Pub Date : 2021-01-07DOI: 10.1201/9780824745097-18
D. Kawabata, T. Mimori
1.1 What is it? Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs of the body, especially the skin, joints, blood, kidneys and central nervous system. "Chronic" means that it can last for a long time. "Autoimmune" means that there is a disorder of the immune system, which, instead of protecting the body from bacteria and viruses, attacks the patient’s own tissues. The name "systemic lupus erythematosus" dates back to the early 20th century. "Systemic" means that it affects many organs of the body. The word "lupus" is derived from the Latin word for "wolf" and it refers to the characteristic butterfly-like rash on the face, which is similar to the white markings on a wolf’s face. "Erythematosus" in Greek means "red" and it refers to the redness of the skin rash.
{"title":"[Systemic lupus erythematosus].","authors":"D. Kawabata, T. Mimori","doi":"10.1201/9780824745097-18","DOIUrl":"https://doi.org/10.1201/9780824745097-18","url":null,"abstract":"1.1 What is it? Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs of the body, especially the skin, joints, blood, kidneys and central nervous system. \"Chronic\" means that it can last for a long time. \"Autoimmune\" means that there is a disorder of the immune system, which, instead of protecting the body from bacteria and viruses, attacks the patient’s own tissues. The name \"systemic lupus erythematosus\" dates back to the early 20th century. \"Systemic\" means that it affects many organs of the body. The word \"lupus\" is derived from the Latin word for \"wolf\" and it refers to the characteristic butterfly-like rash on the face, which is similar to the white markings on a wolf’s face. \"Erythematosus\" in Greek means \"red\" and it refers to the redness of the skin rash.","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"44 1","pages":"359-63"},"PeriodicalIF":0.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90712798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metformin, a biguanide, is considered in EASD and ADA to be a first-line glucose-lowering agent for patients with type 2 diabetes. The effectiveness of metformin as an anti-diabetic drug is explained by its ability to lower blood glucose by decreasing hepatic glucose production, stimulating glucose uptake in the muscle, and increasing fatty acid oxidation in adipose tissue. The exact mechanism of this effect has not been fully understood, but metformin is thought to activate hepatic AMP-activated protein kinase (AMPK), and it suppresses liver glucagon signal by increasing AMP due to inhibition of mitochondrial respiratory complex I. Caution is advised to avoid use of metformin in patients at risk for lactic acidosis (e.g., in patients with advanced renal and liver insufficiency, infection, dehydration, alcoholism, or in those using diuretics or SGLT2 inhibitor).
{"title":"[Biguanide].","authors":"Yasushi Tanaka","doi":"10.32388/fgfp4j","DOIUrl":"https://doi.org/10.32388/fgfp4j","url":null,"abstract":"Metformin, a biguanide, is considered in EASD and ADA to be a first-line glucose-lowering agent for patients with type 2 diabetes. The effectiveness of metformin as an anti-diabetic drug is explained by its ability to lower blood glucose by decreasing hepatic glucose production, stimulating glucose uptake in the muscle, and increasing fatty acid oxidation in adipose tissue. The exact mechanism of this effect has not been fully understood, but metformin is thought to activate hepatic AMP-activated protein kinase (AMPK), and it suppresses liver glucagon signal by increasing AMP due to inhibition of mitochondrial respiratory complex I. Caution is advised to avoid use of metformin in patients at risk for lactic acidosis (e.g., in patients with advanced renal and liver insufficiency, infection, dehydration, alcoholism, or in those using diuretics or SGLT2 inhibitor).","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"121 1","pages":"647-51"},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78425653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SU drug promotes insulin secretion by acting on pancreatic β cell. The hypoglycemic effect is the most powerful among oral diabetic drugs with high cost-effectiveness. Particularly for the Japanese with type 2 diabetes caused by a decrease in insulin secretion as a main pathological condition, it was widely used until the present since 1957 and largely contributed for the sickness. On the other hand, it is true that a number of issues such as a prolonged hypoglycemic coma or obesity due to a neglect of proper usage, patient education, and a possibility of second failure have been discussed so far. After a structure of K(ATP) channel on pancreatic β cell as playing an important role with insulin secretion is clarified recently and neonatal diabetes mellitus by the genetic defect is reported, a new possibility for SU drug receives attention. Furthermore, a receptor of SU drug on β cell membrane was solely known as a target molecule for SU drug, but since a binding to Epac2 as a protein to detect a part of SU drug's cAMP signal within β cell is determined, a relation with an enhancing mechanism of insulin secretion by incretin is being clarified at present. As understanding a new potential for SU drug, we consider a positioning and proper usage for SU drug again.
{"title":"[Sulfonylurea].","authors":"R. Usuda","doi":"10.32388/pflxxq","DOIUrl":"https://doi.org/10.32388/pflxxq","url":null,"abstract":"SU drug promotes insulin secretion by acting on pancreatic β cell. The hypoglycemic effect is the most powerful among oral diabetic drugs with high cost-effectiveness. Particularly for the Japanese with type 2 diabetes caused by a decrease in insulin secretion as a main pathological condition, it was widely used until the present since 1957 and largely contributed for the sickness. On the other hand, it is true that a number of issues such as a prolonged hypoglycemic coma or obesity due to a neglect of proper usage, patient education, and a possibility of second failure have been discussed so far. After a structure of K(ATP) channel on pancreatic β cell as playing an important role with insulin secretion is clarified recently and neonatal diabetes mellitus by the genetic defect is reported, a new possibility for SU drug receives attention. Furthermore, a receptor of SU drug on β cell membrane was solely known as a target molecule for SU drug, but since a binding to Epac2 as a protein to detect a part of SU drug's cAMP signal within β cell is determined, a relation with an enhancing mechanism of insulin secretion by incretin is being clarified at present. As understanding a new potential for SU drug, we consider a positioning and proper usage for SU drug again.","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"36 1","pages":"409-15"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75618801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Secondary diabetes may occur in association with endocrine or nonendocrine disorders. The most common endocrine diseases associated with glucose intolerance are those involving the overproduction of counter regulatory hormones. Nonendocrine conditions associated with glucose intolerance or diabetes fall into three general categories: pancreatic diseases, drug-induced diabetes, and genetic syndromes. The therapy for secondary diabetes centers on the correction of an underlying disturbance. Patients with fasting hyperglycemia should be treated with an understanding of the pathophysiologic basis of their diabetes. in autoimmune diabetes (Type 1 diabetes and LADA Type diabetes), its etiopathogenesis is established and the primary disorder is pancreatic β-cell damage, and in Type 2 diabetes the primary cause is insulin resistance, in secondary diabetes, the etiopathogenesis of glucose homeostasis disorders is diverse and most often multifactorial.
{"title":"[Secondary diabetes].","authors":"K. Tsuda, Y. Seino","doi":"10.32388/gkxjre","DOIUrl":"https://doi.org/10.32388/gkxjre","url":null,"abstract":"Secondary diabetes may occur in association with endocrine or nonendocrine disorders. The most common endocrine diseases associated with glucose intolerance are those involving the overproduction of counter regulatory hormones. Nonendocrine conditions associated with glucose intolerance or diabetes fall into three general categories: pancreatic diseases, drug-induced diabetes, and genetic syndromes. The therapy for secondary diabetes centers on the correction of an underlying disturbance. Patients with fasting hyperglycemia should be treated with an understanding of the pathophysiologic basis of their diabetes. in autoimmune diabetes (Type 1 diabetes and LADA Type diabetes), its etiopathogenesis is established and the primary disorder is pancreatic β-cell damage, and in Type 2 diabetes the primary cause is insulin resistance, in secondary diabetes, the etiopathogenesis of glucose homeostasis disorders is diverse and most often multifactorial.","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"17 1","pages":"203-8"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90632318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[LDL-cholesterol].","authors":"I. Sakurabayashi","doi":"10.32388/ey4ao8","DOIUrl":"https://doi.org/10.32388/ey4ao8","url":null,"abstract":"","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"21 1","pages":"20-3"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87652701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Pancreas transplantation].","authors":"T. Nemoto, K. Kubota","doi":"10.32388/gzg3vx","DOIUrl":"https://doi.org/10.32388/gzg3vx","url":null,"abstract":"","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"11 1","pages":"631-5"},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87233795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xylitol is a prevalent sugar substitute found in a wide variety of foods, particularly those labeled as ‘‘low carb.’’ It is found in many medicines and dental products both for its antibacterial activity and to increase palatability. Originally, this toxin was recognized as a problem in dogs following sugarless gum ingestions. Xylitol is generally nontoxic to mammals except for dogs. In the dog, xylitol induces marked increases in insulin production and occasionally hepatopathy. The clinical syndrome is manifested with signs consistent with profound hypoglycemia, hypokalemia, hypophosphatemia, and acute hepatic failure. Treatment relies upon administration of intravenous glucose, hepatic support, and general supportive care. & 2013 Published by Elsevier Inc.
{"title":"[Xylitol].","authors":"Z. Kizaki, T. Sawada","doi":"10.32388/wk8lmt","DOIUrl":"https://doi.org/10.32388/wk8lmt","url":null,"abstract":"Xylitol is a prevalent sugar substitute found in a wide variety of foods, particularly those labeled as ‘‘low carb.’’ It is found in many medicines and dental products both for its antibacterial activity and to increase palatability. Originally, this toxin was recognized as a problem in dogs following sugarless gum ingestions. Xylitol is generally nontoxic to mammals except for dogs. In the dog, xylitol induces marked increases in insulin production and occasionally hepatopathy. The clinical syndrome is manifested with signs consistent with profound hypoglycemia, hypokalemia, hypophosphatemia, and acute hepatic failure. Treatment relies upon administration of intravenous glucose, hepatic support, and general supportive care. & 2013 Published by Elsevier Inc.","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"6 1","pages":"607-10"},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82139352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.1093/med/9780198832447.003.0017
H. Itoh, M. Nagayama, Tomoko Maeda
This chapter looks at the role of cardiac rehabilitation for those at risk of cardiac disease or who have sustained a cardiac event. Cardiac rehabilitation has been a priority area for a long time in the National Service Framework for Coronary Heart Disease, NHS Improvement Plan, and now features in the NHS Long Term Plan. The introduction of certification for cardiovascular prevention and rehabilitation programmes (CPRP) has meant that their quality can be measured. The introduction of more technology-based interventions has opened up the opportunity for more people to participate, particularly for individuals who could not, or did not want to attend a traditional CPRP.
{"title":"[Cardiac rehabilitation].","authors":"H. Itoh, M. Nagayama, Tomoko Maeda","doi":"10.1093/med/9780198832447.003.0017","DOIUrl":"https://doi.org/10.1093/med/9780198832447.003.0017","url":null,"abstract":"This chapter looks at the role of cardiac rehabilitation for those at risk of cardiac disease or who have sustained a cardiac event. Cardiac rehabilitation has been a priority area for a long time in the National Service Framework for Coronary Heart Disease, NHS Improvement Plan, and now features in the NHS Long Term Plan. The introduction of certification for cardiovascular prevention and rehabilitation programmes (CPRP) has meant that their quality can be measured. The introduction of more technology-based interventions has opened up the opportunity for more people to participate, particularly for individuals who could not, or did not want to attend a traditional CPRP.","PeriodicalId":19307,"journal":{"name":"Nihon rinsho. Japanese journal of clinical medicine","volume":"1 1","pages":"503-9"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88150279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：