Background Percutaneous electrical nerve field stimulation (PENFS) improves symptoms in adolescents with functional abdominal pain disorders (FAPDs). However, little is known about its impact on sleep and psychological functioning. We evaluated the effects of PENFS on resting and evoked pain and nausea, sleep and psychological functioning, and long‐term outcomes. Methods Patient ages 11–19 years with FAPD requiring PENFS as standard care were recruited. Evoked pain was elicited by a Water Load Symptom Provocation Task (WL‐SPT) before and after four weeks of treatment. Pain, gastrointestinal symptoms, sleep, somatic symptoms, and physical and psychological functioning were assessed. Actigraphy was used to measure daily sleep–wake patterns. Key Results Twenty patients (14.3 ± 2.2 years old) with FAPD were enrolled. Most patients were females (70%) and white (95%). During pain evoked by WL‐SPT, visual analog scale (VAS) pain intensity and nausea were lower following PENFS compared with baseline (p = 0.004 and p = 0.02, respectively). After PENFS, resting VAS pain unpleasantness (p = 0.03), abdominal pain (p < 0.0001), pain catastrophizing (p = 0.0004), somatic complaints (0.01), functional disability (p = 0.04), and anxiety (p = 0.02) exhibited significant improvements, and some were sustained long‐term. Self‐reported sleep improved after PENFS (p's < 0.05) as well as actigraphy‐derived sleep onset latency (p = 0.03). Conclusions and Inferences We demonstrated improvements in resting and evoked pain and nausea, sleep, disability, pain catastrophizing, somatic complaints, and anxiety after four weeks of PENFS therapy. Some effects were sustained at 6–12 months post‐treatment. This suggests that PENFS is a suitable alternative to pharmacologic therapy.

Human milk is considered the optimal nutrition for infants and found to contain significant numbers of viable bacteria. The aim of the study was to assess the effects of a specific synbiotic combination at doses closer to the bacterial cells present in human milk, on intestinal bifidobacteria proportions (relative abundance), reduction of potential pathogens and gut physiological conditions. A clinical study was conducted in 290 healthy infants aged from 6 to 19 weeks. Infants received either a control infant formula or one of the two investigational infant formulas (control formula with 0.8 g/100 ml scGOS/lcFOS and Bifidobacterium breve M-16V at either 1 × 104 cfu/ml or 1 × 106 cfu/ml). Exclusively breastfed infants were included as a reference. Analyses were performed on intention-to-treat groups and all-subjects-treated groups. After 6 weeks of intervention, the synbiotics at two different doses significantly increased the bifidobacteria proportions in healthy infants. The synbiotic supplementation also decreased the prevalence (infants with detectable levels) and the abundance of C. difficile. Closer to the levels in the breastfed reference group, fecal pH was significantly lower while l-lactate concentrations and acetate proportions were significantly higher in the synbiotic groups. All formulas were well tolerated and all groups showed a comparable safety profile based on the number and severity of adverse events and growth. In healthy infants, supplementation of infant-type bifidobacterial strain B. breve M-16V, at a dose close to bacterial numbers found in human milk, with scGOS/lcFOS (9:1) created a gut environment closer to the breastfed reference group. This specific synbiotic mixture may also support gut microbiota resilience during early life.Clinical Trial Registration This clinical study named Color Synbiotics Study, was registered in ClinicalTrials.gov on 18 March 2013. Registration number is NCT01813175. https://clinicaltrials.gov/ct2/show/NCT01813175.

The gastrocolonic response (GCR), often referred to as gastrocolonic reflex, describes a physiologic increase in motor activity of the colon following meal ingestion, which was first described by Cannon in 1902, with the term GCR being proposed by Hertz a few years later. 1,2 The increase in colonic motor activity from baseline maybe subtle or more pronounced, mostly in younger children, resulting in high amplitude propagated contractions (HAPC). 3 The response propagates fecal content and gas throughout the colon and allows new intestinal content to enter the colon. It is typically noted within minutes after meal ingestion. 4 This physiologic response is used as a marker of an intact neuromuscular interaction between the central and enteric nerval system (ENS) in colonic manometry studies. 5 The exact stimuli and pathway of the GCR remain unclear. The vagus nerve was shown to have a stimulatory effect on the GCR. 6 The GCR is evoked by gastric distention and by lipid infusion into the

Introduction Acute gastroenteritis (AGE) is a common problem causing significant mortality and morbidity among children. In clinical settings, zinc deficiency leads to diminished resistance to infectious disorders including acute gastroenteritis, especially in the pediatric populations. Purpose This study aimed to identify the possible effect of body zinc depletion on the severity of acute gastroenteritis among children. The parameters included dehydration status estimated by Modified Vesikari Score (MVS), laboratory findings, amount of intravenous (IV) fluid requirement, need of medications, as well as a clinical course of illness. Materials and Methods We conducted a prospective observational study with 107 children 3 months to 5 years old with AGE that were admitted to an inpatient unit. A comparison was made between children with normal (≥80 μg/dL: n=79 cases) and low serum zinc levels (<80 μg/dL, n=28 cases). Results The definite zinc deficiency (<60 μg/dL) was demonstrated only in 3.7% of cases. The severity of dehydration, classified by MVS, reveals a significantly higher increase in children with low serum zinc levels (12.13 ± 2.4 vs 13.14 ± 1.86 points, p < 0.045). Additionally, the children with low serum zinc levels had a significantly higher number of prolonged vomiting episodes more than 24 hours (42.4% vs 72%, p = 0.013) and three cases of post-gastroenteritis complications, which are prolonged fever and persistent diarrhea, were identified only among patients with low zinc levels (p = 0.003). However, there was no significant difference in IV fluid requirement, a need for medications, as well as the duration of hospitalization between the groups. Conclusion A significantly higher dehydration score, which was assessed by MVS, was demonstrated in the participants with low serum zinc levels. Furthermore, the number of children with prolonged vomiting as well as the evidence of post-gastroenteritis complications was also significantly higher in this group.