Social problems in daily life of patients with dementia

AIM: Most patients with dementia frequently encounter various problems in their daily lives. Those troubles embarrass both the patients and their families, and cause problems for society. However, there have been few scientific reports on the difficulties in the daily life of patients with dementia. Therefore, we tried to clarify the frequency and characteristics of troubles experienced by patients with dementia. METHODS: Seven medical centers treating dementia patients in Okayama Prefecture, Japan, participated in this survey. A total of 737 patients were placed in one of the three groups: a dementia group (n = 478), a mild cognitive impairment group (n = 199) and a control group (n = 60). The frequency of 13 difficulties was scored for each patient. RESULTS: Among normal participants, no person caused these problems once a year or more frequently. "Massive, recurrent buying" and "acts that risk causing a fire" were reported once a year or more for >10% of mild cognitive impairment patients. "Troubles with wealth management" and "troubles with money management" were the most frequent problems of dementia patients. CONCLUSIONS: Several problems are already sometimes encountered in patients with mild cognitive impairment. It would be useful to know which social difficulties are often seen in dementia patients in order to protect the safety of the patients. It is always difficult to balance respecting the autonomy of dementia patients and ensuring their safely

The incidence and distribution of biopsy-proven renal diseases in children

The precise distribution pattern of pediatric renal diseases has seldom been reported especially for young children. In orderto clarify the incidence and distribution of renal diseases in children, 599 renal biopsy specimens obtained from 547 pediatricpatients (≦15 years old) were analyzed by routine light, electron and immunofluorescence microscopy. Among the total biopsycases, the most common renal disease identified in childhood was IgA glomerulonephritis (IgAGN; 37%). More than 80%of patients with IgAGN were discovered by urinary screening at the school, showing asymptomatic proteinuria and/orhematuria. The other major renal diseases were minor glomerular abnormality (12.2%), Henoch-Schönlein purpura nephritis(HSPN; 10.6%), and thin basement membrane disease (7.1%). One of the major causes of pediatric nephrotic syndrome wereminimal change nephrotic syndrome (58%), whereas the other causes were IgAGN (11.6%), HSPN (8.9%), membranousglomerulonephritis (5.4%), membranoproliferative glomerulonephritis (3.6%). In conclusion, IgAGN was the most commonrenal disease also in children as in adolescence. From the age of seven years, the incidence of IgA-GN was highest amongall the pediatric renal diseases during whole childhood period, and the incidence and number of the patients increased as theygrow. On the other hand, there are also many cases with non-progressive clinical courses, such as minor glomerular abnormalityand thin basement membrane disease in children. The renal biopsy following routine urinary screening at the schoolmay be important for the therapeutic and prognostic guidelines of pediatric group of patients with renal diseases

RNA-sequencing reveals positional memory of multipotent mesenchymal stromal cells from oral and maxillofacial tissue transcriptomes

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Factors Associated with Nurses’ Intention to Leave Their Jobs after the Fukushima Daiichi Nuclear Power Plant Accident

We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants\u27 demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR=1.87, 95%CI: 1.02-3.44, p=0.042), anxiety about life in Fukushima City after the accident (OR=5.55, 95%CI: 1.18-26.13, p=0.030), consideration of evacuation from Fukushima after the accident (OR=2.42, 95%CI: 1.45-4.06, p=0.001), consideration of the possible radiation health effects in children (OR=1.90, 95%CI: 1.02-3.44, p=0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR=3.23, p=0.001) were independently associated with the nurses\u27 intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects

ジョシ ダイガクセイ ノ トウ タイシャノウ カンレン ショケンコウシヒョウチ ニ オヨボス シソアブラ セッシュ ト ユウサンソ ウンドウ トレーニング ノ エイキョウ

しそ油はα-リノレン酸を主体とするn-3系多価不飽和脂肪酸源の代表的食品である。多価不飽和脂肪酸は,体内に摂取することにより種々の生理効果を示すことが最近明らかになってきているが,本研究はこの効果を生活習慣病の一次予防に活用する試みの一環として,同様にその効果が期待されている有酸素運動トレーニングと併用することの有効性を検討する意図で企画された。しそ油を毎日20gずつ18人の女子大学生ボランティアに摂取させ,そのうち8人に有酸素運動トレーニングを負荷し,呼吸循環機能,糖代謝機能,血漿脂質パターン,体内活性酸素関連物質,免疫能を中心とする生体防御機能諸指標値を測定した。その結果,しそ油の単独摂取がトレーニングとの併用の有無に関わらず有酸素機能の向上に寄与すること,またしそ油の摂取が空腹時血糖値の低下や血漿中性脂肪値の低下をもたらすことを確認した。一方でしそ油の摂取は血漿過酸化脂質レベルの上昇もたらすが,同時に運動トレーニングを負荷することによって,その上昇が抑制されることを示唆する結果が得られ,その機構として,運動による体内ビタミンCによるビタミンEの還元的活性化の促進がある可能性が示唆された。これらの結果は,食事によるn-3系多価不飽和脂肪酸とビタミンCなどの抗酸化成分の適切な摂取と適度の強さの有酸素運動トレーニングを併用することが,包括的な疾病一次予防に有用な方策である可能性を示している

Endothelial Dysfunction, Increased Arterial Stiffness, and Cardiovascular Risk Prediction in Patients With Coronary Artery Disease: FMD‐J (Flow‐Mediated Dilation Japan) Study A

BackgroundThe usefulness of vascular function tests for management of patients with a history of coronary artery disease is not fully known.Methods and ResultsWe measured flow‐mediated vasodilation (FMD) and brachial–ankle pulse wave velocity (baPWV) in 462 patients with coronary artery disease for assessment of the predictive value of FMD and baPWV for future cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow‐up period of 49.2 months, the first primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver‐operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio, 0.27; 95% confidence interval, 0.06–0.74; P=0.008) and second (hazard ratio, 0.32; 95% confidence interval, 0.09–0.79; P=0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (hazard ratio, 1.86; 95% confidence interval, 1.01–3.44; P=0.04) and second (hazard ratio, 2.19; 95% confidence interval, 1.23–3.90; P=0.008) primary outcomes. Among 4 groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed.ConclusionsIn patients with coronary artery disease, both FMD and baPWV were significant predictors of cardiovascular events. The combination of FMD and baPWV provided further cardiovascular risk stratification

FMD, PWV, and Cardiovascular Events

Background The usefulness of vascular function tests for management of patients with a history of coronary artery disease is not fully known. Methods and Results We measured flow‐mediated vasodilation (FMD) and brachial–ankle pulse wave velocity (baPWV) in 462 patients with coronary artery disease for assessment of the predictive value of FMD and baPWV for future cardiovascular events in a prospective multicenter observational study. The first primary outcome was coronary events, and the second primary outcome was a composite of coronary events, stroke, heart failure, and sudden death. During a median follow‐up period of 49.2 months, the first primary outcome occurred in 56 patients and the second primary outcome occurred in 66 patients. FMD above the cutoff value of 7.1%, derived from receiver‐operator curve analyses for the first and second primary outcomes, was significantly associated with lower risk of the first (hazard ratio, 0.27; 95% confidence interval, 0.06–0.74; P=0.008) and second (hazard ratio, 0.32; 95% confidence interval, 0.09–0.79; P=0.01) primary outcomes. baPWV above the cutoff value of 1731 cm/s was significantly associated with higher risk of the first (hazard ratio, 1.86; 95% confidence interval, 1.01–3.44; P=0.04) and second (hazard ratio, 2.19; 95% confidence interval, 1.23–3.90; P=0.008) primary outcomes. Among 4 groups stratified according to the combination of cutoff values of FMD and baPWV, stepwise increases in the calculated risk ratio for the first and second primary outcomes were observed. Conclusions In patients with coronary artery disease, both FMD and baPWV were significant predictors of cardiovascular events. The combination of FMD and baPWV provided further cardiovascular risk stratification

A Study on Application of E-mail System for an Adolescent with Multiple Handicaps

We tried to apply a personal computer especially word processor and E-mail system for an adolescent with visual, physical and speech handicaps, and we guided him how to operate them by himself through the interface called Ke:nx. We taught him and his parents how to apply word processor and E-mail system designing Ke:nx program and connecting his machine to computer network. By trial and error, he could handle his machine and enjoy his life by using E-mail finally. But, he still needed his parent's support. So we need further improvement of the program of Ke:nx for him in order to operate his machine by himself. Taking into consideration of various needs of people with multiple handicaps, we have to develop personal computer system and support system for all user of E-mail