Daniel Leek Memorial Research Scholarship

Congratulations to Bastyr student, Joshua Goldenberg who took home the first $1000 annual Daniel Leek Memorial Research Scholarship for his updated Cochrane meta-analysis titled, "Probiotics to Prevent Pediatric Antibiotic Associated Diarrhea." The 2011 scholarship was held in conjunction with the Student Research Hall at the NMSA Student Conference on Sunday, August 21st in Phoenix, AZ.

Probiotics to Prevent Pediatric Antibiotic Associated Diarrhea - an updated Cochrane meta-analaysis

Presented by Joshua Goldenberg

Background

Antibiotics prescribed to children may often result in antibiotic-associated diarrhea (AAD). Probiotics may prevent AAD via restoration of the gut microflora. This Cochrane Review Update uses meta-analysis to attempt to assess the efficacy and adverse effects of probiotics for the prevention of pediatric AAD. 

Methods

MEDLINE, EMBASE, CENTRAL, CINAHL, AMED, and the Web of Science (inception to August 2010) were searched along with specialized registers. Only RCTs comparing co-administered probiotics with antibiotics for the prevention of AAD in children (0 to 18 years) were selected. Data extraction and methodological quality assessment was conducted independently and in duplicate by reviewers. Dichotomous data were combined using pooled relative risk or risk difference, and continuous data using weighted mean differences. To explore possible explanations for heterogeneity, subgroup analysis were conducted on probiotic strain, dose, definition of AAD, antibiotic agent, and risk of bias.

Results

Sixteen studies met the inclusion criteria. The complete case analysis for 15/16 trials reporting on the incidence of diarrhea show statistically significant results favoring probiotics over active/non active controls (RR 0.52; 95% CI 0.38 to 0.72). Eleven of the sixteen trials that monitored for adverse events (n = 1583) exhibited a risk difference of 0.00 (95% CI -0.01 to 0.02), with none reporting a serious adverse event.

Conclusions

Probiotics show promise for the prevention of pediatric AAD. Complete case and as randomized analyses yielded statistically significant treatment effect estimates. Despite heterogeneity in probiotic strain, dose, duration, and study quality, the overall evidence supports the protective effect of probiotics in preventing pediatric AAD.  A test for heterogeneity indicates that high (> or = 5 billion colony forming units (CFU)/day) vs. low probiotic dose (< 5 billion CFU/day) explains some of the statistical heterogeneity. Using 11 criteria to evaluate the credibility of the subgroup analysis on probiotic dose, results indicate that this subgroup effect is credible. Although more refined trials are needed, probiotic strains and doses with the most promising evidence (e.g., Lactobacillus rhamnosus, Saccharomyces boulardii at 5-40 billion CFU/day) should be considered for use. 

JOSHUA Z. GOLDENBERG is a naturopathic medical student at Bastyr University. He has been involved in multiple research projects as a student but is currently most fascinated by research methodology, specifically as it relates to CAM. He is founder and director of the Bastyr Student Research Society, RESULTS (a research journal club), and Stats-Brats (a biomedical statistics group). He is also the student representative to the N-PREP research education board at Bastyr. Clinically he is most interested in end of life care and geriatrics as well as counseling, mind/body and botanical medicine.
 

About Dan, the inspiration

Daniel Leek grew up in Rockford, Illinois. He attended Southern Illinois University and earned Bachelor's of Arts Degrees in Psychology, Chemistry, and Physiology. While an undergraduate student Dan followed his interests by attaining employment as a junior researcher in various university laboratories. He worked in a soybean genomics laboratory under Dr. David Lightfoot, and in a neuroendocrinology laboratory under Dr. Laura Murphy. Upon graduation Daniel took employment as a Researcher I under Dr. Jianjun Wang doing proteomics research full-time. After two years of experience Daniel took a Researcher II role in the proteomics laboratory of Dr. Larry Tobacman at the University of Illinois in Chicago.

These laboratory experiences served Daniel well in his role as a medical student at the Southwestern College of Naturopathic Medicine. His goal was to merge his two passions: research and naturopathic medicine. Daniel went well above and beyond the requirements of his studies again as he worked with Dr's Langland and Waters on research projects at both SCNM and Arizona State University's Biodesign Institute. Dan presented to the American Association of Naturopathic Physicians conference on several occasions, and won the prestigious student research award during the August 2010 conference. His hope was to apply "hard science" to the field of herbal medicine.

Aside from his academic accomplishments, Daniel was known for his endearing eccentricities. He enjoyed dressing up as a pirate for costume parties and he always said goodbye  with a "sun and moon" bow with which he clenched his right hand into a fist, and covered his fist with the open palm of his left hand as a symbol of respect and peace. An avid martial artist, Daniel was often seen swinging the bow staff, nun-chucks, or swords. Daniel was a prolific reader of world philosophies, science, and religion. He treated anyone willing to enlightening conversations. While his life was cut short, his memory shall not.

This $1000 scholarship is awarded annually at the NMSA Student conference.

DANIEL LEEK MEMORIAL SCHOLARSHIP ELIGIBILITY
•       All students whose research is accepted to the NMSA’s Research Hall and submit the .pdf of their poster by in advance of the Research Hallwill be considered for the Daniel Leek Scholarship
•       The recipient of the Daniel Leek Scholarship will display excellence and innovation in naturopathic research, clear research objectives, and demonstrate enthusiasm for sharing their knowledge with others.
•       While attendance at the Research Hall on at the NMSA Student Conference is recommended, it is not required to be awarded the $1000 scholarship.
•       The scholarship recipient will be announced at the NMSA Student Conference to be held in Bellevue, WA in 2012.