Relationship of daily hot water bathing at home and hot water spa bathing with underlying diseases in middle-aged and elderly ambulatory patients: A Japanese multicenter cross-sectional study.

The purpose of this study was to clarify the relationship of daily hot water bathing at home (DHW) and hot water spa bathing (HSPA) with the number of underlying diseases in middle-aged and elderly ambulatory patients. We defined the number of underlying diseases as the main outcome and dependent (criterion) variable. The frequency and time of DHW and the frequency of HSPA were set as explanatory variables. Multiple logistic regression analysis was performed for each frequency and time, adjusted age and sex. Odds ratio (OR) and 95% confidence interval (95% CI) were calculated. Among the 1261 patients who participated, there was no significant difference in age between males (n = 508, 72.8 ± 6.8 years) and females (n = 753, 73.5 ± 6.9 years). There was also no significant age difference between males (number of diseases: 2.7 ± 2.0 pts.) and females (number of diseases: 2.7 ± 2.1 pts.) in the occurrence of underlying diseases. Frequency and time of DHW were not associated with the occurrence of underlying diseases. However, compared with participants who utilized hot water spa at least once a week, the occurrence of underlying diseases was significantly associated with bathing frequency: one to three times per month (OR 2.72, 95% CI 1.63-4.52); twice or five times a year (OR 1.92, 95% CI 1.25-2.94). In conclusion, lower frequency of HSPA was significantly associated with increased risk of the occurrence of underlying diseases in middle-aged and elderly ambulatory patients. However, the relationship between proactive use of hot water spa and patients' mental and physical support should be clarified by well-designed cohort studies. The present study was registered as UMIN000033018 by the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) in Japan (refer: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037643).

A ghrelin gene variant may predict crossover rate from restricting-type anorexia nervosa to other phenotypes of eating disorders: a retrospective survival analysis.

BACKGROUND: Patients with anorexia nervosa restricting type (AN-R) often develop bulimic symptoms and crossover to AN-binge eating/purging type (AN-BP), or to bulimia nervosa (BN). We have reported earlier that genetic variants of an orexigenic peptide ghrelin are associated with BN. Here, the relationship between a ghrelin gene variant and the rate of change from AN-R to other phenotypes of eating disorders (EDs) was investigated. METHODS: Participants were 165 patients with ED, initially diagnosed as AN-R. The dates of their AN-R onset and changes in diagnosis to other subtypes of ED were investigated retrospectively. Ghrelin gene 3056 T-->C SNP (single nucleotide polymorphism) was genotyped. Probability and hazard ratios were analyzed using life table analysis and Cox's proportional hazard regression model, in which the starting point was the time of AN-R onset and the outcome events were the time of (i) onset of binge eating, that is, when patients changed to binge eating AN and BN and (ii) recovery of normal weight, that is, when patients changed to BN or remission. RESULTS: Patients with the TT genotype at 3056 T-->C had a higher probability and hazard ratio for recovery of normal weight. The ghrelin SNP was not related with the onset of binge eating. CONCLUSION: The 3056 T-->C SNP of the ghrelin gene is related to the probability and the rate of recovery of normal body weight from restricting-type AN.

[Functional somatic syndrome from the viewpoint of comprehensive medicine].

Comprehensive medicine represents a medical treatment which is provided based on comprehensive understanding of patients, by grasping each patient as "a person who is living, now and here" in any case at any time. Its basic model was created by Day SB, Frankl VE and others as the biopsychosocial-existential model. In practicing this medicine, Ikemi Y and Nagata K introduced Oriental medicine into the modern medicine (Occidental medicine), and they proposed that establishment of psychosomatic medicine as the interface between the two should be essential. This concept has become the base of the integrative medicine, and its objective is to provide comprehensive medicine. Functional somatic syndrome (FSS) cannot be comprehended by the pathogenetic modern medicine. FSS can first be grasped in the concept of salutogenesis. In Oriental medicine, a functional pathological condition is regarded as an unorganized disease, and doctors who treat such patients are called "Jyo-i" (superior doctors). Therefore, there are many methods to assess the functional pathological conditions in the concept of Oriental medicine. On the other hand, doctors who are accustomed to establish diagnosis or treat organic diseases may misdiagnose FSS as a psychological disease (somatogenic pseudoneurosis) in not a few cases. FSS is affected by the lifestyle specific to individual patients. Therefore, it is essential to understand these patients comprehensively, namely biologically psychological, socially and existentially.

Effects of antidepressant treatment on heart rate variability in major depression: a quantitative review.

BACKGROUND: The literature measuring effects of antidepressant and electroconvulsive therapy (ECT) for major depression on heart rate variability (HRV) in medically well individuals was reviewed. METHODS: Fourteen studies evaluating HRV were included. Twenty three pre-post or within group comparisons were available. Treatment impact on measures of HRV was pooled over studies. We examined different classes of antidepressants, and for short and long electrocardiogram (ECG) recordings separately. RESULTS: Tricyclic antidepressants (TCAs) were associated with declines in most measures of HRV and significant increase in heart rate (HR) in studies with short recording intervals. No significant changes were found for longer recording times.Treatment effects with selective serotonin reuptake inhibitors (SSRIs) were more variable. Short-recording studies revealed a significant decrease in HR and an increase in one HRV measure. In two 24-hour recording studies no significant changes were observed. No relationship between ECT and HRV has been established in the literature. The effects of other drugs are reported. LIMITATIONS: Few studies measure the effects of treatment of depression on HRV. Existing studies have generally used very small samples, employing a variety of measurements and methodologies. CONCLUSION: We confirm that TCAs are associated with a large decrease in HRV and increase HR. However, data for SSRIs is not clear. Although the effect of SSRIs on HRV is weaker than for TCAs, evidence shows that SSRIs are associated with a small decrease in HR, and an increase in one measure of HRV. The use of TCAs in depression leads to changes in HRV that are associated with increased risk of mortality.

Effects of charcoal kiln saunas (Jjimjilbang) on psychological states.

This uncontrolled intervention study explored the effects of sauna bathing utilizing residual heat from charcoal kilns (charcoal kiln saunas) on psychological states. Forty-five volunteers (24 males and 21 females; mean age 51.9 years (S.D. 15.7) visiting a bamboo charcoal kiln in Japan participated in the study. They completed a shortened version of the Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) before and after charcoal kiln sauna bathing in order to determine mood and anxiety states. Six factors relating to mood were measured using the POMS: Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor, Fatigue, and Confusion. The two anxiety concepts of state anxiety and trait anxiety were also measured. Changes in psychological states before and after sauna bathing were then determined. All mood scales and both manifest anxiety measures were improved after sauna bathing. Charcoal kiln sauna bathing appears to improve mood and decrease anxiety. It is a limitation of this study that this was a descriptive prospective and an uncontrolled intervention study. Further investigation of the improvement of trait anxiety is required.

Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa.

BACKGROUND: Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes. METHOD: All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores. RESULTS: In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness. CONCLUSION: The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.

[Stress in traditional Oriental medicine and clinical chemistry--from the viewpoint of salutogenesis].

The main methodology of modern medicine is pathogenesis, and that of traditional Oriental medicine, complementary and alternative medicine, and mind-body medicine is salutogenesis. Health in pathogenesis is an absolute idea, and health, disease, and death are separate. However from the viewpoint of salutogenesis, the human condition in pathology progresses continuously from health to disease (functional, organic and fatal one) to death, and in each level the subject can create relative health according to the condition. The evaluation of stress consists of evaluating wear-and-tear and the repair and restoration of the body. The general adaptation syndrome, 17-KS-S(S), 17-OHCS (OH), the S/OH ratio, and traditional Oriental medicinal evaluation are clearly related. It may be said that medical care in the new era (comprehensive medicine) consists of pathogenesis by modern medicine, salutogenesis by traditional Oriental medicine, complementary and alternative medicine and mind-body medicine, and the patient's individual autonomy (self-determination by self-responsibility).

[The medicine of nurturing life energy--health creation and self-organization].

It is reality that human's body and mind are being created by life energy through every moment of life. As modern medicine does not consider this life energy itself, the most modern people hardly does not think it's intuitive meaning and use it to actualize their health and happiness in life. They can consider the outcome of life phenomena in the fields of physical, psychological, sociological and ethical sides, but they can not ask what life energy is, and subsequently can not use it in their life. Therefore, they live to make effort to actualize how to change life style considering of medical scientific facts (Evidence-Based-Medical Health Care). The intuitive life's action which can contact with the outer worlds, has the dynamic relationship with them and it creates new body and mind continuously. Modern medicine has not researched this dynamic life energy itself. What has life energy, single gene, single cell, single organ such as the brain and heart and single human beings, have been maintained their life by using their common and universal two life energies which are called self-organization, self-creativity and communicative ability. These two life energies of them were communicating with themselves or each others and their environments, and recreating their form and function continuously every moment of lives. It was conceptualized "Body-Mind-Spirit (Life-energy)-Life Dynamics". All of life phenomena which are not only diseases but also health, come from the results of "Body-Mind-Spirit-Life Dynamics". When we communicate with the outer worlds in "Real Self", human beings will keep the highest state of "Body-Mind-Spirit-Life Dynamics". We clarified that human beings can actualize the healthy and happy lives by themselves from understanding this idea, it also means for them to be able to create healthy personality through their lives and we clarified new assessment way of life energy simultaneously.

[A study of logotherapy for chronic low back pain patients].

DHEA-S (dehydroepiandrosterone sulfate) has many roles in human body as comprehensive vital power, whose metabolite is urine 17-KS-S (abbreviated S), having function of anti-cortisol. The metabolite of cortisol is urine 17-OHCS (abbreviated OH). DHEA-S is produced not only in adrenal glands but in brain. In order to examine the effects of logotherapy, urine S and OH were examined. Subjects were chronic low back pain patients treated by loxoprofen sodium (NSAID). In Group 1 (n = 11) logotherapy was not added, but in Group 2 (n = 10) it was added. Before the treatment, both groups showed low S and high OH. After 3 weeks, Group 2 showed higher S and lower OH than Group 1. After 18 weeks, 4 cases (40%) were relapsed in Group 2, and 10 (90.9%) were in Group 1 (p < 0.05). Group 2 was divided into 2 groups; relapsed group (n = 4) and non-relapsed group (n = 6). S, OH, S/OH were examined between 2 groups of Group 2 and Group 1. Relapsed group of Group 2 and Group 1 showed lower S and higher OH than non-relapsed group of Group 2. [Discussion] Logotherapy is a method to activate comprehensive human vital power. This is the mechanism through stimulating and activating human brain function.