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1.
Vox Sang ; 113(3): 297-299, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29359332

RESUMO

The risk of transfusion-transmitted infection (TTI) for severe fever with thrombocytopenia syndrome virus (SFTSV) is a concern because person-to-person transmission resulting from contact with SFTSV-contaminated blood has been reported. To obtain information regarding the risk of TTI-SFTSV, antibody testing was performed for blood samples donated in an severe fever with thrombocytopenia syndrome-endemic area in Japan. No antibody-positive samples were detected among 3990 samples. This finding suggested that there were few cases of SFTSV infection among donors and that the risk of TTI-SFTSV was also estimated low in Japan.


Assuntos
Infecções por Bunyaviridae/epidemiologia , Phlebovirus/imunologia , Reação Transfusional/epidemiologia , Adulto , Anticorpos Antivirais/sangue , Doadores de Sangue , Infecções por Bunyaviridae/sangue , Feminino , Humanos , Japão , Masculino , Phlebovirus/patogenicidade , Reação Transfusional/sangue , Reação Transfusional/virologia
2.
Proc Natl Acad Sci U S A ; 112(6): 1670-4, 2015 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-25624483

RESUMO

The perovskite PbCrO3 is an antiferromagnetic insulator. However, the fundamental interactions leading to the insulating state in this single-valent perovskite are unclear. Moreover, the origin of the unprecedented volume drop observed at a modest pressure of P = 1.6 GPa remains an outstanding problem. We report a variety of in situ pressure measurements including electron transport properties, X-ray absorption spectrum, and crystal structure study by X-ray and neutron diffraction. These studies reveal key information leading to the elucidation of the physics behind the insulating state and the pressure-induced transition. We argue that a charge disproportionation 3Cr(4+) → 2Cr(3+) + Cr(6+) in association with the 6s-p hybridization on the Pb(2+) is responsible for the insulating ground state of PbCrO3 at ambient pressure and the charge disproportionation phase is suppressed under pressure to give rise to a metallic phase at high pressure. The model is well supported by density function theory plus the correlation energy U (DFT+U) calculations.

3.
J Evol Biol ; 30(6): 1110-1123, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28306172

RESUMO

Adaptation to different environments can promote population divergence via natural selection even in the presence of gene flow - a phenomenon that typically occurs during ecological speciation. To elucidate how natural selection promotes and maintains population divergence during speciation, we investigated the population genetic structure, degree of gene flow and heterogeneous genomic divergence in three closely related Japanese phytophagous ladybird beetles: Henosepilachna pustulosa, H. niponica and H. yasutomii. These species act as a generalist, a wild thistle (Cirsium spp.) specialist and a blue cohosh (Caulophyllum robustum) specialist, respectively, and their ranges differ accordingly. The two specialist species widely co-occur but are reproductively isolated solely due to their high specialization to a particular host plant. Genomewide amplified fragment-length polymorphism (AFLP) markers and mitochondrial cytochrome c oxidase subunit I (COI) gene sequences demonstrated obvious genomewide divergence associated with both geographic distance and ecological divergence. However, a hybridization assessment for both AFLP loci and the mitochondrial sequences revealed a certain degree of unidirectional gene flow between the two sympatric specialist species. Principal coordinates analysis (PCoA) based on all of the variable AFLP loci demonstrated that there are genetic similarities between populations from adjacent localities irrespective of the species (i.e. host range). However, a further comparative genome scan identified a few fractions of loci representing approximately 1% of all loci as different host-associated outliers. These results suggest that these three species had a complex origin, which could be obscured by current gene flow, and that ecological divergence can be maintained with only a small fraction of the genome is related to different host use even when there is a certain degree of gene flow between sympatric species pairs.


Assuntos
Besouros/genética , Fluxo Gênico , Deriva Genética , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Animais , Especiação Genética , Seleção Genética
4.
J Oral Rehabil ; 44(1): 51-58, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27883208

RESUMO

Sarcopenia is an age-related loss of muscle mass and muscle strength or physical performance. There are limited data on the association between oral health and sarcopenia. To test the hypothesis that impaired dentition status was associated with sarcopenia, we conducted a cross-sectional study. A total of 272 community-dwelling Japanese adults aged ≥75 years for whom data were available from comprehensive health examinations conducted in 2015 were included in this study. During dental examination, the number of natural teeth and occluding pairs of natural teeth was counted. In denture wearers, the fit of the removable dentures was also evaluated. The criteria proposed by the Asian Working Group for Sarcopenia were used to define sarcopenia. A multivariable logistic regression model was used to evaluate the association between dentition status and the presence of sarcopenia. The prevalence of sarcopenia was 25·7% (70/272). Compared to individuals with ≥10 occluding pairs of natural teeth, those with no occluding pairs of natural teeth had significantly higher risk of having sarcopenia (adjusted odds ratio, 3·37; 95% confidence interval, 1·07-10·61), after adjusting for possible confounders. In addition, compared to individuals with well-fitting dentures, those with ill-fitting dentures had significantly higher risk of having sarcopenia (adjusted odds ratio, 5·07; 95% confidence interval, 1·59-16·19). Our findings suggest that impaired dentition status is significantly associated with sarcopenia among community-dwelling Japanese adults aged ≥75 years. Future longitudinal studies with larger, more diverse populations are necessary to validate our findings.


Assuntos
Prótese Total/estatística & dados numéricos , Avaliação Geriátrica , Boca Edêntula/epidemiologia , Saúde Bucal/estatística & dados numéricos , Sarcopenia/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dentição , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Boca Edêntula/fisiopatologia , Prevalência , Sarcopenia/fisiopatologia
5.
J Periodontal Res ; 51(5): 681-8, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26740384

RESUMO

BACKGROUND AND OBJECTIVE: Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013. MATERIAL AND METHODS: Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models. RESULTS: Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis. CONCLUSION: Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.


Assuntos
Disfunção Cognitiva/complicações , Periodontite/complicações , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas , Povo Asiático , Índice de Massa Corporal , Doenças Cardiovasculares , Disfunção Cognitiva/epidemiologia , Depressão , Educação , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Hipertensão , Japão/epidemiologia , Estudos Longitudinais , Masculino , Periodontite/epidemiologia , Análise de Regressão , Fatores de Risco , Fatores Sexuais , Fumar , Fatores Socioeconômicos
6.
Phys Rev Lett ; 114(11): 117001, 2015 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-25839302

RESUMO

We report the discovery of superconductivity on the border of long-range magnetic order in the itinerant-electron helimagnet MnP via the application of high pressure. Superconductivity with T(sc)≈1 K emerges and exists merely near the critical pressure P(c)≈8 GPa, where the long-range magnetic order just vanishes. The present finding makes MnP the first Mn-based superconductor. The close proximity of superconductivity to a magnetic instability suggests an unconventional pairing mechanism. Moreover, the detailed analysis of the normal-state transport properties evidenced non-Fermi-liquid behavior and the dramatic enhancement of the quasiparticle effective mass near P(c) associated with the magnetic quantum fluctuations.

7.
Phys Rev Lett ; 114(8): 086401, 2015 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-25768771

RESUMO

We report electrical resistivity, ac magnetic susceptibility, and x-ray absorption spectroscopy measurements of intermediate valence YbNi_{3}Ga_{9} under pressure and magnetic field. We have revealed a characteristic pressure-induced Yb valence crossover within the temperature-pressure phase diagram, and a first-order metamagnetic transition is found below P_{c}∼9 GPa where the system undergoes a pressure-induced antiferromagnetic transition. As a possible origin of the metamagnetic behavior, a critical valence fluctuation emerging near the critical point of the first-order valence transition is discussed on the basis of the temperature-field-pressure phase diagram.

8.
Community Dent Health ; 32(2): 104-10, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26263604

RESUMO

OBJECTIVE: To investigate the relationship of dental status to food diversity among older Japanese. DESIGN AND SETTING: A community-based cross-sectional study conducted in the town of Tosa, Kochi Prefecture, Japan. METHODS: The study participants were 252 Japanese (84 men and 168 women, average age 81.2 years) and dentate participants were classified into three groups: 1-9 teeth, 10-19 teeth and 20 or more teeth. Food diversity was assessed as a validated measure of dietary quality using the 11-item Food Diversity Score Kyoto (FDSK-11), which evaluates frequency of consumption of 11 main food groups. Multivariable analysis of the differences in FDSK-11 score ranging from 0 to 11, with a higher score indicating greater food diversity, among the three dental status groups was conducted using general linear models. All the performed analyses were stratified by gender. RESULTS: There was no association between dental status and food diversity score in models for men. In contrast, women with ≤ 9 teeth and with 10-19 teeth had significantly lower FDSK-11 scores than women with ≥ 20 teeth after adjusting for confounders (p < 0.001 and p = 0.009, respectively). Additionally, there was a trend toward lower scores for FDSK-11 with fewer teeth (p = 0.001). CONCLUSION: A less varied diet, as indicated by low FDSK-11 score, was observed in female participants with fewer teeth. Tooth loss was associated with poor diet quality among older Japanese women.


Assuntos
Comportamento Alimentar , Nível de Saúde , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos Transversais , Dentição , Dentaduras , Diabetes Mellitus/fisiopatologia , Ingestão de Alimentos/fisiologia , Escolaridade , Feminino , Humanos , Japão , Arcada Parcialmente Edêntula/fisiopatologia , Masculino , Mastigação/fisiologia , Fatores Sexuais , Perda de Dente/fisiopatologia
9.
J Med Primatol ; 43(2): 111-4, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24304143

RESUMO

Oral malignancy is rare in chimpanzees. A 34-year-old female chimpanzee (Pan troglodytes) at Kumamoto Sanctuary, Japan, had developed it. Treatment is technically difficult for chimpanzees while malignant neoplasm is seemingly rising in captive populations. Widespread expert discussion, guidelines for treatment, especially for great apes in terminal stages is urgently needed.


Assuntos
Animais de Zoológico , Doenças dos Símios Antropoides/diagnóstico , Neoplasias Bucais/veterinária , Pan troglodytes , Sarcoma/veterinária , Animais , Doenças dos Símios Antropoides/patologia , Doenças dos Símios Antropoides/terapia , Evolução Fatal , Feminino , Hepacivirus/isolamento & purificação , Japão , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/terapia , Sarcoma/diagnóstico , Sarcoma/terapia
10.
Phys Rev Lett ; 111(17): 176403, 2013 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-24206506

RESUMO

The A-site ordered perovskite (AA(3)')B(4)O(12) can accommodate transition metals on both A' and B sites in the crystal structure. Because of this structural feature, it is possible to have narrow-band electrons interacting with broadband electrons from different sublattices. Here we report a new A-site ordered perovskite (CaCu(3))Ir(4)O(12) synthesized under high pressure. The coupling between localized spins on Cu(2+) and itinerant electrons from the Ir-O sublattice makes Kondo-like physics take place at a temperature as high as 80 K. Results from the local density approximation calculation have confirmed the relevant band structure. The magnetization anomaly found at 80 K can be well rationalized by the two-fluid model.

11.
Phys Rev Lett ; 109(18): 187004, 2012 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-23215319

RESUMO

We report the discovery of a pressure-induced heavy fermion superconductivity in a nonmagnetic orbital ordering state in the cubic compound PrTi(2)Al(20). In particular, we found that the transition temperature and the effective mass associated with the superconductivity are dramatically enhanced as the system approaches the putative quantum critical point of the orbital order. Our experiment indicates that the strong orbital fluctuations may provide a nonmagnetic glue for Cooper pairing.

12.
Phys Rev Lett ; 108(23): 236403, 2012 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-23003979

RESUMO

We report a comprehensive high-pressure study on the triple-layer T'-La4Ni3O8 with a suite of experimental probes, including structure determination, magnetic, and transport properties up to 50 GPa. Consistent with a recent ab inito calculation, application of hydrostatic pressure suppresses an insulator-metal spin-state transition at P(c)≈6 GPa. However, a low-spin metallic phase does not emerge after the high-spin state is suppressed to the lowest temperature. For P>20 GPa, the ambient T' structure transforms gradually to a T(†)-type structure, which involves a structural reconstruction from fluorite La-O2-La blocks under low pressures to rock-salt LaO-LaO blocks under high pressures. Absence of the metallic phase under pressure has been discussed in terms of local displacements of O2- ions in the fluorite block under pressure before a global T(†) phase is established.

13.
Phys Rev Lett ; 106(5): 056602, 2011 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-21405419

RESUMO

Studies of the structure, magnetization, and resistivity under pressure on stoichiometric normal spinel Co[V(2)]O(4) single crystals show (i) absence of a structural distortion, (ii) abnormal magnetic critical exponents, and (iii) metallic conductivity induced by pressures at low temperatures. All these results prove that Co[V(2)]O(4) sits on the edge of the itinerant-electron limit. Compared with similar measurements on Fe[V(2)]O(4) and other A[V(2)]O(4) studies, it is shown that a critical V-V separation for a localized-itinerant electronic phase transition exists.

14.
J Evol Biol ; 24(7): 1421-32, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21545419

RESUMO

Detecting the isolating barrier that arises earliest in speciation is critically important to understanding the mechanism of species formation. We tested isolating barriers between host races of a phytophagous ladybird beetle, Henosepilachna diekei (Coleoptera: Coccinellidae: Epilachnine), that occur sympatrically on distinct host plants. We conducted field surveys for the distribution of the beetles and host plants, rearing experiments to measure six potential isolating factors (adult host preference, adult and larval host performance, sexual isolation, egg hatchability, F(1) hybrid inviability, and sexual selection against F(1) hybrids), and molecular analyses of mitochondrial ND2 and the nuclear ITS2 sequences. We found significant genetic divergence between the host races, and extremely divergent host preference (i.e. habitat isolation) and host performance (i.e. immigrant inviability), but no other isolating barriers. The fidelity to particular host plants arises first and alone can prevent gene flow between differentiating populations of phytophagous specialists.


Assuntos
Besouros/fisiologia , Comportamento Alimentar/fisiologia , Animais , DNA Intergênico/genética , DNA Mitocondrial/genética , Demografia , Especiação Genética , Variação Genética , Indonésia , Espécies Introduzidas , Lamiaceae , Larva/fisiologia , Mikania , Especificidade da Espécie
15.
Vox Sang ; 99(4): 307-13, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20576022

RESUMO

BACKGROUND AND OBJECTIVES: In previous studies, we reported the transmission of hepatitis E virus (HEV) by transfusion, and the frequent detection of HEV markers in Japanese blood donors with elevated ALT levels. For the current study, we carried out a nationwide survey of the prevalence of IgG anti-HEV in qualified blood donors throughout Japan. MATERIALS AND METHODS: The 12,600 samples from qualified blood donors were collected from seven blood centres (1800 per centre) representing nearly all regions of Japan. Samples were from age- and sex-matched blood donors who tested negative for all the current blood screening tests. The samples were screened using the in-house IgG anti-HEV ELISA. Sequentially, the positive samples were tested by the commercial IgG anti-HEV ELISA. RESULTS: Of 12,600 samples, 431 (3·4%) were regarded as positive for IgG anti-HEV. The prevalence of IgG anti-HEV was higher in eastern Japan (5·6%) than in western Japan (1·8%) (P<0·001), and was also age-dependent and higher in men (3·9%) than in women (2·9%) (P=0·002). CONCLUSION: The spread of the domestic infection of HEV was observed in qualified blood donors in Japan. A higher prevalence of IgG anti-HEV was observed in male donors, older donors and in donors residing in eastern Japan. Further studies are necessary to clarify the potential risk of transfusion-transmission of HEV in Japan.


Assuntos
Doadores de Sangue , Seleção do Doador , Anticorpos Anti-Hepatite/sangue , Vírus da Hepatite E , Hepatite E , Imunoglobulina G/sangue , Fatores Etários , Coleta de Dados , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Hepatite E/sangue , Hepatite E/epidemiologia , Humanos , Japão/epidemiologia , Masculino , Prevalência , Estudos Soroepidemiológicos , Fatores Sexuais
16.
Epidemiol Infect ; 137(11): 1615-22, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19379540

RESUMO

Legionnaires' disease (LD) is a major cause of severe community-acquired pneumonia but the source and mode of transmission are not always apparent, especially in sporadic cases. We hypothesized that LD can be acquired from the air-conditioning systems of motor cars. Swabs were taken from the evaporator compartments of the air-conditioning system of scrapped cars. Healthy subjects who were mainly employees of regional transportation companies were tested for antibody to Legionella pneumophila serogroups 1-6; they also completed a questionnaire. Legionella species were detected in 11/22 scrapped cars by the loop-mediated isothermal amplification method. The prevalence of microplate agglutination titres > or =1:32 was significantly higher in subjects who sometimes used car air-conditioning systems. Although we did not prove a direct link between Legionella spp. in the car evaporator and LD, our findings point to a potential risk of car air-conditioning systems in LD, which needs further investigation.


Assuntos
Ar Condicionado/efeitos adversos , Condução de Veículo , Doença dos Legionários/etiologia , Exposição Ocupacional , Vigilância da População , Adulto , Humanos , Japão/epidemiologia , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/diagnóstico , Doença dos Legionários/epidemiologia , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Prevalência , Fatores de Risco , Testes Sorológicos
17.
J Endocrinol ; 188(2): 333-44, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16461559

RESUMO

Aging is associated with a decrease in growth hormone (GH) secretion, appetite and energy intake. As ghrelin stimulates both GH secretion and appetite, reductions in ghrelin levels may be involved in the reductions in GH secretion and appetite observed in the elderly. However, only preliminary studies have been performed on the role of ghrelin in elderly subjects. In this study, we sought to clarify the physiologic implications of the age-related alterations in ghrelin secretion by determining plasma ghrelin levels and other clinical parameters in healthy elderly subjects. Subjects were > or = 65 years old, corresponding to the SENIEUR protocol, had not had a resection of the upper gastrointestinal tract and had not been treated with hormones. One hundred and five volunteers (49 men and 56 women) were admitted to this study (73.4 +/- 6.3 years old). Plasma levels of acylated ghrelin in elderly female subjects positively correlated with serum IGF-I levels and bowel movement frequency and negatively with systolic blood pressure. In elderly men, desacyl ghrelin levels correlated only weakly with bowel movement frequency. These findings suggest that the plasma levels of the acylated form of ghrelin may influence the age-related alterations in GH/IGF-I regulation, blood pressure and bowel motility. These observational associations warrant further experimental studies to clarify the physiologic significance of these effects.


Assuntos
Defecação/fisiologia , Fator de Crescimento Insulin-Like I/análise , Hormônios Peptídicos/sangue , Acilação , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Glicemia/análise , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Feminino , Grelina , Hormônio do Crescimento Humano/sangue , Humanos , Insulina/sangue , Leptina/sangue , Masculino
18.
Nat Commun ; 7: 12146, 2016 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-27431724

RESUMO

The coexistence and competition between superconductivity and electronic orders, such as spin or charge density waves, have been a central issue in high transition-temperature (Tc) superconductors. Unlike other iron-based superconductors, FeSe exhibits nematic ordering without magnetism whose relationship with its superconductivity remains unclear. Moreover, a pressure-induced fourfold increase of Tc has been reported, which poses a profound mystery. Here we report high-pressure magnetotransport measurements in FeSe up to ∼15 GPa, which uncover the dome shape of magnetic phase superseding the nematic order. Above ∼6 GPa the sudden enhancement of superconductivity (Tc≤38.3 K) accompanies a suppression of magnetic order, demonstrating their competing nature with very similar energy scales. Above the magnetic dome, we find anomalous transport properties suggesting a possible pseudogap formation, whereas linear-in-temperature resistivity is observed in the normal states of the high-Tc phase above 6 GPa. The obtained phase diagram highlights unique features of FeSe among iron-based superconductors, but bears some resemblance to that of high-Tc cuprates.

19.
Cytogenet Genome Res ; 108(1-3): 248-54, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15545737

RESUMO

The terminal C-bands that are a specific feature of chimpanzee chromosomes were dissected using a molecular cytogenetic technique, PRINS, with primers for telomeric sequences, subterminal satellite, and retrotransposable elements (HERV-K and -W). These DNA elements jointly formed a large block of retrotransposable compound repeat DNA organization (RCRO) at the terminal C-band regions of 30 chromosomes, and are also located at the centromeric regions of some chromosomes. Additionally, a block consisting of all members of the RCRO has transposed to the middle (q31.1) of the long arm of chromosome 6, and three members, the subterminal satellite and the two HERVs, have integrated into the proximal region (q14.4) of the long arm of chromosome 14. Terminal RCROs seem to induce and prolong the bouquet stage in meiotic prophase, and to affect chiasma formation, together with interstitial RCROs. It is also postulated that RCROs may cause a position effect to gene expression, resulting in gene silencing and/or late replication.


Assuntos
Cromossomos de Mamíferos/genética , DNA/genética , Meiose/genética , Pan troglodytes/genética , Prófase/genética , Recombinação Genética/genética , Retroelementos/genética , Animais , Conformação de Ácido Nucleico , Pan paniscus/genética , Sequências Repetitivas de Ácido Nucleico/genética , Telômero/genética
20.
Biomed Pharmacother ; 59 Suppl 1: S31-9, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16275504

RESUMO

By means of a multivariate Cox model, we investigated the predictive value of a depressive mood on vascular disease risk in middle-aged community-dwelling people. In 224 people (88 men and 136 women; mean age: 56.8 +/- 11.2 years) of U town, Hokkaido (latitude: 43.45 degrees N, longitude: 141.85 degrees E), a chronoecological health watch was started in April 2001. Consultations were repeated every 3 months. Results at the November 30, 2004 follow-up are presented herein. 7-day/24-h blood pressure (BP) and heart rate (HR) monitoring started on a Thursday, with readings taken at 30-min intervals between 07:00 h and 22:00 h and at 60-min intervals between 22:00 h and 07:00 h. Data stored in the memory of the monitor (TM-2430-15, A and D company, Japan) were retrieved and analyzed on a personal computer with a commercial software for this device. Subjects were asked to answer a self-administered questionnaire inquiring about 15 items of a depression scale, at the start of study and again after 1-2 years. Subjects with a score higher by at least two points at the second versus first screening were classified as having a depressive mood. The other subjects served as the control group. The mean follow-up time was 1064 days, during which four subjects suffered an adverse vascular outcome (myocardial infarction: one man and one woman; stroke: two men). Among the variables used in the Cox proportional hazard models, a depressive mood, assessed by the Geriatric Depression Scale (GDS), as well as the MESOR of diastolic (D) BP (DBP-MESOR) and the circadian amplitude of systolic (S) BP (SBP-Amplitude) showed a statistically significant association with the occurrence of adverse vascular outcomes. The GDS score during the second but not during the first session was statistically significantly associated with the adverse vascular outcome. In univariate analyses, the relative risk (RR) of developing outcomes was predicted by a three-point increase in the GDS scale (RR = 3.088, 95% CI: 1.375-6.935, P = 0.0063). Increases of 5 mmHg in DBP-MESOR and of 3 mmHg in SBP-Amplitude were associated with RRs of 2.143 (95% CI: 1.232-3.727, P = 0.0070) and 0.700 (95% CI: 0.495-0.989, P = 0.0430), respectively. In multivariate analyses, when both the second GDS score and the DBP-MESOR were used as continuous variables in the same model, GDS remained statistically significantly associated with the occurrence of cardiovascular death. After adjustment for DBP-MESOR, a three-point increase in GDS score was associated with a RR of 2.172 (95% CI: 1.123-4.200). Monday endpoints of the 7-day profile showed a statistically significant association with adverse vascular outcomes. A 5 mmHg increase in DBP on Monday was associated with a RR of 1.576 (95% CI: 1.011-2.457, P = 0.0446). The main result of the present study is that in middle-aged community-dwelling people, a depressive mood predicted the occurrence of vascular diseases beyond the prediction provided by age, gender, ABP, lifestyle and environmental conditions, as assessed by means of a multivariate Cox model. A depressive mood, especially enhanced for 1-2 years, was associated with adverse vascular outcomes. Results herein suggest the clinical importance of repetitive assessments of a depressive mood and the need to take sufficient care of depressed subjects. Another result herein is that circadian and circaseptan characteristics of BP variability measured 7-day/24-h predicted the occurrence of vascular disease beyond the prediction provided by age, gender, depressive mood and lifestyle, as assessed by means of a multivariate Cox model. Earlier, we showed that the morning surge in BP on Mondays was statistically significantly higher compared with other weekdays. Although a direct association between the Monday surge in BP and cardiovascular events could not be demonstrated herein, it is possible that the BP surge on Monday mornings may also trigger cardiovascular events. We have shown that depressive people exhibit a more prominent circaseptan variation in SBP, DBP and the double product (DP) compared to non-depressed subjects. In view of the strong relation between depression and adverse cardiac events, studies should be done to ascertain that depression is properly diagnosed and treated. Chronodiagnosis and chronotherapy can reduce an elevated blood pressure and improve the altered variability in BP and HR, thus reducing the incidence of adverse cardiac events. This recommendation stands at the basis of chronomics, focusing on prehabilitation in preference to rehabilitation, as a public service offered in several Japanese towns.


Assuntos
Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Ritmo Circadiano/fisiologia , Depressão/psicologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Escalas de Graduação Psiquiátrica , Fatores de Risco , Inquéritos e Questionários
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