Objective : An adequate risk stratification protocol is important in cardiac rehabilitation. However, defining this is difficult in patients with myocardial infarction in the early recovery phase, because the maximal exercise testing for determining the stratification cannot be performed in this phase. The purpose of this study was to investigate the usefulness of the risk stratification protocol of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) based on an index without cardiopulmonary exercise testing. Methods :We investigated 164 patients with ST-elevation myocardial infarction who completed the acute rehabilitation program after percutaneous coronary intervention. Patients were classified into low, moderate, and high-risk groups by the risk stratification,and then we calculated their Thrombolysis in Myocardial Infarction risk score for STEMI (TIMI RS), Global Registry of Acute Coronary Events risk model (GRACE RS), Primary Angioplasty in Myocardial Infarction risk score (PAMI RS), and Zwolle risk score for STEMI (Zwolle RS) which are the major comprehensive risk scores designed for predicting short-term outcome after acute coronary syndromes. We compared the risk scores among the three groups, and we investigated major adverse cardiac events (MACE) during supervised exercise in the early recovery phase. Results : As a result, we found a statistically significant difference between the low-risk group and the high-risk group in all risk scores. In addition, there were no MACE during supervised exercise in this period. Conclusion : This study suggests that, by using the AACVPR risk stratification protocol based on an index without cardiopulmonary exercise testing, it is possible to roughly classify the risk in this phase, and that it is useful for defining safe exercise regimes in patients with ST-elevation myocardial infarction in the early recovery phase.

The purpose of this study was to investigate heme oxygenase-1 (HO-1) mRNA expression and bilirubin concentration alteration in humans exposed to acute hypoxia. Fourteen healthy adult males were randomly assigned to a sea level group and a hypoxia group, and then exposed to normoxia (400 m, 20.0 %O₂) and hypoxia (3,000 m, 14.5 %O₂) respectively, in a hypoxic chamber for 3 hours. SpO₂ during hypoxia were significantly lower than those at sea level (P＜0.05). Indirect bilirubin levels after hypoxia were significantly higher than those at sea level (P＜0.05). However, HO-1 mRNA expression was unaltered by hypoxia. In conclusion, our data indicate that an acute exposure to hypoxia at resting state for 3 hours might lead to antioxidative cytoprotective response without any increase in HO-1 gene expression.

Physical fitness of 900 volunteers over 60 years of age were analyzed using a 6-item battery test to obtain fundamental data on the fitness status of the aged Japanese. The test battery consisted of stepping, vertical jump, grip strength, breath holding, body flexion and one-leg balancing, and could be performed safely with relatively mild physical stress in the elderly after simple screening by measurement of resting blood pressure and oral check on mobility problems of the knee and the hip. Males showed significantly higher values in vertical jump, grip strength and breath holding, while females showed significantly higher values in body flexion. There were no sex differences in stepping and one-leg balancing. Lowing trend was found in the score with age in all items except breath holding, but the extent of the reduction differed among the measure elements of fitness. Most of measured items showed significant correlations each other. The values obtained with this test are considered to be useful for future analysis of the fitness of aged people and also to determine the exercise appropriate for them.

Clozapine has been demonstrated to be useful for treating refractory schizophrenia. However, hypersalivation occurs in 31.0-97.4% of the patients treated with clozapine. Accordingly, some patients who are disturbed by their hypersalivation refuse to continue with clozapine treatment. This study investigated the efficacy of the anticholinergic agent scopolamine butylbromide against clozapine-induced hypersalivation. Five schizophrenia patients were coadministered scopolamine butylbromide (30-60 mg/day) for 4 weeks. At the baseline and after 4 weeks' treatment, we subjectively evaluated hypersalivation using a visual analog scale and objectively assessed it using the Drooling Severity Scale and Drooling Frequency Scale. As a result, improvements in the patients' Drooling Severity Scale and Drooling Frequency Scale scores, but no improvements in their visual analog scale scores, were observed after scopolamine butylbromide treatment. These results indicate that at least some schizophrenic patients with clozapine-induced hypersalivation would benefit from scopolamine butylbromide treatment. We conclude that clozapine-induced hypersalivation is one factor of stress to patients. Subjective hypersalivation was not improved, but objective hypersalivation was, by scopolamine butylbromide treatment. However, scopolamine butylbromide and clozapine possess anticholinergic effects so clinicians should closely monitor patients who take scopolamine butylbromide.
Clozapine ; Humans ; Schizophrenia ; Scopolamine Hydrobromide* ; Sialorrhea* ; Visual Analog Scale

No abstract available.
Aorta, Thoracic ; Transcatheter Aortic Valve Replacement