Search

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia among older people and has a significant impact on quality of life. However, it is not always perceived as a serious mental health risk. This study investigated the understanding, perceptions, and attitudes toward the risk of depressive state associated with older patients with AF. Methods: We conducted a quantitative survey in April–June 2021 among patients with AF aged ≥65 years (n = 156), and physicians or cardiologists attending at least 10 older patients with AF annually (n = 158). Results: In total, 45% of patients considered AF a cause of a depressive state. In contrast, 16% of physicians reported that they considered AF a cause of a depressive state. Fifty‐two percent of the patients had experienced a depressive state. Of these, 98% expressed that a depressive state lowered their quality of life. Two of the three patients reported that they would consult their physicians if they felt depressed. By contrast, 30% of physicians responded that even if they perceived their patients as depressed, they prescribe anti‐anxiety medication but do not refer the patient to psychiatrists. Of the physicians, 50% stated that they did not regard the association of AF and depressive state as serious, although both physicians and patients understood that negative anxiety, such as fear of AF attacks, strokes, or heart failure, was the most important contributor to a depressive state. Conclusion: Establishing mental healthcare involving physicians together with psychiatrists is necessary to improve the mental and physical health outcomes for older patients with AF. Geriatr Gerontol Int 2023; 23: 543–548. [ABSTRACT FROM AUTHOR]

A 49-year-old woman visited our emergency department because of exertional dyspnea due to severe left ventricular functional failure. It progressed to disseminated intravascular coagulation and disturbance of consciousness on day 67 of admission. Gram-positive bacilli were detected from two different blood culture samples on day 67 of admission. An API-Coryne test and sequencing (1~615 bp) of the 16S rRNA gene were performed, and the strain was identified as Corynebacterium striatum. The bacterium was detected from the removed central venous catheter tip too, and the patient was diagnosed with catheter-related bloodstream infection by C. striatum. However, treatment was not effective, and the patient died on day 73 of admission.

Eye exposure to hexavalent chromium (Cr(VI)) acid can cause blindness. A 42-year-old man working in a plating operation presented to the emergency department following a workplace incident. He had unintentionally fallen into a tank containing a mixture of 25% Cr(VI) and sulfuric acid (2.0 g/L) at a temperature of approximately 40 °C. The tank dimensions tank were 8 (depth) × 4 (width) × 3 (length) meters. A colleague rescued him from the tank, and he underwent a full body wash at the worksite. Emergency services adequately flushed both eyes with a 0.9% saline solution. He had significant corneal injury; however, no other significant injuries occurred. Upon presentation at the emergency department, the patient underwent a whole-body shower, and both eyes were flushed with 0.9% saline solution. As a treatment for acute chromium poisoning, he received dimercaprol and ascorbic acid. Additionally, he received eye drops for chemical corneal injury. The patient later underwent bilateral corneal transplants for chemical corneal injury but remained nearly blind. We describe a case of severe chemical corneal injury with limbal stem cell deficiency, leading to blindness due to Cr (VI) acid exposure. [ABSTRACT FROM AUTHOR]

Purpose: The diagnostic accuracy of the interferon-gamma release assay (IGRA) in immunosuppressed patients remains unclear. Methods: A systematic review and meta-analysis were performed for diagnostic test accuracy of IGRA in tuberculosis (TB) infection among people living with HIV (PLWHIV). Summary estimates of sensitivity and specificity were calculated using both univariate and bivariate models. Results: The meta-analysis included 45 of the 1,242 first-screened articles. The total number of PLWHIV was 6,525; 3,467 had TB disease, including 806 cases of LTBI and 2,661 cases of active TB. The overall diagnostic odds ratio (DOR) of IGRA in the diagnosis of TB disease was 10.0 (95% confidence interval (CI) 5.59, 25.07), with an area under the curve (AUC) of 0.729. The DOR was better for QFT (14.2 (95%CI 4.359, 46.463)) than T-SPOT (10.0 (95%CI 3.866 26.033)). The sensitivity and specificity of QFT and T-SPOT were 0.663 (95%CI 0.471, 0.813), 0.867 (95%CI 0.683 0.942), and 0.604 (95%CI 0.481, 0.715), 0.862 (95%CI 0.654, 0.954), respectively, in the bivariate model. The sensitivity of IGRA in the diagnosis of LTBI was 0.64 (95%CI 0.61, 0.66). Conclusion: IGRA was useful in the diagnostic of TB disease in PLWHIV, and QFT showed a better tendency of DOR than T-SPOT. IGRA showed a limited effect to rule out LTBI in PLWHIV. [ABSTRACT FROM AUTHOR]

Although diabetic peripheral neuropathy is the most common diabetic microangiopathic complication, several other neuropathy syndromes can occur in the context of diabetes. We describe a rare case of polyneuropathy associated with diabetic ketoacidosis in a patient with new‐onset type 1 diabetes. A 42‐year‐old man with diabetic ketoacidosis was admitted to our hospital with complications of respiratory and renal failure requiring mechanical ventilation and hemodialysis, respectively. After diabetic ketoacidosis improved from the critical state, he developed upper‐ and lower‐limb paralysis with sensory disturbances and pain, as well as right facial paralysis, left recurrent nerve paralysis, and left hypoglossal nerve paralysis. Autonomic nerve function was also impaired. As the pathophysiology, prevention, and treatment of polyneuropathy associated with diabetic ketoacidosis are unclear, the neurologic function of patients with diabetic ketoacidosis should be closely monitored. [ABSTRACT FROM AUTHOR]

Summary: The potato tuber or potato rot nematode, Ditylenchus destructor , causes severe damage to garlic (Allium sativum) produced in Japan. Although consumption of a nematode-infected garlic bulb is not harmful to human health, it causes consumer dissatisfaction because the infected bulb deteriorates quickly. In addition, nematode-contaminated garlic cloves are inadvertently used as seed garlic for next season, which then leads to nematode-infested fields and increases yield loss. However, infected garlic bulbs look the same as healthy ones, and hence have been unknowingly distributed and sold. A method is needed to discriminate infected garlic bulbs from non-infected garlic bulbs before distribution in the market, but to date no suitable technique has been developed. The objective of this study was to identify specific odour-active compounds associated with nematode-infected garlic through the use of analytical chemistry. Garlic cloves were infected with cultured nematodes under controlled conditions, and the volatile odour-active compounds were analysed by an 'odour identification system' which included gas chromatography-olfactometry (GC-O), GC-fractionation (GC-F), GC-mass spectrometry (GC-MS), and odour/aroma-specific database. Two specific odour-active compounds associated with nematode-infected garlic cloves were identified as allyl methyl disulfide and eugenol, and two others were tentatively identified as (E)-1-allyl-2-(prop-1-en-1-yl)disulfane and allyl methyl trisulfide. These specific odour-active compounds may be useful as indicators to detect nematode-infected garlic bulbs in a non-destructive manner. [ABSTRACT FROM AUTHOR]

Research on elderly financial exploitation has mostly focused on financial abuse that occurs in families and other types of trusted relationships. As such, little is known about financial frauds and scams perpetrated by strangers. Financial fraud and scam prevention activities for older adults must be promoted, for which the correlation between the psychological, social, and cognitive characteristics of their vulnerability needs to be determined. The present study aimed to determine whether cognitive decline is a risk factor for scam vulnerability in older adults. Thus, we created a scam vulnerability scale for older adults with cognitive decline and analyzed the data to reveal the correlation between them, including inhibition and executive function. We conducted an interview survey with 50 older adults with cognitive decline (average age: 79.42 years, SD: 5.44) and 51 older adults without cognitive decline (average age: 76.12 years, SD: 5.82). The interview survey included the scam vulnerability scale, psychosocial questionnaires, and neuropsychological tests. The scale included six items with a four-point Likert scale based on a previous study. Hierarchical multiple regression analysis revealed that lower scores on the Japanese version of the Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Jcog; indicating higher general cognitive function) correlated with higher scam vulnerability in the cognitive decline group (β = −0.46, p < 0.001). In addition, men were found to be more vulnerable in both groups (cognitive decline group: β = −0.29, p = 0.015, cognitive non-decline group; β = −0.32, p = 0.018). Inhibition and executive function were found not to correlate significantly with scam vulnerability. These results suggest that mild cognitive decline correlates with higher scam vulnerability, whereas moderate to severe cognitive decline correlates with lower vulnerability, possibly because it makes understanding the scam attempt itself difficult. Older adults with mild cognitive decline and their families, particularly those visiting elderly care or outpatient facilities, should be notified of the scam vulnerability of older clients using the ADAS-Jcog score as an index to help them avoid victimization. [ABSTRACT FROM AUTHOR]

Background: Mild behavioral impairment (MBI) is associated with accelerated cognitive decline and greater risk of dementia. However, the neural correlates of MBI have not been completely elucidated.Objective: The study aimed to investigate the correlation between cognitively normal participants and participants with amnestic mild cognitive impairment (aMCI) using resting-state functional magnetic resonance imaging.Methods: The study included 30 cognitively normal participants and 13 participants with aMCI (20 men and 23 women; mean age, 76.9 years). The MBI was assessed using the MBI checklist (MBI-C). Region of interest (ROI)-to-ROI analysis was performed to examine the correlation between MBI-C scores and functional connectivity (FC) of the default mode network, salience network, and frontoparietal control network (FPCN). Age, Mini-Mental State Examination score, sex, and education were used as covariates. A p-value of 0.05, with false discovery rate correction, was considered significant.Results: A negative correlation was observed between the MBI-C total score and FC of the left posterior parietal cortex with the right middle frontal gyrus. A similar result was obtained for the MBI-C affective dysregulation domain score.Conclusion: FPCN dysfunction was detected as a neural correlate of MBI, especially in the affective dysregulation domain. This dysfunction may be associated with cognitive impairment in MBI and conversion of MBI to dementia; however, further longitudinal data are needed to examine this relationship. [ABSTRACT FROM AUTHOR]

Guided bone regeneration is the most commonly used technique for vertical ridge augmentation (VRA), and it is popular because it is less invasive and highly formative. Since the augmented site is exposed to external pressure, it is preferable to support the membrane using a framework to maintain the shape of the VRA. Recently, a titanium framework–reinforced ultrafine titanium membrane was developed by laser processing technology. The technique allows microperforations to be made (φ20 μm) into a titanium membrane, which is expected to prevent fibrous tissue ingrowth from outside the membrane. In addition, significant bone regeneration was confirmed on ridge defects in previous animal studies. However, the membrane tends to crumple during the bending process, because it is very thin (20 nμm); thus, the bending procedures are technically sensitive. Since this titanium honeycomb membrane was first approved for clinical use in Japan, no international clinical reports have been published. The purpose of this case report is to describe a technical note for a 3-dimensional curvature bending method in VRA using the newly developed honeycomb structure titanium membrane. [ABSTRACT FROM AUTHOR]