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In another study, a randomized clinical study of 28 participants supplemented with the probiotic Lactobacillus casei Shirota to evaluate the impact on metabolic syndrome, reported the enrichment of the genus Parabacteroides of the Porphyromonadaceae family 23 , supporting the possibility that probiotic supplementation during antibiotic treatment may have increased the relative amount of the family Porphyromonadaceae in our study

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However, completely absent progress after 8-12 weeks suggests either ineffective protocol or injury severity beyond peptide intervention requiring medical evaluation