食生活の多様性とうつ病および自殺の有病率との関連 ―26年間の国際比較研究―

Purpose: This study aimed to determine the associations of dietary diversity with depression and suicide rates by an ecological analysis using 26-years worldwide statistics.Methods: Average food supply and energy supply by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database (FAOSTAT). Dietary diversity scores were calculated from food group classifications. Age-standardized depression prevalence and suicide rates per 100,000 people by country were obtained from the Global Burden of Disease (GBD) 2017 database. The association between food diversity scores and depression prevalence and suicide rates was analyzed by a mixed effects model controlling for covariates in 137 countries with populations of 1 million or greater.Results: A significant negative association was found in the analysis of the relationship between dietary diversity and the prevalence of major depression in the model controlled for all covariates [β (se) = –225.6 (61.9), p < 0.001]. In addition, a significant negative association between dietary diversity and the suicide rate was also found in the model controlled for all covariates [β (se) = –3.08 (1.50), p < 0.05].Conclusion: Dietary diversity was significantly negatively associated with the rates of major depression and suicide. Diets rich in foods may reduce the prevalence of depression and suicide rate.【目的】本研究は、26年間の世界的な統計を用いた生態学的分析により、食生活の多様性とうつ病や自殺率との関連を明らかにすることを目的とした。【方法】生産と家庭間の喪失を除く国別平均食料供給量とエネルギー供給量を国連食糧農業機関統計局データベース（FAOSTAT）から入手した。食物群分類から食事多様性スコアを算出した。年齢標準化された国別の人口10万人当たりのうつ病有病率と自殺率は、Global Burden of Disease（GBD）2017データベースから取得した。人口100万人以上の137カ国を対象に、食品多様性スコアとうつ病有病率および自殺率との関連を、共変量を制御した混合効果モデルで解析した。【結果】食生活の多様性とうつ病の有病率との関係を分析したところ、すべての共変量を調整したモデルにおいて、有意な負の関連が認められた［β（se）＝－225.6（61.9）、p < 0.001］。さらに、食生活の多様性と自殺率との間の有意な負の関連も、すべての共変量を調整したモデルで認められた［β（se）= －3.08（1.50）、p < 0.05］。【結論】食生活の多様性は、うつ病および自殺の発生率と有意に負の関連があった。食物を豊富に含む食事は、うつ病や自殺を減少させる可能性がある

Endoscopic combined intrarenal surgery for renal allograft lithiasis using “sheath-connection technique”: A case report

A 66-year-old man was diagnosed with renal allograft lithiasis. Although retrograde intrarenal surgery was attempted, a ureteral access sheath (UAS) was difficult to insert. Subsequently, we planned the endoscopic combined intrarenal surgery (ECIRS) using the “Sheath-connection technique.” We indwelled the two UAS anterogradely and retrogradely, unified them at the bladder and the junction of the two UAS was passed through the ureterovesical junction. We successfully performed ECIRS

Trajectories of the Prevalence of Sarcopenia in the Pre- and Post-Stroke Periods: A Systematic Review

Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to identify trajectories of the prevalence of sarcopenia in the pre- and post-stroke periods and to determine the diagnostic criteria used in patients with stroke. We searched for literature in six databases: MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Ichushi-web (in Japanese). We included 1627 studies in the primary screening, and 35 studies were finally included. Of the 35 studies, 32 (91.4%) included Asian patients, and the criteria of the Asian Working Group for Sarcopenia was mainly used as the diagnostic criteria. Nineteen studies used muscle strength and muscle mass to diagnose sarcopenia, whereas a full assessment, including physical performance, was performed in five studies. The estimated prevalences of sarcopenia in pre-stroke, within 10 days of stroke, and from 10 days to 1 month after stroke were 15.8%, 29.5%, and 51.6%, respectively. Sarcopenia increased by approximately 15% from pre-stroke to 10 days, and increased by approximately 20% from 10 days to 1 month. Healthcare providers should note that the prevalence of sarcopenia increases during the acute phase in patients with stroke

Efficacy and Safety of the &ldquo;Trisection Method&rdquo; Training System for Robot-Assisted Radical Cystectomy at a Single Institution in Japan

To maintain a surgeon&rsquo;s concentration, reduce fatigue, and train young surgeons, surgical procedures for bladder cancer are divided into the following parts: robot-assisted radical cystectomy (RARC), bowel reconstruction, and totally intracorporeal urinary diversion (ICUD) (RARC+ICUD). Each part is performed by a different surgeon (Trisection method). We retrospectively evaluated the efficacy and safety of this approach at a single institution in Japan. One hundred consecutive patients who underwent RARC+ICUD at Gifu University Hospital between November 2018 and August 2022 were included in this study. The patient background, surgical outcomes, and postoperative complications were compared between surgeries by first-, second-, and third-generation surgeons. The overall survival (OS) and recurrence-free survival (RFS) were compared between surgeries by each generation. Of the 100 patients, 19, 38, and 43 RARCs were performed by first-, second-, and third-generation surgeons, respectively. There were 35, 25, and 39 patients who underwent ileal conduit, neobladder, and ureterocutaneostomy, respectively. No significant differences were found among the patients respective to the type of ICUDs. Although the first-generation surgeon had a significantly shorter operative time with RARC, the surgical time for bowel reconstruction, length of hospital stays, and incidence of postoperative complications were not significantly different among the groups. Additionally, OS and RFS did not differ significantly among the generations. The &ldquo;Trisection method&rdquo; is an effective and safe concept with no difference in outcomes between the generations of surgeons

Resting Energy Expenditure in Older Inpatients: A Comparison of Prediction Equations and Measurements

Determining energy requirements are an important component of nutritional support for patients with malnutrition; however, the validity of prediction equations for resting energy expenditure (REE) is disputed in older hospitalized patients. We aimed to assess the validity of these equations in older hospitalized patients in Japan. This was a single-center, cross-sectional study of 100 patients aged &ge;70 years, hospitalized between January 2020 and December 2021. REE was measured using an indirect calorimeter and was compared to the predicted values calculated from five REE prediction equations. The mean (95% confidence interval) measured REE was 968.1 (931.0, 1005.3) kcal/day, and the mean predicted REE was higher for the FAO/WHO/UNU (1014.3 [987.1, 1041.6] kcal/day, p = 0.164) and Schofield (1066.0 [1045.8, 1086.2] kcal/day, p &lt; 0.001) equations and lower for the Harris-Benedict (898.6 [873.1, 924.1] kcal/day, p = 0.011), Ganpule (830.1 [790.3, 869.9] kcal/day, p &lt; 0.001), and body weight (kg) &times; 20 (857.7 [821.9, 893.5] kcal/day, p &lt; 0.001) equations. In the age group analysis, none of the predicted values were within a 10% error for more than 80% of patients aged 70&ndash;89 years and &ge;90 years. The five REE prediction equations did not provide accurate estimates. Validated REE prediction equations need to be developed for older hospitalized patients

Prevalence and outcomes of sarcopenic obesity in patients with colorectal cancer

   Sarcopenia in patients with colorectal cancer is associated with increased postoperative complications and poor survival outcomes. Although previous studies have reported conflicting results regarding the association between obesity and all-cause mortality in colorectal cancer patients, one review reported that higher visceral adiposity is associated with increased all-cause mortality. Although sarcopenic obesity in colorectal cancer may have poor prognosis, the prevalence and diagnostic methods of sarcopenic obesity remain unclear. A better understanding of sarcopenic obesity in colorectal cancer patients can facilitate improved nutrition and rehabilitation interventions and promote research.</p

Prevalence of Dysphagia in Patients with Heart Failure

Background:Dysphagia, or swallowing disorders, represents a significant health concern as it can lead to severe health events such as aspiration pneumonia, choking, and malnutrition. With the global increase in the aging population, reports of dysphagia have emerged not only in common causative conditions like stroke but also in a range of other disorders. Notably, an increasing number of cases have been documented where patients with heart failure develop dysphagia following hospitalization. Understanding the prevalence and implications of dysphagia in individuals with heart failure is believed to contribute to the advance swallowing rehabilitation practices.Objective and Review Questions:The purpose of this scoping review is to identify the prevalence of dysphagia in hospitalized heart failure patients and to identify its related factors. The research question for this review is “What is the prevalence of dysphagia and its related factors in heart failure patients?”</p