In recent years, cancer treatment methods have diversified, and there are increasing numbers of occasions where patients or their families are required to make increasingly complex decisions. Currently, there are no guidelines for determining the process and the individual who decides the treatment strategy for cancer patients who are unable to decide for themselves. Particularly, no report has been published on decision-making for end-of-life care in patients with intellectual disabilities. This report documents our involvement in decision-making during end-of-life care for a cancer patient with intellectual disabilities. This patient’s decision-making ability or lack thereof was determined using reliable and validated assessment scales. The collective decision to not resuscitate in case of cardiac arrest and to care for the patient in the palliative care unit was made through a multidisciplinary collaboration between the social welfare team and the hospital based on reports and guidelines from abroad. Going forward, guidelines for decision-making support for terminal ill cancer patients with intellectual disabilities and decision-making by proxies for such patients need to be established in Japan.

OBJECTIVEYoung women being underweight is a public health problem in Japan. The aim of this study was to investigate this problem by measuring lymphocyte count as an indicator of nutritional status.

METHODSThe subjects were 114 women aged 20-39 who participated in an annual health checkup for residents in a city in Aichi, Japan. Data from a questionnaire, physical examination, and blood tests were analyzed in relation to women who were severely underweight [body mass index (BMI) /= 25 kg/m(2)).

RESULTSLymphocyte count tended to be lower with a decrease in BMI. The prevalence of low lymphocyte count of <1,500/mm(3) increased in underweight women. In women who had restricted food intake for weight loss, leukocyte count, and total serum protein, and lymphocyte count were lower. A multivariate logistic regression analysis showed the association of low lymphocyte count to being severely underweight [odds ratio (OR): 1.95; 95% confidence interval (CI): 1.07-3.56] and to restricted food intake for weight loss (OR: 3.73; 95% CI: 0.91-15.30).

CONCLUSIONThis study suggests that being severely underweight and on restricted food intake for weight loss in adult women can be risk factors for low lymphocyte count, an indicator of malnutrition. It is important for young women to maintain BMI >17.5 kg/m(2) and not to restrict food intake when of normal weight or underweight in order to prevent malnutrition.

BACKGROUND: Heat shock protein 70 (HSP70) exhibits protective effects against ultraviolet (UV)-induced premature skin aging. A standardized extract of Asparagus officinalis stem (EAS) is produced as a novel and unique functional food that induces HSP70 cellular expression. To elucidate the anti-photoaging potencies of EAS, we examined its effects on HSP70 expression levels in UV-B-irradiated normal human dermal fibroblasts (NHDFs). METHODS: NHDFs were treated with 1 mg/mL of EAS or dextrin (vehicle control) prior to UV-B irradiation (20 mJ/cm). After culturing NHDFs for different time periods, HSP70 mRNA and protein levels were analyzed using real-time polymerase chain reaction and western blotting, respectively. RESULTS: UV-B-irradiated NHDFs showed reduced HSP70 mRNA levels after 1-6 h of culture, which were recovered after 24 h of culture. Treatment with EAS alone for 24 h increased HSP70 mRNA levels in the NHDFs, but the increase was not reflected in its protein levels. On the other hand, pretreatment with EAS abolished the UV-B irradiation-induced reduction in HSP70 expression at both mRNA and protein levels. These results suggest that EAS is capable to preserve HSP70 quantity in UV-B-irradiated NHDFs. CONCLUSIONS EAS exhibits anti-photoaging potencies by preventing the reduction in HSP70 expression in UV-irradiated dermal fibroblasts.
Asparagus Plant ; Cells, Cultured ; Female ; Fibroblasts ; drug effects ; radiation effects ; HSP70 Heat-Shock Proteins ; biosynthesis ; Humans ; Middle Aged ; Plant Extracts ; pharmacology ; Polymerase Chain Reaction ; Skin ; drug effects ; radiation effects ; Skin Aging ; drug effects ; radiation effects ; Telomere ; metabolism ; Ultraviolet Rays ; adverse effects