Jomyaku Keicho Eiyo

Purpose: The safety and efficacy of a long-term oral rehydration therapy (ORT), using an oral rehydration solution, was investigated in the elderly subjects without dehydration.
Methods: The elderly subjects at geriatric nursing homes and those who had not dehydration were studied. The study was designed as a multicenter randomized controlled investigation, consisting of two groups, a non-intervention control group that did not receive ORT (41 subjects as CN group) and an intervention group that received ORT (41 subjects as OS group). The intervention group, OS group, consumed 500 to 1000 mL of an oral rehydration solution daily for 30 days.
Results: No abnormal findings were observed in vital signs and blood chemistry outcomes, and complications and influences on diet consumption were not observed in the OS group, confirming the safety of the ORT therapy in the elderly. With regard to the efficacy, an increase in fractional excretion ratio of sodium, a decrease in BUN/Cr ratio, and a decrease in plasma osmolality were observed to show the effect of increasing the amount of water in the body.
Conclusion: The results of this study showed the safety of a long-term daily use of ORT in the elderly persons who do not have dehydration condition and also suggested its effectiveness in the prevention of dehydration.

View full abstract

Purpose: Strong Wakamoto (GWT;Gut Working Tablet) is a Japanese traditional fermented medicine and a combination of Aspergillus oryzae NK-fermented grain germ (A. oryzae NK-koji) as its major component, Enterococcus faecium-fermented grain germ and dried yeast. GWT and A. oryzae NK-koji named a probiotics-koji. The purpose of this study was to investigate the usefulness of two probiotics-kojis on intestinal lesions of trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats.
Methods: Sprague-Dawley rats were fed with or without 5% the probiotics-koji for 4 weeks and received an enema of TNBS/50% ethanol to induce colitis. The effect of these probiotics-kojis was evaluated on 7 days after administration of TNBS/50% ethanol.
Results: Treatment with 5% the probiotics-koji significantly improved loss of body-weight, increase of colon weight and histological damage score of colon mucosa, and decrease of superoxidedismutase (SOD) activity, faecal Lactobacillus sp. when compared to the TNBS-colitis group without 5% the probiotics-koji. The increased TNF-α and cytokine induced neutrophil chemoattractant-1 (CINC-1) expressions in colonic tissue after TNBS enema were significantly ameliorated when GWT or A. oryzae NK-koji was given (p<0.05, p<0.01).
Conclusion: The two probiotics-kojis of GWT and A. oryzae NK-koji protected the worse of the colonic lesions, and improved the intestinal environment of TNBS-induced colitis in rats.

View full abstract

Rationale: Gastrostomy (GS) is the main surgical therapy for alleviating swallowing difficulty, gastroesophageal reflux, and respiratory problems in severely handicapped patients. Many of these patients may have the postprandial hyperglycemia (PH) but few are aware of it.
Methods: For a more precise validation of the PH or and hypoglycemia than that performed previously, we used continuous glucose monitoring (CGM) system for 72 successive hours. We examined 21 patients (13 men and 8 women; age, 2-19 years). We explored 3 types of therapeutic methods for PH: two diets containing slowly digested carbohydrate for controlling the glucose level, an alpha-glucosidase inhibitor, and a mixed-minced diet (MMD).
Results: Of the 21 patients, 11 showed a blood glucose level of more than 180 mg/dl during and after the intake of a conventional elemental diet (CED). And condition of 9 of the 11 PH patients was controlled by the therapeutic methods. A MMD showed lower glucose level with short infusion time compared with other meals.
Conclusion: After GS, many of the severely handicapped patients had PH. MMD may change the tolerance of glucose in diets and is one of the best therapeutic methods among diets and medication.

View full abstract

Show abstractHide abstract

OBJECTIVE: The objective of this study is to clarify the relation between the fasting period and the nutritional status in stroke patients in the acute stage, comparing groups of stroke types and subtypes.
METHODS: From July 2009 to June 2010, we retrospectively investigated patients with strokes newly admitted to four major hospitals in the Noto district of Japan. Information on the severity of stroke, the fasting period, the transitional changes of the body mass index (BMI) and the level of serum albumin after admission were examined. A total of 508 patients were included in this study with a mean age of 75.4 years. There was a standard deviation of 11.0 years. Statistical differentiation was detected by p<0.05.
RESULTS: The mean fasting periods of all patients was 2.3±7.7 days (mean ±SD), that of the cerebral infarction (CI) group was 1.8±6.7 days, that of the intracerebral hemorrhage (ICH) group was 3.5±10.6 days, and that of the subarachnoid hemorrhage (SAH) ; 3.5±5.4 days. The fasting period was positively correlated with the score of National Institute of Health Stroke Scale (NIHSS) on admission. The fasting period of CI was significantly shorter than that of ICH and SAH. In all stroke types BMI and the level of serum albumin at the end of the acute stage of the stroke were significantly lower than those on admission. In addition, the amounts of the decrease of those parameters in patients with cardiogenic cerebral embolism were statistically larger than those of lacunar infarction.
CONCLUSIONS: This study shows that the fasting period after stroke onset varies according to the severity of disease and to the type of stroke. A positive relationship between the fasting period and the depression of nutritional condition is suggested.

View full abstract

Download PDF (619K)

Register with J-STAGE for free!