A symptom severity questionnaire for patients suffering from functional gastrointestinal disorder: FGI-Checklist.

BACKGROUND AND AIM: A well-validated, comprehensive checklist of functional gastrointestinal (FGI) disorder (FGID) symptom severity for tracking symptom profile changes over time is lacking. We aim to develop and validate a comprehensive symptom severity checklist for FGID. METHODS: A 20-item scale, including both upper and lower gastrointestinal symptoms, was generated to measure the symptom severity commonly found in FGID. Patients who experienced at least monthly symptoms of FGID with negative endoscopy findings were invited to complete the FGI-Checklist, Patient Health Questionaire-9 for assessing depressive symptoms, and Patient Health Questionnaire-15 for assessing somatic symptoms at baseline. A subset of patients who met Rome III diagnostic criteria of gastroesophageal reflux disease, functional dyspepsia, and irritable bowel syndrome received medication treatment for 8-12 weeks and completed the FGI-Checklist again at a follow-up visit. Exploratory factor analysis was performed for subscales formation and psychometric properties were measured. RESULTS: Six hundred and forty-one patients were recruited for current study and 108 (16.8%) of them completed the FGI-Checklist again at follow-up. Exploratory factor analysis identified a five-factor solution accounting for 66.8% of the total variance. The five factors are named esophageal syndrome, reflux syndrome, functional dyspepsia syndrome, nausea and vomiting syndrome, and abdominal and bowel syndrome. The FGI-Checklist total score correlated with Patient Health Questionaire-9 and Patient Health Questionnaire-15 (all P < 0.001), which demonstrated good construct validity. Good item-internal consistency was found (Cronbach's alphas: 0.69-0.87). Responsiveness for reflux syndrome subscale, functional dyspepsia syndrome subscale, and abdominal and bowel syndrome subscale after medication treatment was significant (paired-t-test: all P < 0.01). CONCLUSION: The instrument, Checklist, is valid and reliable.

Functional dyspepsia susceptibility is associated with TGFB1 gene polymorphisms (RS4803455, RS1800469) in H pylori-negative Chinese population.

BACKGROUND: We previously published that altered expression of gastric TRPV1, BDNF, and peripheral cytokines was present in patients with functional dyspepsia. We herein examine whether genetic predisposition in altered biomarkers influences dyspeptic, sleep, and mood symptoms in patients with FD without previous infection. METHODS: Consecutive adult FD patients (Rome III) with no recent history of gastroenteritis and asymptomatic age- and sex-matched healthy controls were recruited for upper endoscopy. Subjects with GERD and IBS as predominant symptoms, diabetes mellitus, current or previous H pylori infection, psychiatric illness, and recent use of NSAID or PPI were excluded. The genetic associations with dyspeptic symptoms, sleep quality, and mood symptoms were evaluated. Genetic polymorphisms in TRPV1, TGFB1, TNF, COMT, BDNF, IL6, IL8, IL10, and IL12 were analyzed. KEY RESULTS: Twenty-nine male FD patients and 104 female FD patients were age matched (±3 years) with 81 healthy subjects. All had postprandial distress syndrome (PDS) as predominant subtype (PDS: 130, EPS: 3). SNPs in TGFB1 showed significant associations in dyspeptic patients after age and sex adjustment [for RS4803455: in the codominant model (C/A, OR = 0.34 (0.18-0.65), P = .004); in the dominant model (genotype C/C vs C/A-A/A, OR = 0.42 (0.23-0.77), P = .004); and in the overdominant model (genotype C/C-A/A vs C/A, OR = 0.38 (0.21-0.70), P < .001)] [for RS1800469: in dominant model (genotype A/A vs A/G-G/G, OR = 0.52 (0.27-0.99), P = .043)]. A allele in RS4803455 was associated with higher HADS depression score (P = .05) and epigastric burning sensation(P = .01). CONCLUSIONS AND INFERENCES: Our data showed that dyspeptic patients predispose genetic difference in TGFB1 which may influence the severity of dyspepsia.

Association between life events and change in depressive symptoms in Hong Kong Chinese elderly.

BACKGROUND: Life event was regarded as an important risk factor for depression. Only a few prospective studies had examined the impact of life events individually and in combination. This study examined the relationship between life events and change in depressive symptoms. METHODS: Depressive symptoms were assessed longitudinally using Geriatric Depression Scale (GDS) in 2630 community-dwelling Chinese elderly aged 65 or above. A cutoff score of 8 or higher indicated clinically relevant depressive symptoms. Subjects identified as demented were excluded. Eight life events experienced in the past year were assessed at 2year follow up. Logistic regression analyses were performed with adjustments for baseline GDS score and potential confounders such as sociodemographic, developmental and social factors, alcohol consumption, medical history and physical health status. RESULTS: In men, experience of two events (OR=2.493) and three or more events (OR=3.199) was independently associated with increased risk of having depression. In women, the risk increased only in experiencing three or more events (OR=5.558). Moreover, life event affected depressive symptoms differently for men and women. Loss of pet and serious financial trouble were associated with an increase in depressive symptoms among men, but serious illness or accident of partner, and loss of a hobby were significant among women. Experience in either good or bad important events increased risk of depression in both sexes. LIMITATIONS: The main limitation was all subjects were ambulatory volunteers. CONCLUSIONS: The occurrence of single life event had contributed to the onset of depression and multiple events had a cumulative effect.

Visual functioning and quality of life among the older people in Hong Kong.

OBJECTIVES: This study aimed to examine the association of visual functioning and health-related quality of life (HRQOL) among the older community in Hong Kong. DESIGN: This study used the baseline examination of a cohort study MrOs and MsOs (a large study for osteoporosis in men and women). SETTING: This study was set in the Hong Kong community. PARTICIPANTS: A total of 4000 ambulatory community-dwelling Chinese men and women aged 65 years or above participated in this study. MEASUREMENTS: Health-related quality of life was assessed by Medical Outcomes Study Short Form-12 (SF-12), with physical component summary (PCS) and mental component summary (MCS) scores. Demographics, medical history, mental status, and quality of life were obtained from face-to-face interviews, using standard structured questionnaire. Visual functions (i.e., binocular visual acuity, contrast sensitivity, and stereopsis) were assessed by different visual tests after refraction corrections. Different visual functions were tested simultaneously in multiple ordinal logistic regression models. RESULTS: Better binocular visual acuity, contrast sensitivity, and stereopsis were associated with higher PCS. Visual acuity and contrast sensitivity was associated with PCS after adjustment of different visual functions and sex, age, education level, cognitive status, and history of diabetes in multivariate analysis, (OR = 0.73, 95% CI = 0.54 0.98) for low vision (≤6/24) compared with ≥6/9 in visual acuity and (OR = 1.34, 95% CI = 1.09 1.64) for contrast sensitivity row b 5-8 (best) compared with 0-1 (worst). MCS was only associated with visual acuity and contrast sensitivity, but no association was found after adjustment. CONCLUSION: Apparent association was found between visual functions and HRQOL among older community in Hong Kong. In addition to visual acuity, contrast sensitivity is also important, so eye care should also cover.

Agrowaste-based nanofibers as a probiotic encapsulant: fabrication and characterization.

This study explored the potential of soluble dietary fiber (SDF) from agrowastes, okara (soybean solid waste), oil palm trunk (OPT), and oil palm frond (OPF) obtained via alkali treatment, in the nanoencapsulation of Lactobacillus acidophilus . SDF solutions were amended with 8% poly(vinyl alcohol) to produce nanofibers using electrospinning technology. The spinning solution made from okara had a higher pH value at 5.39 ± 0.01 and a higher viscosity at 578.00 ± 11.02 mPa·s (P < 0.05), which resulted in finer fibers. FTIR spectra of nanofibers showed the presence of hemicellulose material in the SDF. Thermal behavior of nanofibers suggested possible thermal protection of probiotics in heat-processed foods. L. acidophilus was incorporated into the spinning solution to produce nanofiber-encapsulated probiotic, measuring 229-703 nm, visible under fluorescence microscopy. Viability studies showed good bacterial survivability of 78.6-90% under electrospinning conditions and retained viability at refrigeration temperature during the 21 day storage study.

Characteristics of age-related changes in bone compared between male and female reference Chinese populations in Hong Kong: a pQCT study.

There have been few comprehensive studies on the age-related changes in bone mineral density (BMD) and bone structure in Chinese people. Using peripheral quantitative computed tomography (pQCT), we assessed volumetric BMD of both trabecular and cortical bone and their geometry at both radius and tibia in 620 Chinese men and 638 women, aged 20­98 years, in Hong Kong. Cortical BMD did not start declining until after the age of 50 years in women and the age of 60 years in men. In contrast, trabecular BMD declined with age starting from adulthood in both sexes, and the rates of decline accelerated after the age of 50 years only in women. The integral and trabecular bone area expanded with age in older men and women, primarily at the tibia. Cortical bone area decreased significantly in older women, particularly at the tibia, while it decreased only slightly with aging in men. The moment of inertia decreased with age at the radius in older men and women. At the tibia, age-related decline accelerated in older women, but not in older men. It was concluded that trabecularization of bone in response to declining BMD and mechanical loading may be maladaptive by reducing cortical bone area, if periosteal apposition cannot keep pace with it.