Katsuro Kashima

Prevalence of childhood obesity from 1978 to 2007 in Japan

Background:  There are few cross‐sectional and longitudinal studies on identification of the age of onset of obesity. The purpose of the present study was therefore to investigate 30 years of cross‐sectional and longitudinal changes in the prevalence of obesity from 1978 to 2007 in Japanese children and adolescents between 5 and 17 years of age, using population‐based samples.

Relationship between weather and onset of acute myocardial infarction: Can days of frequent onset be predicted?

BACKGROUND The aim of this study was to clarify the relationship between onset of acute myocardial infarction (AMI) and weather conditions, to determine whether days in which AMI onset is likely can be predicted. METHODS AND RESULTS Of the 929 patients admitted to our hospitals in Kagoshima prefecture with AMI, subjects comprised 611 patients. Days of frequent onset (F-days) were defined as days with > or = 3 patients/day admitted for AMI, with days of non-frequent onset (N-days) defined as days with < 3 patients/day. Meteorological factors were measured, and daily differences in all parameters and intraday temperature differences on the onset day, and 1 and 2 days before onset were calculated. F-days were significantly associated with intraday temperature differences on the onset day (10.3 degrees C vs. 7.9 degrees C, p=0.005), 1 day before onset (10.7 degrees C vs. 7.9 degrees C, p=0.002), and 2 days before onset (11.3 degrees C vs. 7.9 degrees C, p=0.0001). A cutoff intraday temperature difference of > or = 9.4 degrees C on 1 and 2 days before onset was predictive of F-days with 89% sensitivity and 87% specificity. CONCLUSIONS Intraday temperature differences offer a powerful predictor of F-days. Onset of AMI can be predicted based on weather conditions over the preceding 1-2 days.

Mid-term mortality of very elderly patients with acute myocardial infarction with or without coronary intervention

BACKGROUND The risk benefit of percutaneous coronary intervention (PCI) in very elderly patients with acute myocardial infarction (AMI) is currently unclear. Here, we aim to identify the characteristics of these patients and clarify their mid-term mortality rate with or without PCI. METHODS AND RESULTS 77 patients (> or =80 years) were chosen from 506 patients with AMI, and treated with (n=32) or without (n=45) PCI. The mean age and time from onset to admission increased in patients having undergone no PCI. The reasons for PCI refusal were patient/family preference (40%), renal dysfunction (17.8%), or cognitive impairment (13.3%). Patients treated with PCI had lower mid-term mortality than those without PCI (34.4% vs 62.2%; p=0.02), while patients taking beta-blockers displayed a significantly lower mortality rate than those without (18.2% vs 63.6%; p=0.0003). Cognitively impaired patients had a higher mortality rate compared with cognitively normal patients (80.0% vs 46.3%; p=0.005). Multivariate analysis indicated that systolic blood pressure on admission, PCI, and beta-blocker therapy independently decreased mid-term mortality in these patients. CONCLUSIONS PCI and beta-blocker therapy displayed significantly beneficial effects on mid-term mortality in very elderly AMI patients. Elderly-specific trials concerning coexisting disorders are needed to further examine the treatment-related benefits.

A case of transient mid-ventricular ballooning syndrome with a rapid and uncommon recovery

A 60-year-old woman presented with acute pulmonary edema followed by cardiopulmonary arrest due to idiopathic ventricular fibrillation. Owing to immediate cardioversion, her electrocardiogram showed sinus rhythm and echocardiography did not show any wall motion abnormalities. The next day, echocardiographic re-examination was characterized by akinesis of both apical and mid segments of the left ventricle. One hour later, subsequently performed coronary angiography revealed non-occlusive coronary artery disease, but left ventriculography demonstrated only akinesis of mid-ventricular segment with hypercontractile other segments. Further echocardiographic investigation on the following day showed total resolution of left ventricular wall motion abnormalities. The diagnosis of mid-ventricular ballooning syndrome was made according to the findings of left ventriculography. In this case, the time course changes of both patients pathophysiological condition and echocardiographic wall motion from the onset to recovery are rapid and uncommon.