Background: This study examined how the frequency of in-person, telephone, text-based communication, and video interactions with non-cohabiting family and friends relates to loneliness among older adults in Japan. Methods: We analyzed data from 6,786 adults aged ≥65 in the 2024 Japan COVID-19 and Society Internet Survey (JACSIS) study. Interaction frequency with non-cohabiting family and friends was categorized into none (reference), monthly, and weekly or more. Loneliness was measured using the 3-item UCLA Loneliness Scale and dichotomized at ≥4, indicating loneliness; a ≥7 cut-off was used in sensitivity analyses. Logistic regression models adjusted for sociodemographic, lifestyle, and health-related factors. Results: For family, significant associations with lower loneliness were observed only at weekly frequencies—in-person (adjusted odds ratio [aOR]=0.764, 95% confidence interval [CI] 0.664–0.879), text (aOR=0.747, 95% CI 0.659–0.846), and telephone (aOR=0.624, 95% CI 0.543–0.718), whereas for friends, significant associations were observed at monthly frequencies—in-person (aOR=0.621, 95% CI 0.549–0.701), text (aOR=0.881, 95% CI 0.778–0.997), and telephone (aOR=0.734, 95% CI 0.659–0.819). Video calls were associated with lower odds of severe loneliness (score ≥7) in sensitivity analyses—weekly calls with family (aOR=0.736, 95% CI 0.547–0.991) and monthly calls with friends (aOR=0.656, 95% CI 0.470–0.917). Conclusion Interactions with friends show associations with lower levels of loneliness at lower frequencies than family contact. While text and phone calls are broadly associated with reduced loneliness, video calls showed an association specifically with a lower prevalence of severe loneliness, underscoring the potential for tailored communication strategies.

An 84-year-old woman, who had undergone ligation for a coronary pulmonary artery fistula, coronary aneurysmectomy, and coronary artery bypass grafting at the age of 76 years, was referred to another hospital for chest pain and diagnosed with acute myocardial infarction based on coronary angiography results. The day after admission, she was transferred to our hospital after her blood pressure decreased and echocardiography showed left ventricular rupture. The Impella CP was introduced on the same day, and the surgery was performed on day 8 after one week of heart failure management. Intraoperative findings revealed a ruptured site in the lateral wall, which was repaired by patch closure. The patient was transferred for rehabilitation on postoperative day 24. As the patient was elderly with multiple organ failure and at high operative risk, a preoperative period to allow remodeling of the infarcted myocardium was considered crucial for a successful repair procedure. The left ventricle was decompressed using the Impella system to prevent enlargement of the rupture site in this case, and a 7-day preoperative optimization period was sufficient for improving myocardial damage. Thus, preoperative Impella-assisted management for left ventricular rupture might be effective in cases of free wall rupture after cardiac surgery with stable hemodynamic status as in the present case or oozing rupture.

A 65-year old man with a diagnosis of aortic regurgitation from childhood referred to our hospital due to palpitations and dyspnea on exertion. Transthoracic echocardiography showed severe aortic regurgitation, but the form of left coronary aortic cusp was not detected clearly. Trans esophageal echocardiography revealed small left coronary aortic sinus covered with a rudimentary left coronary cusp. Right coronary angiography showed retrograde flow to left coronary artery, and pooling of contrast material in the aortic cusp. Cannulation into the left coronary ostium could not be performed, aortography revealed no antegrade left coronary blood flow. The patient underwent aortic valve replacement with mechanical valve after resection of the rudimentary left coronary cusp, and ascending aorta replacement using selective cerebral perfusion. The post operative course was uneventful. We report on a rare case of occlusion of left coronary ostium with a rudimentary aortic cusp.

BACKGROUND: Studies reported adverse behavioral development including internalizing and externalizing problems in association with prenatal exposure to bisphenol A (BPA) and phthalates; however, findings were not sufficient due to using different assessment tools and child ages among studies. This study aimed to examine associations between maternal serum levels of BPA and phthalate metabolites and behavioral problems at preschool age. METHODS: The Strengths and Difficulties Questionnaire (SDQ) was used to assess behavioral problems at 5 years of age. BPA and phthalate metabolite levels in the first trimester maternal serum was determined by LC-MS/MS for 458 children. Variables used for adjustment were parental ages, maternal cotinine levels, family income during pregnancy, child sex, birth order, and age at SDQ completed. RESULTS: The median concentrations of BPA, MnBP, MiBP, MEHP, and MECPP, primary and secondary metabolites of phthalates, were 0.062, 26.0, 7.0, 1.40, and 0.20 ng/ml, respectively. MECPP level was associated with increase conduct problem risk (OR = 2.78, 95% CI 1.36-5.68) overall and the association remained after child sex stratification, and odds ratios were increased with wider confidence interval (OR = 2.85, 95% CI 1.07-7.57 for boys, OR = 4.04, 95% CI 1.31-12.5 for girls, respectively). BPA, ∑DBP (MnBP + MiBP), and ∑DEHP (MEHP+MECPP) levels were not associated with any of the child behavioral problems. CONCLUSIONS Our analyses found no significant association between BPA or summation of phthalate metabolite levels and any of the behavioral problems at 5 years of age but suggested possible association between MECPP levels and increased risk of conduct problems.
Adult ; Age Factors ; Benzhydryl Compounds ; blood ; Child, Preschool ; Environmental Exposure ; analysis ; Female ; Humans ; Male ; Phenols ; blood ; Phthalic Acids ; blood ; Pregnancy ; Prenatal Exposure Delayed Effects ; epidemiology ; Problem Behavior ; Smoking ; epidemiology ; Socioeconomic Factors

A 80-year-old woman was referred to our hospital for coagulation abnormality and huge abdominal aortic aneurysm (AAA). She had persistent hemorrhage from the surgical wound after the operation for her cubital tunnel syndrome 5 days before. Enhanced computed tomography image revealed AAA with a maximum diameter of 91 mm. Laboratory data were compatible with disseminated intravascular coagulation (DIC). Due to the marked hemorrhagic status, we thought the open repair of AAA was an extremely risky procedure. We initiated the medical treatment with gabexate mesilate. However, the hemorrhage continued after 2 weeks of medical therapy. We performed endovascular aneurysm repair (EVAR). DIC improved after the procedure. Postoperative enhanced computed tomography image showed regression of the aneurysm with no endoleak. EVAR might be an acceptable procedure for AAA with DIC.