Age Stratification and Impact of Eicosapentaenoic Acid and Docosahexaenoic Acid to Arachidonic Acid Ratios in Ischemic Stroke Patients.

AIM: We focused on the ratios of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to arachidonic acid (AA) and explored the significance of these ratios relative to clinical characteristics by age in ischemic stroke patients. METHODS: We enrolled patients with acute ischemic stroke who underwent radiological investigations and laboratory examinations, including measurement of serum EPA, DHA, and AA levels, and controls. Patients were classified according to age (＜65, 65-74, and ≥ 75 years) and the tertile of EPA/AA and DHA/AA ratios, and clinical aspects were compared with these factors. RESULTS: We analyzed 373 patients (age 70.2±13.4 years; 245 males) and 105 controls. Among stroke patients, patients aged ＜65 years had the lowest EPA/AA (0.35±0.23, p=0.006) and DHA/AA (0.73±0.27, p＜0.001) ratios. Compared with controls, patients aged ＜65 years showed lower EPA/AA (vs. 0.49±0.25, p＜0.001) and DHA/AA (vs. 0.82±0.26, p=0.009) ratios. From logistic regression analysis, the EPA/AA (odds ratio 0.18, 95% confidence interval 0.04-0.81, p=0.026) and DHA/AA (odds ratio 0.09, 95% confidence interval 0.02-0.33, p＜0.001) ratios were inversely related to patients aged ＜65 years. According to age-stratified analyses, we found an association of aortic arch calcification with a lower EPA/AA ratio for patients aged ≥ 75 years and an association of multiple infarctions and cerebral white matter lesions with a lower EPA/AA ratio for patients aged 65-74 years (p＜0.05). CONCLUSIONS: The ratios of EPA/AA and DHA/AA could be specific markers for younger stroke patients. The EPA/AA ratio may be related to aortic arch calcification for elderly stroke patients and to multiple infarctions and cerebral white matter disease for middle-aged stroke patients.

Human case of bacteremia due to Streptococcus suis serotype 5 in Japan: The first report and literature review.

Streptococcus suis is a zoonotic pathogen that can be transferred from pigs to humans. The serotypes 2 and 14 are prevalent among patients with S. suis infections, while other serotypes (i.e., 1, 4, 5, 16, and 24) have been detected in rare human cases. To the best of our knowledge, the present patient handling with raw pork is the first human case of uncomplicated bacteremia due to S. suis serotype 5 in Japan. We confirmed the new sequence type 752 of this isolate. Virulence-associated gene profiling was performed; both sly (encoding the hemolysin suilysin) and mrp (encoding a muramidase-released protein) were detected without amplification of epf (encoding the extracellular factor). Our polymerase chain reaction-based results indicated that this isolate possessed both tet(O), the tetracycline-resistance determinant, and erm(B), the macrolide/lincosamide-resistance determinant. In addition, we provide the review of literature concerning clinical and microbiological features of four human cases of infection due to S. suis serotype 5. Clinicians should be aware of this microorganism when examining and treating patients with fever, who are handling raw pork or having close contact with infected pigs even if they are immunocompetent.