Characteristics of Respiratory Diseases in Older People

Abstract: Pneumonia among old people is the fourth leading cause of death, and its mortality has remained the same for the last 100 years despite development of antibiotics. We have elucidated the onset mechanism of pneumonia among old people and developed methods for its prevention. Its primary cause is considered to be cerebrovascular disorders in the basal ganglia, and absence of substance P causes sub-clinical aspiration, which in turn causes pneumonia. Prevention of pneumonia is now possible without the use of antibiotics by increasing substance P. As old people are immune-compromised by depressed state, measures against depression are important for preventing infections such as pneumonia and common cold. The older the patient is, the more intense the effect of gene appears. It was shown that elderly persons with L polymorphism of heme oxygenase (HO)-1 gene are more susceptible to pulmonary emphysema. Systemic examination of the elderly, particularly their physiological characteristic, is essential for treatment of elderly persons with respiratory diseases

Age, gender, insulin and blood glucose control status alter the risk of ischemic heart disease and stroke among elderly diabetic patients

<p>Abstract</p> <p>Background</p> <p>We analyzed the effects of insulin therapy, age and gender on the risk of ischemic heart disease (IHD) and cerebrovascular accident (CVA) according to glycemic control.</p> <p>Methods and Results</p> <p>We performed a prospective cohort study (Japan Cholesterol and Diabetes Mellitus Study) of type 2 diabetes patients (n = 4014) for 2 years. The primary endpoint was the onset of fatal/non-fatal IHD and/or CVA, which occurred at rates of 7.9 and 7.2 per 1000 person-years, respectively. We divided diabetic patients into four groups based on age (≤ 70 and > 70) and hemoglobin A1C levels (≤ 7.0 and > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure and low HDL-C in patients under 70 years of age with fair glycemic control and was associated with low diastolic blood pressure in the older/fair group. Interestingly, insulin use was associated with IHD in the older/poor group (OR = 2.27, 95% CI = 1.11-5.89; p = 0.026) and was associated with CVA in the older/fair group (OR = 2.09, 95% CI = 1.06-4.25; p = 0.028). CVA was associated with lower HDL-C and longer duration of diabetes in younger/poor glycemic control group. Results by stepwise analysis were similar. Next, patients were divided into four groups based on gender and diabetic control(hemoglobinA1C < or > 7.0%). Multiple regression analysis revealed that IHD was associated with high systolic blood pressure in male/fair glycemic control group, age in male/poor control group, and short duration of diabetic history in females in both glycemic control groups. Interestingly, insulin use was associated with IHD in the male/poor group(OR = 4.11, 95% CI = 1.22-8.12; p = 0.018) and with CVA in the female/poor group(OR = 3.26, 95% CI = 1.12-6.24; p = 0.02). CVA was associated with short duration of diabetes in both female groups.</p> <p>Conclusions</p> <p>IHD and CVA risks are affected by specific factors in diabetics, such as treatment, gender and age. Specifically, insulin use has a potential role in preventing IHD but may also be a risk factor for CVA among the diabetic elderly, thus revealing a need to develop improved treatment strategies for diabetes in elderly patients. The Japan Cholesterol and Diabetes Mellitus Study was formulated to evaluate them(Umin Clinical Trials Registry, clinical trial reg. no. UMIN00000516; <url>http://www.umin.ac.jp/ctr/index.htm</url>).</p

Synthesis of the Four Stereoisomers of 6-Acetoxy-19-methylnonacosane, the Most Potent Component of the Female Sex Pheromone of the New World Screwworm Fly, with Special Emphasis on Partial Racemization in the Course of Catalytic Hydrogenation

Starting from the enantiomers of citronellal and 1-octyn-3- ol, all four stereoisomers of 6-acetoxy-19-methylnonacosane were synthesized with sufficiently high stereochemical purities (more than 90% ee at C-6; about 97% ee at C-19) for their biological testing as the female sex pheromone of the screwworm fly (Cochliomyia hominivorax). All four isomers showed strong pheromone activity even at 1 μg, and no significant difference was observed in their potency. Adams’ platinum oxide was found to cause partial racemization of enantiomerically pure secondary propargylic alcohols in the course of their catalytic hydrogenation to saturated and secondary alcohols, while palladium-charcoal was less potent in causing partial racemization. A new HPLC-based discrimination of chiral and secondary alcohols proved to be useful in following such a subtle partial racemization

Synthesis of the Four Stereoisomers of 7-Acetoxy-15-methylnonacosane, a Component of the Female Sex Phermone of the Screwworm Fly, \u3ci\u3eCocliomyia hominivorax\u3c/i\u3e)

The four stereoisomers of 7-acetoxy-15-methylnonacosane (1), a component of the female sex pheromone of the New World screwworm fly (Cocliomyia hominivorax) were synthesized. The stereogenic center at C-15 of 1 originated from that of the enantiomers of citronellal, and that at C-7 was generated by lipase-catalyzed asymmetric acetylation of (3RS,11R)- and (3RS,11S)-17-methyl-1-trimethylsilylpentacos-1-yn-3-ol (13). Three of the stereoisomers of 1 showed equivalent good pheromone activity, while the activity of (7R,15R)-1 was weak