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BA.2 is a subvariant of the SARS-CoV-2 Omicron variant. XBB.1.5 and XBB.1.16, recombinants of the BA.2.10.1 and BA.2.75 sublineages, were circulating SARS-CoV-2 variants of interest in July 2023 (1,2), but [...]

BA.5 is a subvariant of the SARS-CoV-2 Omicron variant (1). Since July 2022, Omicron BA.5 has been the dominant variant in Japan (2,3). According to Japan's Infectious Diseases Control Law, [...]

Aims: Constipation is a common gastrointestinal disorder that is associated with a high cardiovascular event rate in the general population. Although constipation is common in patients with cardiovascular diseases, only a few studies have examined the relationship between constipation and the prognosis of patients with heart failure. This study aimed to evaluate the effects of constipation on the prognosis of patients with acute heart failure. Methods and results: We investigated 397 patients admitted to our hospital from December 2020 to December 2022 with acute heart failure (mean age, 81 ± 13 years; 54% men). Patients with constipation were defined as those either taking laxatives regularly or diagnosed with constipation according to the International Statistical Classification of Diseases and Related Health Problems. During the follow‐up periods (median, 173 days), 35 patients died, and 74 experienced readmission due to heart failure. Kaplan–Meier analysis before and after propensity score matching using 14 variables revealed that the risk of readmission due to heart failure was significantly higher in patients with constipation than in those without (before: log‐rank P = 0.014, after: log‐rank P = 0.0027). The adjusted Cox proportional hazards analysis revealed that the hazard ratio for readmission due to heart failure was 2.61 (95% confidence interval, 1.38–4.94, P = 0.0032). The risk of all‐cause death was not significantly different between the two groups (hazard ratio, 1.76; 95% confidence interval, 0.61–5.06; P = 0.30). Conclusions: Constipation status was strongly associated with a higher risk of readmission for heart failure in patients with acute heart failure. [ABSTRACT FROM AUTHOR]

Background: Despite the advances in the treatment of cardiovascular diseases, effective treatment remains to be established to improve the quality of life and prognosis of patients with chronic coronary syndromes. This study was aimed to evaluate the effectiveness and safety of the low-intensity pulsed ultrasound (LIPUS) therapy, which we have developed as a novel non-invasive angiogenic therapy through upregulation of endothelial nitric oxide synthase (eNOS). Methods and findings: We conducted a randomized, double-blind, placebo-controlled (RCT) pilot trial of the LIPUS therapy for patients with refractory angina pectoris. The patients who received optimal medical therapy without indication of PCI or CABG due to the lack of graftability or complexity of coronary lesions were enrolled. They were randomly divided into the LIPUS treatment group (N = 31) and the placebo group (N = 25) in a 1:1 fashion. The LIPUS therapy was performed in a transthoracic manner for 20 min for 3 sections each (mitral, papillary muscle, and apex levels) under the conditions that we identified; frequency 1.875 MHz, intensity 0.25 MPa, and 32 cycles. The primary endpoint was weekly use of nitroglycerin. Secondary endpoints included stress myocardial perfusion imaging and others. The average weekly nitroglycerin use (times/week) was decreased from 5.50 to 2.44 in the LIPUS group and from 5.94 to 2.83 in the placebo group. The changes in the average weekly nitroglycerin use were comparable; -3.06 (95% CI: -4.481 to -1.648) in the LIPUS group (P<0.01) and -3.10 (95% CI: -4.848 to -1.356) in the placebo group (P<0.01). No adverse effects were noted. Conclusions: In the present study, the LIPUS therapy did not further ameliorate chest pain as compared with optimal medications alone in patients with refractory angina pectoris. The present findings need to be confirmed in another trial with a large number of patients. (Registration ID: UMIN000012369). [ABSTRACT FROM AUTHOR]

Background: The question of whether Parkinson's disease (PD) patients have nocturnal polyuria (NP) has not yet been fully answered. Objectives: To determine whether NP was present in PD patients and if so, what its relevant factors were. Methods: This was a retrospective analysis. We had 36 consecutive referred PD patients: age, 71.5 years (range, 54–83 years); 24 men, 12 women; mean disease duration, 2.5 years (1.0–4.5 years); Hoehn and Yahr motor scale, 3.0 (2.0–3.5); all ambulatory; all on treatment. All the PD patients completed a lower urinary tract symptom (LUTS questionnaire) and a bladder diary, and underwent urodynamics testing. Results: NP was identified in 56% of patients. NP was more common in patients with nocturia (p < 0.05), and in patients with urodynamic detrusor overactivity (p < 0.01). There was no relation between NP and gender, age, PD medications, blood pressure, or comorbid diabetes. Conclusions: A total of 56% of PD patients had NP, which had a close relation with detrusor overactivity (p < 0.01). These findings suggest that in PD, the loss of dopaminergic neurons leads to NP (hypothalamic circuit) and detrusor overactivity (nigrostriatal circuit). [ABSTRACT FROM AUTHOR]

The present article reviewed autonomic dysfunction in older individuals. The following estimated incidences are reported among octogenarians (age >80 years): white matter disease (WMD), 80%; Alzheimer's disease (AD), 33%; and dementia with Lewy bodies (DLB), 7%–8%. A combination of AD + WMD is the most common. The estimated incidence in octogenarians of diabetes that produces small fiber neuropathy is 30%. Orthostatic hypotension, overactive bladder, and bowel motility dysfunction also increase with age. The links between all of these disorders are still obscure, but associations have been postulated between orthostatic hypotension with DLB and diabetes, between overactive bladder with WMD and DLB (AD in part), and between bowel motility dysfunction with DLB and diabetes. Management and care of autonomic dysfunction is thus necessary to maximize the quality of life of older individuals and avoid emergency of syncope, urinary retention, or ileus. [ABSTRACT FROM AUTHOR]