Prevalence of functional gastrointestinal disorders in Taiwan: questionnaire-based survey for adults based on the Rome III criteria.

Functional gastrointestinal disorders (FGID) are a group of disorders of the digestive system in which the chronic or recurrent symptoms cannot be explained by the presence of structural or tissue abnormality. This survey used a modified Rome III questionnaire on the health and nutrition status of a general population in Taiwan during 2005-2008. A total of 4,275 responders completed the questionnaire. The sample was evenly distributed for men (n=2,137) and women (n=2,138). The prevalence of FGID was 26.2%. Unspecified functional bowel disorder was the most prevalent (8.9%). The second was functional dyspepsia (5.3%), and the third were irritable bowel syndrome (4.4%) and functional constipation (4.4%). Women had a greater prevalence than males (33.2% compared to 22.4%, p<0.05) with regards to total FGID. Most categories of FGID were significantly prominent in women, except functional diarrhea. The FGID groups took fewer servings of vegetables and fruits than the non-FGID group each day (vegetables 2.51 vs 2.70, p<0.001; fruits 0.82 vs 0.91, p<0.001). Smoking, alcohol consumption, and betel nut chewing had no significant impaction on prevalence of FGID. The mean BSRS (brief-symptom rating scale) for screening depression and suicide ideation was higher in the FGID group (2.86 vs 1.63, p<0.001). In conclusion, FGID diagnosed with Rome III criteria are not uncommon in Taiwan's general population. Subjects who met the Rome III criteria for FGID in Taiwan were younger, had less vegetables and fruits intake, higher BSRS scores and were of greater female predominance.

Profile of nucleotides and nucleosides in Taiwanese human milk.

BACKGROUND: Human milk-borne nucleotides and their related metabolic products have been reported to have important physiological roles in breast-fed infants. The purpose of this study was to measure the concentrations of free nucleotides and nucleosides in human milk from Taiwanese women. METHODS: A total of 24 individual milk specimens were collected from women in Taipei and Kaohsiung, at four stages of lactation. Vegetarian or non-vegetarian dietary patterns were recorded. The samples were analyzed for nucleotides and nucleosides by high-performance liquid chromatography. RESULTS: The mean (±standard deviation) free nucleotide and nucleoside concentrations in Taiwanese human milk were 213.13 ± 76.26 µmol/L and 16.38 ± 7.11 µmol/L. The predominant nucleotide was cytidine diphosphate for almost all samples, regardless of the location, stage of lactation, or dietary status of the subjects. Overall, the mean concentrations of cytidine diphosphate, cytidine monophosphate, uridine monophosphate, guanosine monophosphate, adenosine monophosphate, and inosine monophosphate, in milk samples were 129.86 µmol/L, 49.10 µmol/L, 5.60 µmol/L, 0.82 µmol/L, 2.96 µmol/L, and 25.25 µmol/L, respectively (equivalent to 61.0%, 23.1%, 2.6%, 0.4%, 1.0%, and 11.9% of free nucleotide composition). In free nucleosides, cytidine and uridine were predominant during all stages of lactation. The average concentrations of cytidine, uridine, adenosine, guanosine, and inosine, in milk samples were 9.25 µmol/L, 6.33 µmol/L, 0.18 µmol/L, 0.36 µmol/L, and 0.23 µmol/L, respectively (equivalent to 56.5%, 38.7%, 1.1%, 2.2%, and 1.4% of free nucleoside composition). Comparing vegetarian and non-vegetarian statuses, it was found that the total free nucleotide concentration was high in the vegetarian group (p=0.037). CONCLUSION: Our data showed a wide range of concentrations of individual nucleotides and nucleosides in Taiwanese human milk. Unique dietary status could affect the nucleotide and nucleoside levels in human milk, especially the nucleotides in our study. However, the mechanism of modulation of nucleotide and nucleoside levels in human milk is not clear.

Delirium due to scopolamine patch in a 4-year-old boy.

The scopolamine patch is usually used to reduce postoperative nausea and vomiting associated with anesthesia and/or surgery. It is also commonly used for the prevention of motion sickness. Transdermal scopolamine patches have been used for decades and there are few reports in the literature of toxic psychosis associated with the product. Most documented cases of acute psychosis following administration of scopolamine or other anticholinergic agents have been from the adult population. Here we present a 4-year-old boy with deteriorated cognitive function and changed mental status acutely. Besides flushing skin and psychotic behaviors including bizarre actions, hallucinations, aggressive behavior, hyperactivity, and incoherent speech were also noticed. Symptoms and signs were resolved after removal of scopolamine patch and conservative management. This case is possibly one of the youngest patients to exhibit such toxic effects. We hope to relay information about common agents with anticholinergic effects to clinical practitioners and remind that drug-induced psychosis should be considered in children with acute changes in behavior.

An uncommon cause of abdominal pain and diarrhea-gastrinoma in an adolescent.

Gastrinoma is a hormone-secreting tumor associated with the Zollinger-Ellison syndrome. It is quite rare among children, and it is also uncommon in locations other than the pancreas and the duodenum in the pediatric group. Here, we describe an adolescent male, presenting with recurrent secretory diarrhea and abdominal cramping pain, who had a solitary gastrinoma in the lesser sac, close to the stomach. The prognosis was good after complete resection.