Early walking time is associated with recovery of activities of daily living during hospitalization in older patients with community-acquired pneumonia: A single-center prospective study.

AIM: Pneumonia is a common disease with a high mortality rate among older adults that is associated with a decline in activities of daily living (ADL) during hospitalization. The aims of this study were to investigate the following: (i) early physical activity time among older patients hospitalized with community-acquired pneumonia; and (ii) the association of physical activity time with the recovery of ADL. METHODS: A prospective observational study was carried out in patients aged ≥65 years hospitalized with community acquired pneumonia. We measured the time spent standing and walking as physical activity time using the activPAL accelerometer from the third to the ninth day of admission. Patients underwent rehabilitation during their hospitalization, and rehabilitation effectiveness was calculated using the motor Functional Independence Measure on admission and at day 10. We used stepwise multiple regression to examine the relationship between physical activity time and rehabilitation effectiveness. RESULTS: A total of 87 patients were included in the analysis. Median (interquartile range) physical activity time was 69 min/day (43-103 min/day). In the multiple regression model, a greater daily walking time, higher cognitive and physical function, and ADL at admission were independently associated with rehabilitation effectiveness (adjusted R2  = 0.32, P < 0.0001). For every increase of 10 min/day of walking time, ADL improved by 7.8% (B = 7.8, 95% CI 1.3-14.2, P = 0.02). CONCLUSIONS: Older patients hospitalized with community-acquired pneumonia have low levels of physical activity, and increasing early walking time might be an effective strategy to accelerate the recovery of ADL. Geriatr Gerontol Int 2021; 21: 1099-1104.

Coffee consumption is inversely associated with depressive status in Japanese patients with type 2 diabetes.

Depression has been reported to be more prevalent among diabetic patients than non-diabetic individuals. Although depression and diabetes are causally and bi-directionally related, the influence of food intake frequency on depressive symptoms in diabetic patients has not been fully evaluated. This cross-sectional study analyzed data obtained from 89 patients with type 2 diabetes who completed self-administered questionnaires regarding food intake frequency, diabetic variables, physical activity and depressive states. The prevalence of a "definite" depressive state was 16.9%. The duration of diabetes, hemoglobin A1c levels, diabetic microvascular complications and physical activity levels were similar between depressed and non-depressed patients. Daily intakes of total lipids, n-6 polyunsaturated fatty acids and lipid energy ratios were significantly lower, and the carbohydrate energy ratio was significantly higher in depressed than in non-depressed patients. Coffee consumption was inversely associated with depressive symptoms, but no significant association was found between tea or green tea consumption and depressive symptoms. The logistic regression analysis showed that coffee consumption was an independent predictor of non-depressed status in diabetic patients. This might be due to biologically active compounds containing in coffee other than caffeine.

Chest pain and ST segment depression caused by expansion of gastric tube used for esophageal reconstruction.

We describe a 76-year-old man in whom a gastric tube was used for esophageal reconstruction via the anterior mediastinum after esophagectomy for esophageal cancer. Stenosis of the tube resulted in fluid accumulation, which directly compressed the heart and caused angina-like chest pain associated with ST-segment depression in lead V(2-3) on the electrocardiogram (ECG). Coronary angiography revealed no stenosis. Drainage of the fluid in the gastric tube resulted in immediate relief of symptoms and normalization of ECG. Angina-like chest pain associated with ST segment changes were caused by expansion of the gastric tube and compression of the heart.

The use of a hydrophilic-coated catheter during transradial cardiac catheterization is associated with a low incidence of radial artery spasm.

BACKGROUND: Radial artery spasm (RAS) is a common complication of transradial approach (TRA) to percutaneous coronary angiography (CAG) and coronary intervention. Lower friction resistance between catheter and RA wall may reduce RAS upon insertion, manipulation, and withdrawal of the catheter. The aim of this study was to investigate whether the use of a hydrophilic-coated (HC) catheter, which has lower friction coefficient, could reduce the incidence of RAS compared with a non-hydrophilic-coated (NHC) catheter. METHODS: A total 250 patients attempted diagnostic CAG using 5-French catheters via the TRA between September 2000 and April 2002. Two hundred thirty-four (93.6%) patients who achieved successful coronary cannulation were selected for the study. NHC catheters were used in 149 patients (63.7%), and HC catheters were used in 85 patients (36.3%). We compared the incidence of RAS between NHC and HC catheters. RESULTS: RAS occurred in 17 (7%) patients totally. RAS was less likely to occur in HC group (one patient, 1%) than in the NHC group (16 patients, 11%, P = 0.007). CONCLUSIONS: We conclude that the use of HC catheters can reduce RAS upon insertion, manipulation, and withdrawal of the catheter compared with NHC catheters.