulans GBI-30 , 6086 experienced borderline statistically significant improvement in the Patient Pain Assessment score ( P = .052 ) and statistically significant improvement in Pain Scale ( P = .046 ) vs placebo . Compared with placebo , Bacillus coagulans GBI-30 , 6086 treatment result ed in greater improvement in patient global assessment and self-assessed disability ; reduction in CRP ; as well as the ability to walk 2 miles , reach , and participate in daily activities . There were no treatment-related adverse events reported throughout this study . Conclusions Results of this pilot study suggest that adjunctive treatment with Bacillus coagulans GBI-30 , 6086 LAB probiotic appeared to be a safe and effective for patients suffering 
    Output:
    
The administration of Lactobacillus casei strain Shirota in CFS patients , over the course of 8 weeks , reduced anxiety scores .
Likewise , this probiotic changed the faecal composition following 8 weeks of treatment .
Additionally , the treatment with Bifidobacterium infantis 35624 in CFS patients , during the same period , reduced inflammatory biomarkers .
The evidence about the usefulness of probiotics in CFS and FMS patients remains limited .
The studied strains of probiotics have demonstrated a significant effect on modulating the anxiety and inflammatory processes in CFS patients .