Factors associated with good self-rated health of non-disabled elderly living alone in Japan: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Self-rated health (SRH) is reported as a reliable predictor of disability and mortality in the aged population and has been studied worldwide to enhance the quality of life of the elderly. Nowadays, the elderly living alone, a particular population at great risk of suffering physical and mental health problems, is increasing rapidly in Japan and could potentially make up the majority of the aged population. However, few data are available pertaining to SRH of this population. Given the fact that sufficient healthcare is provided to the disabled elderly whereas there is little support for non-disabled elderly, we designed this population-based survey to investigate SRH of non-disabled elderly living alone and to identify the factors associated with good SRH with the purpose of aiding health promotion for the elderly.</p> <p>Methods</p> <p>A cross-sectional study was conducted in a metropolitan suburb in Japan. Questionnaires pertaining to SRH and physical conditions, lifestyle factors, psychological status, and social activities, were distributed in October 2005 to individuals aged ≥ 65 years and living alone. Response rate was 75.1%. Among these respondents, a total of 600 male and 2587 female respondents were identified as non-disabled elderly living alone and became our subjects. Multivariate logistic regression was used to identify the factors associated with good SRH and sex-specific effect was tested by stepwise logistic regression.</p> <p>Results</p> <p>Good SRH was reported by 69.8% of men and 73.8% of women. Multivariate logistic regression analysis showed that good SRH correlated with, in odds ratio sequence, "can go out alone to distant places", no depression, no weight loss, absence of self-rated chronic disease, good chewing ability, and good visual ability in men; whereas with "can go out alone to distant places", absence of self-rated chronic disease, no weight loss, no depression, no risk of falling, independent IADL, good chewing ability, good visual ability, and social integration (attend) in women.</p> <p>Conclusion</p> <p>For the non-disabled elderly living alone, sex-appropriate support should be considered by health promotion systems from the view point of SRH. Overall, the ability to go out alone to distant places is crucial to SRH of both men and women.</p

Long-Term Follow-up of Erythrocyte Porphobilinogen Deaminase Activity in a Patient With Acute Intermittent Porphyria: The Relationship between the Enzyme Activity and Abdominal Pain Attacks

The relationship between the onset of abdominal pain attack and the urinary levels of δ-aminolevulinic acid, porphobilinogen, uroporphyrin, and the activity of erythrocyte porphobilinogen deaminase was studied on a monthly basis over a four-year period in a 29-year-old male patient with acute intermittent porphyria. A close relationship is seen between the onset of pain episodes and sharp decreases of porphobilinogen deaminase activity. The activity normalizes as the patient improves, suggesting that this enzyme is a more sensitive monitor for acute intermittent porphyria attacks than the urinary parameters currently used for its diagnosis. Our results suggest that month-by-month testing of porphobilinogen deaminase activity in acute intermittent porphyria patients is a good practice to predict episodes of acute abdominal pain before its onset, also allowing estimation of possible promoting factors and in establishing optimal specific therapies

Evaluation of Urinary Nickel using Inductively Coupled Plasma Argon Emission Spectrometry

Nickel is a rare earth metal and is widely used in modern industry. Its overexposure in human beings can provoke significant effects including lung, cardiovascular and kidney diseases. As an index of occupational exposure, urine is widely used for the monitoring of nickel concentration because it is a minimally invasive method. Recent studies have used atomic absorption spectrometry to measure nickel concentration. In this study, we introduced a novel inductively coupled plasma argon emission spectrometry (ICPAES) which enables us to measure multiple elements simultaneously with smaller volume and with lower detection limits compared to conventional atomic absorption emission spectrometry, and we established the new measuring method by determining the appropriate wavelengths for nickel concentration. Furthermore, using the established new measuring method, we investigated the correlation between a single oral administration of nickel and urine elimination in rats. As a result, different concentrations of nickel standard solutions were measured by ICPAES, and among five specific wavelengths of nickel, 221.647 nm and 231.604 nm were chosen because they had the highest inclines of both signal to background (S/B) ratio and emission intensity in simple linear regression analysis. Next, by using healthy human urine samples which had not been exposed to nickel, 231.604 nm was determined to be the most appropriate wavelength because it did not present abnormal intensity due to obstacle wavelength. Male Wistar rats received an oral administration of nickel ranging from 0.025 mg/kg to 250 mg/kg, which are equivalent from 0.0015% to 15% of LD50, and during the following 24 hours, urine samples were collected and the nickel concentration was measured by ICPAES. With a single oral administration of nickel, there was an increase in urine nickel concentration in a dose- dependent manner and the appropriate equation was developed. Acute renal failure was not observed in these dosage of oral nickel administration by analyzing NAG, β2-microglobulin, urine albumin and urine protein. It was concluded that the obtained nickel reference values using ICPAES would be useful for the early diagnosis of nickel intoxication and in the assessment of the exposure to nickel

Acute Dose- and Time-dependent Toxicity of Monochloroacetic Acid after Subcutaneous Injection in Rats

The effects of monochloroacetic acid (MCA) on serum concentrations of AST, m-AST, ALT, glu- cose, BUN, creatinine, lactate and pyruvate were examined in fasted rats. Rats were subcutaneously injected with saline or 108 (LD50) or 135 (LD70), 162 (LD90) mg/kg MCA solution. Blood samples were analyzed 1, 1.5 and 2 hr after injection. Serum AST, m-AST and ALT activities were increased dose-dependently. The serum glucose concentration increased over the 1-2 hrs in the control group and the LD50 group. In the LD70 group, the serum glucose concentration decreased over 1-1.5 hrs and did not change again by 2 hr. In the LD90 group, the serum glucose concentration decreased time-dependently over the 1-2 hrs. The BUN and creatinine concentrations increased dose- and time-dependently over the 1-2 hrs. The serum lactate and pyruvate concentrations increased dose- dependently. The LD90 group showed the greatest decrease in serum glucose concentration and the greatest increase in serum lactate, pyruvate and m-AST levels by 2 hr. Thus, MCA injured hepatic cells dose-dependently. A large amount of MCA caused severe damage to liver mitochondria after a 1.5-hr lag time. It was deduced that sharp changes in m-AST, glucose, lactate and pyruvate levels are closely related to a sudden worsening of the clinical MCA toxicity condition. Monitoring of the MCA concentration in blood just after exposure and any change of m-AST activity with time could possibly be of prognostic value, particularly in flagging any sudden worsening clinical condition

Acute Toxicity after Monochloroacetic Acid Exposure in Rats

This study aimed to clarify the lethal toxicity in acute monochloroacetic acid (MCA) poisoning. MCA was subcutaneously injected in rats and blood was collected. We measured metabolites and hormones related to gluconeogenesis. The blood glucose level in the MCA-treated group was signifi- cantly reduced. Serum concentrations of acetoacetate and 3-hydroxybutyric acid were decreased and serum free fatty acid levels were increased in the MCA-treated group, whereas serum concen- trations of carnitine were reduced. Concentrations of plasma ammonia in the treated group were more than 5 times higher than those in the control group. Serum concentrations of hyperglycemic hormones (catecholamine, ACTH, cortisol, glucagon) were significantly increased in the MCA-treat- ed group. Serum concentrations of insulin were within the reference value in both groups. It was concluded that hypoglycemia caused by exposure to MCA is not due to the resultant hormonal dis- turbance, but might be partly induced by impaired beta-oxidation of fatty acid owing to the inade- quate biosynthesis of carnitine. Hypoglycemia, hypoketonemia and hyperammonemia may play roles in MCA poisoning deaths