Determinants of gait independence after mechanical ventilation in the intensive care unit: a Japanese multicenter retrospective exploratory cohort study.

PURPOSE: Gait independence is one of the most important factors related to returning home from the hospital for patients treated in the intensive care unit (ICU), but the factors affecting gait independence have not been clarified. This study aimed to determine the factors affecting gait independence at hospital discharge using a standardized early mobilization protocol that was shared by participating hospitals. MATERIALS AND METHODS: Patients who entered the ICU from January 2017 to March 2018 were screened. The exclusion criteria were mechanical ventilation < 48 hours, age < 18, loss of gait independence before hospitalization, being treated for neurological issues, unrecoverable disease, unavailability of continuous data, and death during ICU stay. Basic attributes, such as age, ICU length of stay, information on early mobilization while in the ICU, Medical Research Council (MRC) sum-score at ICU discharge, incidence of ICU-acquired weakness (ICU-AW) and delirium, and the degree of gait independence at hospital discharge, were collected. Gait independence was determined using a mobility scale of the Barthel Index, and the factors that impaired gait independence at hospital discharge were investigated using a Cox proportional hazard regression analysis. RESULTS: One hundred thirty-two patients were analyzed. In the univariate analysis, age, APACHE II score, duration of mechanical ventilation, ICU length of stay, incidence of delirium, and MRC sum-score at ICU discharge were extracted as significant. In the multivariate analysis, age (p = 0.014), MRC sum-score < 48 (p = 0.021), and delirium at discharge from ICU (p < 0.0001) were extracted as significant variables. CONCLUSIONS: We found that age and incidence of ICU-AW and delirium were significantly related to impaired gait independence at hospital discharge.

Comparing time-series of chemical concentrations in zebrafish (Danio rerio) embryos/larvae exposed to teratogens with different hydrophobicity; caffeine, sodium valproate, and diethylstilbestrol.

Developmental toxicity is an adverse developmental outcome, i.e., death, malformation, growth retardation, or functional deficiency. Recently, alternative methods of assessing developmental toxicity using zebrafish (Danio rerio) as a preliminary screening have attracted attention because of their low cost and high throughput. However, most toxicity evaluations have been based on a chemical concentration in an aqueous solution, and the chemical concentrations in embryos/larvae and their temporal behavior have in most cases been unclear, regardless of differences of chemical hydrophobicity. In the present study, we selected three teratogens with different hydrophobicities (caffeine, CA, log Kow -0.07; sodium valproate, VA, log Kow 0.26 (pH 7.4); and diethylstilbestrol, DES, log Kow 5.07), and we measured their concentrations in embryos/larvae exposed to these chemicals every 24 hr post-fertilization (hpf) until 144 hpf. Kinetic analysis based on a one-compartment fish model that yields first order kinetics for CA and VA revealed that concentrations of both CA and VA in embryos/larvae increased gradually and became saturated by around 100 hpf. In contrast, DES concentrations in embryos/larvae reached a maximum at 48 or 72 hpf and then decreased gradually. The present study suggests that the temporal pattern of chemical concentrations is a function of the hydrophobicity of the chemicals.

Prophylactic effectiveness of suplatast tosilate in children with asthma symptoms in the autumn: a pilot study.

BACKGROUND: Exacerbations of bronchial asthma usually occur in the autumn. To our knowledge, however, the effectiveness of drugs for preventing exacerbations of asthma in the autumn has not been studied previously, except for leukotriene receptor antagonists and Omalizmab. METHODS: This study compared the prophylactic effectiveness of suplatast tosilate with that of mequitazine in children with asthma symptoms, which is usually exacerbated in the autumn. The study group comprised 27 children aged 2 to 15 years who required treatment for asthmatic attacks during the past year and tested positive at least for mite allergen in the preceding autumn. The subjects were randomly assigned to receive either suplatast or mequitazine. The primary endpoint of this study was the number of days without symptoms during the 8 weeks of treatment. In addition, the Japanese Pediatric Asthma Control Program (JPAC) scores were also recorded every 2 weeks in each group. RESULTS: Overall, 14 patients received suplatast, and 13 received mequitazine for 8 weeks from September through early October. During follow-up, the number of days without symptoms and the total JPAC scores did not differ significantly between the groups. However, as compared with weeks 1 to 2 of treatment, the mean number of days without symptoms during weeks 7 to 8 increased significantly in only the suplatast group (8.6 vs. 11.5 days; p = 0.004). CONCLUSIONS: Our results suggest that short-term additional treatment with suplatast is useful for preventing asthma symptoms in children with asthma, which is usually exacerbated in the autumn.

[Survey of nutrient and food-group intake of cancer outpatients given chemotherapy].

A survey of nutrient and food oral intake was undertaken to clarify problems in nourishment support of chemotherapy outpatients with cancer diseases. The ingestion frequency survey (Food Frequency Questionnaire Based on Food Groups: FFQg) of nutrient and food intake was carried out in 54 patients, after chemotherapy at an outpatient clinic in Hyogo Prefectural Nishinomiya Hospital during three weeks from June 25,2007 to July 13,2007. Among them, 50 patients (92.6%) reported a valid response (14 breast, 13 colon, 6 stomach, 9 pancreas, and 8 other cancers). Body mass index (BMI; kg/m2, mean +/-SD) grouped by the type of the cancer was 22.3+/-3.1 in breast, 21.3+/-2.6 in colon, 17.9+/-2.0 stomach, 18.0+/-1.2 in pancreas and 22.6+/-1.8 in other cancers. BMIs in stomach or pancreas cancer patients were significantly low compared to those in patients with breast, colon, or other cancers. Each group's caloric intake per standard weight (kcal: mean+/-SD) was 31.4+/-5.3 in breast, 27.7+/-5.6 in colon, 34.2+/-10.3 in stomach, 29.1+/-5.0 in pancreas, and 26.8+/-6.4 in other cancers. No significant differences were recognized among them. In conclusion, oral intake in chemotherapy outpatients was secured from the result for each type of cancer; however, BMI was low in outpatients with stomach or pancreas cancer in spite of ingestion of food enough to maintain standard weight.

Early intervention with suplatast tosilate for prophylaxis of pediatric atopic asthma: a pilot study.

The onset of asthma may be related to Th2 cytokine dominance at the time when food allergies occur several months after birth. This study investigated the effectiveness of early intervention with a Th2 cytokine inhibitor (suplatast tosilate) for prevention of asthma in infants with food allergies and atopic dermatitis. Suplatast tosilate dry syrup (6 mg/kg daily) or a histamine H(1)-blocker (ketotifen fumarate dry syrup: 0.06 mg/kg daily) was administered randomly to 53 infants with atopic dermatitis caused by food allergies. The primary endpoints were the incidence of asthma and the time to the onset of wheezing. The peripheral blood Th1/Th2 ratio, total IgE level, and eosinophil count were measured before and after treatment. After 24 months of treatment, the prevalence of asthma was significantly lower in the suplatast group (20.8%) than in the ketotifen group (65.6%, p < 0.01). Additionally, the time from the start of treatment to the initial episode of wheezing for infants who developed asthma was significantly longer in the suplatast group than the ketotifen group (p < 0.01). Furthermore, the eosinophil count was significantly decreased by suplatast treatment (p < 0.05), and there was a significant difference between the suplatast and ketotifen groups with respect to both the eosinophil count (p < 0.01) and the Th1/Th2 ratio (p < 0.05). The results of the present pilot study suggest that suplatast tosilate is useful for the primary prevention of wheezing and asthma in children.

Carbonyl compounds vaporize from oil with steam during deep-frying.

Used frying oil recovered from food manufacturing companies in Japan and recycled often shows lower carbonyl (COV) and peroxide values (POV) than oil simply heated at 180 degrees C for 20 h does. In this study the reasons for the low COV of oil used for deep-frying were investigated by employing model experiments and actual commercial frying. The results suggested that in actual frying, the factor most influencing the low COV was vaporization of carbonyl compounds, together with steam generated from water contained in frying foodstuffs. It was also suggested that the low levels of COV were attributable partly to inhibition by protein, amino acids exuded from frying foodstuffs, and starch, and slightly to the effects of natural antioxidants in fresh oil and frying foodstuffs, oil absorption by frying foodstuffs, and dilution of oil in use by fresh oil added between uses. On the other hand, the chemical properties of oil in a fryer and in batter coatings of deep-fried foods made with the former oil were checked. Content of polar compounds (PC) and color score were obviously worse in the oil extracted from batter coatings than in that in the fryer, but there were no differences in COV or content of triacylglycerol (TG) of the two oils.