Internal medicine
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Comparative Study
Age- and gender-related differences in correlations between abdominal obesity and obesity-related metabolic risk factors in Japanese.
There have been conflicting data regarding the relationship between obesity and coronary heart disease (CHD) in Japan. Obesity was reported to be a risk factor of CHD in young and middle-aged males, but not in females or older males. The age- and gender-related differences in the correlations between obesity and obesity-related metabolic risk factors might contribute to these conflicting data. ⋯ The correlations between abdominal obesity and obesity-related metabolic risk factors were stronger in younger men than in older men and women among Japanese.
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Hemodialysis patients are at an increased risk of bleeding due to the platelet dysfunction caused by uremia and the use of anticoagulants during dialysis. Spontaneous spinal hematoma is a rare disorder as a complication in hemodialysis patients. ⋯ Here, we report the case of 77-year-old woman who presented with spinal cord compression due to spontaneous spinal epidural hematoma associated with hemodialysis. When an end-stage renal disease patient suffers from back pain and neurological deficits, the clinician should be alerted for the spontaneous spinal epidural hematoma as well as cerebrovascular events.
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Plasma brain natriuretic peptide (BNP) is used as a marker of congestive heart failure. Moreover, plasma BNP levels are increased in patients with acute ischemic stroke, in particular, cardioembolic stroke. We investigated whether the plasma BNP level can also be used as a biological marker to differentiate specific stroke subtype, in particular cardioembolic stroke from the other ischemic stroke subtypes. ⋯ Plasma BNP level is significantly higher in CE patients than in other stroke subtypes, and thus physicians should strongly consider CE when the plasma BNP level is over 140.0 pg/mL in patients with acute ischemic stroke.
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Multicenter Study
Hospital-based study of the prognostic factors in adult patients with acute community-acquired bacterial meningitis in Tokyo, Japan.
Prognostic factors related to community-acquired bacterial meningitis (BM) in adult patients have been evaluated using multivariate analysis in The Netherlands, where the rate of antibiotic resistance was low. However, an evaluation of these factors in countries with a high rate of antibiotic resistance has not yet been done. Thus, we studied the prognostic factors in adults with community-acquired BM in our hospitals, which are located in Tokyo, Japan, where the rate of antibiotic resistance is high. ⋯ Patients with a low GCS at the initiation of antibiotic therapy and low thrombocyte counts had unfavorable outcomes. With appropriate antibiotic administration, the antibiotic-resistant bacteria were not identified as an unfavorable prognostic factor, even in an area with a high rate of antibiotic resistance.
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Exercise is recommended for the treatment and prevention of cardiac disorders. Relaxation of the sympathetic nervous system has been considered to be one of the therapeutic mechanisms. However, the means by which the level of daily physical activity affects sympathetic activity remains unclear. ⋯ The daily level of physical activity affects sympathetic tone, and an appropriate level results in sympathetic relaxation. The results of this study provide a useful index to enable patients with cardiac disorder to perform exercise without overloading.