Plasma metabolomic profiling reflects the malnourished and chronic inflammatory state in recessive dystrophic epidermolysis bullosa.

BACKGROUND: Recessive dystrophic epidermolysis bullosa (RDEB) is a hereditary blistering disorder characterized by skin fragility, chronic inflammation, malnutrition, and fibrosis. Metabolomics is an emerging investigative field that helps elucidate disease pathophysiology and identify biomarkers. However, previous metabolomic studies in RDEB are limited. OBJECTIVE: To investigate the plasma metabolomic profiles in RDEB patients. METHODS: We recruited 10 RDEB patients and 10 age-/gender-matched healthy controls. Peripheral blood samples were collected and plasma metabolomic profiling was performed by LC-MS/MS analysis. MS data processing and compound identification were executed by MS-DIAL. Enrichment analysis was performed by MetaboAnalyst 5.0. RESULTS: Metabolomic analyses demonstrated that most amino acid levels were downregulated in RDEB patients, and the extent of insufficiency correlated with clinical severity. Several metabolites were dysregulated in RDEB, including glutamine and glutamate metabolism, tryptophan-to-kynurenine ratio, phenylalanine-to-tyrosine ratio, and succinate accumulation. LIMITATIONS: The study was limited by small case numbers and the unrepresentativeness of a single time-point blood sample. CONCLUSION: Our study demonstrated the altered metabolomic profiles in RDEB, reflecting the disease severity, the chronic inflammatory and malnourished status, while the fibrotic signatures were not evident.

The characteristics, management, and aftercare of patients with suicide attempts who attended the emergency department of a general hospital in northern Taiwan.

BACKGROUND: Suicide is a serious public health problem worldwide. The emergency department (ED) is often the first place of contact with medical and mental health care for suicidal patients. This study aimed to determine the characteristics, management, and aftercare of patients who attempted suicide and then were taken to the ED of a general hospital in Taipei, Taiwan. METHODS: Our study was a cross-sectional retrospective study that consecutively recruited patients with suicide attempts attended to the ED of a general hospital from June 2004 to May 2005. The patients' medical information and records pertaining to their emergency visit were subsequently reviewed. RESULTS: Overall, 481 persons were recruited into our study. The male:female ratio of total surviving attempters was approximately 1:4 and the average age was 33.6 [standard deviation (SD) 12.3] years. The most frequently observed general characteristics from which participants suffered were mental illness (73.1%) and interpersonal problems (76.1%). Nearly all patients (91.7%) received ED on-site psychosocial assessments from social workers (SWs) and psychiatrists in 84.2% and 53.4% of cases, respectively. Less than half of patients (45.1%) were referred to psychiatric outpatient aftercare, and only 26.1% contacted the psychiatric outpatient clinics after discharge from the ED. The stated reasons for psychiatric outpatient referral were associated with interpersonal problems, current psychiatric illness, the ED on-site psychiatrist consultation, and admission to medical, surgical, or psychiatric wards. However, individuals with interpersonal problems, previous psychiatric intervention, and ED on-site psychiatrist consultation were significantly more likely to attend outpatient psychiatric aftercare. CONCLUSION: Individuals who harmed themselves had a high rate of psychiatric morbidity and interpersonal problems. However, their adherence to psychiatric outpatient aftercare was low. Improved identification of the needs of patients with suicidal tendencies who did not attend outpatient services will have implications for future services provided to this patient population, and will better enable medical personnel to most effectively assist in suicide attempt interventions.

Religious beliefs along the suicidal path in northern Taiwan.

This study aimed to understand the current inclinations toward depression and compulsion for members of four different religious groups, and to predict religious beliefs along the suicide path through analyzing the lifetime prevalence of suicidal ideation and suicide attempts for members of these religious groups. Participants in this cross-sectional study, which adopted purposive sampling, were members of Christianity, Catholicism, Buddhism, and Taoism in northern Taiwan. In the case of suicide experiences, suicides among people one knows, and tendency toward compulsion and depression, there are statistical differences between the four religions. According to the results, some people with suicidal tendency will attend religious activities; therefore, we predict that religious beliefs play an important role in suicide prevention.

Development of nutrient databases for epidemiological studies in Taiwan.

The nutrient and related databases are essential for calculating intake values in epidemiological studies. To suit our research needs, we have developed an integrated management system not only for processing individual dietary questionnaires including 24-hour recalls, food records and Chinese food frequency questionnaires (CFFQ), but also for maintaining and tracking updated food composition databases. The recall and record calculation system (Normal University Food and Nutrient Calculation System: NUCAL system) considers date of recall/record, number of days and meal separations. The CFFQ editing system (CFFQES system) contains the management of food list, and frequency and portion size selections to facilitate processing the various versions of CFFQ. Since the extension of many bioactive compounds including polyphenols, pollutants and carcinogens in foods and water is considered by epidemiological hypotheses, limitation of current food composition tables needs to be noticed and improved. Laboratory analyses are the foundation of food databases, more resources and efforts are urgently needed for analysing the local food items. In practical uses of efficient data processing procedures, the multiple grouping and nomenclature systems need further attention in the future. Nutrient databases need multidisciplinary efforts and play the key role for the success of epidemiological studies.