BackgroundIrritable bowel syndrome (IBS) is a functional disorder of the digestive tract that causes chronic abdominal symptoms. We evaluated the effects of Lactobacillus brevis KB290 (KB290), which has been demonstrated to be effective at improving bowel movements and the composition of intestinal microflora, on IBS symptoms.MethodsWe performed a placebo control double-blind cross matched trial. Thirty-five males and females (aged 6 years and above) who had been diagnosed with IBS according to the Rome III criteria were divided into 2 groups, and after a 4-week pre-trial observation period, they were administered test capsules containing KB290 or placebo for 4 weeks (consumption period I). Then, the capsule administration was suspended for 4 weeks in both groups (washout period), before the opposite capsules were administered for a further 4 weeks (consumption period II). Fecal samples were collected on the first day of the pre-consumption observation period, the last day of consumption period I, the last day of the washout period, and the last day of consumption period II. In addition, the subjects’ IBS symptoms and quality of life (QOL) and any adverse events that they experienced were evaluated.ResultsNo significant difference in IBS symptoms was noted among the various periods. However, the mean QOL scores were improved during the test capsule consumption.The frequencies of watery and mushy feces were significantly lower in the test capsule consumption period than during the pre-consumption observation period, and the frequency of abdominal pain was significantly reduced in the test capsule consumption period compared with the other periods.The frequency of the genus Bifidobacterium was significantly higher, and that of the genus Clostridium was significantly lower, after the test capsule consumption than after the placebo consumption. The frequencies of the genera Lactobacillus, Bacteroides, and Enterococcus were also investigated, but no differences in their frequencies were detected between the placebo and test capsule consumption periods.ConclusionsProbiotics, the safety of which has been established, are used widely in various foods and can now be purchased readily. The results of the present study suggest that KB290 is useful for early intervention in IBS.

Higher HFI in asymptomatic asthmatic children may indicate small airway obstruction. Additional ICS treatment may improve the pulmonary function indices representing small airway function with simultaneous HFI decreases in such patients.

This paper describes a 6-year-old boy with recurrent ileocecal intussusception due to lymphoid hyperplasia in the terminal ileum, which was diagnosed preoperatively by colonoscopy. At the age of 3 years, he developed diarrhea and a tender abdominal mass. He was diagnosed as having intussusception by ultrasound and was treated by hydrostatic barium enema. After resolution, he had three recurrent episodes of intussusception. A contrast barium enema revealed a small mass in the ileocecal region. Colonoscopy showed several exaggerated folds of the terminal ileum and a biopsy showed lymphoid hyperplasia. Because the repeated intussusception seemed to have been caused by the lymphoid hyperplasia in the terminal ileum, he underwent an ileocecal resection without any subsequent recurrence. Based on the above findings, we conclude that a colonoscopy may thus be useful both for diagnosing lymphoid hyperplasia in the terminal ileum as a cause of recurrent intussusception and for deciding how to manage it.

Background The detection of wheezes as an exacerbation sign is important in certain respiratory diseases. However, few highly accurate clinical methods are available for automatic detection of wheezes in children. This study aimed to develop a wheeze detection algorithm for practical implementation in children. Methods A wheeze recognition algorithm was developed based on wheezes features following the Computerized Respiratory Sound Analysis guidelines. Wheezes can be detected by auscultation with a stethoscope and using an automatic computerized lung sound analysis. Lung sounds were recorded for 30 s in 214 children aged 2 months to 12 years and 11 months in a pediatric consultation room. Files containing recorded lung sounds were assessed by two specialist physicians and divided into two groups: 65 were designated as "wheeze" files, and 149 were designated as "no-wheeze" files. All lung sound judgments were agreed between two specialist physicians. We compared wheeze recognition between the specialist physicians and using the wheeze recognition algorithm and calculated the sensitivity, specificity, positive predictive value, and negative predictive value for all recorded sound files to evaluate the influence of age on the wheeze detection sensitivity. Results The detection of wheezes was not influenced by age. In all files, wheezes were differentiated from noise using the wheeze recognition algorithm. The sensitivity, specificity, positive predictive value, and negative predictive value of the wheeze recognition algorithm were 100%, 95.7%, 90.3%, and 100%, respectively.

Background: In adolescence, physical symptoms may develop due to psychosocial problems, but such problems are not fully evaluated in school medical checkups. The aim of the study was to compare the characteristics of students with high and low scores on the Questionnaire for Triage and Assessment with 30 items (QTA30) in a school health checkup. Methods: The QTA30 (a self-completed questionnaire) was used in checkups for 3,414 students from the 5th grade of primary schools to the 3rd grade of junior high schools in south Wakayama Prefecture. The students were divided into groups with high (QTA30 ≥ 37) and low (QTA30 < 37) risk for psychosomatic disorder. Eleven items, including gender, grade, lifestyle habits, and life events, were compared between these groups, and in subgroups with and without recent absence from school. Results: The QTA30 response rate was 87.9%. The high-risk group had significantly more 3rd grade students (P < 0.001), females (P < 0.001), problems with teachers or friends (P < 0.001), and experience of bullying (P < 0.001), in addition to game playing for ≥2 h (P < 0.001), late bedtime (P < 0.001), and many absences (P < 0.001). Students in the high-risk group with no absences for 1 month regardless of age still had a late bedtime and problems with friends, and 76.4% of the high-risk students had not visited a medical institution. Conclusions: Use of the QTA30 facilitated detection of psychosomatic stress in school medical checkups, with latent risks of truancy detectable at an early phase. The QTA30 may thus be useful in early intervention for psychosomatic stress of adolescents.