N. Watanabe, Ko Ogawa, Yuuya Nakamura, Kouichirou Inoguchi, Akinori Ochi, Yuuta Chiba, Yoshimi Oonishi, Shirou Kawasaki, Masayoshi Oonuma, T. Itou, Tatsuya Onuki, T. Adachi, Youichi Kobayashi
: No prospective, randomized study has been conducted to date in Japan comparing the use of warfarin and rivaroxaban for preventing thrombotic and bleeding events in the perioperative period of catheter ablation （ CA ） for atrial fibrillation （ AF ） . This was a prospective, open-label randomized study assessing the safety and efficacy of warfarin and rivaroxaban in the perioperative period of CA for AF. Thrombotic events including silent cerebral lesion （ SCL ） detected by magnetic resonance imaging （ MRI ） , bleeding events, and coagulation test results were assessed in correlation with interrupted warfarin or rivaroxaban in the perioperative period of CA for AF. Finally, thirty-six patients （ 18 men; aged 65 ± 9.4 years ） who underwent CA for AF were prospectively enrolled. instance of symptomatic cerebral infarction occurred, but 12 of 36 patients （ 33.3 ％） showed new SCLs during the postprocedural cerebral MRI examination （ 8/21 in the rivaroxaban group and 4/15 in the warfarin group; P ＝ 0.47 ） . The duration of hospitalization was significantly shorter in the rivaroxaban group than in the warfarin group （ 6 vs. 8 days; P ＝ 0.0135 ） . The incidence of minor bleeding was significantly lower in the rivaroxaban group than in the warfarin group （ 0 ％ vs. 26.6 ％ ; P ＝ 0.078 ） . D-dimer concentration was significantly higher in the SCL group than in the no-SCL group （ P ＝ 0.024 ） under warfarin, while the values of protein S （ P ＝ 0.017 ） and prothrombin time （ P ＝ 0.018 ） were significantly lower in the SCL group than in the no-SCL group under rivaroxaban. CA is safer than warfarin usage with respect to the incidence of minor bleeding. In patients receiving rivaroxaban therapy, a lower protein S level may be correlated with the incidence of SCL in CA.
{"title":"Prospective Randomized Study of the Safety and Efficacy of Interrupted Anticoagulant’s Therapy in the Perioperative Period of Catheter Ablation for Atrial Fibrillation: The SEACOAST Rhythm AF Trial","authors":"N. Watanabe, Ko Ogawa, Yuuya Nakamura, Kouichirou Inoguchi, Akinori Ochi, Yuuta Chiba, Yoshimi Oonishi, Shirou Kawasaki, Masayoshi Oonuma, T. Itou, Tatsuya Onuki, T. Adachi, Youichi Kobayashi","doi":"10.15369/SUJMS.32.221","DOIUrl":"https://doi.org/10.15369/SUJMS.32.221","url":null,"abstract":": No prospective, randomized study has been conducted to date in Japan comparing the use of warfarin and rivaroxaban for preventing thrombotic and bleeding events in the perioperative period of catheter ablation （ CA ） for atrial fibrillation （ AF ） . This was a prospective, open-label randomized study assessing the safety and efficacy of warfarin and rivaroxaban in the perioperative period of CA for AF. Thrombotic events including silent cerebral lesion （ SCL ） detected by magnetic resonance imaging （ MRI ） , bleeding events, and coagulation test results were assessed in correlation with interrupted warfarin or rivaroxaban in the perioperative period of CA for AF. Finally, thirty-six patients （ 18 men; aged 65 ± 9.4 years ） who underwent CA for AF were prospectively enrolled. instance of symptomatic cerebral infarction occurred, but 12 of 36 patients （ 33.3 ％） showed new SCLs during the postprocedural cerebral MRI examination （ 8/21 in the rivaroxaban group and 4/15 in the warfarin group; P ＝ 0.47 ） . The duration of hospitalization was significantly shorter in the rivaroxaban group than in the warfarin group （ 6 vs. 8 days; P ＝ 0.0135 ） . The incidence of minor bleeding was significantly lower in the rivaroxaban group than in the warfarin group （ 0 ％ vs. 26.6 ％ ; P ＝ 0.078 ） . D-dimer concentration was significantly higher in the SCL group than in the no-SCL group （ P ＝ 0.024 ） under warfarin, while the values of protein S （ P ＝ 0.017 ） and prothrombin time （ P ＝ 0.018 ） were significantly lower in the SCL group than in the no-SCL group under rivaroxaban. CA is safer than warfarin usage with respect to the incidence of minor bleeding. In patients receiving rivaroxaban therapy, a lower protein S level may be correlated with the incidence of SCL in CA.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"461 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82986816","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}
: Pentazocine is an intravenously administered preoperative analgesic, but patients occasionally experience nausea and vomiting as an adverse reaction to this drug. As nausea and vomiting may interfere with the patient ʼ s postoperative rest, prevention of the reaction is necessary. This study aimed to survey postoperative nausea and vomiting （ PONV ） caused by pentazocine administered for catheter ablation. Patients receiving catheter ablation often experience pain during venipuncture and radiofrequency application, thus they are frequently placed under mild to deep sedation. Patients who underwent catheter ablation February and July 2016 were analyzed retrospectively. The preoperative analgesic dose and PONV were assessed. ％） 30 pentazocine, administration, subjects or thiopental 218 subjects ; mg mg group in the 30 mg group （ p ＝ 0.005 Analysis of postoperative 6 subjects in the 15 mg group （ 4.5 ％） and 14 subjects in the 30 mg group （ 11.5 ％） postoperative a higher percentage in the 30 mg group （ p ＝ 0.04 ） . Fur-thermore, the data indicate that being female is also an independent indicator of PONV. The results of this study suggest a relationship between pentazocine dose and PONV and that the incidence of PONV is directly related to an increased pentazocine dose.
{"title":"The Effect of Pentazocine on Nausea and Vomiting Following Catheter Ablation","authors":"Ryohei Kuroiwa, Satoko Handa, K. Inomata, Y. Kato","doi":"10.15369/sujms.32.103","DOIUrl":"https://doi.org/10.15369/sujms.32.103","url":null,"abstract":": Pentazocine is an intravenously administered preoperative analgesic, but patients occasionally experience nausea and vomiting as an adverse reaction to this drug. As nausea and vomiting may interfere with the patient ʼ s postoperative rest, prevention of the reaction is necessary. This study aimed to survey postoperative nausea and vomiting （ PONV ） caused by pentazocine administered for catheter ablation. Patients receiving catheter ablation often experience pain during venipuncture and radiofrequency application, thus they are frequently placed under mild to deep sedation. Patients who underwent catheter ablation February and July 2016 were analyzed retrospectively. The preoperative analgesic dose and PONV were assessed. ％） 30 pentazocine, administration, subjects or thiopental 218 subjects ; mg mg group in the 30 mg group （ p ＝ 0.005 Analysis of postoperative 6 subjects in the 15 mg group （ 4.5 ％） and 14 subjects in the 30 mg group （ 11.5 ％） postoperative a higher percentage in the 30 mg group （ p ＝ 0.04 ） . Fur-thermore, the data indicate that being female is also an independent indicator of PONV. The results of this study suggest a relationship between pentazocine dose and PONV and that the incidence of PONV is directly related to an increased pentazocine dose.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"468 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75153166","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}
Maiko Suzuki, T. Kamatani, Yuriko Sato, Ryogo Katada, Atsutoshi Yaso, T. Shirota
Necrotizing sialometaplasia is a benign lesion affecting the minor salivary glands of the hard palate. This lesion may be clinically and histopathologically confused with malignant lesions. A case of a 47-year-old man who presented with necrotizing sialometaplasia on the left side of the hard palate is herein reported. A biopsy was performed, and the condition was diagnosed based on immunohistochemistry. The lesion receded following treatment with tranexamic acid and sodium azulene sulfonate. The symptom of painful swelling on the hard palate subsided within 10 days. The palatal lesion had disappeared completely 4 months later.
{"title":"A Case of Necrotizing Sialometaplasia of the Hard Palate Treated with Tranexamic Acid and Sodium Azulene Sulfonate","authors":"Maiko Suzuki, T. Kamatani, Yuriko Sato, Ryogo Katada, Atsutoshi Yaso, T. Shirota","doi":"10.15369/sujms.32.215","DOIUrl":"https://doi.org/10.15369/sujms.32.215","url":null,"abstract":"Necrotizing sialometaplasia is a benign lesion affecting the minor salivary glands of the hard palate. This lesion may be clinically and histopathologically confused with malignant lesions. A case of a 47-year-old man who presented with necrotizing sialometaplasia on the left side of the hard palate is herein reported. A biopsy was performed, and the condition was diagnosed based on immunohistochemistry. The lesion receded following treatment with tranexamic acid and sodium azulene sulfonate. The symptom of painful swelling on the hard palate subsided within 10 days. The palatal lesion had disappeared completely 4 months later.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75378546","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}
K. Akiyama, S. Ikezawa, Yumi Hasegawa, Y. Sugisita, Ryota Kaneko, Naoko Okamoto, Masaya Koganesawa, Sachio Fujita, Ryosuke Matsuno, D. Toyama, Hirokazu Ikeda, Shohei Yamamoto
: Long-term cognitive effects following acute lymphoblastic leukemia treatment have been reported for Caucasians; however, these data remain unclear for other ethnicities and the treatment of other cancers. Here, we assessed cognitive function in Japanese childhood cancer survivors. This study enrolled 53 Japanese survivors of childhood cancer （ mean age, 9.5 years; 36 boys and 17 girls ） . evaluated performance-based cognitive function using the Wechsler Intelligence Scale for Children - Fourth Edition （ WISC - Ⅳ ） . , working memory with the standardized mean and standard deviation SD; 100 and 15, respectively ） classified patients into three groups depending on the cumulative methotrexate （ MTX ） dose （ none, 1 – 19 g / m 2 , and ＞ 20 g / m 2 ） . Full-scale among the four WISC – Ⅳ index than 20 g / m 2 , respectively; P =0.05 ） . Japanese childhood cancer survivors, including those in the non-MTX group, demonstrated significant PS impairment. High-dose MTX treatment might be associated with neurocognitive deficiencies, particularly in WM. Although current treatments are associated with high cure rates, future research and interventions are required to improve cognitive function in these patients.
急性淋巴细胞白血病治疗后对白种人的长期认知影响已有报道;然而，这些数据对于其他种族和其他癌症的治疗仍然不清楚。在这里，我们评估了日本儿童癌症幸存者的认知功能。这项研究招募了53名日本儿童癌症幸存者(平均年龄9.5岁;男孩36名，女孩17名)。使用韦氏儿童智力量表第四版(WISC -Ⅳ)评估基于表现的认知功能。，工作记忆的标准化均值和标准差SD;根据甲氨蝶呤(MTX)的累积剂量(无、1 - 19 g / m2和> 20 g / m2)将患者分为三组(分别为100和15)。四家机构中WISC -Ⅳ指数分别大于20 g / m2;P =0.05)。日本儿童癌症幸存者，包括那些非mtx组，表现出显著的PS损伤。大剂量甲氨蝶呤治疗可能与神经认知缺陷有关，特别是在WM中。虽然目前的治疗方法与高治愈率有关，但需要未来的研究和干预措施来改善这些患者的认知功能。
{"title":"Neurocognitive Evaluation of Japanese Childhood Cancer Survivors","authors":"K. Akiyama, S. Ikezawa, Yumi Hasegawa, Y. Sugisita, Ryota Kaneko, Naoko Okamoto, Masaya Koganesawa, Sachio Fujita, Ryosuke Matsuno, D. Toyama, Hirokazu Ikeda, Shohei Yamamoto","doi":"10.15369/sujms.32.25","DOIUrl":"https://doi.org/10.15369/sujms.32.25","url":null,"abstract":": Long-term cognitive effects following acute lymphoblastic leukemia treatment have been reported for Caucasians; however, these data remain unclear for other ethnicities and the treatment of other cancers. Here, we assessed cognitive function in Japanese childhood cancer survivors. This study enrolled 53 Japanese survivors of childhood cancer （ mean age, 9.5 years; 36 boys and 17 girls ） . evaluated performance-based cognitive function using the Wechsler Intelligence Scale for Children - Fourth Edition （ WISC - Ⅳ ） . , working memory with the standardized mean and standard deviation SD; 100 and 15, respectively ） classified patients into three groups depending on the cumulative methotrexate （ MTX ） dose （ none, 1 – 19 g / m 2 , and ＞ 20 g / m 2 ） . Full-scale among the four WISC – Ⅳ index than 20 g / m 2 , respectively; P =0.05 ） . Japanese childhood cancer survivors, including those in the non-MTX group, demonstrated significant PS impairment. High-dose MTX treatment might be associated with neurocognitive deficiencies, particularly in WM. Although current treatments are associated with high cure rates, future research and interventions are required to improve cognitive function in these patients.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89680639","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}
Keiichiro Ikeda, Taku Harada, Y. Tarumi, H. Ochiai, T. Shirasawa, Takahiko Yoshimoto, Akira Minoura, J. Hiroshige, A. Kokaze, K. Dohi
: Emergency department （ ED ） crowding due to frequent visitors increases medical costs and endangers the safety of patients who need prompt treatment. Although some studies have examined the social background of frequent visitors to the ED, there are few comprehensive studies of factors related to frequent ED visits in Japan. The present study examined whether public assistance status, age, and underlying conditions are associated with frequent visits to the ED. Subjects in this study were patients over 20 years of age who visited the ED of General Medicine in Showa University Hospital in Tokyo, Japan, from April 1, 2014, to March 31, 2015 （ n ＝ 6,182 ） . Information regarding sex, age, public insurance, hypertension, diabetes mellitus, dyslipidemia, chronic obstructive pulmonary disease, cancer, dysuria, bronchial asthma, and chronic kidney disease was collected using a patient database created from medical and hospital records. Based on a previous study, subjects who visited the ED four or more times were defined as frequent visitors, while those who visited the ED less than four times were considered infrequent visitors. Logistic regression analysis was performed to calculate odds ratios （ ORs ） and 95 ％ confidence intervals （ CIs ） for frequent ED visits. of public assistance significantly increased the OR for frequent visits （ 4.26, 95 ％ CI: 1.90 - 9.56 ） , even after adjusting for sex, age, and potential confounding factors （ OR: 3.89, 95 ％ CI: 1.62 - 9.35 ） . The current study found a significant association between frequent ED visits and the receipt of public assistance. outpatient physicians and welfare officers and work together with patients to address their specific medical and social vulnerabilities.
{"title":"Association between Public Assistance and Frequent Emergency Department Visits in Urban Areas of Japan: A Case-Control Study","authors":"Keiichiro Ikeda, Taku Harada, Y. Tarumi, H. Ochiai, T. Shirasawa, Takahiko Yoshimoto, Akira Minoura, J. Hiroshige, A. Kokaze, K. Dohi","doi":"10.15369/sujms.32.73","DOIUrl":"https://doi.org/10.15369/sujms.32.73","url":null,"abstract":": Emergency department （ ED ） crowding due to frequent visitors increases medical costs and endangers the safety of patients who need prompt treatment. Although some studies have examined the social background of frequent visitors to the ED, there are few comprehensive studies of factors related to frequent ED visits in Japan. The present study examined whether public assistance status, age, and underlying conditions are associated with frequent visits to the ED. Subjects in this study were patients over 20 years of age who visited the ED of General Medicine in Showa University Hospital in Tokyo, Japan, from April 1, 2014, to March 31, 2015 （ n ＝ 6,182 ） . Information regarding sex, age, public insurance, hypertension, diabetes mellitus, dyslipidemia, chronic obstructive pulmonary disease, cancer, dysuria, bronchial asthma, and chronic kidney disease was collected using a patient database created from medical and hospital records. Based on a previous study, subjects who visited the ED four or more times were defined as frequent visitors, while those who visited the ED less than four times were considered infrequent visitors. Logistic regression analysis was performed to calculate odds ratios （ ORs ） and 95 ％ confidence intervals （ CIs ） for frequent ED visits. of public assistance significantly increased the OR for frequent visits （ 4.26, 95 ％ CI: 1.90 - 9.56 ） , even after adjusting for sex, age, and potential confounding factors （ OR: 3.89, 95 ％ CI: 1.62 - 9.35 ） . The current study found a significant association between frequent ED visits and the receipt of public assistance. outpatient physicians and welfare officers and work together with patients to address their specific medical and social vulnerabilities.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79097164","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}
N. Suzuki, A. Katagiri, S. Nakatani, K. Kikuchi, Toshihiko Gocho, F. Yanagisawa, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Y. Kubota, K. Konishi, F. Yamamura, Hitoshi Yoshida
{"title":"Gastrointestinal Endoscopy for Patients with High Levels of Serum CEA and CA19-9","authors":"N. Suzuki, A. Katagiri, S. Nakatani, K. Kikuchi, Toshihiko Gocho, F. Yanagisawa, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Y. Kubota, K. Konishi, F. Yamamura, Hitoshi Yoshida","doi":"10.15369/sujms.32.115","DOIUrl":"https://doi.org/10.15369/sujms.32.115","url":null,"abstract":"","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"90 1","pages":"115-123"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80924178","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}
Toshihiko Gokan, Mitsuharu Kawamura, Shuhei Arai, Kosuke Yoshikawa, Hiroki Tanisawa, Ko Ogawa, Akinori Ochi, Yoshimi Onishi, Y. Munetsugu, Hiroyuki Ito, Tatsuya Onuki, Youichi Kobayashi, T. Shinke
Survivors of ventricular fibrillation out-of-hospital cardiac arrest(VFOHCA)due to potentially reversible causes such as acute coronary syndrome(ACS), vasospastic angina and electrolyte abnormalities are considered low risk for recurrent arrhythmia. Accordingly, implantable cardioverter-de brillator therapy is not routinely recommended in such patients. We investigated the risk of mortality and the value of ICD therapy for VF-OHCA. Among 2,248 cardiopulmonary arrest patients presenting at our hospital, we retrospectively investigated 110 patients with VF-OHCA who were admitted for treatment. We divided the patients based on ICD(n=71) or No-ICD status(n=39), and on reversible cause(n=70) or irreversible cause(n=40). The groups were compared for baseline characteristics, mortality and ICD therapies. Patients with a reversible cause had a signi cantly lower rate of ICD implantation than those with an irreversible cause(P=0.03). Males in the ICD group presented more frequently than those in the No-ICD group, and cardiac mortality in patients with acute coronary syndrome was signi cantly lower with ICD therapy than without ICD(P=0.04). The rate of appropriate ICD therapies with a reversible cause was 28%, and the rst ICD therapy was highest within 1 year post-implantation. Patients with VF-OHCA due to a reversible cause remain at high risk of recurrent ventricular arrhythmias, suggesting that ICD implantation is a reasonable approach in such cases.
{"title":"Effect of Implantable Cardioverter-defibrillator Therapy for Ventricular Fibrillation Patients with Out-of-hospital Cardiac Arrest","authors":"Toshihiko Gokan, Mitsuharu Kawamura, Shuhei Arai, Kosuke Yoshikawa, Hiroki Tanisawa, Ko Ogawa, Akinori Ochi, Yoshimi Onishi, Y. Munetsugu, Hiroyuki Ito, Tatsuya Onuki, Youichi Kobayashi, T. Shinke","doi":"10.15369/sujms.32.43","DOIUrl":"https://doi.org/10.15369/sujms.32.43","url":null,"abstract":"Survivors of ventricular fibrillation out-of-hospital cardiac arrest(VFOHCA)due to potentially reversible causes such as acute coronary syndrome(ACS), vasospastic angina and electrolyte abnormalities are considered low risk for recurrent arrhythmia. Accordingly, implantable cardioverter-de brillator therapy is not routinely recommended in such patients. We investigated the risk of mortality and the value of ICD therapy for VF-OHCA. Among 2,248 cardiopulmonary arrest patients presenting at our hospital, we retrospectively investigated 110 patients with VF-OHCA who were admitted for treatment. We divided the patients based on ICD(n=71) or No-ICD status(n=39), and on reversible cause(n=70) or irreversible cause(n=40). The groups were compared for baseline characteristics, mortality and ICD therapies. Patients with a reversible cause had a signi cantly lower rate of ICD implantation than those with an irreversible cause(P=0.03). Males in the ICD group presented more frequently than those in the No-ICD group, and cardiac mortality in patients with acute coronary syndrome was signi cantly lower with ICD therapy than without ICD(P=0.04). The rate of appropriate ICD therapies with a reversible cause was 28%, and the rst ICD therapy was highest within 1 year post-implantation. Patients with VF-OHCA due to a reversible cause remain at high risk of recurrent ventricular arrhythmias, suggesting that ICD implantation is a reasonable approach in such cases.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87508270","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}
Hiroshi Saito, Makoto Shoji, Iori Taki, Remi Murase, D. Kamei, T. Shinke, S. Iwai
: Heart failure （ HF ） is a common disease in elderly patients, particularly in those presenting as readmission for worsening HF. While recent studies have revealed mortality-associated factors in this population, little is known about prognostic factors associated with worsening HF. To investigate this clinical evidence gap in patients aged over 75 years, we retrospectively investigated 165 patients hospitalized for HF at Showa University Hospital, of whom 65 （ 39.4 ％） were readmitted for worsening HF. We extracted the candidate variables based on univariate analysis, and then elucidated the independent prognostic factors by multivariate analysis. Compared with non-readmitted patients, readmitted patients with worsening HF had lower left ventricular ejection fraction （ LVEF ） （ 39 ％ vs. 50 ％ , P ＝ 0.002 ） and body mass index （ BMI ） （ 19.9 kg/m 2 vs. 21.4 kg/m 2 , P ＝ 0.007 ） , higher levels of B-type natriuretic peptide （ BNP ） （ 478 pg/ml vs. 198 pg/ml, P ＜ 0.001 ） , and heart rate （ HR ） （ 71.0 beats/min vs. 67.0 beats/min, P ＝ 0.021 ） upon discharge during the primary admission. Multivariate logistic analysis identified LVEF ＜ 40 ％ , BMI ＜ 21 kg/m 2 , BNP ≥ 500 pg/ml, Charlson score ≥ 3, and HR ≥ 70 beats/min upon initial discharge as independent prognostic factors. Based on these factors, readmission for worsening HF was more frequent in those with our proposed risk score of ≥ 3.0 than in those with a risk score ＜ 3.0 （ P ＜ 0.001 ） , and we suggested five prognostic factors for HF patients over 75 years old. Our proposed risk score combines these factors and might predict readmission for worsening HF in the elderly population.
{"title":"Five Prognostic Factors for Readmission in Patients Over 75 Years Old with Worsening Heart Failure","authors":"Hiroshi Saito, Makoto Shoji, Iori Taki, Remi Murase, D. Kamei, T. Shinke, S. Iwai","doi":"10.15369/sujms.32.33","DOIUrl":"https://doi.org/10.15369/sujms.32.33","url":null,"abstract":": Heart failure （ HF ） is a common disease in elderly patients, particularly in those presenting as readmission for worsening HF. While recent studies have revealed mortality-associated factors in this population, little is known about prognostic factors associated with worsening HF. To investigate this clinical evidence gap in patients aged over 75 years, we retrospectively investigated 165 patients hospitalized for HF at Showa University Hospital, of whom 65 （ 39.4 ％） were readmitted for worsening HF. We extracted the candidate variables based on univariate analysis, and then elucidated the independent prognostic factors by multivariate analysis. Compared with non-readmitted patients, readmitted patients with worsening HF had lower left ventricular ejection fraction （ LVEF ） （ 39 ％ vs. 50 ％ , P ＝ 0.002 ） and body mass index （ BMI ） （ 19.9 kg/m 2 vs. 21.4 kg/m 2 , P ＝ 0.007 ） , higher levels of B-type natriuretic peptide （ BNP ） （ 478 pg/ml vs. 198 pg/ml, P ＜ 0.001 ） , and heart rate （ HR ） （ 71.0 beats/min vs. 67.0 beats/min, P ＝ 0.021 ） upon discharge during the primary admission. Multivariate logistic analysis identified LVEF ＜ 40 ％ , BMI ＜ 21 kg/m 2 , BNP ≥ 500 pg/ml, Charlson score ≥ 3, and HR ≥ 70 beats/min upon initial discharge as independent prognostic factors. Based on these factors, readmission for worsening HF was more frequent in those with our proposed risk score of ≥ 3.0 than in those with a risk score ＜ 3.0 （ P ＜ 0.001 ） , and we suggested five prognostic factors for HF patients over 75 years old. Our proposed risk score combines these factors and might predict readmission for worsening HF in the elderly population.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75067782","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}
Y. Miyata, S. Ohta, A. Tanaka, K. Akimoto, Hiroki Sato, Tomoki Uno, Haruna Sato, Yoshitaka Uchida, M. Jinno, K. Hirai, H. Inoue, T. Honma, Mayumi Yamamoto, S. Suzuki, H. Sagara
: Mepolizumab is a monoclonal antibody against interleukin-5 used for the treatment of severe asthma. The effect of long-term mepolizumab administration and its persistence in clinical practice is poorly understood. Thus, this study aimed to investigate the effect of long-term administration of mepolizumab in patients with severe asthma. Mepolizumab was administered to 20 patients with severe asthma. We then prospectively followed the patients for 104 weeks to investigate the efficacy of long-term mepolizumab administration in clinical practice. Eleven patients were evaluated for 104 weeks. Mepolizumab administration reduced asthma exacerbations in a year from 52 to 104 weeks and improved asthma control in every period as assessed by questionnaires. Also, blood eosinophil counts decreased at every point, and blood basophil counts decreased at 104 weeks. We compared various parameters among the 11 patients who continued administration for more than 104 weeks and 7 patients who discontinued treatment due to ineffectiveness. Significant differences were observed in disease duration, maximum expiratory flow at 50%, and blood basophil count. improved asthma symptoms in patients with severe asthma and reduced the frequency of exacerbations.
{"title":"Efficacy of Mepolizumab for Long-term Treatment in Patients with Severe Asthma","authors":"Y. Miyata, S. Ohta, A. Tanaka, K. Akimoto, Hiroki Sato, Tomoki Uno, Haruna Sato, Yoshitaka Uchida, M. Jinno, K. Hirai, H. Inoue, T. Honma, Mayumi Yamamoto, S. Suzuki, H. Sagara","doi":"10.15369/SUJMS.32.247","DOIUrl":"https://doi.org/10.15369/SUJMS.32.247","url":null,"abstract":": Mepolizumab is a monoclonal antibody against interleukin-5 used for the treatment of severe asthma. The effect of long-term mepolizumab administration and its persistence in clinical practice is poorly understood. Thus, this study aimed to investigate the effect of long-term administration of mepolizumab in patients with severe asthma. Mepolizumab was administered to 20 patients with severe asthma. We then prospectively followed the patients for 104 weeks to investigate the efficacy of long-term mepolizumab administration in clinical practice. Eleven patients were evaluated for 104 weeks. Mepolizumab administration reduced asthma exacerbations in a year from 52 to 104 weeks and improved asthma control in every period as assessed by questionnaires. Also, blood eosinophil counts decreased at every point, and blood basophil counts decreased at 104 weeks. We compared various parameters among the 11 patients who continued administration for more than 104 weeks and 7 patients who discontinued treatment due to ineffectiveness. Significant differences were observed in disease duration, maximum expiratory flow at 50%, and blood basophil count. improved asthma symptoms in patients with severe asthma and reduced the frequency of exacerbations.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81835425","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}
Hironori Tanaka, M. Hayashi, M. Awaya, Yumiko Kusunoki, N. Tanaka, K. Tomura, Hisato Fujihara, Toru Watanabe, Hirokazu Ikeda, Tadanori Sasaki
Azithromycin (AZM) injection tends to increase injection site pain when administered in excess of 2 mg / ml. As AZM is frequently used in combination therapies, it is expected to be administered at a high concentration in clinical use due to uid restrictions. Therefore, in this study, the relation between AZM concentration and injection site pain was examined. From January 2012 to July 2017, we retrospectively investigated the medical records of patients who were administered AZM by injection at Showa University Fujigaoka Hospital. Vascular pain was related to intensive care unit (ICU) administration (P=0.003) compared with that in general wards and a long duration of administration (P=0.002). The number of days of AZM injection should be kept as short as possible. Given that the risk of injection site pain is increased in the ICU, we recommend switching to oral administration. Further collection of safety data in patients on uid restriction is necessary, and high concentration AZM administration should be considered.
{"title":"A Retrospective Study of Injection Site Pain from Azithromycin Injection in Japanese Patient","authors":"Hironori Tanaka, M. Hayashi, M. Awaya, Yumiko Kusunoki, N. Tanaka, K. Tomura, Hisato Fujihara, Toru Watanabe, Hirokazu Ikeda, Tadanori Sasaki","doi":"10.15369/sujms.32.207","DOIUrl":"https://doi.org/10.15369/sujms.32.207","url":null,"abstract":"Azithromycin (AZM) injection tends to increase injection site pain when administered in excess of 2 mg / ml. As AZM is frequently used in combination therapies, it is expected to be administered at a high concentration in clinical use due to uid restrictions. Therefore, in this study, the relation between AZM concentration and injection site pain was examined. From January 2012 to July 2017, we retrospectively investigated the medical records of patients who were administered AZM by injection at Showa University Fujigaoka Hospital. Vascular pain was related to intensive care unit (ICU) administration (P=0.003) compared with that in general wards and a long duration of administration (P=0.002). The number of days of AZM injection should be kept as short as possible. Given that the risk of injection site pain is increased in the ICU, we recommend switching to oral administration. Further collection of safety data in patients on uid restriction is necessary, and high concentration AZM administration should be considered.","PeriodicalId":23019,"journal":{"name":"The Showa University Journal of Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82428472","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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