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Epidemiologic analysis of Crohn disease in Japan: increased dietary intake of n-6 polyunsaturated fatty acids and animal protein relates to the increased incidence of Crohn disease in Japan.

We examined the correlation between the incidence of Crohn disease and dietary change in a relatively homogeneous Japanese population. The incidence and daily intake of each dietary component were compared annually from 1966 to 1985. The univariate analysis showed that the increased incidence of Crohn disease was strongly (P < 0.001) correlated with increased dietary intake of total fat (r = 0.919). animal fat (r = 0.880), n-6 polyunsaturated fatty acids (r = 0.883), animal protein (r = 0.908), milk protein (r = 0.924), and the ratio of n-6 to n-3 fatty acid intake (r = 0.792). It was less correlated with intake of total protein (r = 0.482, P < 0.05), was not correlated with intake of fish protein (r = 0.055, P > 0.1), and was inversely correlated with intake of vegetable protein (r = -0.941, P < 0.001). The multivariate analysis showed that increased intake of animal protein was the strongest independent factor with a weaker second factor, an increased ration of n-6 to n-3 polyunsaturated fatty acids. The present study in association with reported clinical studies suggests that increased dietary intake of animal protein and n-6 polyunsaturated fatty acids with less n-3 polyunsaturated fatty acids may contribute to the development of Crohn disease.

Adult↗

[The current status of infectious enteritis in Japan--reports of the "Research Group for Infectious Enteric Diseases, Japan" in the last 5 years (1996-2000)].

The patients or carriers with infectious enteritis admitted to the Hospitals for infectious diseases in the last 5 years (1996-2000) were studied. The total number of cases admitted in each year were 969, 1,113, 981, 637 and 573 respectively. A total of 1,527 Shigella spp. strains including 1,078 strains from overseas travelers' cases were isolated. The isolates of Salmonella spp. excluding S. Typhi and S. Paratyphi A were 562 in number. A total of 61 Vibrio cholerae O1 strains including 44 strains from overseas travelers was isolated. These V. cholerae O1 strains were all of El Tor type. Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum and Isospora belli were detected in 225, 46, 3 and 3 cases respectively. Abdominal pain, nausea and vomiting were frequently observed in the cases caused by Vibrio parahaemolyticus. The highest body temperature and the highest frequency of bowel movements were revealed in the cases caused by Salmonella spp. Bloody stool was observed in 55.3% of the cases due to Escherichia coli, in 40.5% of the cases due to Campylobacter spp. and in 24.1% of cases due to Shigella spp. As for shigellosis and salmonellosis, the clinical symptoms were more serious in the domestic cases than those in travelers. OFLX-resistant strains accounted for 1.7% of Shigella spp. isolates. No strains of Salmonella spp. were resistant to OFLX. The incidence of drug-resistant isolates of Campylobacter jejuni were 26.0% for OFLX and 2.5% for EM.

Drug Resistance, Bacterial↗

Japan assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS): rationale and design.

BACKGROUND: Many trials have shown that 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors reduce the incidence of cardiovascular events and mortality. One method of decreasing the incidence of cardiovascular events could be to reduce the progression of coronary atherosclerosis, and a recent study found that atorvastatin can cause coronary plaque to regress. To generalize this finding, using conventional HMG-CoA reductase inhibitors at many Japanese centers, randomized trials of pitavastatin and atorvastatin will be conducted with patients with acute coronary syndrome (ACS). METHODS AND RESULTS: Patients with ACS who have undergone successful percutaneous coronary intervention under intravascular ultrasound guidance will be studied. They will be randomly allocated to pitavastatin or atorvastatin groups and followed up for 8-12 months. The primary endpoint will be the percent change in coronary plaque volume, and secondary endpoints will include absolute changes in coronary plaque volume, serum lipid levels and inflammatory markers. The safety profile will also be evaluated. CONCLUSIONS: This study will examine the ability of HMG-CoA reductase inhibitors to regress coronary plaque in Japanese patients with ACS and the findings should help to improve the prognosis of such patients and clarify the involved mechanisms.

Atorvastatin↗