- 著者
- Miho Shogenji Mikako Yoshida Koyomi Sumiya Tsutomu Shimada Yasunori Ikenaga Yoru Ogawa Kohei Hirako Yoshimichi Sai
- 出版者
- The Japanese Association of Rehabilitation Medicine
- 雑誌
- Progress in Rehabilitation Medicine (ISSN:24321354)
- 巻号頁・発行日
- vol.7, pp.20220028, 2022 (Released:2022-05-25)
- 参考文献数
- 34
- 被引用文献数
- 1
Objectives : Many stroke patients experience motor and cognitive dysfunctions that make living at home challenging. We aimed to identify the factors associated with hospital discharge to home in older stroke patients in convalescent rehabilitation wards where intensive and comprehensive inpatient rehabilitation are performed following acute-phase treatment.Methods : A retrospective cohort study was conducted among 1227 older stroke patients registered in the database of the Council of Kaga Local Stroke Network, Japan, between 2015 and 2019. Patients’ basic characteristics, discharge destination, type and severity of stroke, cognitive status, and activities of daily living (ADL) including continence were evaluated.Results : The proportion of subjects discharged to home was 62.3%. The mean hospital stay in the home discharge group was shorter than that in the non-home discharge group (111 days vs. 144.6 days, P <0.001). The following factors were associated with discharge to home: age (adjusted odds ratio [AOR]: 2.801, 95% confidence interval [CI] [1.473, 2.940]; P <0.001), sex (AOR: 1.513, 95% CI [1.112, 2.059]), stroke type (AOR: 1.426, 95% CI [1.013, 2.007]), low cognitive status (AOR: 3.750, 95% CI [2.615, 5.379]), low level of bladder control (AOR: 2.056, 95% CI [1.223, 3.454]), and low level of bowel control (AOR: 2.823, 95% CI [1.688, 4.722]).Conclusions : Age, sex, stroke type, cognitive function, and ADL scores for bladder and bowel control were associated with discharge to home. Improving continence management regarding both voiding and defecation may be a promising care strategy to promote hospital discharge to home in older stroke patients.
- 著者
- Hiroko Makihara Yuka Koike Masatomi Ohta Emi Horiguchi-Babamoto Masahito Tsubata Kaoru Kinoshita Tomoko Akase Yoshio Goshima Masaki Aburada Tsutomu Shimada
- 出版者
- 公益社団法人日本薬学会
- 雑誌
- Biological and Pharmaceutical Bulletin (ISSN:09186158)
- 巻号頁・発行日
- vol.39, no.7, pp.1137-1143, 2016-07-01 (Released:2016-07-01)
- 参考文献数
- 42
- 被引用文献数
- 19
Visceral obesity induces the onset of metabolic disorders such as insulin resistance and diabetes mellitus. Adipose tissue is considered as a potential pharmacological target for treating metabolic disorders. The fruit of Terminalia bellirica is extensively used in Ayurvedic medicine to treat patients with diseases such as diabetes mellitus. We previously investigated the effects of a hot water extract of T. bellirica fruit (TB) on obesity and insulin resistance in spontaneously obese type 2 diabetic mice. To determine the active ingredients of TB and their molecular mechanisms, we focused on adipocyte differentiation using mouse 3T3-L1 cells, which are widely used to study adipocyte physiology. We show here that TB enhanced the differentiation of 3T3-L1 cells to mature adipocytes and that one of the active main components was identified as gallic acid. Gallic acid (10–30 µM) enhanced the expression and secretion of adiponectin via adipocyte differentiation and also that of fatty acid binding protein-4, which is the target of peroxisome proliferator-activated receptor gamma (PPARγ), although it does not alter the expression of the upstream genes PPARγ and CCAAT enhancer binding protein alpha. In the PPARγ ligand assay, the binding of gallic acid to PPARγ was undetectable. These findings indicate that gallic acid mediates the therapeutic effects of TB on metabolic disorders by regulating adipocyte differentiation. Therefore, TB shows promise as a candidate for preventing and treating patients with metabolic syndrome.