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Inada K, Saito Y, Baba K, Fukui D, Masuda Y, Inoue S, Masuda T. Factors associated with death, hospitalization, resignation, and sick leave from work among patients with schizophrenia in Japan: a nested case-control study using a large claims database. BMC Psychiatry 2024; 24:22. [PMID: 38172827 PMCID: PMC10765934 DOI: 10.1186/s12888-023-05474-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Premature mortality, frequent relapse that easily leads to hospitalization, and discontinuous employment are key challenges for the treatment of schizophrenia. We evaluated risk factors for important clinical outcomes (death, hospitalization, resignation, and sick leave from work) in patients with schizophrenia in Japan. METHODS A nested case-control study was conducted for patients with schizophrenia identified in a Japanese claims database. For each outcome, the case was matched with up to four controls of the same age, sex, index year, and enrollment status (employee or dependent family). Potential risk factors were defined by prescriptions or diagnoses within 3 months prior to or in the month of the event. The association among potential risk factors and each outcome was evaluated using multivariable conditional logistic regression analysis with stepwise variable selection. RESULTS The number of cases and eligible patients for each outcome were 144 and 38,451 (death), 1,520 and 35,225 (hospitalization), 811 and 18,770 (resignation), and 4,590 and 18,770 (sick leave), respectively. Depression was a risk factor for death (odds ratio [OR]: 1.92; 95% confidence interval [CI]: 1.12, 3.29), hospitalization (OR: 1.22; 95% CI: 1.05, 1.42), and sick leave from work (OR: 1.46; 95% CI: 1.36, 1.57). Other risk factors for death were hospitalization history, Charlson Comorbidity Index (CCI) score, and prescription for laxatives. Prescriptions for hypnotics, laxatives, and anticholinergics were risk factors for hospitalization. Prescriptions for hypnotics and anticholinergics were risk factors for resignation. CCI score, prescription for hypnotics, laxatives, and antidiabetics were risk factors for sick leave from work. CONCLUSIONS Our findings suggest that depression and some physical symptoms, such as constipation and extrapyramidal symptoms, are risk factors for important clinical outcomes in patients with schizophrenia. Attention should be paid to both depression and physical symptoms for the treatment of schizophrenia.
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Affiliation(s)
- Ken Inada
- Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Yoshitaka Saito
- Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kenji Baba
- Medical Science, Sumitomo Pharma Co., Ltd., Osaka, Japan
| | - Daisuke Fukui
- Global Data Design Office, Sumitomo Pharma Co., Ltd., Tokyo, Japan
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Kamae I, Zhong Y, Hara H, Inoue K, Yasaka M, Reddy VY, Holmes DR, Sakurai M, Gavaghan MB, Amorosi SL, McGovern AM, Priest V, Inoue S, Shibahara H, Akehurst RL. Cost-effectiveness of left atrial appendage closure with Watchman for non-valvular atrial fibrillation patients in Japan. J Med Econ 2023; 26:1357-1367. [PMID: 37819734 DOI: 10.1080/13696998.2023.2266275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
AIMS Left atrial appendage closure (LAAC) has been demonstrated to be cost-saving relative to oral anticoagulants for stroke prophylaxis in patients with non-valvular atrial fibrillation (NVAF) in the United States and Europe. This study assessed the cost-effectiveness of LAAC with the Watchman device relative to warfarin and direct oral anticoagulants (DOACs) for stroke risk reduction in NVAF from a Japanese public healthcare payer perspective. METHODS A Markov model was developed with 70-year-old patients using a lifetime time horizon. LAAC clinical inputs were from pooled, 5-year PROTECT AF and PREVAIL trials; warfarin and DOAC inputs were from published meta-analyses. Baseline stroke and bleeding risks were from the SALUTE trial on LAAC. Cost inputs were from the Japanese Medical Data Vision database. Probabilistic and one-way sensitivity analyses were performed. RESULTS Over the lifetime time horizon, LAAC was less costly than warfarin (savings of JPY 1,878,335, equivalent to US $17,600) and DOACs (savings of JPY 1,198,096, equivalent to US $11,226). LAAC also provided 1.500 more incremental quality-adjusted life years (QALYs) than warfarin and 0.996 more than DOACs. In probabilistic sensitivity analysis, LAAC was cost-effective relative to warfarin and DOACs in 99.98% and 99.73% of simulations, respectively. LAAC dominated (had higher cumulative QALYs and was less costly than) warfarin and DOACs in 89.94% and 83.35% of simulations, respectively. CONCLUSIONS Over a lifetime time horizon, LAAC is cost-saving relative to warfarin and DOACs for stroke risk reduction in NVAF patients in Japan and is associated with improved quality-of-life.
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Affiliation(s)
- Isao Kamae
- Graduate School of Public Policy, University of Tokyo, Tokyo, Japan
| | - Yue Zhong
- Heath Economics and Market Access, Boston Scientific, Marlborough, MA, USA
| | - Hidehiko Hara
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Koichi Inoue
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masahiro Yasaka
- Department of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Vivek Y Reddy
- Icahn School of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Stacey L Amorosi
- Heath Economics and Market Access, Boston Scientific, Marlborough, MA, USA
| | - Alysha M McGovern
- Heath Economics and Market Access, Boston Scientific, Marlborough, MA, USA
| | - Virginia Priest
- Health Economics and Market Access, Boston Scientific Asia Pacific, Singapore
| | | | | | - Ronald L Akehurst
- BresMed Health Solutions, Sheffield, UK
- University of Sheffield, Sheffield, UK
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Ikeda S, Azuma MK, Fujimoto K, Shibahara H, Inoue S, Moline M, Ishii M, Mishima K. Cost-effectiveness analysis of lemborexant for treating insomnia in Japan: a model-based projection, incorporating the risk of falls, motor vehicle collisions, and workplace accidents. Psychol Med 2022; 52:2822-2834. [PMID: 35506334 PMCID: PMC9647554 DOI: 10.1017/s0033291722000356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Lemborexant has demonstrated statistically significant improvements in sleep onset and sleep maintenance compared with placebo and zolpidem tartrate extended release, measured both objectively using polysomnography and subjectively using sleep diaries, in the phase 3 clinical trial SUNRISE 1. This study evaluated the cost-effectiveness of lemborexant compared with suvorexant, zolpidem immediate release (IR), and untreated insomnia. METHODS A decision-tree model was developed for falls, motor vehicle collisions, and workplace accidents associated with insomnia and insomnia treatments from a Japanese healthcare perspective and with a 6-month time horizon. The model extracted subjective sleep onset latency treatment responses and disutility values for non-responders from SUNRISE 1. Cost-effectiveness was assessed using incremental cost per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses were conducted to evaluate the impact of parameter uncertainty on the results. RESULTS In the base-case analysis, the mean estimated QALYs for lemborexant, suvorexant, zolpidem-IR, and untreated insomnia were 0.4220, 0.4204, 0.4113, and 0.4163, and expected medical costs were JPY 34 034, JPY 38 371, JPY 38 139, and JPY 15 383, respectively. Lemborexant saved JPY 4337 and JPY 4105 compared with suvorexant or zolpidem-IR, respectively, while conferring QALY benefits. The incremental cost-effectiveness ratio (ICER) of lemborexant compared with that of untreated insomnia was JPY 3 220 975 /QALY. Lemborexant was dominant over suvorexant and zolpidem-IR and was cost-effective when compared with untreated insomnia. Sensitivity analyses supported the results' robustness. CONCLUSIONS In a Japanese clinical practice setting, lemborexant may represent a better investment for treating insomnia in the healthcare system in Japan.
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Affiliation(s)
- Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
| | | | | | - Hidetoshi Shibahara
- CRECON Medical Assessment Inc., Tokyo, Japan
- Graduate School of Health and Welfare, International University of Health and Welfare, Tokyo, Japan
| | | | | | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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Ikeda S, Azuma MK, Fujimoto K, Shibahara H, Inoue S, Moline M, Ishii M, Mishima K. Cost-effectiveness analysis of lemborexant for treating insomnia in Japan: A model-based projection, incorporating the risk of falls, motor vehicle collisions, and workplace accidents - CORRIGENDUM. Psychol Med 2022; 52:2847. [PMID: 35770451 PMCID: PMC9647547 DOI: 10.1017/s0033291722001854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
| | | | | | - Hidetoshi Shibahara
- CRECON Medical Assessment Inc., Tokyo, Japan
- Graduate School of Health and Welfare, International University of Health and Welfare, Tokyo, Japan
| | | | | | | | - Kazuo Mishima
- Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan
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Ishikawa T, Inoue S, Kawaguchi M. A pediatric case of severe systemic pneumatosis during airway pressure release ventilation. Medicina Intensiva (English Edition) 2022; 46:544-545. [PMID: 36057443 PMCID: PMC9432805 DOI: 10.1016/j.medine.2020.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/19/2020] [Indexed: 11/20/2022]
Affiliation(s)
- T Ishikawa
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
| | - S Inoue
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan.
| | - M Kawaguchi
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
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6
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Baba K, Naoi I, Shibahara H, Inoue S, Aino H. [Direct medical costs of Parkinson's disease by Hoehn and Yahr severity in Japan: An analysis of administrative claims data]. Rinsho Shinkeigaku 2022; 62:524-531. [PMID: 35753784 DOI: 10.5692/clinicalneurol.cn-001708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
To estimate the medical costs related to Parkinson's disease (PD) by Hoehn and Yahr (HY) scale, we conducted a descriptive study by using a large-scale hospital based administrative claims database in Japan. Approximately 20,000 PD patients who had a diagnosis of PD with HY severity between April 2008 and December 2018 were included in the analysis. Estimated PD related outpatient costs, frequency of hospitalization, length of stay, and inpatient costs were increased with HY severity. Our estimates of the PD related medical costs are based on the large-scale claims database, despite limitations such as the reliability of HY severity in the claims data, could be used in future cost-effectiveness studies for treatment of PD.
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7
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Inoue S, Hayashi T, Teishima J. Impact of low-intensity extracorporeal shock wave therapy on sexual function after non-nerve-sparing robot-assisted laparoscopic radical prostatectomy. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Inoue S, Xu H, Maswana JC, Kobayashi M. Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model. INQUIRY 2022; 59:469580221091397. [PMID: 35420903 PMCID: PMC9019330 DOI: 10.1177/00469580221091397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The aim of this study was to construct a system dynamics (SD) model to estimate the future medical care expenditure and to address the dynamic issues of health care that should be resolved. In particular, the measures for promoting the spread of generic drug (GE drug) usage in Japan and reducing cancer-related medical expenses were investigated regarding their future impact on medical finances. Methods The SD model was constructed from FY 2018 to FY 2050. The change in the future GE drug quantity share was analyzed by using a regression equation. The impact of the increase in medical expense for cancer and the change in the future national medical care expenditure were also estimated. Results The annual total medical care expenditure in FY 2050 would arrive at 58.9–64.2 trillion JPY (US$ 535.1–584.0 billion) (1.3–1.5 times higher than that in FY 2018) with different trends in age groups. The cumulative total medical care expenditure was expected to decrease by about 787.0–989.4 billion JPY (US$ 7.2–9.0 billion) if the impact of the spread of GE drug usage was considered. On the other hand, due to the continuous increase in the cancer-related medical expense, the cumulative total medical care expenditure was estimated to increase about 7554.3–11715.0 billion JPY (US$ 68.7–106.5 billion). Conclusions If the cancer-related medical expense continues to increase in the future, an increase of 686.4–1104.2 billion JPY (US$ 6.2–10.0 billion) in FY 2050 is expected which suggests that this disease field should be prioritized regarding the measures to maintain medical finances.
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Affiliation(s)
| | - Hua Xu
- Faculty of Business Sciences, The University of Tsukuba, Tokyo, Japan
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Okubo Y, Tang AC, Inoue S, Torisu-Itakura H, Ohtsuki M. Comparison of Treatment Goals between Users of Biological and Non-Biological Therapies for Treatment of Psoriasis in Japan. J Clin Med 2021; 10:jcm10245732. [PMID: 34945027 PMCID: PMC8709044 DOI: 10.3390/jcm10245732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Previously, our cross-sectional observational study in Japan revealed high (68%) discordance within treatment goals between psoriasis patients and their physicians. Objective: This secondary analysis aimed to determine whether patient and physician users of biologics have higher treatment goals than users of non-biologics. Methods: A survey for both patients and physicians on background characteristics, disease severity, treatment goals, treatment satisfaction, and health-related quality of life was conducted at 54 sites. Association between treatment goals and biologic/non-biologic users was assessed using ordinal logistic regression models. Results: In total, 449 patient-physician pairs agreed to participate; 425 completed the survey and were analyzed. More biologic users than non-biologic users reported complete clearance (Psoriasis Area and Severity Index 100) as a treatment goal (patient-reported: 23.6% vs. 16.1%; physician-reported: 26.9% vs. 2.2%). Biologic users were significantly associated with higher treatment goals than non-biologic users (patient-reported: 1.8 (1.15–2.87) (odds ratio (9 5% CI)), p = 0.01; physician-reported: 11.0 (5.72–21.01), p < 0.01). Among biologic users, higher treatment goals were associated with higher treatment satisfaction (patient- and physician-rated); lower treatment goals were associated with back lesions and increasing patient age (patient-rated) and higher disease severity (physician-rated). Conclusion: Use of biologics among patients with psoriasis was associated with higher treatment goals. Further use of biologics contributed to treatment satisfaction. Appropriate treatment goals that are shared among patients and their physicians may improve treatment outcomes.
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Affiliation(s)
- Yukari Okubo
- Department of Dermatology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan;
| | - Ann Chuo Tang
- Eli Lilly Japan K.K., Akasaka Garden City 13F, 4-15-1 Akasaka, Minato-ku, Tokyo 107-0052, Japan
- Correspondence:
| | - Sachie Inoue
- Crecon Medical Assessment Inc., 2-12-15 Shibuya, Shibuya-ku, Tokyo 150-0002, Japan;
| | - Hitoe Torisu-Itakura
- Eli Lilly Japan K.K., Lilly Plaza One Bldg., 5-1-28, Isogamidori, Chuo-ku, Kobe 651-0086, Japan;
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Tochigi-ken, Japan;
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Watanabe T, Tachibana K, Shinoda Y, Minamisaka T, Inui H, Ueno K, Inoue S, Hoshida S. Impact of low-dose or under-dose direct oral anticoagulant on coagulation and fibrinolytic markers in patients with atrial fibrillation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is known to increase the risks of cerebral and systemic embolism. Apart from vitamin K antagonists, edoxaban, a direct oral anticoagulant (DOAC), has been approved for oral anticoagulation in patients with non-valvular AF. On the other hand, DOACs are sometimes prescribed at off-label under-doses for patients who have undergone ablation for AF. Prothrombin fragment F1+2 is an activation peptide released from prothrombin during thrombin formation. The purpose of this study is to compare the effects of DOAC doses on coagulation and fibrinolytic markers.
Methods and results
A total of 88 patients with AF (age: 68±11 years, male:45%, paroxysmal AF n=49, persistent AF n=39) were recruited. All patients were received edoxaban (60mg or 30mg) once a day. For the purpose of the study, patients were divided into three groups according to whether they had been treated before the ablation procedure under an appropriate standard dose group (n=30 [34.1%]), appropriate low-dose group (n=35 [39.8%]), or off-label under-dose group (n=23 [26.1%]). We examined the coagulation and fibrinolytic markers, and echocardiographic parameters before ablation. All patients were followed up for 12 months after AF ablation. Creatinine clearance was significantly higher in appropriate standard-dose group than in appropriate low-dose or off-label under-dose group (101.1±38.4, 57.1±15.9 and 73.2±14.6 mL/min, respectively; P<0.001). There were no significant baseline differences in AF type, history of stroke/transient ischemic attack (TIA), plasma B-type natriuretic peptide, protein C, fibrinogen, D-dimer level, left ventricular ejection fraction or left atrium dimension among the three groups. Prothrombin fragment F1+2 level was significantly lower in the appropriate standard-dose group than the appropriate low-dose and off-label under-dose groups (105.9±29.4, 142.6±41.3 and 142.8±84.9 pmol/L, respectively; P=0.011, Figure). One patient in the appropriate low-dose group had a TIA and 1 patient in the off-label under-dose group had a bleeding event during the follow up period after ablation.
Conclusion
Our results suggest that an appropriate standard dose of edoxaban is needed to suppress hypercoagulability in patients with AF.
Funding Acknowledgement
Type of funding sources: None. Prothrombin fragment F1+2 level
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Affiliation(s)
- T Watanabe
- Osaka General Medical Center, Osaka, Japan
| | | | | | | | - H Inui
- Yao Municipal Hospital, Yao, Japan
| | - K Ueno
- Yao Municipal Hospital, Yao, Japan
| | - S Inoue
- Yao Municipal Hospital, Yao, Japan
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Yasuda M, Tachi T, Osawa T, Watanabe H, Inoue S, Makino T, Nagaya K, Morita M, Tanaka K, Aoyama S, Kasahara S, Teramachi H, Mizui T. Risk factors for thrombocytopenia and analysis of time to platelet transfusion after azacitidine treatment. Pharmazie 2021; 76:444-449. [PMID: 34481536 DOI: 10.1691/ph.2021.1566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The use of azacitidine (AZA) has been known to lead to a high incidence of hematotoxic adverse events. The aims of this study were to identify the risk factors for thrombocytopenia after the administration of AZA and to analyze time to the initial platelet transfusion. Sixty-two patients with myelodysplastic syndrome (MDS), who were treated with AZA in Gifu Municipal Hospital between March 2012 and June 2020, were included in this study. The risk factors for thrombocytopenia were identified using univariate analysis of patient characteristics, disease type, and laboratory values immediately before the start of treatment. Variables with p<0.2 identified in the univariate analysis were used as independent variables in the multivariate analysis. This analysis identified "creatinine clearance (CCr) <60 mL/min" as a significant factor (odds ratio, 4.790; 95% confidence interval [CI], 1.380-16.70; p=0.014). Subsequently, time in days to the initial platelet transfusion after the initial administration of AZA was analyzed using the log-rank test. The overall median time in days to platelet transfusion was 370 days. The log-rank test was used to determine the influence of patient characteristics, disease type, and laboratory values immediately before the start of treatment. The subsequent Cox proportional hazard regression analysis using variables with p<0.2 as independent variables identified "hemoglobin (Hb) <8.0 g/dL" as a significant factor (hazard ratio, 2.143; 95% CI, 1.001-4.573; p=0.048). The results of this study led to the following clinical implications: first, patients with CCr of <60 mL/min at the start of treatment should be treated with caution due to the risk of thrombocytopenia. Second, patients with Hb of <8.0 g/dL at the start of treatment may require platelet transfusion in the early stage of treatment.
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Affiliation(s)
- M Yasuda
- Department of Pharmacy, Gifu Municipal Hospital, Japan; Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan;,
| | - T Tachi
- Department of Pharmacy, Gifu Municipal Hospital, Japan; Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan
| | - T Osawa
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - H Watanabe
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Inoue
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - T Makino
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - K Nagaya
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - M Morita
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - K Tanaka
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Aoyama
- Department of Pharmacy, Gifu Municipal Hospital, Japan
| | - S Kasahara
- Department of Hematology, Gifu Municipal Hospital, Gifu, Japan
| | - H Teramachi
- Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, Japan
| | - T Mizui
- Department of Pharmacy, Gifu Municipal Hospital, Japan
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Murota H, Fujimoto T, Oshima Y, Tamada Y, Yanagishita T, Murayama N, Inoue S, Okatsu H, Miyama H, Yokozeki H. Cost-of-illness study for axillary hyperhidrosis in Japan. J Dermatol 2021; 48:1482-1490. [PMID: 34245048 PMCID: PMC8518070 DOI: 10.1111/1346-8138.16050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/17/2021] [Accepted: 06/12/2021] [Indexed: 12/01/2022]
Abstract
The prevalence of primary axillary hyperhidrosis in Japan is 5.75% (males, 6.60%; females, 4.72%) in the population aged 5–64 years. No study on comprehensively evaluated direct medical costs, hygiene product costs, and productivity loss in axillary hyperhidrosis patients has been published in Japan. The aim of this study was to estimate the cost of illness for axillary hyperhidrosis in Japan by conducting a nationwide insurance claims database analysis and a cross‐sectional Web‐based survey. Among patients diagnosed with primary axillary hyperhidrosis at least once between November 2012 and October 2019, health insurance receipt data of 1447 patients were analyzed. A cross‐sectional Web‐based survey was conducted on 321 patients aged 16–59 years with axillary hyperhidrosis to calculate hygiene product costs and productivity loss using a Work Productivity and Activity Impairment questionnaire. Furthermore, nationwide estimation was performed for the hygiene product costs and productivity loss based on the number of patients estimated from the prevalence. The annual direct medical costs per axillary hyperhidrosis patient were ¥91 491 in 2016, ¥93 155 in 2017, and ¥75 036 in 2018. In all of these years, botulinum toxin type A injection accounted for approximately 90% of the total costs. The annual total cost of hygiene products per axillary hyperhidrosis patient was ¥9325. The overall work impairment (%) of working patients with axillary hyperhidrosis was 30.52%, and its monthly productivity loss was ¥120 593/patient. The activity impairment (%) of full‐time housewives with axillary hyperhidrosis was 49.05% and its monthly productivity loss was ¥176 368/patient. The annual hygiene product cost based on the nationwide estimation was ¥24.5 billion and the monthly productivity loss was ¥312 billion. The significant cost associated with axillary hyperhidrosis was clarified. If out‐of‐pocket expenses for treatments not covered by health insurance are included in the estimation, the cost will further increase.
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Affiliation(s)
- Hiroyuki Murota
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | - Tomoko Fujimoto
- Ikebukuro Nishiguchi Fukurou Dermatology Clinic, Tokyo, Japan
| | - Yuichiro Oshima
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Yasuhiko Tamada
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Takeshi Yanagishita
- Department of Dermatology, Aichi Medical University School of Medicine, Aichi, Japan
| | - Naoya Murayama
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | | | - Hiromichi Okatsu
- Medical Affairs Department, Kaken Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Hiroshi Miyama
- Medical Affairs Department, Kaken Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
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Okubo Y, Torisu-Itakura H, Hanada T, Aranishi T, Inoue S, Ohtsuki M. Evaluation of treatment satisfaction misalignment between Japanese psoriasis patients and their physicians - Japanese psoriasis patients and their physicians do not share the same treatment satisfaction levels. Curr Med Res Opin 2021; 37:1103-1109. [PMID: 33896280 DOI: 10.1080/03007995.2021.1920898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES High treatment satisfaction in both patients and physicians is an important factor in improving quality of life in psoriasis patients. This study aimed to evaluate treatment satisfaction alignment between psoriasis patients and physicians and to identify factors associated with satisfaction misalignment, especially "physician-predominant" misalignment. METHODS This is a nationwide multicenter cross-sectional study. Subjects were paired moderate to severe psoriasis outpatients and their physicians. Treatment satisfaction was evaluated on a scale from 0 to 10. Subjects were defined as "misaligned" when the difference in treatment satisfaction was over ±1 between the patient-physician pair. RESULTS A total of 425 pairs were collected from 54 facilities in Japan. The mean patient age and disease duration were 56.5 years and 18.7 years, respectively. The mean physician age was 50.6 years and 69.6% of physicians specialized in psoriasis. Treatment satisfaction misalignment was found in 49.9% of the patient-physician pairs. Among misaligned pairs, 43.6% were "physician-predominant" pairs. In the multivariate logistic regression analyses, "treatment is effective" was the most important reason for treatment satisfaction (odds ratio [OR]: 35.5; 95% confidence interval [CI]: 5.43, 231.78). Symptoms in the genital area (OR: 10.2; 95% CI: 2.55, 40.93) and lack of understanding of treatment options by patients (OR: 7.5; 95% CI: 2.19, 25.94) were key factors leading to "physician-predominant" status. CONCLUSIONS The results suggest that genital psoriasis plays an important role in treatment satisfaction from the patient perspective, and illustrate the importance of communication between patients and physicians which potentially resolves these factors and improves misalignment.
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Affiliation(s)
- Yukari Okubo
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | | | | | | | | | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
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Miki N, Inoue S, Shibahara H, Kurazono K, Perard R, Tateishi R. A cost-effectiveness analysis of lusutrombopag for thrombocytopenia in patients with chronic liver disease in Japan. JGH Open 2021; 5:879-887. [PMID: 34386595 PMCID: PMC8341178 DOI: 10.1002/jgh3.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/06/2021] [Indexed: 11/16/2022]
Abstract
Background and Aim Thrombocytopenia is a frequent hematological condition in chronic liver disease (CLD) patients increasing the risk of bleeding in patients undergoing invasive procedures. Without an alternative, clinical guidelines recommended the use of platelet transfusion (PT) prior to procedure to prevent this bleeding risk. Lusutrombopag (LUSU), an orally active, small‐molecule thrombopoietin receptor agonist, was developed as an alternative to PT. The objective of this study was to evaluate a cost‐effectiveness of LUSU as a potential alternative to PT in Japan. Methods A cost‐effectiveness analysis of LUSU relative to PT was conducted by a simulation model consisting of a decision tree combined to Markov model. Quality‐adjusted life years (QALYs) were used as an indicator of efficacy, and the analysis was conducted from the Japanese public healthcare payer's perspective. The time horizon of the analysis was 50 years (a lifetime) and the discount rate was set at 2%. Results LUSU gained 6.1803 QALYs with an expected lifetime costs of 2 380 219 JPY compared to PT with 6.1712 QALYs gained and expected lifetime costs of 2 382 908 JPY. Thus, LUSU was deemed dominant compared with PT. Based on probabilistic analyses, the chance of LUSU being dominant and the incremental cost‐effectiveness ratio being below 5 million JPY/QALY was estimated at 51.8% and 78.3%, respectively, demonstrating the robustness of the results. Conclusions LUSU was evaluated as an efficacious and cost‐saving treatment option for Japanese CLD patients with thrombocytopenia who required a planned invasive procedure compared with PT and economically should be considered as an alternative treatment.
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Inoue S, Igarashi A, Iguchi Y, Akagi T. Cost-Effectiveness Analysis of Percutaneous Patent Foramen Ovale Closure Preventing Secondary Ischemic Stroke in Japan. J Stroke Cerebrovasc Dis 2021; 30:105884. [PMID: 34153592 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/18/2021] [Accepted: 05/09/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Patent foramen ovale is a hemodynamically insignificant interatrial communication that may cause ischemic stroke. Percutaneous patent foramen ovale closure reduces the risk for recurrent ischemic stroke in patients with a history of cryptogenic ischemic stroke. This study evaluated the cost-effectiveness of patent foramen ovale closure against medical therapy in patients after their first cryptogenic ischemic stroke in Japan. MATERIALS AND METHODS The cost-effectiveness of patent foramen ovale closure compared with medical therapy was evaluated using the Markov model. The target patients started with patent foramen ovale closure or medical therapy for preventing secondary ischemic stroke under a stable state. Quality-adjusted life year was used as the outcome of effectiveness, and the analysis was conducted with a discount rate of 2% applied to both cost and effectiveness. The results of a multicenter open-label randomized controlled trial (RESPECT trial) evaluating patent foramen ovale closure using the Amplatzer™ PFO Occluder were used as clinical evidence. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio. It was evaluated as cost-effective if it was lower than 5 million JPY/ quality-adjusted life year. RESULTS Patent foramen ovale closure was dominant over medical therapy by 2.53 quality-adjusted life years and an estimated cost reduction of 2,353,926 JPY. The probability of patent foramen ovale closure being dominant was 82.9%. CONCLUSIONS Patent foramen ovale closure was dominant over medical therapy for preventing secondary ischemic stroke in patients with cryptogenic ischemic stroke.
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Affiliation(s)
| | - Ataru Igarashi
- Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Kanagawa, Japan; Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Iguchi
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teiji Akagi
- Department of Cardiovascular Medicine, Okayama University, Okayama, Japan
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Hayashi T, Ikeda K, Taniyama D, Hsi R, Inoue S, Teishima J, Akabane S, Sentani K, Yasui W, Yamamoto H, Kuraoka K, Hinoi T. Clinicopathological characteristics of upper tract urothelial cancer with loss of immunohistochemical expression of mismatch repair proteins. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Okumura H, Inoue S, Naidoo S, Holmstrom S, Akaza H. Cost-effectiveness analysis of enzalutamide for patients with chemotherapy-naïve metastatic castration-resistant prostate cancer in Japan. Jpn J Clin Oncol 2021; 51:1319-1329. [PMID: 34037235 PMCID: PMC8326386 DOI: 10.1093/jjco/hyab071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 04/24/2021] [Accepted: 04/29/2021] [Indexed: 11/30/2022] Open
Abstract
Background We aimed to evaluate cost-effectiveness of enzalutamide in chemotherapy-naïve metastatic castration-resistant prostate cancer patients in Japan. Methods A Markov model was developed to capture time spent by patients in various health states: stable, progression and death. Abiraterone acetate and docetaxel were set as active comparators. Clinical outcomes were obtained from the PREVAIL, COU-AA-302 and TAX327 trials. Treatment sequence, concomitant drugs and therapies for adverse events were estimated from responses to a survey by 14 Japanese prostate cancer experts. The analytic perspective was public healthcare payer, with a 10-year time horizon. The incremental cost-effectiveness ratio was estimated from quality-adjusted life-years and Japanese public healthcare costs. Probabilistic sensitivity analysis was performed to assess the robustness of the findings. Results According to the survey, the most common treatment sequences were (i) enzalutamide → docetaxel → cabazitaxel (enzalutamide-first sequencing), (ii) abiraterone → enzalutamide → docetaxel (abiraterone-first sequencing) and (iii) docetaxel→ enzalutamide → cabazitaxel (docetaxel-first sequencing). In the base-case analysis, enzalutamide-first sequencing saved 1.74 million Japanese Yen versus abiraterone-first sequencing, with a 0.129 quality-adjusted life-year gain (dominant). Enzalutamide-first sequencing had a cost increase of 4.44 million Japanese Yen over docetaxel-first sequencing, with a 0.371 quality-adjusted life-years gain. The incremental cost-effectiveness ratio of enzalutamide-first sequencing versus docetaxel-first sequencing was estimated as 11.94 million Japanese Yen/quality-adjusted life-years. Probabilistic sensitivity analyses demonstrated that, compared with abiraterone-first sequencing, enzalutamide-first sequencing had an 87.4% probability of being dominant. Conclusions Results modeled herein suggest that the enzalutamide-first sequencing is more cost-effective than the abiraterone-first sequencing, but less cost-effective than docetaxel-first sequencing for chemotherapy-naïve patients with metastatic castration-resistant prostate cancer.
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Affiliation(s)
| | - Sachie Inoue
- CRECON Medical Assessment Inc., Shibuya-ku, Tokyo, Japan
| | | | | | - Hideyuki Akaza
- Strategic Investigation on Comprehensive Cancer Network, The University of Tokyo, Tokyo, Japan
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Takenaka M, Matsumoto M, Murota H, Inoue S, Shibahara H, Yoshida K, Takigawa S, Ishimoto A. Cost‐effectiveness analysis of delgocitinib in adult patients with atopic dermatitis in Japan. J Cutan Immunol Allergy 2021. [DOI: 10.1002/cia2.12163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Motoi Takenaka
- Department of Dermatology Nagasaki University Nagasaki Japan
| | - Mai Matsumoto
- Department of Dermatology Nagasaki University Nagasaki Japan
| | - Hiroyuki Murota
- Department of Dermatology Nagasaki University Nagasaki Japan
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Abstract
BACKGROUND Alzheimer's disease dementia (ADD) is the leading cause of long-term care in Japan. OBJECTIVE This study estimates the annual healthcare and long-term care costs in fiscal year 2018 for adults over 65 years of age with ADD in Japan and the informal care costs and productivity loss for their families. METHODS Healthcare and long-term care costs for ADD were estimated according to the disease severity classified by the clinical dementia rating (CDR) score, using reports from a literature review. For the costs of time spent on caregiving activities, productivity loss for ADD family caregivers aged 20-69 and informal care costs for all ADD family caregivers were estimated. RESULTS The total healthcare cost of ADD was JPY 1,073 billion, of which 86% (JPY 923 billion) was attributed to healthcare costs other than ADD drug costs (JPY 151 billion). The healthcare costs other than ADD drug costs by severity were less than JPY 200 billion for CDR 0.5, CDR 1, and CDR 2, respectively, but increased to JPY 447 billion (48%) for CDR 3. The public long-term care costs were estimated to be JPY 4,783 billion, which increased according to the severity. Total productivity loss for ADD family caregivers aged 20-69 was JPY 1,547 billion and the informal care cost for all ADD family caregivers was JPY 6,772 billion. CONCLUSION ADD costs have a significant impact on public-funded healthcare, long-term care systems, and families in Japan. To minimize the economic burden of ADD, prolonging healthy life expectancy is the key factor to address.
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Affiliation(s)
- Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Wada-Isoe
- Department of Dementia Research, Kawasaki Medical School, Okayama, Japan
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Kusumi I, Inoue S, Baba K, Nosaka T, Anzai T. A propensity score matching analysis for cardio metabolic risk of antipsychotics in patients with schizophrenia using Japanese claims data. BMC Psychiatry 2020; 20:584. [PMID: 33298025 PMCID: PMC7724711 DOI: 10.1186/s12888-020-02987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the cardio-metabolic risk in schizophrenia patients treated by atypical antipsychotic drugs compared with that in those treated without atypical antipsychotic drugs using a nationwide insurance claims database and medical examination database in Japan. METHODS Eligible patients were defined as those meeting the following two criteria: (i) A diagnosis of schizophrenia (ICD-10 code: F20) was made between 1 January 2005 and 31 December 2017, with data available for at least 6 months before the diagnosis was made (index month), and (ii) health check-up data were available within ±3 months of the index month. The primary endpoint was changes in cardio-metabolic risk based on the Suita score at 1 year, and the secondary endpoints were changes in medical examination data related to cardio-metabolic risk (total cholesterol [TC], triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, body mass index [BMI], and hemoglobin A1c) at 1 year. The primary endpoint was evaluated by multivariate analysis, with the cumulative chlorpromazine equivalent amount and the baseline Suita score added as covariates. RESULTS One-hundred eighty five pairs of propensity score (PS)-matched patients were evaluated. Patients receiving atypical antipsychotic drugs exhibited a greater change in the Suita score and a risk of coronary heart disease based on the Suita score of 0.530 and 0.098%, respectively, than patients not receiving atypical antipsychotic drugs, but there was no significant difference (p = 0.412 and 0.610). The significant changes in TC and BMI were determined as 6.525 mg/dL and 0.380 kg/m2 greater, respectively, in patients treated with atypical antipsychotic drugs (p = 0.037 and 0.011). CONCLUSIONS There were no significant increases in changes in the Suita score at 1 year by treatment with atypical antipsychotic drugs compared with treatment without atypical antipsychotic drugs. However, the TC and BMI were significantly higher in patients treated with atypical antipsychotic drugs.
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Affiliation(s)
- Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido Japan
| | - Sachie Inoue
- CRECON Medical Assessment Inc, 2-12-15, Shibuya, Shibuya-ku, Tokyo, Japan
| | - Kenji Baba
- Sumitomo Dainippon Pharma Co., Ltd., 13-1, Kyobashi 1-Chome, Chuo-ku, Tokyo, Japan
| | - Tadashi Nosaka
- Sumitomo Dainippon Pharma Co., Ltd., 13-1, Kyobashi 1-Chome, Chuo-ku, Tokyo, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido Japan
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21
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Hayashi T, Ikeda K, Sakamoto N, Sentani K, Hsi RS, Sekino Y, Kitano H, Goto K, Inoue S, Yasui W, Black PC, Teishima J. Transition of ANXA10 expression is a useful diagnostic and prognostic marker in upper tract urothelial carcinoma. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Umemoto N, Imaoka T, Inoue S, Oshima S, Itou R, Sakakibara T, Shimizu K, Ishii H, Murohara T. Impact of stress myocardial blood flow as an important predictor for major adverse cardiac and cerebrovascular event in hemodialysis patients, even in patients without myocardial perfusion abnormality. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the clinical setting, ischemic heart disease (IHD) is a major problem not only in general patients but also in regular hemodialysis (HD) patients. Positron emission tomography (PET) is becoming a reliable modality for detecting coronary artery disease. Of course, PET illustrates myocardial perfusion (MP), PET also measures myocardial blood flow (MBF) directly. We have reported stress MBF is an independent predictor in HD population. Although some prior studies show CFR is an independent predictor for their prognosis in patients without MP abnormality, there is limited data about the predictability of stress MBF in HD patients without MP abnormality.
Methods
A total 438 of HD patients who undergone 13NH3PET for suspected IHD were enrolled. All patients were undergone13NH3PET at Nagoya Radiological Diagnosis Foundation. After we excluded patients whose summed stress score (SSS) <4, we identified 182 eligible patients. Patients were divided into two group according to the median value of CFR levels; low stress MBF group (≤2.56) and high stress MBF group (>2.56). We followed up them up to 4.2 years (median 2.4 years) and collected their data. We evaluated their major adverse cardiac cerebrovascular event. We performed Kaplan-Meyer analysis and multivariable cox regression models. Furthermore, we evaluated the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when CFR added into a model with established risk factors.
Result
There were intergroup difference in baseline characteristics: age, gender, prior CVD and diabetes. Kaplan-Meyer analysis shows statistically intergroup difference [log rank p=0.013, hazard ratio (HR) 0.413, 95% confidential interval (CI) 0.220–0.775]. Multivariable cox regression model for MACCE shows CFR is an independent risk factor (p=0.004, HR 0.311, 95% CI 0.137–0.684). As regarding model discrimination, all of C-index (0.832 vs 0.796, p=0.15), NRI (0.513, p=0.008) and IDI (0.032, p=0.033) were greatest in a predicting model with established risk factors plus stress MBF.
Conclusion
The low stress MBF group has poor prognosis in MACCE comparing to the high stress MBF group. Stress MBF is an independent risk factor for MACCE. Adding stress MBF on conventional risk factors could more accurately predict MACCE in HD patients, even in patients without MP abnormality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Imaoka
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Oshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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Umemoto N, Imaoka T, Inoue S, Itou R, Oshima S, Sakakibara T, Shimizu K, Ishii H, Murohara T. Diabetes and hemodialysis are important factor for decrease coronary flow reserve even in the patients with normal myocardial perfusion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In clinical setting, patients with traditional coronary risk factors are at high risk for coronary artery disease (CAD). Such patients who complain chest discomfort are usually performed nuclear myocardial perfusion (MP) test. We sometimes find patients whose PET result shows normal MP and abnormal coronary flow reserve (CFR). However, there are limited data about the predictors for decreased CFR. In the view of describe above, we have investigated the parameters for decreased CFR in the patients without MP abnormality.
Methods and results
From 20th April 2013 to 21st December 2018, we performed 2,930 13N- ammonia PET for suspected CAD. After excluding the follows; 966 patients with repeated test, 54 patients with incomplete data, one patient missed, we investigated 1,909 eligible patients' data. We performed least square to identify the factors decreased CFR. Hemodialysis (HD), age, prior revascularization, diabetes (DM) and body mass index (BMI) were independent risk factor for decreased CFR in all population. On the other hand, HD, age, DM, hypertension and BMI were independent risk factor for decreasing CFR in patients without MP abnormality. According to the result of least square methods, we classified all patients into four groups; without DM/ without HD group, with DM/ without HD group, without DM/ with HD group and with DM/ with HD group. The value of CFR in each group were as follows: without DM/ without HD group (median, 1st quartile-3rd quartile; 2.88, 2.21–3.52), with DM/ without HD group (2.65, 2.00–3.38), without DM/ with HD group (2.29, 1.67–2.95) and with DM/ with HD group (1.97, 1.43–2.68). There were statistically significant intergroup differences. The value of CFR in the patients without MP abnormality were as follows: without DM/ without HD group (3.04, 2.47–3.65), with DM/ without HD group (2.98, 2.40–3.61), without DM/ with HD group (2.52, 2.10–3.08) and with DM/ with HD group (2.38, 1.86–2.97). Even in the patients without MP abnormality, there were also statistically significant intergroup differences.
Conclusion
According to our 13N-ammonia PET data analysis, DM and HD were important and independent factors for decreased CFR. Even in the patients without MP abnormality, DM and HD were important factor for decreased CFR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Imaoka
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - S Oshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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Nitta K, Tachibana G, Wajima R, Inoue S, Ohigashi T, Otsuka N, Kurashima H, Santo K, Hashimoto M, Shibahara H, Hirukawa M, Sugiyama K. Predicting Lifetime Transition Risk of Severe Visual Field Defects Using Monte Carlo Simulation in Japanese Patients with Primary Open-Angle Glaucoma. Clin Ophthalmol 2020; 14:1967-1978. [PMID: 32764862 PMCID: PMC7360425 DOI: 10.2147/opth.s247618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/28/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To maintain visual fields and quality of life over a lifetime, medical practice must be conducted taking into consideration not only visual field progression but also future visual field changes that occur over the patients’ expected lifespan. The purpose of this study is to investigate the feasibility of establishing a model that predicts prognosis, estimating the proportion of glaucoma patients with severe visual field defects. Patients and Methods The data of 191 patients with primary open-angle glaucoma, with a predominance of normal-tension glaucoma, were used for this study. The model was developed based on patients’ backgrounds and risk factors, using Monte Carlo simulation. A “severe visual field defect” was defined as ≤-20 dB. The mean deviation (MD) value for 10,000 virtual patients in each simulation pattern (144 patterns) was calculated using a predictive formula to estimate the MD slope, and the effects of risk factors and intraocular pressure (IOP) reduction on the proportion of patients with severe visual field defects were evaluated. Results Younger age, later-stage disease, more severe glaucomatous structural abnormalities and the presence of disc hemorrhage were associated with an increase in the progression rate of patients with severe visual field defects. Conversely, lower IOP was associated with a decrease in this rate. Conclusion Combining regression analysis with Monte Carlo simulation could be a useful method for developing predictive models of prognosis in glaucoma patients.
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Affiliation(s)
- Koji Nitta
- Department of Ophthalmology, Fukui-Ken Saiseikai Hospital, Fukui, Japan.,Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Gaku Tachibana
- Department of Ophthalmology, Fukui-Ken Saiseikai Hospital, Fukui, Japan.,Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Ryotaro Wajima
- Department of Ophthalmology, Fukui-Ken Saiseikai Hospital, Fukui, Japan.,Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | | | - Tatsuya Ohigashi
- Japan Medical Affairs Group, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Naomi Otsuka
- Japan Medical Affairs Group, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Hiroaki Kurashima
- Japan Medical Affairs Group, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Kazunori Santo
- Japan Medical Affairs Group, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | - Masayo Hashimoto
- Japan Medical Affairs Group, Santen Pharmaceutical Co., Ltd., Osaka, Japan
| | | | | | - Kazuhisa Sugiyama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Acciari VA, Ansoldi S, Antonelli LA, Arbet Engels A, Baack D, Babić A, Banerjee B, Barres de Almeida U, Barrio JA, Becerra González J, Bednarek W, Bellizzi L, Bernardini E, Berti A, Besenrieder J, Bhattacharyya W, Bigongiari C, Biland A, Blanch O, Bonnoli G, Bošnjak Ž, Busetto G, Carosi R, Ceribella G, Cerruti M, Chai Y, Chilingarian A, Cikota S, Colak SM, Colin U, Colombo E, Contreras JL, Cortina J, Covino S, D'Amico G, D'Elia V, Da Vela P, Dazzi F, De Angelis A, De Lotto B, Delfino M, Delgado J, Depaoli D, Di Pierro F, Di Venere L, Do Souto Espiñeira E, Dominis Prester D, Donini A, Dorner D, Doro M, Elsaesser D, Fallah Ramazani V, Fattorini A, Ferrara G, Foffano L, Fonseca MV, Font L, Fruck C, Fukami S, García López RJ, Garczarczyk M, Gasparyan S, Gaug M, Giglietto N, Giordano F, Gliwny P, Godinović N, Green D, Hadasch D, Hahn A, Herrera J, Hoang J, Hrupec D, Hütten M, Inada T, Inoue S, Ishio K, Iwamura Y, Jouvin L, Kajiwara Y, Karjalainen M, Kerszberg D, Kobayashi Y, Kubo H, Kushida J, Lamastra A, Lelas D, Leone F, Lindfors E, Lombardi S, Longo F, López M, López-Coto R, López-Oramas A, Loporchio S, Machado de Oliveira Fraga B, Maggio C, Majumdar P, Makariev M, Mallamaci M, Maneva G, Manganaro M, Mannheim K, Maraschi L, Mariotti M, Martínez M, Mazin D, Mender S, Mićanović S, Miceli D, Miener T, Minev M, Miranda JM, Mirzoyan R, Molina E, Moralejo A, Morcuende D, Moreno V, Moretti E, Munar-Adrover P, Neustroev V, Nigro C, Nilsson K, Ninci D, Nishijima K, Noda K, Nogués L, Nozaki S, Ohtani Y, Oka T, Otero-Santos J, Palatiello M, Paneque D, Paoletti R, Paredes JM, Pavletić L, Peñil P, Perennes C, Peresano M, Persic M, Prada Moroni PG, Prandini E, Puljak I, Rhode W, Ribó M, Rico J, Righi C, Rugliancich A, Saha L, Sahakyan N, Saito T, Sakurai S, Satalecka K, Schleicher B, Schmidt K, Schweizer T, Sitarek J, Šnidarić I, Sobczynska D, Spolon A, Stamerra A, Strom D, Strzys M, Suda Y, Surić T, Takahashi M, Tavecchio F, Temnikov P, Terzić T, Teshima M, Torres-Albà N, Tosti L, van Scherpenberg J, Vanzo G, Vazquez Acosta M, Ventura S, Verguilov V, Vigorito CF, Vitale V, Vovk I, Will M, Zarić D, Nava L. Bounds on Lorentz Invariance Violation from MAGIC Observation of GRB 190114C. Phys Rev Lett 2020; 125:021301. [PMID: 32701326 DOI: 10.1103/physrevlett.125.021301] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/20/2020] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
On January 14, 2019, the Major Atmospheric Gamma Imaging Cherenkov telescopes detected GRB 190114C above 0.2 TeV, recording the most energetic photons ever observed from a gamma-ray burst. We use this unique observation to probe an energy dependence of the speed of light in vacuo for photons as predicted by several quantum gravity models. Based on a set of assumptions on the possible intrinsic spectral and temporal evolution, we obtain competitive lower limits on the quadratic leading order of speed of light modification.
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Affiliation(s)
- V A Acciari
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ansoldi
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L A Antonelli
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | | | - D Baack
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - A Babić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - B Banerjee
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - U Barres de Almeida
- Centro Brasileiro de Pesquisas Fsicas (CBPF), 22290-180 URCA, Rio de Janeiro (RJ), Brasil
| | - J A Barrio
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Becerra González
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - W Bednarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - L Bellizzi
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - E Bernardini
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Berti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - J Besenrieder
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - W Bhattacharyya
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - C Bigongiari
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Biland
- ETH Zurich, CH-8093 Zurich, Switzerland
| | - O Blanch
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - G Bonnoli
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - Ž Bošnjak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - G Busetto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - R Carosi
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - G Ceribella
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Cerruti
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - Y Chai
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A Chilingarian
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - S Cikota
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - S M Colak
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - U Colin
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Colombo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J L Contreras
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - J Cortina
- Centro de Investigaciones Energticas, Medioambientales y Tecnolgicas, E-28040 Madrid, Spain
| | - S Covino
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - G D'Amico
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - V D'Elia
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Da Vela
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - F Dazzi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A De Angelis
- Università di Padova and INFN, I-35131 Padova, Italy
| | - B De Lotto
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Delfino
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - J Delgado
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Depaoli
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Di Pierro
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - L Di Venere
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - E Do Souto Espiñeira
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Dominis Prester
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - A Donini
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Dorner
- Universität Würzburg, D-97074 Würzburg, Germany
| | - M Doro
- Università di Padova and INFN, I-35131 Padova, Italy
| | - D Elsaesser
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - V Fallah Ramazani
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - A Fattorini
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - G Ferrara
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - L Foffano
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M V Fonseca
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - L Font
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - C Fruck
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Fukami
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - R J García López
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Garczarczyk
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | - S Gasparyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - M Gaug
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - N Giglietto
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - F Giordano
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - P Gliwny
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - N Godinović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Green
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Hadasch
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Hahn
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Herrera
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - J Hoang
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - D Hrupec
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Hütten
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Inada
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Inoue
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Ishio
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - Y Iwamura
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Jouvin
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kajiwara
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Karjalainen
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - D Kerszberg
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - Y Kobayashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - H Kubo
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Kushida
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - A Lamastra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Lelas
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - F Leone
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - E Lindfors
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - S Lombardi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - F Longo
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M López
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - R López-Coto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A López-Oramas
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Loporchio
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - C Maggio
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - P Majumdar
- Saha Institute of Nuclear Physics, HBNI, 1/AF Bidhannagar, Salt Lake, Sector-1, Kolkata 700064, India
| | - M Makariev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Mallamaci
- Università di Padova and INFN, I-35131 Padova, Italy
| | - G Maneva
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - M Manganaro
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - K Mannheim
- Universität Würzburg, D-97074 Würzburg, Germany
| | - L Maraschi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - M Mariotti
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Martínez
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Mazin
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S Mender
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - S Mićanović
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Miceli
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - T Miener
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - M Minev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - J M Miranda
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - R Mirzoyan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E Molina
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - A Moralejo
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - D Morcuende
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - V Moreno
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - E Moretti
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - P Munar-Adrover
- Departament de Física, and CERES-IEEC, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - V Neustroev
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - C Nigro
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nilsson
- Finnish MAGIC Consortium: Finnish Centre of Astronomy with ESO (FINCA), University of Turku, FI-20014 Turku, Finland; Astronomy Research Unit, University of Oulu, FI-90014 Oulu, Finland
| | - D Ninci
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - K Nishijima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Noda
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - L Nogués
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - S Nozaki
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Ohtani
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - T Oka
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - J Otero-Santos
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Palatiello
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - D Paneque
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - R Paoletti
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - J M Paredes
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Pavletić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - P Peñil
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - C Perennes
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M Peresano
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | - M Persic
- Università di Udine, and INFN Trieste, I-33100 Udine, Italy
| | | | - E Prandini
- Università di Padova and INFN, I-35131 Padova, Italy
| | - I Puljak
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - W Rhode
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - M Ribó
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - J Rico
- Institut de Física d'Altes Energies (IFAE), The Barcelona Institute of Science and Technology (BIST), E-08193 Bellaterra (Barcelona), Spain
| | - C Righi
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - A Rugliancich
- Università di Pisa, and INFN Pisa, I-56126 Pisa, Italy
| | - L Saha
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, E-28040 Madrid, Spain
| | - N Sahakyan
- The Armenian Consortium: ICRANet-Armenia at NAS RA, A. Alikhanyan National Laboratory
| | - T Saito
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - S Sakurai
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - K Satalecka
- Deutsches Elektronen-Synchrotron (DESY), D-15738 Zeuthen, Germany
| | | | - K Schmidt
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - T Schweizer
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J Sitarek
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - I Šnidarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - D Sobczynska
- University of Lodz, Faculty of Physics and Applied Informatics, Department of Astrophysics, 90-236 Lodz, Poland
| | - A Spolon
- Università di Padova and INFN, I-35131 Padova, Italy
| | - A Stamerra
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - D Strom
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - M Strzys
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - Y Suda
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T Surić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Takahashi
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - F Tavecchio
- National Institute for Astrophysics (INAF), I-00136 Rome, Italy
| | - P Temnikov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - T Terzić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - M Teshima
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - N Torres-Albà
- Universitat de Barcelona, ICCUB, IEEC-UB, E-08028 Barcelona, Spain
| | - L Tosti
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | | | - G Vanzo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - M Vazquez Acosta
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, and Universidad de La Laguna, Departamento de Astrofísica, E-38206 La Laguna, Tenerife, Spain
| | - S Ventura
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - V Verguilov
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, BG-1784 Sofia, Bulgaria
| | - C F Vigorito
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - V Vitale
- Istituto Nazionale Fisica Nucleare (INFN), 00044 Frascati (Roma) Italy
| | - I Vovk
- Japanese MAGIC Consortium: ICRR, The University of Tokyo, 277-8582 Chiba, Japan; Department of Physics, Kyoto University, 606-8502 Kyoto, Japan; Tokai University, 259-1292 Kanagawa, Japan; RIKEN, 351-0198 Saitama, Japan
| | - M Will
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D Zarić
- Croatian Consortium: University of Rijeka, Department of Physics, 51000 Rijeka; University of Split-FESB, 21000 Split; University of Zagreb-FER, 10000 Zagreb; University of Osijek, 31000 Osijek; Rudjer Boskovic Institute, 10000 Zagreb, Croatia
| | - L Nava
- National Institute for Astrophysics (INAF), Osservatorio Astronomico di Brera, 23807 Merate, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Trieste, 34149 Trieste, Italy
- Institute for Fundamental Physics of the Universe (IFPU), 34151 Trieste, Italy
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Murota H, Inoue S, Yoshida K, Ishimoto A. Cost of illness study for adult atopic dermatitis in Japan: A cross-sectional Web-based survey. J Dermatol 2020; 47:689-698. [PMID: 32383191 PMCID: PMC7384180 DOI: 10.1111/1346-8138.15366] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/31/2020] [Indexed: 01/10/2023]
Abstract
Atopic dermatitis is a pruritic, eczematous dermatitis, the symptoms of which chronically fluctuate with remissions and relapses. Although a high psychosomatic and economic burden caused by atopic dermatitis is expected, few studies have been conducted estimating the cost of illness, including the self-medication costs and productivity loss due to atopic dermatitis. The aim of this study was to conduct a cross-sectional, Web-based survey of the direct medical costs, self-medication costs and productivity loss for adult atopic dermatitis patients, and estimate the burden of Japanese adult atopic dermatitis patients by disease severity. In a physician survey, the medical resource consumption related to medical treatments was surveyed by disease severity. The direct medical costs were calculated by multiplying the medical resource consumption and medical fee corresponding to each treatment. Based on the results of a patient survey, the self-medication costs and productivity loss were estimated by sex and disease severity. Atopic dermatitis-related productivity loss was calculated based on absenteeism, presenteeism, overall work impairment for employed workers and activity impairment for housewives. The nationwide estimations were calculated based on the estimated number of atopic dermatitis patients, employed workers with atopic dermatitis, and housewives with atopic dermatitis in their 20s-50s in Japan. Based on the surveys, all costs per patient and the scores increased with disease severity. The cost of illness for adult atopic dermatitis patients in Japan was estimated to be approximately JPY 3 trillion/year. Considering the physical and mental burdens, the burden of illness for adult atopic dermatitis was demonstrated to be vast.
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Inoue S, Hayashi T, Hieda K, Miyamoto S, Fujii S, Sekino Y, Kitano H, Ikeda K, Goto K, Teishima J, Matsubara A. Longitudinal analysis of conventional laparoscopic, posterior retroperitoneoscopic, and laparoendoscopic single-site adrenalectomy regarding cosmesis and satisfaction outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33186-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yamaki K, Terashi M, Ogura S, Inoue S, Naka N, Nakagaki T, Oka N, Koyama Y. Anti-allergic effect of the Src family kinase inhibitor saracatinib. Pharmazie 2020; 75:339-343. [PMID: 32635977 DOI: 10.1691/ph.2020.9949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The aim of this study was to evaluate the anti-anaphylactic and anti-allergic potentials of saracatinib, a Src family kinase inhibitor that was already shown to be safe in clinical trials when it was used as an anti-cancer drug. Using in vitro mast cell models, we found that saracatinib inhibited the degranulation response and cytokine production in RBL2H3 cells that were stimulated with IgE and antigen without affecting cell viability. Phosphorylation of Lyn, Akt, a PI3K substrate, and MAPKs including ERK, JNK, and p38, as well as the intracellular Ca2+ increase induced by this stimulation were also suppressed by saracatinib. This drug also inhibited symptoms in our established anaphylaxis mouse model, anaphylaxis-dependent spotted distribution of immune complex in skin (ASDIS). The intravenous injection of the mixture of IgE and antigen induced acute spotted distribution of immune complex in skin in hairless HR-1 mice, and its inhibition by intradermal injection of saracatinib was observed. Moreover, toluidine blue-stained skin sections indicated that the degranulation ratio of dermal mast cells was reduced in saracatinib-treated skin compared with vehicle-treated skin. Because only a few signaling inhibitors are used as anti-anaphylaxis and anti-allergic drugs, these results indicated the valuable suggestion that saracatinib and the Src family kinase inhibitors are good candidates for anti-anaphylaxis and anti-allergic drugs.
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Affiliation(s)
- K Yamaki
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan;,
| | - M Terashi
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - S Ogura
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - S Inoue
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - N Naka
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - T Nakagaki
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - N Oka
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
| | - Y Koyama
- Laboratory of Pharmacology, Kobe Pharmaceutical University, Kobe, Japan
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Kohada Y, Hayashi T, Hsi R, Yukihiro K, Sentani K, Goto K, Inoue S, Ohara S, Teishima J, Kajiwara M, Nishisaka T, Mikami J, Anan G, Ito J, Kaiho Y, Sato M, Yasui W, Akio M. Recurrence and progression free survival of intermediate risk NMIBC: The impact of conditional evaluation and sub-classification. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Okiyama N, Nakamura Y, Ishitsuka Y, Inoue S, Kubota N, Saito A, Watanabe R, Fujisawa Y, Igawa K. Successful topical treatment with ketoconazole for facial rashes refractory to dupilumab in patients with atopic dermatitis: case reports. J Eur Acad Dermatol Venereol 2020; 34:e474-e476. [DOI: 10.1111/jdv.16383] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/20/2022]
Affiliation(s)
- N. Okiyama
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Nakamura
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Ishitsuka
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - S. Inoue
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - N. Kubota
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - A. Saito
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - R. Watanabe
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Y. Fujisawa
- Department of Dermatology Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - K. Igawa
- Department of Dermatology Dokkyo Medical University School of Medicine Tochigi Japan
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Ishikawa T, Inoue S, Kawaguchi M. A pediatric case of severe systemic pneumatosis during airway pressure release ventilation. Med Intensiva 2020; 46:S0210-5691(20)30109-1. [PMID: 32482369 PMCID: PMC9402261 DOI: 10.1016/j.medin.2020.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 12/02/2022]
Affiliation(s)
- T Ishikawa
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
| | - S Inoue
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan.
| | - M Kawaguchi
- Department of Anesthesiology and Division of Intensive Care, Nara Medical University, Kashihara, Nara, Japan
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32
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Inoue S, Nakao K, Hanyu M, Hayashida K, Shibahara H, Kobayashi M, Asaoka M, Nishikawa K, Clancy S, Koshiishi J, Sakamaki H. Cost-Effectiveness of Transcatheter Aortic Valve Implantation Using a Balloon-Expandable Valve in Japan: Experience From the Japanese Pilot Health Technology Assessment. Value Health Reg Issues 2020; 21:82-90. [DOI: 10.1016/j.vhri.2019.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/30/2019] [Accepted: 07/22/2019] [Indexed: 11/17/2022]
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Iwano T, Yoshimura K, Inoue S, Odate T, Ogata K, Funatsu S, Tanihata H, Kondo T, Ichikawa D, Takeda S. Breast cancer diagnosis based on lipid profiling by probe electrospray ionization mass spectrometry. Br J Surg 2020; 107:632-635. [PMID: 32246473 PMCID: PMC7216899 DOI: 10.1002/bjs.11613] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/08/2020] [Indexed: 12/14/2022]
Affiliation(s)
- T Iwano
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
| | - K Yoshimura
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
| | - S Inoue
- Department of Digestive , Breast and Endocrine Surgery, Yamanashi, Japan
| | - T Odate
- Department of Pathology, University of Yamanashi, Chu, Yamanashi, Japan
| | - K Ogata
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - S Funatsu
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - H Tanihata
- Shimadzu Corporation, Nakagyo, Kyoto, Japan
| | - T Kondo
- Department of Pathology, University of Yamanashi, Chu, Yamanashi, Japan
| | - D Ichikawa
- Department of Digestive , Breast and Endocrine Surgery, Yamanashi, Japan
| | - S Takeda
- Department of Anatomy and Cell Biology, Faculty of Medicine, Yamanashi, Japan
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Ro Y, Hamada C, Io H, Hayashi K, Inoue S, Hirahara I, Tomino Y. Early Diagnosis of CAPD Peritonitis Using a New Test Kit for Detection of Matrix Metalloproteinase (MMP)-9. Perit Dial Int 2020. [DOI: 10.1177/089686080402400119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Y. Ro
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - C. Hamada
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - H. Io
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - K. Hayashi
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - S. Inoue
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
| | - I. Hirahara
- Terumo Corporation Biological Evaluation Center Kanagawa Japan
| | - Y. Tomino
- Division of Nephrology Department of Internal Medicine Juntendo University School of Medicine Tokyo
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Ubara Y, Hara S, Katori H, Arizono K, Ikeguti H, Yokoyama K, Hinosita F, Inoue S, Kuzuhara K, Yamada A, Mimura N. Acute Pancreatitis in a Capd Patient in Association with Hemolytic Anemia. Perit Dial Int 2020. [DOI: 10.1177/089686089701700123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Y. Ubara
- Department of Interna Medicine1, Tokyo, Japan
| | - S. Hara
- Department of Interna Medicine1, Tokyo, Japan
| | - H. Katori
- Department of Interna Medicine1, Tokyo, Japan
| | - K. Arizono
- Department of Interna Medicine1, Tokyo, Japan
| | - H. Ikeguti
- Department of Interna Medicine1, Tokyo, Japan
| | - K. Yokoyama
- Department of Interna Medicine1, Tokyo, Japan
| | - F. Hinosita
- Department of Interna Medicine1, Tokyo, Japan
| | - S. Inoue
- Department of Surgery Toranomon Hospital Kidney Center Minatoku, Tokyo, Japan
| | - K. Kuzuhara
- Department of Surgery Toranomon Hospital Kidney Center Minatoku, Tokyo, Japan
| | - A. Yamada
- Department of Interna Medicine1, Tokyo, Japan
| | - N. Mimura
- Department of Interna Medicine1, Tokyo, Japan
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Takekita Y, Inoue S, Baba K, Nosaka T. Rehospitalization Risk of Receptor-Affinity Profile in Antipsychotic Drug Treatment: A Propensity Score Matching Analysis Using a Japanese Employment-Based Health Insurance Database. Neuropsychiatr Dis Treat 2020; 16:2871-2879. [PMID: 33299315 PMCID: PMC7721289 DOI: 10.2147/ndt.s276030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to examine whether there is a difference in the risk of rehospitalization when antipsychotics are classified into two groups treated using drugs with a higher or lower affinity to H1 or α1 receptors than to D2 receptors (histamine H1 receptors, adrenaline α1 receptors [HA] high- and HA low-affinity drug group, respectively) based on affinity to receptors related to sedation using a nationwide insurance claims database in Japan. PATIENTS AND METHODS We identified eligible patients by the following two criteria: (i) hospitalization due to schizophrenia (International Classification of Disease [ICD]-10 code: F20 or F25) in psychiatric wards between January 1st, 2005 and August 31st, 2017, and (ii) administration of HA high- or HA low-affinity drugs in the next month after discharge from the earliest hospitalization due to schizophrenia (index month). The primary endpoint was rehospitalization due to schizophrenia. The secondary endpoints were (i) involuntary rehospitalization, (ii) concomitant use of anxiolytics/hypnotics, mood stabilizers, and antiparkinsonian drugs, (iii) all-cause death, and (iv) medication discontinuation. Propensity score (PS) matching analysis was applied, and the hazard ratio (HR) of the event rate in the HA high-affinity drug group relative to the HA low-affinity drug group was calculated using Cox's proportional hazards model. RESULTS Two thousand nine hundred and forty patients were identified as eligible patients. Among PS-matched patients (819 in each group), the HR in the HA high-affinity drug group compared with the HA low-affinity drug group was 1.018 (0.822-1.260, P = 0.870). Other outcomes did not differ significantly between the two groups. CONCLUSION No significant difference was observed in the rehospitalization risk due to schizophrenia associated with HA high-affinity antipsychotic drugs. Although this study was a retrospective PS-matched cohort study, the possibility of masking of the rehospitalization risk cannot be excluded because more than 80% of the patients were administered an anxiolytic/hypnotic at the time of admission.
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Affiliation(s)
| | | | - Kenji Baba
- Sumitomo Dainippon Pharma Co, Ltd, Tokyo, Japan
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Sakamaki H, Nakao K, Matsumoto T, Inoue S. Cost-effectiveness analysis of percutaneous mitral valve repair with the MitraClip delivery system for patients with mitral regurgitation in Japan. J Med Econ 2019; 22:1312-1320. [PMID: 31516049 DOI: 10.1080/13696998.2019.1668132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: The objective of the study is to evaluate the cost-effectiveness of percutaneous mitral valve repair (TMVr) with the MitraClip NT system (MitraClip procedure) for patients with symptomatic severe mitral regurgitation (MR) at high surgical risk in line with the methodological guideline for cost-effectiveness evaluation by the Ministry of Health, Labour and Welfare.Material and Methods: The cost-effectiveness of MitraClip procedure was evaluated using a Markov model. Patients are classified into four New York Heart Association classes in each cycle. The model considered MitraClip complication ("major vascular complication", "major bleeding complication", "non-cerebral thromboembolism"), adverse events, re-implantation with MitraClip device, mitral valve surgery, and congestive heart failure hospitalization. For the evidence on additional benefits, a study compared with propensity score-matched medical therapy group was used in the analysis. The analysis was conducted from the perspective of a public healthcare payer with a discount rate of 2% for both cost and effectiveness.Results: In the base-case analysis, total cost and quality-adjusted life year (QALY) gained (Life year (LY) gained) were 7,541,151 JPY and 3.23 QALYs (3.85 LYs) for MitraClip group, and 4,699,692 JPY and 1.79 QALYs (2.43 LYs) for medical therapy group, respectively. The incremental cost-effectiveness ratio (ICER) of MitraClip procedure versus medical therapy was 1.97 million JPY/QALY (US$18,570/QALY, US$1 = 106 JPY), which was evaluated to be cost-effective. The probability of ICER of MitraClip procedure versus medical therapy being 5 million JPY/QALY was 96.7%.Limitations: There are two limitations. Firstly, the parameters for the comparators were based on some assumptions. However, it was a conservative setting against MitraClip group. Secondary, the mortality rate and adverse events of MitraClip group in a lifetime were estimated from data during a year after the procedure.Conclusions: MitraClip procedure improved life-years and quality of life in patients at high surgical risk and it was also a cost-effective treatment option.
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Affiliation(s)
- Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | - Koichi Nakao
- Division of Cardiology, Cardiovascular Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan
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Morita M, Nakamura A, Tanaka H, Saito R, Inoue S, Harada T, Yamada T, Nakagawa T, Jingu D, Sugawara S. Phase II study of low-dose afatinib maintenance treatment for patients with EGFR-mutated non-small cell lung cancer (NJLCG1601). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz437.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shibata N, Sumi T, Umemoto N, Kajiura H, Inoue S, Iio Y, Sugiura T, Taniguchi T, Asai T, Yamada M, Shimizu K, Murohara T. P5410Combination assessment of renal and hepatic dysfunction improves the predictability of prognosis in patients with acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Renal dysfunction is associated with poor mortality in patients with heart failure (HF). Hepatic dysfunction, assessed by Fibrosis-4 (FIB4) index, has also prediction ability in acute decompensated HF (ADHF) patients. We investigated whether the assessment of the combination of FIB4 index and renal dysfunction improves predictability in patients with ADHF.
Methods
We retrospectively enrolled consecutive 758 patients who admitted due to ADHF from January 2011 to February 2018 and followed up for one year. FIB4 index on admission was calculated by the formula: age (yrs) × AST[U/L] / (platelets [103/μL] × (ALT[U/L])1/2). Study subjects were divided into high FIB4 index (>3.25) and low FIB4 index (≤3.25), furthermore each group were classified by the presence/absence of CKD (estimated glomerular filtration rate <60 ml/min/1.73m). We have generated four groups; low FIB4/without CKD (n=154), low FIB4/with CKD (n=294), high FIB4/without CKD (n=56), and high FIB4/with CKD (n=254). The primary outcome was defined as all-cause mortality in one year. We performed Kaplan-Meyer analysis and multivariable Cox regression models. Furthermore, we evaluated the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when FIB4 index and renal dysfunction added to a baseline model.
Results
In total, 106 patients died in one year. High FIB4 index and CKD showed significantly higher 1-year mortality (high FIB4 index: 19.7% vs 10.3%, p<0.001, CKD: 17.0% vs 6.7%, p<0.001, respectively). Kaplan-Meyer analysis shows that high FIB4 index with CKD showed statistically higher mortality than the others (vs low FIB4/without CKD, p<0.001, vs high FIB4/without CKD, p=0.031, vs low FIB4/with CKD, p<0.001, respectively).
Multivariate Cox regression model revealed that both high FIB4 index and CKD were an independent risk predictor of 1-year mortality (FIB4 index: p<0.001, HR 1.06, 95% CI 1.035–1.087, CKD: p=0.004, HR 1.834, 95% CI 1.213–2.773, respectively) in patients with ADHF.
A baseline model for prediction of 1-year mortality was determined by multivariable logistic regression including age, body mass index, systolic blood pressure, and serum albumin (C-index: 0.688). Adding high FIB4 index and CKD to the baseline model, all of C-index (0.738, p=0.04), NRI (0.122, p=0.067), and IDI (0.024, p=0.004) were improved.
Receiver operating characteristic curves
Conclusions
Combination assessment of renal and hepatic dysfunction could improve the predictability of prognosis in patients with ADHF.
Acknowledgement/Funding
None
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Affiliation(s)
- N Shibata
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Sumi
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - N Umemoto
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - H Kajiura
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Sugiura
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Taniguchi
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Asai
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - M Yamada
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - K Shimizu
- Ichinomiya municipal hospital, Department of cardiology, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Hospital, Department of cardiology, Nagoya, Japan
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Sumi T, Umemoto N, Kajiura H, Inoue S, Iio Y, Shibata N, Sugiura T, Taniguchi T, Asai T, Yamada M, Shimizu K, Murohara T. P4551Prognostic utility of Palliative Prognostic Index for prediction of 30-day and 1-year outcome in patients with acute decompensated heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The prognosis of heart failure remains poor similar to the terminal cancer patients, although recent progress in medical treatment. Palliative Prognostic Index (PPI) is a widely used prognostic index for terminal cancer patients (PPI includes: Palliative Performance Scale, oral intake, oedema, dyspnea at rest and delirium), suggesting the short-term prognostic marker of terminal cancer patients.
Purpose
The purpose of this study was to evaluate the impact of PPI on 30-day mortality, 1-year mortality and 1-year events (including all-cause mortality, readmission due to heart failure and new onset of cerebral infarction after hospital discharge) among acute decompensated heart failure (ADHF) patients.
Method
Study subjects comprised of consecutive 764 patients who admitted due to ADHF and followed up for 1-year. PPI were calculated at the time of hospital admission. Study subjects were divided into two groups based on the PPI: L-PPI (PPI<6) and H-PPI (6≤PPI). We calculated the C-index, net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) to evaluate the improvement of prediction ability on 30-day mortality.
Result
H-PPI showed significantly higher 30-day mortality than L-PPI [7.9% vs 2.0%, log rank p<0.001, Hazard retio (HR): 1.26, 95% confidential interval(CI): 1.14–1.37, p<0.001], 1-year mortality [20.0% vs 12.7%, log rank p=0.022, HR 1.15, 95% CI 1.09–1.21, p<0.001]and 1-year events [45.5% vs 31.1%, log rank p<0.001, HR 1.13, 95% CI 1.09–1.17, p<0.001]. Multivariate cox proportional hazard models adjusted with several covariates revealed that PPI was an independent predictor of 30-day mortality (HR: 1.23, 95% CI: 1.10–1.36, p<0.001), 1-year mortality (HR: 1.10, 95% CI: 1.04–1.16, p<0.001) and 1-year events (HR: 1.11, 95% CI: 1.07–1.15, p<0.001), respectively.
A reference model for prediction of 30-day mortality was determined including left ventricular ejection fraction and serum albumin concentration by multivariable logistic regression analysis. (P<0.05) (C-index: 0.720) Adding PPI to the reference model (C-index: 0.773) significantly improved both NRI (0.458, p=0.038) and IDI (0.046, p=0.007), respectively.
Conclusion
We suggest that assessment of PPI showed good prognostic ability for 30-day and 1-year outcome, while PPI provided additional prognostic information in patients with ADHF.
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Affiliation(s)
- T Sumi
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - H Kajiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - N Shibata
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Sugiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Taniguchi
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Asai
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - M Yamada
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Graduate School of Medicine, Cardiology, Nagoya, Japan
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Umemoto N, Ooshima S, Katou M, Kajiura H, Inoue S, Iio Y, Itou R, Sakakibara T, Ishii H, Shimizu K, Murohara T. P6240The impact of stress myocardial blood flow as a very strong predictor for all-cause mortality, cardiovascular mortality and adverse cardiac and cerebrovascular event in hemodialysis population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the clinical setting, ischemic heart disease (IHD) is a major problem not only in general patients but also in regular hemodialysis (HD) patients. 13ammonia positron emission tomography (13NH3PET) is an established and excellent diagnostic device for IHD. Although coronary flow reserve is the most important index in IHD diagnosis, there are limited data about stress myocardial blood flow (MBF). We investigated the prognosis predictability of stress MBF in all-cause mortality, cardiovascular (CV) mortality and adverse cardiac and cerebrovascular event (MACCE).
Methods and results
A total 438 of HD patients who undergone 13NH3PET for suspected IHD were enrolled. 29 cases were excluded due to revascularization therapy in 60 days. In total we collected 409 eligible cases. All patients were undergone13NH3PET at Nagoya Radiological Diagnosis Foundation. Patients were divided into two group according to the median value of stress MBF levels; low stress MBF group (<2.12) and high stress MBF group (≥2.12). We followed up them up to 4.2 years (median 2.4 years) and collected their data. We evaluated their all-cause mortality, CV mortality and MACCE. Kaplan-Meyer analysis shows that intergroup difference in all-cause mortality (log rank p=0.001, hazard ratio [HR] 0.411, 95% confident interval [CI] 0.261–0.632), CV mortality (log rank p=0.002, HR 0.324, 95% CI 0.157–0.625) and MACCE (log rank p<0.001, HR 0.465, 95% CI 0.324–0.657). Multiple cox analysis that include established risk factors shows CFR is an independent risk factor for all-cause mortality (HR 0.261, 95% CI 0.154–0.442), CV mortality (HR 0.172, 95% CI 0.079–0.374) and MACCE (HR 0.329, 95% CI 0.213–0.503). As a result of the incremental value with C-index, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) when CFR added into a model with established risk factors, each indicator shows adding stress MBF on established risk factors improve the predictability in all-cause mortality, CV mortality and MACCE (all-cause mortality; NRI 0.642, p<0.001, IDI 0.091, p<0.001, CV mortality NRI 0.809, p<0.001, IDI 0.116, p<0.001, MACCE; NRI 0.646, p<0.001, IDI 0.072, p<0.001).
Conclusion
Considering prognosis of HD population, stress MBF is an important and independent predictor for all-cause mortality, CV mortality and MACCE. As a result of our investigation, stress MBF is one of most strong predictors in HD population.
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Affiliation(s)
- N Umemoto
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Ooshima
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - M Katou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - H Kajiura
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - S Inoue
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - Y Iio
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - R Itou
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - T Sakakibara
- Kyoritsu Hospital, department of cardiology, Nagoya, Japan
| | - H Ishii
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
| | - K Shimizu
- Ichinomiya Municipal Hospital, Ichinomiya, Japan
| | - T Murohara
- Nagoya University Hospital, department of cardiology, Nagoya, Japan
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Yakabe D, Ikeda S, Chishaki A, Tsutsui H. P3764Morphological mechanisms of atrial functional mitral regurgitation in patients with atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Atrial functional mitral regurgitation (AFMR) occurs in patients with atrial fibrillation. However, morphological mechanisms of AFMR are poorly understood.
Purpose
The purpose of this study was to examine the morphological characteristics in patients with AFMR.
Methods
Among consecutive 795 patients undergoing initial radiofrequency catheter ablation (RFCA) at our hospital, twenty-five patients with persistent AF accompanied by AFMR (≥ moderate) before RFCA (AFMR group) were studied. Age-matched 25 patients with persistent AF without MR were defined as a control group.
Results
Left ventricular ejection fraction (LVEF) was lower and left atrium volume index was larger in the AFMR group (Table). Mitral valve annulus diameter and length of anterior mitral leaflet (AML) were similar between groups, whereas length of posterior mitral leaflet (PML) was significantly shorter in the AFMR group. Smaller tethering angle of AML (γ in the figure) and shorter tethering height were significantly associated with the occurrence of AFMR, which were different from morphology of functional mitral regurgitation in patients with dilated LV. Multiple regression analysis revealed that less tenting height (p<0.05) and LA dilatation toward the posterior (p<0.01) were significantly related to AFMR.
Echocardiographic parameters AFMR (n=25) Control (n=25) P value Age, y 69±8 66±10 NS Male, n (%) 9 (36) 20 (80) P=0.001 LVEF,% 60±9 67±6 P=0.004 LAD, mm 44±5 41±7 NS LAVI, ml/m2 56±17 41±13 P<0.001 MV diameter, mm 3.9±0.4 3.8±0.5 NS α angle, ° 34±9 35±7 NS β angle, ° 48±9 50±8 NS γ angle, ° 32±5 37±5 P=0.0005 AML length, mm 3.0±0.5 3.0±0.5 NS PML length, mm 2.1±0.1 2.4±0.1 P=0.03 Tenting height, mm 1.5±0.1 1.8±0.1 P=0.02 D, mm 0.8±0.3 0.5±0.3 P=0.001 LVEF: left ventricular ejection fraction; LAD: left atrial diameter; LAVI: left atrial volume index; AML: anterior mitral leaflet; PML: posterior mitral leaftlet.
Conclusions
AFMR occurs in patients with unique morphological features, such as less tethering height and LA dilatation toward the posterior.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - D Yakabe
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Omori Y, Inoue S, Otsuka T, Nagamatsu Y, Sorimachi A, Ishikawa T. REDUCTION IN AMBIENT GAMMA DOSE RATE FROM RADIOCESIUM DUE TO SNOW COVER. Radiat Prot Dosimetry 2019; 184:510-513. [PMID: 31038711 DOI: 10.1093/rpd/ncz091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the present study, variations in ambient gamma dose rate associated with snow cover were examined in a radioactive-contaminated site in Fukushima Prefecture, Japan. The ambient gamma dose rates decreased with increasing snow depth. The reduction trends were different between fresh snow (0.1-0.2 g/cm3) and granular snow (0.3-0.4 g/cm3) depending on snow density. Snow cover water content (snow water equivalent) calculated from snow depth and density was a key parameter governing the reduction in the ambient gamma dose rate. The ambient gamma dose rates reduced to 0.6 and 0.5 at 4 g/cm2 and 8 g/cm2 of snow water equivalent, respectively. Based on gamma-ray flux density distributions, the ambient gamma dose rates from the primary gamma rays decreased more compared to those from scattered gamma rays due to snow cover.
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Affiliation(s)
- Y Omori
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - S Inoue
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - T Otsuka
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - Y Nagamatsu
- MD Program, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - A Sorimachi
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
| | - T Ishikawa
- Department of Radiation Physics and Chemistry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, Japan
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Nagaoka K, Mukai Y, Kawai S, Takase S, Sakamoto K, Inoue S, Ikeda S, Chishaki A, Tsutsui H. P1025Clinical predictors for the improvement of left ventricular ejection fraction and prognosis after catheter ablation of atrial fibrillation in patients with systolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Catheter ablation (CA) of atrial fibrillation (AF) improves left ventricular ejection fraction (LVEF) and clinical outcomes in patients with left ventricular systolic dysfunction (LVSD). However, predictors of the improvement of LV function and clinical outcomes by CA were poorly understood.
Purpose
We examined the efficacy of CA in AF patients with LVSD and predictive factors associated with clinical outcomes.
Method
Among consecutive 795 patients undergone initial RFCA at our hospital, we studied 51 patients with LVSD (LVEF ≤50%). Improved LVEF more then 5% at 1-year after CA was classified as “responder” to CA. We analyzed clinical variables and echocardiographic parameters before and after the CAs.
Results
In the responder group, LVEF was significantly improved 1-year after catheter ablation compared with the non-responder group. (ΔLVEF 22±12% vs. −1±4%, p<0.001). The responder group was significantly younger, had more non-paroxysmal AF, smaller LV systolic diameter and lower plasma BNP level before CA (Table). Late gadolinium enhancement (LGE)-positive rate in cardiovascular magnetic resonance imaging (CMR) before CA was higher in the non-responder group than in the responder group (100% [6/6] vs. 38% [5/13], p<0.005). After CAs of AF, event-free survival from hospitalization for heart failure was significantly higher in the responder group (Figure) with less AF recurrence (27% vs. 47%, p=0.04) than in the non-responder group.
Baseline characteristics Responder (N=35) Non-Responder (N=16) P value Age, y 62±11 69±8 p<0.01 Male, n (%) 26 (74) 13 (76) NS Non-pAF 26 (74) 4 (24) p<0.01 LAD, mm 48±7 48±8 NS LAVI, ml/m2 54±17 58±20 NS LVDd, mm 54±7 58±10 NS LVDs, mm 43±7 48±10 p=0.05 EF, % 37±8 38±8 NS BNP (pg/ml) 278±225 684±848 p<0.05
Conclusion
Younger age, absence of LV dilatation, lower plasma BNP, or absence of LGE may well predict favorable clinical outcomes after CA in patients with LVSD.
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Affiliation(s)
- K Nagaoka
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - Y Mukai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Kawai
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Takase
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - K Sakamoto
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Inoue
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - S Ikeda
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
| | - H Tsutsui
- Kyushu University Graduate School of Medical Sciences, Department of Cardiovascular Medicine, Fukuoka, Japan
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Biswas K, Mizutani Y, Takayama S, Ishitsuka A, Iddamalgoda A, Takahashi A, Yang L, Yang F, Katayama I, Inoue S. 549 Disappearance of keratinocyte expression of Glycoprotein Non-metastatic B (GPNMB) / Osteoactivin in vitiligo – possible involvement of Th1/Th 17 cytokines. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Nakata Y, Furuya S, Shimizu H, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kawaida H, Inoue S, Kono H, Ichikawa D. MON-PO416: Effects of Preoperative Skeletal Muscle Mass and Neutrophil Lymphocyte Ratio on the Prognosis of Stage II and III Colorectal Cancer. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32249-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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47
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Wang Q, Yang L, Biswas K, Iddamalgoda A, Guo J, Kuroda Y, Murase D, Inoue S, Tsuruta D, Katayama I. 545 Keratinocyte-derived glycoprotein non-metastatic melanoma protein B protects melanocytes from oxidative stress in a CD44-independent manner. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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48
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Furuya S, Ashizawa N, Nakata Y, Shimizu H, Akaike H, Hosomura N, Kawaguchi Y, Amemiya H, Sudo M, Kawaida H, Inoue S, Kono H, Ichikawa D. MON-PO398: Examination of Immune-Nutritional Index Before and After Surgery and Prognosis for Colon Cancer Patients: Possibility to Nutritional Precision Medicine. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32231-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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49
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Uchida M, Hada M, Yamada M, Inma D, Ariyoshi S, Aoki K, Inoue S, Shimazoe T, Mitsuiki K, Haraguchi T. Impact of a systematic education model for palliative care in cancer. Pharmazie 2019; 74:499-504. [PMID: 31526444 DOI: 10.1691/ph.2019.9417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In clinical practice, pharmacists are continually required to improve their knowledge and expertise; however, the postgraduate education system for professional development cannot be confidently stated to be well established. The establishment of a systematic and multifaceted educational curriculum should be useful to improve home care and pharmacists' contribution; therefore, we developed a curriculum in collaboration with the university faculty of pharmaceutical sciences, department of pharmacy in hospital, and the Fukuoka Pharmaceutical Association. Class topics were extracted from the "Kanwa-Iryou-Yakugaku", edited by the Japanese Society for Pharmaceutical Palliative Care and Sciences. The items are necessary to perform palliative care as a pharmacist. A class schedule of 6 days (24 classes in total) was formulated. Questionnaires on comprehension degree before and after each class were provided to the participants. Comprehension was assessed on a scale of 1 to 10, where "I do not understand at all" was 1 and "I understand enough" was 10. The average recovery rates of questionnaires from each class were 92.6 % and 88.9 % before and after class, respectively. The average number of participants who completely answered the questionnaire before and after class was 45.6; therefore, these data were analyzed. Comprehension degree on each topic had significantly increased after attendance of all classes (p < 0.01). The comprehension degree of participants of the medical science of palliative care did greatly improve. Consequently, it is clear that the standard education model constructed was meaningful for the professional development of pharmacists in palliative care medicine.
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Tanaka K, Tachi T, Hori A, Osawa T, Nagaya K, Makino T, Inoue S, Yasuda M, Mizui T, Nakada T, Goto C, Teramachi H. Cost utility analysis of pharmacist counseling care for breast cancer chemotherapy outpatients. Pharmazie 2019; 74:439-442. [PMID: 31288902 DOI: 10.1691/ph.2019.9327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Chemotherapy for cancer is increasingly implemented in the outpatient setting. Pharmacists contribute to cancer treatment by conducting counseling during outpatient chemotherapy visits. They provide guidance on drug treatment, side effects, and side effect countermeasures on every visit. However, there have been few economic evaluations of pharmacist involvement in outpatient chemotherapy. Therefore, we performed a cost utility analysis. We assigned usual care (control) and pharmacist counseling to two groups of 19 patients receiving outpatient chemotherapy for breast cancer at Gifu Municipal hospital. Quality of life was measured at three timepoints before and during chemotherapy treatment using the EuroQol 5 dimension instrument (EQ-5D). EQ-5D values across the timepoints were 0.831, 0.757, and 0.791 for the control group, and 0.882, 0.883, and 0.921 for the pharmacist counseling group. The additional cost in the pharmacist counseling group was 2,227 yen per counseling session. The change in quality-adjusted life years (QALY) was a maximum of -0.021±0.186 in the control group and 0.007±0.199 in the pharmacist counseling group. The maximum cost for one QALY was 1,360,558 yen (≈12,460 US dollars). Pharmacists' counseling in outpatient cancer chemotherapy for breast cancer patients had an acceptable incremental cost-effect ratio, contributing to improved patient quality of life without significant additional expenditure to healthcare.
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