Allostatic load and frailty do not covary significantly among older residents of Greater Poland.

BACKGROUND: Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person's ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association. METHODS: To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression. RESULTS: ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty. CONCLUSION: In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among seniors.

Type A Acute Aortic Dissection Presenting With Arch and Abdominal Aortic Aneurysms.

Herein, we present the case of an 89-year-old female who presented with acute aortic dissection involving the arch and abdominal aneurysms. Emergent total arch replacement with a frozen elephant trunk was the first-line approach taken to save the patient's life. Although prolonged mechanical ventilation necessitated a tracheostomy, subsequent endovascular aortic repair mitigated the risk of rupture in the abdominal aortic aneurysm. While managing acute aortic syndrome with multiple aneurysms poses a challenge for surgeons, a diagnosis based on computed tomography angiography and timely intervention alleviated the critical condition.

Pulsatile thrombus evacuation from the false lumen of an occluded carotid artery in acute aortic dissection.

Herein, we present a case of aortic dissection with right carotid artery occlusion that was treated successfully with thrombus evacuation from the false lumen of the occluded carotid artery during hemiarch replacement. This procedure is performed with two maneuvers: aggressive retrieval of the thrombus from the innominate artery during circulatory arrest and thrombus evacuation from the false lumen of the right common carotid artery through a right neck incision with the heart beating. In this alternative method, thrombi can be evacuated more naturally and briskly, using pulsatile flow.

Distal Arch Aneurysm Discovered With Dysphagia.

A 64-year-old man sought medical attention from a family physician, expressing concerns about dysphagia. Recognizing the complexity of the symptoms, the family physician promptly engaged the expertise of an attending physician at a regional hospital to ensure accurate diagnosis and management. Plain computed tomography (CT) revealed a space-occupied lesion located posterior to the trachea. Although mediastinal tumor was suspected at first, contrast-enhanced CT revealed a distal arch aneurysm that compressed the esophagus. The patient underwent total arch replacement, and the postoperative course was uneventful.

Deep Femoral Artery Aneurysm Resection and Revascularization With a Saphenous Vein.

An incidental discovery was made of a right deep femoral artery aneurysm (DFAA) in a plain computed tomography (CT) scan of a 72-year-old male. Although he had been diagnosed with type B aortic dissection six years ago and was followed for 12 months in the outpatient clinic, the patient was no longer receiving regular checkups. After a thorough discussion between cardiovascular surgeons and interventional radiologists, it was decided to proceed with aneurysm resection and revascularization. The postoperative course was uneventful, and the patient was discharged home without complications.

An Escherichia coli-Induced Distal Arch Aneurysm Presenting With Hemoptysis.

Infected thoracic aneurysms are a rare and potentially life-threatening condition that present with non-specific symptoms. We describe here a case of an 83-year-old female who presented to the emergency department with the chief complaint of vomiting blood. The patient had presented to the emergency department 40 days earlier with abdominal pain, fever, and leukocytosis. She had a medical history of traumatic liver injury resulting in bile duct stenosis, necessitating percutaneous transhepatic gallbladder drainage and subsequent bile duct-jejunal anastomosis 25 years ago. Emergency contrast-enhanced computed tomography (CT) revealed an irregular distal arch aneurysm. According to the patient's present symptoms, CT findings, and medical history, infected thoracic aneurysm was suspected. Total arch replacement was performed promptly, followed by thorough antibiotic therapy. Following successful treatment, the patient's condition stabilized, and she was transferred to a rehabilitation facility for further recovery.

Worsening Isolated Superior Mesenteric Artery Dissection on the Day After Discharge.

A 59-year-old male was transported to the emergency department by ambulance with complaints of left-sided abdominal pain. Blood gas analysis revealed elevated lactate, and plain computed tomography revealed no bowel ischemic change. Contrast-enhanced computed tomography revealed isolated superior mesenteric artery dissection with mildly stenosed true lumen. The patient was treated with conservative management on admission. Staged fluid intake, oral prescriptions, and diet were commenced with attention to the symptoms. After four days of hospitalization, the patient was discharged with a stable condition. However, the patient returned to our hospital complaining of left lower back pain three hours after discharge. Contrast-enhanced computed tomography revealed an enlarged false lumen with a moderately stenosed true lumen. After a thorough discussion between vascular surgeons and interventional radiologists, conservative management was commenced on the second admission. The clinical course was uneventful, with proof of improved imaging findings.

Conservative Treatment for Isolated Superior Mesenteric Artery Dissection With Severely Narrowed True Lumen.

A 59-year-old male presented to the emergency department with distressing epigastric pain after seeking medical attention at a nearby clinic three hours prior. Upon examination, the attending physician noticed edematous changes in the proximal segment of the superior mesenteric artery, and a subsequent enhanced computed tomography (CT) scan confirmed the diagnosis of an isolated dissection of the artery. Notably, the true lumen of the vessel was significantly narrowed, raising concerns for potential vascular compromise. After extensive consultation between a vascular surgeon and a radiologist, a decision was made to adopt a conservative management approach. The patient was closely monitored with meticulous bowel rest, hydration management, and carefully curated dietary modifications. Over time, subsequent CT scans revealed progressive enlargement of the true lumen, which was highly reassuring to the medical team. As a result of the expert management and diligent care provided, the patient was eventually discharged home without any adverse events or complications. This case highlights the critical role of a multidisciplinary approach in managing complex vascular pathology and underscores the importance of thoughtful clinical decision-making and meticulous monitoring in achieving favorable outcomes.

Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction.

A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlusion of the left middle cerebral artery, which suggested an embolism derived from the vegetation. The patient was then referred to the department of cardiovascular surgery. Transesophageal echocardiography (TEE) revealed perforation of the PML and severe mitral regurgitation (MR). The patient underwent mitral valve repair. The postoperative course was uneventful, and the patient was discharged after six weeks of antibiotic treatment. A fresh autologous pericardium is the material of choice to repair the valve.

DeBakey Type II Acute Aortic Dissection Distant From the Proximal Edge of a Stent Graft: A Case Report Nine Years After Thoracic Endovascular Aortic Repair.

An 84-year-old male with a medical history notable for prior thoracic endovascular aortic repair for thoracic aneurysm nine years ago presented to the emergency department with a chief complaint of transient loss of consciousness. A brain computed tomography showed no remarkable findings. A subsequent computed tomography scan for comprehensive evaluation revealed DeBakey type II acute aortic dissection as evidenced by contrast-enhanced imaging. An intimal tear was found on the ascending aorta distant from the proximal edge of a stent graft. Due to the urgency of the situation, the patient underwent emergent ascending aortic replacement. Following the successful intervention, the patient was transferred to a specialized rehabilitation facility with the goal of facilitating further improvement in their condition.

Retrograde Type A Acute Aortic Dissection With Cerebral Malperfusion Six Years After Thoracic Endovascular Aortic Repair.

A 59-year-old male with prior thoracic endovascular aortic repair presented with altered mental status. Magnetic resonance imaging showed cerebral infarction, and subsequent computed tomography revealed acute type A aortic dissection and right carotid artery occlusion. He underwent total arch replacement with right carotid artery bypass. After successful intervention, he was transferred to a rehabilitation facility for further improvement.

Determining Infected Aortic Aneurysm Treatment Using Focused Detection of Helicobacter cinaedi.

We detected Helicobacter cinaedi in 4 of 10 patients with infected aortic aneurysms diagnosed using blood or tissue culture in Aichi, Japan, during September 2017-January 2021. Infected aortic aneurysms caused by H. cinaedi had a higher detection rate and better results after treatment than previously reported, without recurrent infection.

Effect of waxy barley, Kirarimochi, consumption on bowel movements of late-stage elderly residents at Roken nursing home.

BACKGROUND: It is very important for the late-stage elderly to have the least stressful bowel movements for maintaining a good quality of life. It is generally accepted that consuming adequate dietary fiber is a promising method for the prevention and management of stressful bowel movements such as those during constipation. Therefore, we examined the effect of long-term consumption of waxy barley, which is high in dietary fiber, on the bowel movements of the late-stage elderly living at Roken nursing home (a geriatric health services facility), Japan. METHODS: We compared the defecation and laxative administration frequencies of the subjects before and after waxy barley consumption, for which we served 28 residents a boiled mixture of rice and waxy barley (variety name, Kirarimochi) as the main meals for 5 months, from November to March. In October, all residents were served boiled rice as the main meals. RESULTS: The residents were categorized into "constipated" subjects and "non-constipated" subjects according to their weekly defecation frequency during October. Among the 14 residents categorized as constipated subjects, monthly number of days with defecation in November, January, and March significantly increased in comparison to monthly number of days with defecation in October. In addition, monthly number of days with laxative administration significantly decreased in December and February in comparison to monthly number of days with laxative administration in October. In contrast, the defecation and laxative administration frequencies did not change after waxy barley consumption among the 14 residents categorized as non-constipated subjects. CONCLUSIONS: Consumption of waxy barley, Kirarimochi, for 5 months improved the bowel movements of the constipated subjects; however, the consumption had no effect on the bowel movements of the non-constipated subjects at Roken nursing home. These results indicate that consuming waxy barley, Kirarimochi, is beneficial for the management of constipation in the late-stage elderly residents at Roken nursing home.

Allostatic load differs by sex and diet, but not age in older Japanese from the Goto Islands.

BACKGROUND: Lifelong exposure to stressors promotes physiological dysregulation and produces an allostatic load (AL). In European-derived samples, AL associates significantly with sex, age and health. AIM: To assess associations of AL with age, sex, socio-demographic differences and self-reports of diet and ability to complete activities of daily living in older Japanese residing in rural Nagasaki Prefecture. SUBJECTS AND METHODS: In 2011, 96 older residents of Nagasaki Prefecture, Japan, were assessed for components of AL. They also self-reported their age, principal life-long occupational activity, educational attainments, marital status, dietary choices and abilities to complete daily living activities. RESULTS: Average age was 67.9 years (range = 55-89; SD = 8.65). Among these 48 men and 48 women, AL was not related significantly to age, although women showed lower AL than men. AL did not differ significantly between respondents by occupation, marital status, education or abilities to complete daily activities. Women who reported eating more green/yellow vegetables or consuming more meat had lower AL than their counterparts. Men who reported drinking more alcohol spirits had higher AL. CONCLUSIONS: Among older Japanese residing outside a major urban area, AL varies significantly by sex, but not age, while being associated with dietary choices. Although lack of association with life ways was not expected, AL apparently assesses physiological dysregulation cross-culturally.

Effects of a Whole-grain Paddy Rice Diet on the pH Distribution in the Gizzard and Retention Time of Digesta in the Crop of Broiler Chicks.

We previously reported that a diet containing 65% paddy rice suppressed the colonization of Campylobacter jejuni in the cecum of broiler chicks, suggesting that this type of diet has positive effects on upper gastrointestinal tract function in broilers. To reveal the possible mechanisms involved in this antibacterial effect of the whole-grain paddy rice diet, we performed experiments comparing the digesta passage rate in the crop and gizzard, the development of gizzard, and the pH distribution in the gizzard between groups of chicks fed two different diets, such as ground corn and whole-grain paddy rice. During these experiments, we made the following observations: the chicks in the group fed the whole-grain paddy rice diet had more developed gizzards and significantly larger crop content than the chicks in the group fed the ground corn diet. The chicks fed the whole-grain paddy rice diet retained the digesta in the crop for much longer and had less variation in the pH values in the gizzard than those fed ground corn. On the basis of these observations, we concluded that the hardness of the rice hull in whole-grain paddy rice leads to a larger amount and longer retention of content in the crop, as well as the uniformity of the internal pH of the gizzard, by promoting gizzard activity. We speculate that the hardness of the rice hulls promoted the grinding activity of the gizzard, resulting in the long retention time of the digesta in the crop and uniformity of the internal pH of the gizzard, which may sterilize or suppress Campylobacter growth in the gastrointestinal tract of broiler chicks.

Biofilm formation and resistance to benzalkonium chloride in Listeria monocytogenes isolated from a fish processing plant.

Listeria monocytogenes is a foodborne pathogen that causes the potentially life-threatening illness listeriosis. Previously, a few clones of L. monocytogenes persisting in a cold-smoked fish processing plant were isolated from the plant's products continuously. To evaluate the role of biofilms in the persistence of L. monocytogenes strains specific to this plant, the abilities of the persistent strain (PS) and transient strain (TS) of L. monocytogenes found in this plant to form biofilms were compared, as was resistance to the sanitizing effects of benzalkonium chloride (BC). The PS produced more biofilm than the TS in 48 h. The half-maximal effective concentration (EC50), the BC concentration at which the ATP bioluminescence of each bacterial strain decreased by 50 % relative to its maximum activity, was about 150-fold higher in the PS than in the TS. In contrast, when these values were measured in organisms in a planktonic state, the EC50 of the PS was only 2.2-fold higher than that of the TS. Extracellular polymeric substances (EPS) were extracted from biofilms, and the glucose content of these biofilms was determined with the phenol-sulfuric acid method to estimate the quantity of EPS. The total amount of EPS in the PS biofilm was higher than that in the TS biofilm. These findings suggest that the PS produces greater amounts of biofilm and EPS than the TS, which results in greater resistance of the PS to disinfectants. The persistence of the strain in the fish processing plant might be attributable to these properties.

Effects of a late supper on digestion and the absorption of dietary carbohydrates in the following morning.

BACKGROUND: Our previous experiment showed that the light intensity exposed on the subjects during evening time had no effect in the following morning on the efficiency of the digestion and absorption of dietary carbohydrates ingested at a usual suppertime. People who keep late hours usually have a late suppertime; thus, we examined the effects of a late suppertime on gastrointestinal activity in the following morning in comparison to that of a usual suppertime. METHODS: Twelve female university students volunteered as paid participants. The breath hydrogen test was carried out to estimate the amount of unabsorbed dietary carbohydrates and the percentage of the total amount of dietary carbohydrates in the breakfast that were unabsorbed, as well as to estimate oro-cecal transit time. The respiratory quotient was also measured to find the ratio of carbohydrates/lipid metabolism in the post-breakfast state. Subjects' peripheral blood glucose concentration was measured by a blood glucose meter. The subjects participated under two different experimental conditions: with a usual suppertime (having supper at 18:00) and a late suppertime (having supper at 23:00). RESULTS: The efficiency of the digestion and absorption of dietary carbohydrates in the breakfast under late suppertime conditions was higher than that under usual suppertime conditions. Usual or late suppertime had no effect on the ratio of carbohydrates to lipids oxidized after the subjects had breakfast. There were significant differences in the blood glucose level between the two conditions at 30, 60, 120, 150, and 180 minutes after having breakfast, whereas the mean blood glucose level under late suppertime conditions was significantly higher than under usual suppertime conditions. CONCLUSIONS: Having a late supper showed a worse effect on postprandial serum glucose profiles the following morning. This study confirmed that keeping our usual meal timing is important for our health.

Westernization of dietary patterns among young Japanese and Polish females -- a comparison study.

INTRODUCTION AND OBJECTIVE: Nowadays, the process of the westernization of eating habits is perceived to be one of the main causes of epidemics of civilization diseases, such as metabolic syndrome. The aim of the study was to assess the westernization of eating habits among 100 Japanese (aged 18-23 years) and 111 Polish female students (aged 19-25 years) of nutrition science related faculties. MATERIALS AND METHODS: Food-frequency questionnaires were used to assess a dietary pattern during the four seasons of a one-year investigation. Data obtained in each season was pooled. The frequency of consumption of different foods (servings/week) between the two countries was compared and characterization of the dietary patterns of both studied populations was analyzed by factor analysis. RESULTS: When food consumption between the two countries was compared, apart from total meat and meat products and high-energy drink intake, significant differences were observed in all foods and food groups. Three dietary patterns were identified in both groups. Among Japanese participants, the first pattern was 'traditional Japanese', the second 'sweets and beverages', and the third 'Western', explaining 9.0%, 8.5% and 6.4% of the total variance, respectively. Among Polish participants, the first pattern was 'prudent', the second 'Western', and the third 'sweets and alcoholic beverages', explaining 8.2%, 7.7%, 6.4% of the total variance, respectively. Although the 'Western' dietary pattern was found in both groups, there were some differences in the remaining dietary patterns between the two countries. CONCLUSIONS: In the Japanese participants, significant cultural influences on habitual food intake could still be observed, and the extent of diet westernization seems to be smaller compared to the Polish participants.

Comparison of variations between percentage of body fat, body mass index and daily physical activity among young Japanese and Thai female students.

BACKGROUND: In our series of investigations concerning the causes of seasonal change in fat accumulation in young university students, we could not find any contribution of seasonal variation in the ratio of carbohydrate and fat metabolism to that of body fat percentage in Japanese and Thai participants. After our previous study, we examined the effect of daily physical activity on body fat percentage to look for the major causes of seasonal change in fat accumulation in young university students. FINDINGS: In this study, we measured participants' (young Japanese and Thai university students) daily physical activity by a uniaxial accelerometer in addition to the measurements of body fat percentage and body mass index by a bioelectrical impedance meter. We found that there was significant and moderate negative correlation between body fat percentage and daily step counts among Japanese but not Thai participants. We observed significant, moderate and positive correlations between the percentage of body fat and body mass index among Japanese and Thai participants. CONCLUSIONS: Daily physical activity plays an important role in the seasonal variation of body fat percentage of Japanese female students. Our present study also confirmed the importance of daily physical activity for controlling body mass index and for the prevention of obesity.

Which characteristic of Natto: appearance, odor, or taste most affects preference for Natto.

BACKGROUND: In Japan, consumption of Natto, a fermented bean dish, is recommended because of its high quality protein, digestibility in the gut and its preventive effect on blood clot formation due to high vitamin K content. However, consumption of Natto in Kansai and the Chugoku area (the western part of Honshu) is less than that in the other areas of Japan probably because of a "food related cultural inhibition". In this study, we determined which characteristic of Natto (appearance, odor or taste) most affect subjects' perception of sensory attributes by observation of brain hemodynamics in relation to subjects' preference for Natto. FINDINGS: In this experiment, we defined each subject's changes in brain hemodynamics as (+) or (-) corresponding to an increase or a decrease in total hemoglobin concentration after stimuli compared to that before stimuli. As a result, there was no relation between preference for Natto and change in brain hemodynamics by the stimuli of "looking at" or "smelling", while there was a significant relationship between preference and stimulus of "ingestion"; (+) : (-) = 21:15 in the subjects of the "favorite" group and (+):(-) = 30:7 in the subjects of the "non-favorite" group (P = 0.034). CONCLUSION: This result indicated that characteristic "taste" of Natto most affects preference for Natto.