Morishita Jintan (Japan)

ABSTRACTBackgroundThe long‐term prognosis of patients with heart failure (HF) remains poor. Most patients with HF are older, and multiple factors involved in geriatric syndromes are associated with worse long‐term prognosis. Sarcopenia is a major component of geriatric syndrome. Early diagnosis and therapeutic intervention for sarcopenia are clinically important in patients with HF; however, the prevalence and long‐term prognostic impact of sarcopenia in patients with stage B HF remain unclear. This study aimed to determine the prevalence of sarcopenia in older patients with stage B HF and its impact on the long‐term prognosis.MethodsThe PAPRIKA‐HF study was a multicenter, prospective study that enrolled outpatients ≥ 65 years who were diagnosed with stage B HF. Sarcopenia was assessed based on the Asian Working Group for Sarcopenia 2019 diagnostic criteria. The primary endpoint was a composite endpoint (all‐cause mortality, incident myocardial infarction, or hospitalization for heart failure) of > 2 years.ResultsAmong 312 patients (mean age: 78.2 ± 6.5 years, 45% female), 17.7% (56 of 312 patients) had sarcopenia. The rate of the composite endpoint over 2 years was significantly higher in patients with sarcopenia than in those without (25.0% vs. 2.7%, log‐rank test, p < 0.0001). Multivariate analysis using the Cox proportional hazards model showed that sarcopenia was an independent predictor of long‐term prognosis (hazard ratio: 5.78, 95% confidence interval: 2.16–15.43, p < 0.001).ConclusionsSarcopenia was associated with a worse long‐term prognosis in older patients with stage B HF, highlighting the importance of early diagnosis of sarcopenia.

Herpes zoster is a dermatological disorder characterized by painful vesicles in the affected dermatome. While sensory symptoms are common, motor complications such as postherpetic pseudohernia, a rare condition involving abdominal muscle paresis, can occur. This report describes a neurologist in his mid-30s who developed herpes zoster followed by postherpetic abdominal pseudohernia, which resolved within three months. Pseudohernia associated with herpes zoster isa rare complication that may be misdiagnosed as an abdominal wall hernia. Stress and overwork may contribute to the onset of herpes zoster, highlighting the importance of work-life balance and stress management, especially in medical professionals and prioritizing self-care in medical professionals.

descriminado e pouco discutido devido ao estigma social.

Blackcurrant is available as a traditional medicine in Europe. However, the detailedeffects of blackcurrant on the human gut microbiota remain unknown. In this study, weinvestigated the prebiotic effects of a blackcurrant extract using a human fecal culturemodel in six healthy subjects. Feces were individually inoculated into a medium with orwithout the blackcurrant extract and then fermented for 48 hr under anaerobic conditions.The results obtained from analysis of samples from the fermented medium demonstrated thatafter 48 hr of fermentation, the pH of the medium with the blackcurrant extract wassignificantly decreased (control, 6.62 ± 0.20; blackcurrant extract, 6.41 ± 0.33;p=0.0312). A 16S rRNA gene sequencing analysis of the microbiota of the fermented mediumshowed a significant increase in the relative abundance ofBifidobacteriaceae. In measuring the concentrations of putrefactivecomponents in the fermented medium, we found that the blackcurrant extract significantlyreduced ammonia levels and displayed a tendency toward reduced indole levels. Our resultssuggest that blackcurrant extract could be a potential ingredient for relief ofputrefactive components in the gut.

Villafranca de los Caballeros es una villa toledana del Campo de San Juan que ha sufrido muchas epidemias a lo largo de su historia. Los documentos que van apareciendo en diferentes archivos nos permiten relatar algunas de estas incidencias desde la segunda mitad del siglo XVII hasta el siglo XX. Así podemos reconstruir, en la medida de lo posible, parte del entorno económico y social, los medios sanitarios, las medicinas aplicadas, las medidas de aislamiento y las defensas ante contagio masivo, así como la incidencia de la mortandad en el total de sus habitantes.

Introduction: Plostagrandin E 1 (PGE 1 ) is essential for maintaining the ductus arteriosus (DA) in ductal-dependent congenital heart disease. Recently, relatively long-term administration of PGE 1 became common, especially in patient with hypoplastic left heart syndrome (HLHS) . Staged Norwood approach which consists of bilateral pulmonary artery banding, PGE 1 infusion, and Norwood procedure beyond newborn period provided excellent survival benefit. However, microstructural changes of DA after long-term PGE 1 administration remain unknown. Therefore, we sought to investigate their features of DA after long-term PGE 1 administration using synchrotron based X-ray phase-contrast tomography (XPCT), a novel modality to inspect biological soft tissue, and pathological scrutiny including DA specific immunostaining. Methods: Seventeen DA tissues of HLHS were obtained during Norwood procedure. The median duration of PGE 1 was 48 days (Range 3-123). Radiographic microstructural analysis of DA was performed using X-ray phase contrast tomography at SPring-8 (Hyogo, Japan). Histological changes focused on elastic fiber and smooth muscle formation were evaluated by Elastica van Gieson staining, and expression of prostaglandin E2 receptor EP4 was evaluated by immunohistochemical analysis. Results: XPCT study showed a sclerotic changes of ductal media. There was a significant correlation between the duration of PGE 1 infusion and the mass density of ductal media (R: 0.723, p=0.001). Histological study showed that the duration of PGE1 infusion was positively correlated with the elastic fiber formation (R: 0.795, P=0.002), and negatively correlated with smooth muscle formation (R: -0.83, P&lt;0.001). The EP4 expression was disappeared in all DA. Conclusion: Long-term administration of PGE 1 induced elastogenesis and density growth of the ductal media. In addition, downregulation of EP4 was observed. These results suggested that dosage of PGE 1 could be decreased after definite period of administration.