Coronavirus Infections ; epidemiology ; prevention & control ; transmission ; Global Health ; Humans ; Middle East Respiratory Syndrome Coronavirus

Objectives: Poor sleep is associated with adverse outcomes during childhood. Behavioral insomnia is the most common sleep difficulty experienced by children. The coronavirus disease 2019 (COVID-19) global pandemic in 2020 has profoundly affected children’s sleep patterns. This project aimed to evaluate a one-toone sleep service delivered via online clinics by community sleep practitioners in the UK. Methods: This was an observational pre- and post-evaluation study over a 12-month period. The intervention derived from aspects of cognitive-behavioral therapy for insomnia. The evaluation was questionnaire-based and assessed sleep parameters and well-being. Results: 104 parents returned completed questionnaires. The average time of sleep onset was 1 hour and 39 minutes pre-intervention and 20 minutes post-intervention. The average number of nights per week that children woke up was 3.9 pre-intervention and 0.9 post-intervention; the number of night awakenings fell from 1.9 to 0.5 and the time that children were awake after sleep onset fell from 66.8 minutes to 5.8 minutes. The average time that children were asleep was 8.0 hours per night pre-intervention and 10.2 hours post-intervention. The improvement in all sleep parameters was statistically significant (p<0.05). All parameters of parental and children’s well-being improved significantly (p<0.05), except for perceived ability to drive (p=0.07). All parents stated that they would recommend sleep support and 20% already had done so. Conclusions The COVID-19 pandemic has accelerated the development of remote health care solutions, and in the case of children’s sleep clinics, the online mode of intervention delivery that is as effective, acceptable, and accessible as face-to-face delivery.

Background/Aims: Chronic intestinal pseudo-obstruction (CIPO) is a rare cause of intestinal dysmotility. First-line treatment in adult patients is medical and nutritional therapy. For patients who fail these treatment options, surgical interventions may be an option. In this scoping review, we aim to investigate the current research on surgical interventions for CIPO in adults. Methods: PubMed, Embase, and Scopus were queried for articles related to surgical interventions for adults with CIPO. Search terms included:intestinal dysmotility, intestinal pseudo-obstruction, global intestinal dysmotility, chronic intestinal pseudo-obstruction, gastrointestinal paresis, neurogastrointestinal motility disorder, and chronic small intestinal motility disorder. Results: Initial search identified 4763 records; 4722 were deemed irrelevant after screening and were excluded. The remaining 41 reports were retrieved and assessed for eligibility. Twenty-one additional studies were excluded after in-depth assessment. The remaining 20 reportswere: 9 cohort studies, 7 case reports, and 4 reviews. Of these, 10 studies had study populations of < 10 patients, while 6 had ≥ 10patients. The remaining 4 were reviews. Results of these papers described the safety and effectiveness of various surgical interventions for adults with CIPO, including percutaneous endoscopic procedures, surgical decompression, small bowel resection, and intestinal transplantation. Conclusions Data pertaining to surgical therapy for CIPO is limited. Although this review suggests that surgical interventions for CIPO may be safe and effective for select patients, strong conclusions cannot be made due to limited number of relevant studies and small sample sizes.Concerted efforts to produce data from large studies on adults with CIPO are necessary.

Background/Aims: Chronic intestinal pseudo-obstruction (CIPO) is a rare cause of intestinal dysmotility. First-line treatment in adult patients is medical and nutritional therapy. For patients who fail these treatment options, surgical interventions may be an option. In this scoping review, we aim to investigate the current research on surgical interventions for CIPO in adults. Methods: PubMed, Embase, and Scopus were queried for articles related to surgical interventions for adults with CIPO. Search terms included:intestinal dysmotility, intestinal pseudo-obstruction, global intestinal dysmotility, chronic intestinal pseudo-obstruction, gastrointestinal paresis, neurogastrointestinal motility disorder, and chronic small intestinal motility disorder. Results: Initial search identified 4763 records; 4722 were deemed irrelevant after screening and were excluded. The remaining 41 reports were retrieved and assessed for eligibility. Twenty-one additional studies were excluded after in-depth assessment. The remaining 20 reportswere: 9 cohort studies, 7 case reports, and 4 reviews. Of these, 10 studies had study populations of < 10 patients, while 6 had ≥ 10patients. The remaining 4 were reviews. Results of these papers described the safety and effectiveness of various surgical interventions for adults with CIPO, including percutaneous endoscopic procedures, surgical decompression, small bowel resection, and intestinal transplantation. Conclusions Data pertaining to surgical therapy for CIPO is limited. Although this review suggests that surgical interventions for CIPO may be safe and effective for select patients, strong conclusions cannot be made due to limited number of relevant studies and small sample sizes.Concerted efforts to produce data from large studies on adults with CIPO are necessary.

Background/Aims: Chronic intestinal pseudo-obstruction (CIPO) is a rare cause of intestinal dysmotility. First-line treatment in adult patients is medical and nutritional therapy. For patients who fail these treatment options, surgical interventions may be an option. In this scoping review, we aim to investigate the current research on surgical interventions for CIPO in adults. Methods: PubMed, Embase, and Scopus were queried for articles related to surgical interventions for adults with CIPO. Search terms included:intestinal dysmotility, intestinal pseudo-obstruction, global intestinal dysmotility, chronic intestinal pseudo-obstruction, gastrointestinal paresis, neurogastrointestinal motility disorder, and chronic small intestinal motility disorder. Results: Initial search identified 4763 records; 4722 were deemed irrelevant after screening and were excluded. The remaining 41 reports were retrieved and assessed for eligibility. Twenty-one additional studies were excluded after in-depth assessment. The remaining 20 reportswere: 9 cohort studies, 7 case reports, and 4 reviews. Of these, 10 studies had study populations of < 10 patients, while 6 had ≥ 10patients. The remaining 4 were reviews. Results of these papers described the safety and effectiveness of various surgical interventions for adults with CIPO, including percutaneous endoscopic procedures, surgical decompression, small bowel resection, and intestinal transplantation. Conclusions Data pertaining to surgical therapy for CIPO is limited. Although this review suggests that surgical interventions for CIPO may be safe and effective for select patients, strong conclusions cannot be made due to limited number of relevant studies and small sample sizes.Concerted efforts to produce data from large studies on adults with CIPO are necessary.

BACKGROUND/AIMS: Visceral pain and hypothalamic-pituitary-adrenal axis (HPA) dysregulation is a common characteristic in irritable bowel syndrome (IBS) patients. Previously, we reported that a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) prevents chronic stress-mediated brain function abnormalities by attenuating the HPA axis response. Here, we compared the effect between different probiotic treatments on the perception of visceral pain during colorectal distension (CRD) following a chronic stress and the consequences to the activity of the HPA axis. METHODS: After a 2-week treatment with a combined probiotic formulation, or L. helveticus or B. longum alone in stressed mice, the visceral pain in response to CRD was recorded. The expression of glucocorticoid receptors was determined in the different brain areas involved in the stress response (hypothalamus, hippocampus, and prefrontal cortex). The plasma levels of stress hormones were also measured. RESULTS: A pretreatment using the combination of probiotic formulation significantly reduces the chronic stress-induced visceral hypersensitivity respectively at 0.06, 0.08, and 0.10 mL CRD volume. However, a single probiotic (B. longum or L. helveticus) administration is less effective in reducing visceral pain in stressed mice. Moreover, the expression of the glucocorticoid receptor mRNA was consistently up-regulated in several brain areas after pretreatment with a combined probiotic, which correlated with the normalization of stress response compared to the inconsistent effects of a single probiotic. CONCLUSION: The combination of L. helveticus and B. longum is more effective in regulating glucocorticoid negative feedback on the HPA axis than probiotic alone and subsequently in treating stress-induced visceral pain.
Animals ; Bifidobacterium ; Brain ; Hippocampus ; Humans ; Hypersensitivity ; Irritable Bowel Syndrome ; Lactobacillus helveticus ; Lactobacillus ; Mice ; Plasma ; Probiotics ; Receptors, Glucocorticoid ; RNA, Messenger ; Sulfalene ; Visceral Pain