Effects of L-carnosine and its zinc complex (Polaprezinc) on pressure ulcer healing.

BACKGROUND: L-carnosine (CAR) is an endogenous dipeptide. We aimed to determine the effects of CAR and its zinc complex polaprezinc (PLZ) on pressure ulcer healing in institutionalized long-term care patients. METHODS: This study was a nonrandomized controlled trial with a maximum 4-week follow-up. Forty-two patients with stage II-IV pressure ulcers for 4 or more weeks were allocated to 1 of 3 groups in order of recruitment: the control group (n = 14) was untreated, the PLZ group (n = 10) orally received 150 mg/d PLZ (containing 116 mg CAR and 34 mg zinc), and the CAR group (n = 18) orally received 116 mg/d CAR. Pressure ulcer severity was measured weekly using the Pressure Ulcer Scale for Healing (PUSH) score. RESULTS: At baseline, no significant differences were found among groups in demographic and nutrition parameters and pressure ulcer characteristics (severity, size, and staging). After 4 weeks, the rate of pressure ulcer healing, assessed by the mean weekly improvement in PUSH score, was significantly greater in the CAR (1.6 ± 0.2, P = .02) and PLZ groups (1.8 ± 0.2, P = .009) than in the control group (0.8 ± 0.2). The difference between the CAR and PLZ groups was not significant (P = .73). Actual dietary intakes over this period did not differ significantly among groups. CONCLUSIONS: Our results suggest that CAR and PLZ may almost equally accelerate pressure ulcer healing during 4 weeks. The results need confirmation by randomized controlled trials with larger sample sizes.

Which Stress Does Influence Returning to Work in Japan, Inside or Outside the Workplace?

BACKGROUND: In this cohort study, we investigated the background factors promoting and inhibiting a return to work after long-term absence from work due to sickness among psychiatric outpatients. METHODS: We surveyed 73 psychiatric outpatients who were absent from work for a long time (POAWs), and 42 POAWs who were followed up until the 2-year time point. GHQ-30, NEO-FFI, MPS, RSS and questionnaires in-quiring about background factors, including relationships with others, were used, and the data were compared those who had returned to the work by the 2-year time point with those who had not. RESULTS: Factors promoting a return to work were "extroversion (NEO-FFI)", "organization (MPS)", and "neuroticism (NEO-FFI)", whereas "concern over mistakes (MPS)" was an inhibitory factor. Period of absence from work was markedly associated with psychological stress outside the workplace, while depression, anxiety, and even psychological stress inside the workplace were not. CONCLUSIONS: POAWs left from work by the result of psychiatric problems like depression, anxiety and so on. These were the result of their background factors, their characteristics, and psychological stress in/outside the workplace. After two-year psychiatric treatment, their psychological stress outside the workplace remained as an essential matter. These were inescapable because they were set in private place, while stress at the workplace could be left at the workplace.

Staphylococcus epidermidis Esp inhibits Staphylococcus aureus biofilm formation and nasal colonization.

Commensal bacteria are known to inhibit pathogen colonization; however, complex host-microbe and microbe-microbe interactions have made it difficult to gain a detailed understanding of the mechanisms involved in the inhibition of colonization. Here we show that the serine protease Esp secreted by a subset of Staphylococcus epidermidis, a commensal bacterium, inhibits biofilm formation and nasal colonization by Staphylococcus aureus, a human pathogen. Epidemiological studies have demonstrated that the presence of Esp-secreting S. epidermidis in the nasal cavities of human volunteers correlates with the absence of S. aureus. Purified Esp inhibits biofilm formation and destroys pre-existing S. aureus biofilms. Furthermore, Esp enhances the susceptibility of S. aureus in biofilms to immune system components. In vivo studies have shown that Esp-secreting S. epidermidis eliminates S. aureus nasal colonization. These findings indicate that Esp hinders S. aureus colonization in vivo through a novel mechanism of bacterial interference, which could lead to the development of novel therapeutics to prevent S. aureus colonization and infection.

[Clinical usefulness of multidetector-row CT to evaluate coronary artery calcium score in type 2 diabetes].

PURPOSE: According to recent studies, multidetector-row CT (MDCT) with a retrospective ECG-gating reconstruction algorithm shows a high correlation with coronary artery calcium score determined using electron-beam CT. Diabetes leads to many macrovascular complications, including coronary artery disease. The aim of this study was to evaluate risk factors for cardiac macroangiopathy in type 2 diabetes using MDCT. MATERIALS AND METHODS: An observational cross-sectional study was performed in 90 patients with diabetes mellitus. Coronary calcium data was acquired by MDCT (SOMATOM Volume Zoom, Siemens AG, Medical Solutions, Germany). Physical examinations, laboratory data, glycemic control, and control of other risk factors were analyzed. RESULTS: The coronary artery calcium score increased with age. Multivariant analysis revealed that the coronary calcium score was closely correlated with electrocardiogram evaluation and control of hypertension. CONCLUSIONS: Coronary artery calcium score as determined by MDCT can be used as a screening radiological examination for cardiac macroangiopathy in diabetes patients with electrocardiogram abnormality and hypertension.

Detection of MUC1 and keratin 19 mRNAs in the bone marrow by quantitative RT-PCR predicts the risk of distant metastasis in breast cancer patients.

BACKGROUND: Early detection of micrometastasis in bone marrow is critical for the prognosis of breast cancer patients. Quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) has been used to detect cancer cells in bone marrow, but its utility as a prognostic factor still remains obscure. MATERIALS AND METHODS: Bone marrow samples were aspirated from the anterosuperior iliac spine of 34 patients, immediately after their surgical procedures had been completed. Control samples were also obtained from 10 healthy adult volunteers. The total RNA was extracted from the mononuclear cells, and the expression levels ofbeta-actin, MUC1 and keratin 19 mRNAs were studied by quantitative RT-PCR. Each mRNA level was scored according to the expression level. The sum of these expression scores was defined as the composite expression score, which was employed as the basis of the evaluation. RESULTS: The mean follow-up period was 45 months. Nine patients developed distant metastases, and one developed local recurrence. The 4-year disease relapse rates were 75% (RR=19.38; 95% CI: 1.94-193.20), 28% (RR=3.64; 95% CI: 0.43-31.18), and 8.3% for patients with composite expression scores of 5/6, 3/4 and 2, respectively. The difference among the three groups was statistically significant (log-rank test: p=0.0029), and multivariate analysis also found the composite expression score to be an independent prognostic factor. CONCLUSIONS: Breast cancer patients who show a high composite expression score in bone marrow have a significantly higher risk of recurrence.