Pub Date : 2020-04-22DOI: 10.14789/jmj.2020.66.jmj19-oa23
Y. Nakanishi, Shinobu Sakurai, Y. Kawata, Yoshio Suzuki, Mayu Takaya, Shimpei Fujita, K. Sakuraba, Masataka Hirosawa, Takao Okada
Objective : This study examined the prevalence of and factors affecting normal weight obesity (NWO) among women aged under 40 years old. NWO was having a normal BMI but a high body-fat percentage (BFP). Materials and Methods : We recruited 399 participants aged 1839 during a health checkup and surveyed them about lifestyle patterns, height, weight, body composition, and girth and visceral fat area. Participants were divided into three. Those with a BMI of <25 and a BFP of <30 were classified as non-obese, a BMI of <25 and a BFP of ≥ 30 as NWO, a BMI of ≥ 25 and a BFP of ≥ 30 as obese. The analysis was conducted on NWO (97) and non-obese (262) groups. Results : NWO prevalence ranged from 20% to 30% across the three age groups. NWO participants had lower values for segmental lean body mass, particularly in lower limb, and higher values for abdominal girth and visceral fat area. Among participants aged 3039, those with NWO had higher values for triglycerides and LDL cholesterol and lower values for HDL cholesterol. Regarding lifestyle factors, among those aged 3039, NWO was associated with past weight fluctuation, respectively. In the latter age group, a gain of more than 10 kg since the age of 20 was associated with a 13-fold increase in the odds for NWO. Conclusions : Results suggest that for women under 40 years, detecting NWO early and guidance on effective lifestyle and exercise are necessary.
{"title":"Status of Normal Weight Obesity Among Japanese Women Under 40 Years Old","authors":"Y. Nakanishi, Shinobu Sakurai, Y. Kawata, Yoshio Suzuki, Mayu Takaya, Shimpei Fujita, K. Sakuraba, Masataka Hirosawa, Takao Okada","doi":"10.14789/jmj.2020.66.jmj19-oa23","DOIUrl":"https://doi.org/10.14789/jmj.2020.66.jmj19-oa23","url":null,"abstract":"Objective : This study examined the prevalence of and factors affecting normal weight obesity (NWO) among women aged under 40 years old. NWO was having a normal BMI but a high body-fat percentage (BFP). Materials and Methods : We recruited 399 participants aged 1839 during a health checkup and surveyed them about lifestyle patterns, height, weight, body composition, and girth and visceral fat area. Participants were divided into three. Those with a BMI of <25 and a BFP of <30 were classified as non-obese, a BMI of <25 and a BFP of ≥ 30 as NWO, a BMI of ≥ 25 and a BFP of ≥ 30 as obese. The analysis was conducted on NWO (97) and non-obese (262) groups. Results : NWO prevalence ranged from 20% to 30% across the three age groups. NWO participants had lower values for segmental lean body mass, particularly in lower limb, and higher values for abdominal girth and visceral fat area. Among participants aged 3039, those with NWO had higher values for triglycerides and LDL cholesterol and lower values for HDL cholesterol. Regarding lifestyle factors, among those aged 3039, NWO was associated with past weight fluctuation, respectively. In the latter age group, a gain of more than 10 kg since the age of 20 was associated with a 13-fold increase in the odds for NWO. Conclusions : Results suggest that for women under 40 years, detecting NWO early and guidance on effective lifestyle and exercise are necessary.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116146053","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 : 2020-02-18DOI: 10.14789/jmj.2020.66.jmj19-oa21
M. M. Sudo, A. Mochizuki, E. Kirino, K. Itoh
Objective : Research has demonstrated the positive effects of physical activities on social cognition. The purpose of the present study was to find out whether coordination exercises have a beneficial effect on enhancing social functioning. We investigated the activation of the brain areas associated with doing one-person coordination exercises, as compared to doing two-person coordination exercises. We were interested in testing the hypothesis that two-person coordination exercises activate those brain areas underlying communication abilities, empathy in“theory of mind”(ToM), and working memory in social cognition. Materials : Thirty-four Japanese college students served as subjects. Methods : In the MRI system, the subjects carried out block-designed cognitive tasks containing affective visual stimuli (pleasant, unpleasant, and neutral stimuli). Then they got out of the MRI system and performed both one-person coordination and two-person coordination exercises. Just after the exercises, they were retested using the same types of the affective stimuli in the MRI system. We examined social abilities in terms of empathizing and memory span. Results : The present study provided evidence that coordination exercises activate language, working memory, and theory of mind functions. One of the fMRI results to be noted is that the right, but not the left, anterior cingulate correlated with the working memory function. Conclusions : We provided evidence for the effect of performing coordination exercises on the activation of the left frontal gyrus related to social functioning. We could also provide support for the hypothesis that two-person coordination exercises activate both the working memory function and the ToM function.
{"title":"Effects of Coordination Exercises on Social Functioning: Evidence from fMRI and Social-ability Measures","authors":"M. M. Sudo, A. Mochizuki, E. Kirino, K. Itoh","doi":"10.14789/jmj.2020.66.jmj19-oa21","DOIUrl":"https://doi.org/10.14789/jmj.2020.66.jmj19-oa21","url":null,"abstract":"Objective : Research has demonstrated the positive effects of physical activities on social cognition. The purpose of the present study was to find out whether coordination exercises have a beneficial effect on enhancing social functioning. We investigated the activation of the brain areas associated with doing one-person coordination exercises, as compared to doing two-person coordination exercises. We were interested in testing the hypothesis that two-person coordination exercises activate those brain areas underlying communication abilities, empathy in“theory of mind”(ToM), and working memory in social cognition. Materials : Thirty-four Japanese college students served as subjects. Methods : In the MRI system, the subjects carried out block-designed cognitive tasks containing affective visual stimuli (pleasant, unpleasant, and neutral stimuli). Then they got out of the MRI system and performed both one-person coordination and two-person coordination exercises. Just after the exercises, they were retested using the same types of the affective stimuli in the MRI system. We examined social abilities in terms of empathizing and memory span. Results : The present study provided evidence that coordination exercises activate language, working memory, and theory of mind functions. One of the fMRI results to be noted is that the right, but not the left, anterior cingulate correlated with the working memory function. Conclusions : We provided evidence for the effect of performing coordination exercises on the activation of the left frontal gyrus related to social functioning. We could also provide support for the hypothesis that two-person coordination exercises activate both the working memory function and the ToM function.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126768461","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 : 2020-02-01DOI: 10.14789/jmj.2020.66.jmj19-r05
Kwangseok Yang, M. Matsushita, N. Tamura
{"title":"Methotrexate and Oral Antirheumatic Drugs","authors":"Kwangseok Yang, M. Matsushita, N. Tamura","doi":"10.14789/jmj.2020.66.jmj19-r05","DOIUrl":"https://doi.org/10.14789/jmj.2020.66.jmj19-r05","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121117156","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 : 2019-09-25DOI: 10.14789/jmj.2019.65.jmj19-oa08
Tomohiro Nakamura, R. Kakigi, Noriko Ichinoseki‐Sekine, Takamasa Tsuzuki, Hiroyuki Kobayashi, K. Sakuma, H. Naito
{"title":"ACTN3 R577X Genotype Is Associated with ACTN3 Protein Expression Levels and Myosin Heavy Chain Composition in Japanese College-Level Male Sprinters","authors":"Tomohiro Nakamura, R. Kakigi, Noriko Ichinoseki‐Sekine, Takamasa Tsuzuki, Hiroyuki Kobayashi, K. Sakuma, H. Naito","doi":"10.14789/jmj.2019.65.jmj19-oa08","DOIUrl":"https://doi.org/10.14789/jmj.2019.65.jmj19-oa08","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114799440","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 : 2019-04-27DOI: 10.14789/JMJ.2019.65.JMJ18-CR04
A. Nishizawa, Kiyoshi Ito, Tomoki Nakano
Background: Motor rehabilitation may be rarely disrupted by psychiatric disorders including conversion disorder and catatonia. The amobarbital or diazepam interview can be implemented for both the diagnosis and treatment of these disorders. We report two typical cases presenting with motor paralysis influenced by psychiatric disorder that were effectively diagnosed and treated using the diazepam interview in convalescent rehabilitation. Cases: Case 1 was a 32-year-old man. He experienced severe paralysis and sensory disturbance of the right arm and leg while at work, and then received conservative treatment for stroke. One month later, after the diazepam interview, he rapidly recovered almost entirely from his paralysis and sensory disturbance, which led to a diagnosis of conversion disorder. Case 2 was a 42-yearold man. After becoming an alcoholic, both legs had gradually become severely paralyzed. Two months later, he was uncommunicative and refused rehabilitation and nursing care. He briefly became communicative during the diazepam interview, and was diagnosed with delusional depressed state with stupor. Six months later, both legs remained spastic and paralyzed. Although he was subacute with combined degeneration of the spinal cord, taking conversion disorder overlap into consideration, we conducted the diazepam interview again; he immediately recovered slight voluntary extension and flexion of both legs. Conclusions: We describe two motor disturbance cases influenced by psychiatric disorders. For both patients, the diazepam interview was shown to be an effective method for the diagnosis and treatment of a psychiatric disorder. Our findings suggest that the diazepam interview could be appropriate for use in the rehabilitation area when conducted correctly.
{"title":"The Intravenous Diazepam Interview for Motor Paralysis Cases Influenced by Psychiatric Disorder","authors":"A. Nishizawa, Kiyoshi Ito, Tomoki Nakano","doi":"10.14789/JMJ.2019.65.JMJ18-CR04","DOIUrl":"https://doi.org/10.14789/JMJ.2019.65.JMJ18-CR04","url":null,"abstract":"Background: Motor rehabilitation may be rarely disrupted by psychiatric disorders including conversion disorder and catatonia. The amobarbital or diazepam interview can be implemented for both the diagnosis and treatment of these disorders. We report two typical cases presenting with motor paralysis influenced by psychiatric disorder that were effectively diagnosed and treated using the diazepam interview in convalescent rehabilitation. Cases: Case 1 was a 32-year-old man. He experienced severe paralysis and sensory disturbance of the right arm and leg while at work, and then received conservative treatment for stroke. One month later, after the diazepam interview, he rapidly recovered almost entirely from his paralysis and sensory disturbance, which led to a diagnosis of conversion disorder. Case 2 was a 42-yearold man. After becoming an alcoholic, both legs had gradually become severely paralyzed. Two months later, he was uncommunicative and refused rehabilitation and nursing care. He briefly became communicative during the diazepam interview, and was diagnosed with delusional depressed state with stupor. Six months later, both legs remained spastic and paralyzed. Although he was subacute with combined degeneration of the spinal cord, taking conversion disorder overlap into consideration, we conducted the diazepam interview again; he immediately recovered slight voluntary extension and flexion of both legs. Conclusions: We describe two motor disturbance cases influenced by psychiatric disorders. For both patients, the diazepam interview was shown to be an effective method for the diagnosis and treatment of a psychiatric disorder. Our findings suggest that the diazepam interview could be appropriate for use in the rehabilitation area when conducted correctly.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123876758","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 : 2018-12-06DOI: 10.14789/JMJ.2018.64.JMJ18-OA07
Naruaki Imoto, K. Obinata, T. Nakazawa, S. Sasaki
Objective : This study was performed to validate PCR-based testing for surveillance of Acinetobacter baumannii ( A. baumannii ) in a pediatric ward in response to an outbreak of drug resistant A. baumannii (IS Aba1 / bla OXA-51-like) in our tertiary care hospital. Materials : All children who were admitted to the pediatric ward were included in this study. The surveillance study was carried out from March 2012 to December 2013. Methods : After collecting samples from all children in our pediatric ward, PCR analyses were conducted. IS Aba1 / bla OXA-51-like gene-positive patients were isolated from other patients and strict standard precautionary procedures for infection control were put into practice. Results : During the survey period, a total of 1,038 children underwent surveillance on admission. Of the 16 cases of Acinetobacter baumannii colonization identified during surveillance, 6 were positive for the IS Aba1 / bla OXA-51-like gene, and all IS Aba1 / bla OXA-51-like gene-positive patients received mechanical ventilation. No new IS Aba1 / bla OXA-51-like gene-positive cases were identified during the last six months of surveillance. However, among the 10 IS Aba1 / bla OXA-51-like gene-negative A. baumannii cases, 3 were neonates transferred from the same gynecological hospital. Conclusion : PCR-based testing was effective for stopping transmission of an A. baumannii outbreak in a pediatric ward. This event emphasized the importance of surveillance and interfacility communication among hospitals for prevention of infection outbreaks.
目的:本研究旨在验证基于pcr检测的鲍曼不动杆菌(鲍曼不动杆菌)监测在儿科病房应对耐药鲍曼不动杆菌(IS Aba1 / bla oxa -51样)暴发的效果。资料:所有在儿科病房住院的儿童都被纳入本研究。监测研究于2012年3月至2013年12月进行。方法:收集本院儿科病房所有患儿标本，进行PCR分析。将IS Aba1 / bla oxa -51样基因阳性患者与其他患者隔离，并执行严格的标准感染控制预防程序。结果:调查期间共有1038名儿童在入院时接受监测。在监测中发现的16例鲍曼不动杆菌定植病例中，6例IS Aba1 / bla oxa -51样基因阳性，所有IS Aba1 / bla oxa -51样基因阳性患者均接受机械通气治疗。在过去6个月的监测期间，未发现新的IS Aba1 / bla oxa -51样基因阳性病例。然而，在10例IS Aba1 / bla oxa -51样基因阴性鲍曼不动杆菌病例中，有3例来自同一妇科医院的新生儿。结论:基于聚合酶链反应的检测有效地阻止了儿科病房鲍曼不动杆菌疫情的传播。这一事件强调了监测和医院间设施间沟通对预防感染暴发的重要性。
{"title":"Validation of PCR-Based Testing for Surveillance of Drug Resistant Acinetobacter baumannii (ISAba1/blaOXA-51-Like) in a Pediatric Ward","authors":"Naruaki Imoto, K. Obinata, T. Nakazawa, S. Sasaki","doi":"10.14789/JMJ.2018.64.JMJ18-OA07","DOIUrl":"https://doi.org/10.14789/JMJ.2018.64.JMJ18-OA07","url":null,"abstract":"Objective : This study was performed to validate PCR-based testing for surveillance of Acinetobacter baumannii ( A. baumannii ) in a pediatric ward in response to an outbreak of drug resistant A. baumannii (IS Aba1 / bla OXA-51-like) in our tertiary care hospital. Materials : All children who were admitted to the pediatric ward were included in this study. The surveillance study was carried out from March 2012 to December 2013. Methods : After collecting samples from all children in our pediatric ward, PCR analyses were conducted. IS Aba1 / bla OXA-51-like gene-positive patients were isolated from other patients and strict standard precautionary procedures for infection control were put into practice. Results : During the survey period, a total of 1,038 children underwent surveillance on admission. Of the 16 cases of Acinetobacter baumannii colonization identified during surveillance, 6 were positive for the IS Aba1 / bla OXA-51-like gene, and all IS Aba1 / bla OXA-51-like gene-positive patients received mechanical ventilation. No new IS Aba1 / bla OXA-51-like gene-positive cases were identified during the last six months of surveillance. However, among the 10 IS Aba1 / bla OXA-51-like gene-negative A. baumannii cases, 3 were neonates transferred from the same gynecological hospital. Conclusion : PCR-based testing was effective for stopping transmission of an A. baumannii outbreak in a pediatric ward. This event emphasized the importance of surveillance and interfacility communication among hospitals for prevention of infection outbreaks.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"271 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133473651","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 : 2018-09-07DOI: 10.14789/JMJ.2018.64.JMJ17-OA16
Miharu Kato, M. Sekiya, Yohei Suzuki, Tadashi Sato, Masako Ichikawa, Y. Kodama, K. Seyama, Eri Aikawa-Hirasawa, Kazuhisa Takahashi
*1)Division of Respiratory Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *2)Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan, *3) Department of Respiratory Medicine, Saiseikai Kawaguchi General Hospital, Saitama, Japan, *4)Divisions of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan, *5)Research Institute for Disease of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan
{"title":"Evaluation of Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Using an Accelerometer with Tapestry-Style Display Capability","authors":"Miharu Kato, M. Sekiya, Yohei Suzuki, Tadashi Sato, Masako Ichikawa, Y. Kodama, K. Seyama, Eri Aikawa-Hirasawa, Kazuhisa Takahashi","doi":"10.14789/JMJ.2018.64.JMJ17-OA16","DOIUrl":"https://doi.org/10.14789/JMJ.2018.64.JMJ17-OA16","url":null,"abstract":"*1)Division of Respiratory Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan, *2)Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan, *3) Department of Respiratory Medicine, Saiseikai Kawaguchi General Hospital, Saitama, Japan, *4)Divisions of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan, *5)Research Institute for Disease of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115003589","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 : 2018-08-17DOI: 10.14789/JMJ.2018.64.JMJ17-OA11
S. Nakamaru, K. Sakuraba, Shimpei Fujita
{"title":"Characteristics of Bone Metabolism in Middle-Aged and Older Mountaineers","authors":"S. Nakamaru, K. Sakuraba, Shimpei Fujita","doi":"10.14789/JMJ.2018.64.JMJ17-OA11","DOIUrl":"https://doi.org/10.14789/JMJ.2018.64.JMJ17-OA11","url":null,"abstract":"","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123253154","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 : 2018-08-08DOI: 10.14789/JMJ.2018.64.JMJ18-OA01
Toshiki Takayama, N. Shibata, T. Ohnuma, Koichi Miyakawa, Yoshihide Takeshita, Ayako Suzuki, Moto Nishiguchi, H. Arai
Objective: We aimed to investigate how primary care physicians (PCPs) in Japan use antipsychotics for treating the behavioural and psychological symptoms of dementia (BPSD). Materials and Methods: A nationwide cross-sectional online survey was conducted of PCPs who annually treated patients aged over 65 years with dementia. Responses from 509 PCPs were analysed by binominal logistic regression analysis. Results: Approximately one-third of the PCPs had treated excitatory BPSD (delusion, hallucination, agitation and violence), with half of them prescribing antipsychotics for this. Some PCPs still prescribed antipsychotics for non-excitatory BPSD, such as wandering. More than half of the PCPs had opportunities to learn about the appropriate use of antipsychotics and understood the increased mortality risk in elderly people with dementia. Referring to the Japanese Governmentʼs BPSD guideline for PCPs was negatively associated with antipsychotic dosage (odds ratio=0.491, 95% confidence intervals 0.32-0.75, p-value=0.001) and positively associated with a greater awareness of increased mortality with antipsychotics (odds ratio = 2.149, 95% confidence intervals 1.41-3.27, p-value=0.0004). Conclusion: PCPs continue to prescribe antipsychotics for excitatory BPSD in clinical practice despite official information about mortality risks. Educational material about the appropriate use of the antipsychotics should include specific mention of the risks of using antipsychotics for dementia.
{"title":"Primary Care Physicians' Use of Antipsychotics for the Treatment of Behavioural and Psychological Symptoms of Dementia in Japan","authors":"Toshiki Takayama, N. Shibata, T. Ohnuma, Koichi Miyakawa, Yoshihide Takeshita, Ayako Suzuki, Moto Nishiguchi, H. Arai","doi":"10.14789/JMJ.2018.64.JMJ18-OA01","DOIUrl":"https://doi.org/10.14789/JMJ.2018.64.JMJ18-OA01","url":null,"abstract":"Objective: We aimed to investigate how primary care physicians (PCPs) in Japan use antipsychotics for treating the behavioural and psychological symptoms of dementia (BPSD). Materials and Methods: A nationwide cross-sectional online survey was conducted of PCPs who annually treated patients aged over 65 years with dementia. Responses from 509 PCPs were analysed by binominal logistic regression analysis. Results: Approximately one-third of the PCPs had treated excitatory BPSD (delusion, hallucination, agitation and violence), with half of them prescribing antipsychotics for this. Some PCPs still prescribed antipsychotics for non-excitatory BPSD, such as wandering. More than half of the PCPs had opportunities to learn about the appropriate use of antipsychotics and understood the increased mortality risk in elderly people with dementia. Referring to the Japanese Governmentʼs BPSD guideline for PCPs was negatively associated with antipsychotic dosage (odds ratio=0.491, 95% confidence intervals 0.32-0.75, p-value=0.001) and positively associated with a greater awareness of increased mortality with antipsychotics (odds ratio = 2.149, 95% confidence intervals 1.41-3.27, p-value=0.0004). Conclusion: PCPs continue to prescribe antipsychotics for excitatory BPSD in clinical practice despite official information about mortality risks. Educational material about the appropriate use of the antipsychotics should include specific mention of the risks of using antipsychotics for dementia.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121923980","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}
Nonalcoholic steatohepatitis (NASH), occurs frequently with diabetes mellitus and obesity, contributes to insulin resistance, can develop cirrhosis or even hepatocellular carcinoma (HCC). Although NASH has become more common, its underlying mechanism is still not clear and effective therapy has not been established. Currently, it has been recognized that the multiple parallel factors, including genetic differences, insulin resistance, lipotoxicity and dysbiosis act synergistically in genetically in pathogenesis of NASH. Impaired autophagy parallel to excess lipid supply might explain the progression of NASH to HCC. Liver-specific knockout mice of phosphatase and tensin homolog deleted on chromosome ten (PTEN) develops steatohepatitis followed by HCC, suggesting a potential role for this molecule in development and progression of NASH.
{"title":"Pathophysiology of Nonalcoholic Steatohepatitis","authors":"Sumio Watanabe","doi":"10.14789/JMJ.63.230","DOIUrl":"https://doi.org/10.14789/JMJ.63.230","url":null,"abstract":"Nonalcoholic steatohepatitis (NASH), occurs frequently with diabetes mellitus and obesity, contributes to insulin resistance, can develop cirrhosis or even hepatocellular carcinoma (HCC). Although NASH has become more common, its underlying mechanism is still not clear and effective therapy has not been established. Currently, it has been recognized that the multiple parallel factors, including genetic differences, insulin resistance, lipotoxicity and dysbiosis act synergistically in genetically in pathogenesis of NASH. Impaired autophagy parallel to excess lipid supply might explain the progression of NASH to HCC. Liver-specific knockout mice of phosphatase and tensin homolog deleted on chromosome ten (PTEN) develops steatohepatitis followed by HCC, suggesting a potential role for this molecule in development and progression of NASH.","PeriodicalId":223994,"journal":{"name":"Juntendo Medical Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126212868","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}
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