Efficacy and Safety of a Probiotic Containing Saccharomyces boulardii CNCM I-745 in the Treatment of Small Intestinal Bacterial Overgrowth in Decompensated Cirrhosis: Randomized, Placebo-Controlled Study

(1) Background: The aim was to evaluate the effectiveness of the probiotic containing Saccharomyces boulardii in the treatment of small intestinal bacterial overgrowth (SIBO) in patients with decompensated cirrhosis. (2) Methods: This was a blinded, randomized, placebo-controlled study. (3) Results: After 3 months of treatment, SIBO was absent in 80.0% of patients in the probiotic group and in 23.1% of patients in the placebo group (p = 0.002). The patients with eliminated SIBO had decreased frequency of ascites and hepatic encephalopathy, the increased platelets and albumin levels, the decreased blood levels of total bilirubin, biomarkers of bacterial translocation (lipopolysaccharide [LPS]) and systemic inflammation (C-reactive protein), and positive changes in markers of hyperdynamic circulation compared with the state at inclusion. There were no significant changes in the claudin 3 level (the intestinal barrier biomarker) in these patients. No significant changes were observed in the group of patients with persistent SIBO. The serum level of nitrate (endothelial dysfunction biomarker) was lower in patients with eradicated SIBO than in patients with persistent SIBO. One (5.3%) patient with eradicated SIBO and six (42.9%) patients with persistent SIBO died within the first year of follow-up (p = 0.007). (4) Conclusions: SIBO eradication was an independent predictor of a favorable prognosis during the first year of follow-up.

Quality and safety management at bakeries

For bakeries, the main task is to produce bread of the best quality. In order to do this, the company must control the batches of incoming raw materials, semi-finished products and finished products. The quality of bread is a set of characteristics that determine the consumer properties of food products and ensure safety for humans. The use of the HACCP system is currently mandatory and is of great importance in the field of food production. JSC “Saratov bakery named after I.K. Struzhkin” is the main supplier of bakery products in Saratov and the Saratov region. In the work, a survey of all stages of the technological process of the production of bakery products of the therapeutic and preventive direction was carried out, quality management systems were analyzed. Control critical points have been identified, a package of documents and a plan for the implementation of the HACCP system at the Saratov Bakery named after I.K. Struzhkin JSC have been prepared.