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Suzuki K, Aoki K, Sato E, Yamashina Y, Ishida A, Yagi T. Narrow QRS tachycardia in a patient with recurrence years after "rightward inferior extension" ablation: What is the mechanism? Pacing Clin Electrophysiol 2024. [PMID: 38761057 DOI: 10.1111/pace.15002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/20/2024]
Affiliation(s)
- Keisuke Suzuki
- Department of Cardiovascular Medicine, Sendai City Hospital, Sendai, Japan
| | - Kosuke Aoki
- Department of Cardiovascular Medicine, Sendai City Hospital, Sendai, Japan
| | - Eiji Sato
- Department of Cardiovascular Medicine, Sendai City Hospital, Sendai, Japan
| | | | - Akihiko Ishida
- Department of Cardiovascular Medicine, Sendai City Hospital, Sendai, Japan
| | - Tetsuo Yagi
- Department of Cardiovascular Medicine, Sendai City Hospital, Sendai, Japan
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Fukushima Y, Suzuki K, Kim M, Gu W, Yokoo S, Tsushima Y. Evaluation of bone marrow invasion on the machine learning of 18 F-FDG PET texture analysis in lower gingival squamous cell carcinoma. Nucl Med Commun 2024; 45:406-411. [PMID: 38372047 DOI: 10.1097/mnm.0000000000001826] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVES Lower gingival squamous cell carcinoma (LGSCC) has the potential to invade the alveolar bone. Traditionally, the diagnosis of LGSCC relied on morphological imaging, but inconsistencies between these assessments and surgical findings have been observed. This study aimed to assess the correlation between LGSCC bone marrow invasion and PET texture features and to enhance diagnostic accuracy by using machine learning. METHODS A retrospective analysis of 159 LGSCC patients with pretreatment 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) examination from 2009 to 2017 was performed. We extracted radiomic features from the PET images, focusing on pathologic bone marrow invasion detection. Extracted features underwent the least absolute shrinkage and selection operator algorithm-based selection and were then used for machine learning via the XGBoost package to distinguish bone marrow invasion presence. Receiver operating characteristic curve analysis was performed. RESULTS From the 159 patients, 88 qualified for further analysis (59 men; average age, 69.2 years), and pathologic bone marrow invasion was identified in 69 (78%) of these patients. Three significant radiological features were identified: Gray level co-occurrence matrix_Correlation, INTENSITY-BASED_IntensityInterquartileRange, and MORPHOLOGICAL_SurfaceToVolumeRatio. An XGBoost machine-learning model, using PET radiomic features to detect bone marrow invasion, yielded an area under the curve value of 0.83. CONCLUSION Our findings highlighted the potential of 18 F-FDG PET radiomic features, combined with machine learning, as a promising avenue for improving LGSCC diagnosis and treatment. Using 18 F-FDG PET texture features may provide a robust and accurate method for determining the presence or absence of bone marrow invasion in LGSCC patients.
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Affiliation(s)
| | - Keisuke Suzuki
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma,
| | - Mai Kim
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma,
| | - Wenchao Gu
- Department of Diagnostic and Interventional Radiology, University of Tsukuba, Tennodai, Tsukuba, Ibaraki and
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Showa, Maebashi, Gunma, Japan
| | - Satoshi Yokoo
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma,
| | - Yoshito Tsushima
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Showa, Maebashi, Gunma, Japan
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Suzuki K, Suzuki S, Fujita H, Sakuramoto H, Shioda M, Hirata K. Can calcitonin gene-related peptide monoclonal antibodies ameliorate writer's cramp and migraine? Neuropsychopharmacol Rep 2024. [PMID: 38602109 DOI: 10.1002/npr2.12444] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024] Open
Abstract
Recently, calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) have become available as a prophylactic treatment for migraine and have shown high efficacy and safety in clinical practice. CGRP mAbs have been reported to be effective not only for migraine but also for other comorbidities, such as psychiatric complications in patients with migraine. However, there are no reports examining the effect of CGRP mAbs on dystonia. We treated a patient with comorbid migraine and focal task-specific dystonia (writer's cramp) with a CGRP mAb (erenumab) because of an increase in monthly migraine days despite the addition of migraine prophylaxis. In this patient, erenumab treatment for 3 months led to improvements in symptoms of both focal dystonia and migraine, suggesting a role for CGRP in the pathophysiology of both conditions.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | | | - Mukuto Shioda
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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Imai H, Kijima T, Azuma K, Kishi K, Saito H, Yamaguchi T, Tanizaki J, Yoneshima Y, Fujita K, Watanabe S, Kitazono S, Fukuhara T, Hataji O, Toi Y, Mizutani H, Hamakawa Y, Maemondo M, Ohsugi T, Suzuki K, Horinouchi H, Ohe Y. First-line nivolumab plus ipilimumab with or without chemotherapy for Japanese patients with non-small cell lung cancer: LIGHT-NING study. Jpn J Clin Oncol 2024; 54:452-462. [PMID: 38271158 PMCID: PMC10999773 DOI: 10.1093/jjco/hyad195] [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] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE As first-line treatment for stage IV or recurrent non-small cell lung cancer, combination immunotherapy with nivolumab and ipilimumab, with or without chemotherapy, had demonstrated survival benefits over chemotherapy; however, data on Japanese patients are limited. METHODS LIGHT-NING was a multicenter, observational study and retrospectively collected data. In this interim analysis, we analyzed patients who received combination immunotherapy between 27 November 2020 and 31 August 2021 for the treatment status, safety objectives (treatment-related adverse events and immune-related adverse events incidences), and effectiveness objectives (objective response rate and progression-free survival) to determine the characteristics and early safety information. RESULTS We analyzed 353 patients, with a median follow-up of 7.1 (interquartile range, 5.0-9.7) months. Overall, 60.1 and 39.9% received nivolumab plus ipilimumab with and without chemotherapy, respectively. In these cohorts, the median age was 67 and 72 years; 10.8 and 35.5% were aged ≥75 years; 80.2 and 79.4% were male; 5.2 and 13.5% had a performance score ≥ 2; 32.1 and 27.0% developed grade 3-4 immune-related adverse events; treatment-related deaths were observed in 6 (2.8%) and 5 (3.5%) patients, respectively. Grade 3-4 immune-related adverse event incidence was the highest within the first month of treatment in both cohorts, although the immune-related adverse event risk persisted throughout. No new safety signals were observed at this interim analysis. The median progression-free survival was 6.0 (95% confidence interval, 5.2-7.6) and 5.8 (4.3-7.0) months in nivolumab plus ipilimumab with and without chemotherapy cohorts, respectively. CONCLUSIONS LIGHT-NING offers valuable insights into combination immunotherapy for untreated patients with stage IV or recurrent non-small cell lung cancer in Japanese real-world settings.
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Affiliation(s)
- Hisao Imai
- Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Takashi Kijima
- Department of Respiratory Medicine and Hematology, Hyogo Medical University, School of Medicine, Nishinomiya, Hyogo, Japan
| | - Koichi Azuma
- Division of Respirology, Neurology and Rheumatology, Department of Internal Medicine, Kurume University, School of Medicine, Fukuoka, Japan
| | - Kazuma Kishi
- Department of Respiratory Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Haruhiro Saito
- Department of Thoracic Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Teppei Yamaguchi
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Junko Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasuto Yoneshima
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kohei Fujita
- Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Satoru Kitazono
- Department of Thoracic Medical Oncology, the Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tatsuro Fukuhara
- Department of Respiratory Medicine, Miyagi Cancer Center, Miyagi, Japan
| | - Osamu Hataji
- Respiratory Center, Matsusaka Municipal Hospital, Mie, Japan
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Hideaki Mizutani
- Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan
| | - Yusuke Hamakawa
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan
| | - Makoto Maemondo
- Division of Pulmonary Medicine, Department of Internal Medicine, Iwate Medical University School of Medicine, Iwate, Japan
| | | | - Keisuke Suzuki
- Oncology Medical Affairs, Ono Pharmaceutical Co, Ltd, Osaka, Japan
| | - Hidehito Horinouchi
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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Ayano M, Tsubouchi K, Suzuki K, Kimoto Y, Arinobu Y, Akashi K, Horiuchi T, Okamoto I, Niiro H. Comparing the safety and efficacy of nintedanib starting dose in patients with connective tissue disease-associated interstitial lung diseases. Scand J Rheumatol 2024:1-8. [PMID: 38563202 DOI: 10.1080/03009742.2024.2327159] [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] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This study aimed to analyse whether initiating nintedanib treatment at a reduced dose could improve the treatment continuation rate while maintaining efficacy in patients with connective tissue disease (CTD)-associated interstitial lung disease. METHOD In total, 51 patients (age 61.6 ± 13.2 years; 38 women, 13 men) were retrospectively analysed. The primary endpoint was the cumulative discontinuation rate due to adverse events. Secondary endpoints included changes in drug dosage, efficacy evaluated based on annual changes in forced vital capacity (FVC), and safety assessed based on the frequency of adverse events. RESULTS Eighteen patients who started treatment at the standard dose of 300 mg (standard dosage group) were compared with 33 patients who started treatment at a reduced dose (reduced dosage group). Systemic sclerosis was the most common CTD (n = 32), followed by idiopathic inflammatory myopathies and, rarely, rheumatoid arthritis. Both groups exhibited comparable cumulative discontinuation rates due to adverse events and similar frequencies of adverse events. No significant differences were observed in maintenance doses between the two groups; however, patients in the reduced dosage group had a lower cumulative dose for up to 52 weeks than those in the standard dosage group. No significant differences were observed in changes in FVC between the two groups. CONCLUSION There was no evidence for a difference between the two groups in terms of discontinuation rates, efficacy, and safety. To provide further evidence, future studies using more precise dose-escalation protocols are warranted.
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Affiliation(s)
- M Ayano
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Tsubouchi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Suzuki
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Kimoto
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Arinobu
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Akashi
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Horiuchi
- Department of Internal Medicine, Kyushu University Beppu Hospital, Beppu, Japan
| | - I Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Niiro
- Department of Medical Education, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tsukui D, Takekawa H, Saito K, Okabe R, Tanaka A, Kobayasi S, Igarasi H, Suzuki K, Hamaguchi H. Usefulness of "AcT ratio" in diagnosis of internal carotid artery stenosis: a multicenter, retrospective, observational study. J Med Ultrason (2001) 2024; 51:347-353. [PMID: 38581557 PMCID: PMC11098927 DOI: 10.1007/s10396-024-01409-z] [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] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/14/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE The ratio of the internal carotid artery (ICA) to the common carotid artery (CCA), especially the "AcT ratio," which is a modified measurement method of acceleration time, is useful for diagnosing ICA-origin stenosis. However, previous studies were single-center studies. Therefore, this multicenter, retrospective, cross-sectional study aimed to determine whether a method using the AcT ratio is useful for estimating stenosis rates. METHODS This study included 461 vessels subjected to carotid artery ultrasonography and evaluation for ICA-origin stenosis via NASCET at four hospitals. The duration from the steep rise point to the inflection point or the first peak was defined as AcT on pulsed wave Doppler. The AcT ratio was calculated as AcT of ICA/AcT of ipsilateral CCA. The AcT ratio and rate of ICA-origin stenosis were analyzed using Pearson's correlation coefficient, simple regression analysis, and ROC curve. RESULTS A significant positive correlation was observed between the AcT ratio and NASCET stenosis. NASCET stenosis of ≥ 50% had a sensitivity, specificity, and negative predictive value (NPV) of 70.2%, 71.6%, and 91.5%, respectively, when the cut-off value of the AcT ratio was 1.17. NASCET stenosis of ≥ 70% had a sensitivity, specificity, and NPV of 70.5%, 72.1%, and 95.9%, respectively, when the cut-off value of the AcT ratio was 1.22. CONCLUSIONS The findings of this multicenter, retrospective, cross-sectional study suggest that the AcT ratio is useful for diagnosing ICA-origin stenosis, especially for diagnosis by exclusion. NASCET stenosis of ≥ 50% was considered unlikely if the Act ratio was ≤ 1.17, whereas NASCET stenosis of ≥ 70% was considered unlikely if it was ≤ 1.22.
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Affiliation(s)
- Daisuke Tsukui
- Stroke Center, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Hidehiro Takekawa
- Stroke Center, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan.
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
- Center of Medical Ultrasonics, Dokkyo Medical University, Tochigi, Japan.
| | - Kozue Saito
- Department of Neurology, Nara Medical University, Nara, Japan
| | - Ryuta Okabe
- Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
- Department of Cardiology, Akiru Municipal Medical Center, Tokyo, Japan
| | - Akito Tanaka
- Department of Neurology, Nara Medical University, Nara, Japan
| | - Saro Kobayasi
- Stroke Center, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Haruki Igarasi
- Stroke Center, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga, Mibu, Tochigi, 321-0293, Japan
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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Hatano T, Sengoku R, Nagayama H, Yanagisawa N, Yoritaka A, Suzuki K, Nishikawa N, Mukai Y, Nomura K, Yoshida N, Seki M, Matsukawa MK, Terashi H, Kimura K, Tashiro J, Hirano S, Murakami H, Joki H, Uchiyama T, Shimura H, Ogaki K, Fukae J, Tsuboi Y, Takahashi K, Yamamoto T, Kaida K, Ihara R, Kanemaru K, Kano O. Impact of Istradefylline on Levodopa Dose Escalation in Parkinson's Disease: ISTRA ADJUST PD Study, a Multicenter, Open-Label, Randomized, Parallel-Group Controlled Study. Neurol Ther 2024; 13:323-338. [PMID: 38227133 PMCID: PMC10951171 DOI: 10.1007/s40120-023-00574-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION A higher levodopa dose is a risk factor for motor complications in Parkinson's disease (PD). Istradefylline (IST) is used as adjunctive treatment to levodopa in PD patients with off episodes, but its impact on levodopa dose titration remains unclear. The objective of this study was to investigate the effect of IST on levodopa dose escalation in PD patients with wearing-off. METHODS This was a multicenter, open-label, randomized, parallel-group controlled study (ISTRA ADJUST PD) in which PD patients experiencing wearing-off (n = 114) who were receiving levodopa 300-400 mg/day were randomized to receive IST or no IST (control). Levodopa dose was escalated according to clinical severity. The primary endpoint was cumulative additional levodopa dose, and secondary endpoints were changes in symptom rating scales, motor activity determined by a wearable device, and safety outcomes. RESULTS The cumulative additional levodopa dose throughout 37 weeks and dose increase over 36 weeks were significantly lower in the IST group than in the control group (both p < 0.0001). The Movement Disorder Society Unified Parkinson's Disease Rating Scale Part I and device-evaluated motor activities improved significantly from baseline to 36 weeks in the IST group only (all p < 0.05). Other secondary endpoints were comparable between the groups. Adverse drug reactions (ADRs) occurred in 28.8% and 13.2% of patients in the IST and control groups, respectively, with no serious ADRs in either group. CONCLUSION IST treatment reduced levodopa dose escalation in PD patients, resulting in less cumulative levodopa use. Adjunctive IST may improve motor function more objectively than increased levodopa dose in patients with PD. TRIAL REGISTRATION Japan Registry of Clinical Trials: jRCTs031180248.
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Affiliation(s)
- Taku Hatano
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Renpei Sengoku
- Department of Neurology, Daisan Hospital, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Naotake Yanagisawa
- Medical Technology Innovation Center, Juntendo University and Juntendo Clinical Research and Trial Center, Tokyo, Japan
| | - Asako Yoritaka
- Department of Neurology, Juntendo University Koshigaya Hospital, Saitama, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University Hospital, Tochigi, Japan
| | - Noriko Nishikawa
- Department of Neurology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yohei Mukai
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kyoichi Nomura
- Department of Neurology, Higashimatsuyama Municipal Hospital, Saitama, Japan
| | - Norihito Yoshida
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Miho Kawabe Matsukawa
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hiroo Terashi
- Department of Neurology, Tokyo Medical University, Tokyo, Japan
| | - Katsuo Kimura
- Department of Neurology, Yokohama City University Medical Center, Yokohama, Japan
| | - Jun Tashiro
- Sapporo Parkinson MS Neurological Clinic, Sapporo, Japan
| | - Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hidetomo Murakami
- Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
- Department of Neurology, National Hospital Organization Yokohama Medical Center, Yokohama, Japan
| | - Tsuyoshi Uchiyama
- Department of Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Hideki Shimura
- Department of Neurology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan
- Department of Neurology, Juntendo University Koshigaya Hospital, Koshigaya, Japan
| | - Kotaro Ogaki
- Department of Neurology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Jiro Fukae
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Fukuoka University, Fukuoka, Japan
| | - Kazushi Takahashi
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan
| | | | - Kenichi Kaida
- Department of Neurology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Ryoko Ihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kazutomi Kanemaru
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Osamu Kano
- Department of Neurology, Toho University, Faculty of Medicine, Tokyo, Japan
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Kouzu K, Tsujimoto H, Ishinuki T, Shinji S, Shinkawa H, Tamura K, Uchino M, Ohge H, Shimizu J, Haji S, Mohri Y, Yamashita C, Kitagawa Y, Suzuki K, Kobayashi M, Kobayashi M, Hanai Y, Nobuhara H, Imaoka H, Yoshida M, Mizuguchi T, Mayumi T, Kitagawa Y. The effectiveness of fascial closure with antimicrobial-coated sutures in preventing incisional surgical site infections in gastrointestinal surgery: a systematic review and meta-analysis. J Hosp Infect 2024; 146:174-182. [PMID: 37734678 DOI: 10.1016/j.jhin.2023.09.006] [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] [Received: 06/21/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of the efficacy of fascial closure using antimicrobial-sutures specifically for the prevention of surgical site infections (SSIs) in gastrointestinal surgery, as part of the revision of the SSI prevention guidelines of the Japanese Society of Surgical Infectious Diseases (JSSI). We searched CENTRAL, PubMed and ICHUSHI-Web in May 2023, and included randomized controlled trials (RCTs) comparing antimicrobial-coated and non-coated sutures for fascial closure in gastrointestinal surgery (PROSPERO No. CRD42023430377). Three authors independently screened the RCTs. We assessed the risk of bias and the GRADE criteria for the extracted data. The primary outcome was incisional SSI and the secondary outcomes were abdominal wall dehiscence and the length of postoperative hospital stay. This study was supported partially by the JSSI. A total of 10 RCTs and 5396 patients were included. The use of antimicrobial-coated sutures significantly lowered the risk of incisional SSIs compared with non-coated suture (risk ratio: 0.79, 95% confidence intervals: 0.64-0.98). In subgroup analyses, antimicrobial-coated sutures reduced the risk of SSIs for open surgeries, and when monofilament sutures were used. Antimicrobial-coated sutures did not reduce the incidence of abdominal wall dehiscence and the length of hospital stay compared with non-coated sutures. The certainty of the evidence was rated as moderate according to the GRADE criteria, because of risk of bias. In conclusion, the use of antimicrobial-coated sutures for fascial closure in gastrointestinal surgery is associated with a significantly lower risk of SSI than non-coated sutures.
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Affiliation(s)
- K Kouzu
- Department of Surgery, National Defense Medical College, Japan
| | - H Tsujimoto
- Department of Surgery, National Defense Medical College, Japan.
| | - T Ishinuki
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - S Shinji
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Japan
| | - H Shinkawa
- Department of Hepatobiliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Japan
| | - K Tamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - M Uchino
- Department of Gastroenterological Surgery, Division of Inflammatory Bowel Disease, Hyogo Medical University, Japan
| | - H Ohge
- Department of Infectious Diseases, Hiroshima University Hospital, Japan
| | - J Shimizu
- Department of Surgery, Toyonaka Municipal Hospital, Japan
| | - S Haji
- Department of Surgery, Soseikai General Hospital, Japan
| | - Y Mohri
- Department of Surgery, Mie Prefectural General Medical Center, Japan
| | - C Yamashita
- Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Japan
| | - Y Kitagawa
- Department of Infection Control, National Center for Geriatrics and Gerontology, Japan
| | - K Suzuki
- Department of Infectious Disease Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - M Kobayashi
- Department of Anesthesiology, Hokushinkai Megumino Hospital, Japan
| | - M Kobayashi
- Laboratory of Clinical Pharmacokinetics, School of Pharmacy, Kitasato University, Japan
| | - Y Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Japan
| | - H Nobuhara
- Department of Dentistry, Hiroshima Prefectural Hospital, Japan
| | - H Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Japan
| | - M Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, School of Medicine, Japan
| | - T Mizuguchi
- Department of Nursing, Division of Surgical Science, Sapporo Medical University, Japan
| | - T Mayumi
- Department of Intensive Care Unit, Japan Community Healthcare Organization Chukyo Hospital, Japan
| | - Y Kitagawa
- Keio University, School of Medicine, Japan
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Suzuki K, Mibiki Y, Suzuki M, Nakagata H, Aoki K, Sato E, Yamashina Y, Miyashita T, Ishida A, Yagi T. A case of coronary artery compression syndrome resulting from peri-valvular regurgitation and long-standing atrial fibrillation. J Cardiol Cases 2024; 29:157-160. [PMID: 38646082 PMCID: PMC11031662 DOI: 10.1016/j.jccase.2023.12.003] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 04/23/2024] Open
Abstract
A man in his 70s with a history of mitral valve replacement (MVR) and long-standing persistent atrial fibrillation (AF) presented with effort angina. Coronary angiography revealed severe stenosis of the left main coronary artery (LMCA). As it was an emergent case, PCI (percutaneous coronary intervention) was selected for treatment. Intravascular ultrasonography revealed no atherosclerotic lesions in the LMCA. The LMCA was effectively dilated by the drug-eluting stent. No elevation in intracardiac pressure was observed in cardiac catheterization after PCI. Computed tomography scan indicated potential compression of the LMCA by the surrounding structures. In cases of long-standing persistent AF and an enlarged atrium after MVR, the possibility of LMCA stenosis due to anatomical changes should be considered. Learning Objectives ◾Peri-valvular regurgitation and long-standing persistent atrial fibrillation can potentially cause atrial enlargement.◾Coronary artery stenosis without atherosclerosis can occur due to compression from surrounding structures or shifting of the coronary artery.◾Stent therapy provides a temporary solution and coronary artery bypass grafting or switching should be considered if re-stenosis occurs.
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Affiliation(s)
- Keisuke Suzuki
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Yoshiaki Mibiki
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Mai Suzuki
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Hiroshi Nakagata
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Kosuke Aoki
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Eiji Sato
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | | | | | - Akihiko Ishida
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
| | - Tetsuo Yagi
- Department of Cardiovascular Medicine, Sendai City Hospital, Japan
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Shioda M, Fujita H, Onuma H, Sakuramoto H, Hamaguchi M, Suzuki K. Gait instability, ophthalmoplegia, and chorea with orofacial dyskinesia in a man with anti-Ri antibodies: a case report. Front Neurol 2024; 15:1359781. [PMID: 38572489 PMCID: PMC10987690 DOI: 10.3389/fneur.2024.1359781] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024] Open
Abstract
A 79-year-old man was admitted for 2 weeks of dizziness, followed by diplopia, involuntary movement and progressive gait disturbances. Neurologic examination revealed horizontal and vertical gaze paresis, bilateral choreiform movement with orofacial dyskinesia, and limb/truncal ataxia. MRI revealed fluid-attenuated inversion recovery image-hyperintense signal abnormalities in the dorsal midbrain, pontine and medulla. Within another few days, the patient developed type II acute respiratory failure requiring artificial invasive ventilation. Because autoimmune encephalitis was suspected, he received intravenous immunoglobulin therapy followed by intravenous methylprednisolone, but only his ophthalmoplegia improved minimally. Serological tests were positive for anti-Ri onconeural antibodies. CT-guided mediastinal lymph node biopsy was performed and revealed small cell lung carcinoma. We report the rare manifestation of anti-Ri antibody-associated paraneoplastic neurological syndrome (PNS), and this case can alert us to the importance of respiratory management in this diverse neurologic disease. Furthermore, PNSs positive for anti-Ri antibodies should be added to the list of differential diagnoses of chorea with orofacial dyskinesia.
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Takizawa T, Ihara K, Watanabe N, Takemura R, Takahashi N, Miyazaki N, Shibata M, Suzuki K, Imai N, Suzuki N, Hirata K, Takeshima T, Nakahara J. CGRP-monoclonal antibodies in Japan: insights from an online survey of physician members of the Japanese headache society. J Headache Pain 2024; 25:39. [PMID: 38491415 PMCID: PMC10941476 DOI: 10.1186/s10194-024-01737-y] [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] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/23/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Anti-calcitonin gene-related peptide monoclonal antibodies (CGRPmAbs) have greatly changed migraine treatment options. In Japan, although CGRPmAb guidelines (≥ 4 monthly migraine days (MMDs) and ≥ 1 previous preventive failure) are well-acknowledged, the actual use of CGRPmAbs and the circumstances of the related headache care are unknown. METHODS We conducted an online survey of Japanese Headache Society members, inquiring about the physicians' experience with CGRPmAbs and how they make decisions related to their use. RESULTS Of the 397 respondents, 320 had prescribed CGRPmAbs. The threshold number of previous preventive failures for recommending a CGRPmAb was two for the majority of the respondents (n = 170, 54.5%), followed by one (n = 64, 20.5%). The MMD threshold was ≥ 4 for 71 respondents (22.8%), ≥ 6 for 68 (21.8%), ≥ 8 for 76 (24.4%), and ≥ 10 for 81 (26.0%). The respondents tended to assess treatment efficacy after 3 months (episodic migraine: n = 217, 69.6%, chronic migraine: n = 188, 60.3%). The cost of CGRPmAbs was described by many respondents in two questions: (i) any request for a CGRPmAb (27.7%), and (ii) the most frequently reported reason for responders to discontinue CGRPmAbs (24.4%). CONCLUSIONS Most of the respondents recommended CGRPmAbs to patients with ≥ 2 preventive failures, followed by ≥ 1. The MMD threshold ranged mostly from ≥ 4 to ≥ 10. The concern for costs was raised as a major limiting factor for prescribing CGRPmAbs.
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Affiliation(s)
- Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan.
| | - Keiko Ihara
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan
| | - Narumi Watanabe
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Nobuyuki Takahashi
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoki Miyazaki
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Mamoru Shibata
- Department of Neurology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Noboru Imai
- Department of Neurology and Headache Center, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Norihiro Suzuki
- Department of Neurology, Shonan Keiiku Hospital, Fujisawa, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Takao Takeshima
- Headache Center, Department of Neurology, Tominaga Hospital, Osaka, Japan
- Task Force for the Use of Anti-CGRP Monoclonal Antibodies, The Japanese Headache Society, Tokyo, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Suzuki K, Kai R, Munechika J, Morita K, Makita M, Saeki M, Kanai T, Dohi K, Seino N, Ohgiya Y. Therapeutic challenges in transcatheter arterial embolization for an enlarging subcutaneous hematoma in a patient with neurofibromatosis type 1: A case report. Radiol Case Rep 2024; 19:1211-1214. [PMID: 38259702 PMCID: PMC10801140 DOI: 10.1016/j.radcr.2023.12.012] [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: 10/21/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
A 60-year-old woman with a history of neurofibromatosis type 1, who was admitted with pulmonary hypertension, developed buttock pain and anemia, and contrast-enhanced computed tomography showed a large subcutaneous hematoma with minimal active extravasation. Angiography of the bilateral internal iliac arteries revealed diffuse, irregular blood vessels without extravasation. As the exact bleeding site could not be identified, the patient was managed conservatively. However, the patient's symptoms and anemia worsened the following day. Repeat angiography revealed two pseudoaneurysms in the right inferior gluteal artery, which were embolized using n-butyl-2-cyanoacrylate. Nonetheless, the patient's anemia further worsened the following day. Repeat contrast-enhanced CT revealed another site of extravasation in the enlarging hematoma, but no extravasation was observed on the subsequent angiography. Owing to the worsening anemia and enlarging hematoma, proximal embolization of the irregular bilateral inferior gluteal arteries was performed using gelatin sponge particles. The patient's anemia and symptoms improved. Vasculopathy associated with neurofibromatosis type 1 is rare, with an incidence of approximately 3%. In patients with neurofibromatosis type 1, the blood vessels become fragile because of tunica media thinning and elastic-lamina rupture. Histopathologically, neurofibromatosis type 1-associated vasculopathy is characterized by a mixture of normal and abnormal vessels. Abnormally fragile blood vessels may repeatedly rupture followed by physiological hemostasis, which may explain the diagnostic and therapeutic challenges during angiography in this case. In patients with neurofibromatosis type 1 with acute bleeding, irregular vessels without active extravasation on angiography may be indicated for embolization.
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Affiliation(s)
- Keisuke Suzuki
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Ryozo Kai
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Jiro Munechika
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Koji Morita
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Maya Makita
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Miho Saeki
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Takahiro Kanai
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kenji Dohi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Noritaka Seino
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Radiology, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo 135-8577, Japan
| | - Yoshimitsu Ohgiya
- Department of Radiology, Division of Radiology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
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13
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Ikenouchi H, Suzuki K, Sato A, Yamamoto N, Miyamoto T, Endo K. A case of meningoencephalitis caused by multisystem inflammatory syndrome in adult SARS-CoV-2 infection. J Infect Chemother 2024; 30:263-265. [PMID: 37863259 DOI: 10.1016/j.jiac.2023.10.013] [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] [Received: 07/21/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023]
Abstract
A 37-year-old woman was hospitalized with fever and consciousness disturbance. She showed systemic inflammation with stress cardiomyopathy. Brain computed tomography showed diffuse brain edema. Cerebrospinal fluid (CSF) findings revealed markedly elevated cerebrospinal fluid pressure with pleocytosis, elevated protein, and elevated interleukin 6. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nicking enzyme amplification reaction test using a nasopharyngeal swab was positive, and the patient was diagnosed with SARS-CoV-2 infection. From the negative result of the CSF SARS-CoV-2 polymerase chain reaction test and no findings of bacterial or viral infection, we diagnosed meningoencephalitis by multisystem inflammation syndrome in adults (MIS-A). Intravenous methylprednisolone pulse therapy improved her symptoms and brain edema. There have been no cases of MIS-A with meningoencephalitis, and no initial treatment strategy has been established, especially in emergency cases of suspected MIS-A. The present case suggested Early intravenous methylprednisolone pulse with anti-coronaviral therapies after the exclusion of bacterial infection would be useful in suspected MIS-A with emergent meningoencephalitis cases.
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Affiliation(s)
- Hajime Ikenouchi
- Division of Neurology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan.
| | - Keisuke Suzuki
- Division of Cardiology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan
| | - Ayumi Sato
- Division of Neurology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan
| | - Naoki Yamamoto
- Division of Neurology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan
| | - Tatsuo Miyamoto
- Division of Neurology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan
| | - Kaoru Endo
- Division of Neurology, Sendai City Hospital, 1-1-1 Asuto-Nagamachi, Taihaku-ku, Sendai, 982-8502, Japan
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Suzuki K, Suzuki S, Shiina T, Haruyama Y, Kobayashi S, Shioda M, Hirata K. Real-world effectiveness of erenumab in Japanese patients with migraine. Heliyon 2024; 10:e26568. [PMID: 38420497 PMCID: PMC10900787 DOI: 10.1016/j.heliyon.2024.e26568] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/18/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Background Real-world evidence of erenumab effectiveness in migraine patients in Asia with various comorbidities and multiple previous medication failures is still limited. Methods A 6-month single-center cohort study of 45 patients with episodic or chronic migraine (CM) treated with erenumab was conducted. In the cohort, 60.0% were switching from other calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs), and 66.7% had ≥4 prophylaxis failures. The change in monthly migraine days (MMDs) from baseline and percentages of responders after treatment were calculated. Weekly migraine days (WMDs) were obtained at baseline and at months 1, 2 and 3 and were compared between weeks 2 and 4. Results In total, 36%, 47%, and 63% of patients had a ≥30% response at 1, 3, and 6 months, respectively. The cumulative percentage of patients achieving a ≥30% response over 6 months was 85%. Early responders (average ≥ 30% response at 1-3 months) accounted for 37.8%, 55.6%, and 25.9% of the total, CGRP mAb-naïve, and CGRP mAb-switching groups, respectively. Late responders (average < 30% response at 1-3 months and average ≥ 30% response at 4-6 months) accounted for 46.4%, 37.5%, and 58.8% of nonearly responders in the total, CGRP mAb-naïve, and CGRP mAb-switching groups, respectively. Mild adverse reactions were observed in 5 patients (11.1%). Wearing-off, defined as an increase in the number of WMDs ≥2 between week 2 and week 4, was observed in 2.4-12.5% at months 1-3. Conclusion Erenumab was effective in migraine patients. At least 4-6 months may be preferable for efficacy evaluation in patients switching to erenumab from other CGRP mAbs.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
| | | | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Japan
| | - Saro Kobayashi
- Department of Neurology, Dokkyo Medical University, Japan
| | - Mukuto Shioda
- Department of Neurology, Dokkyo Medical University, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan
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15
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Suzuki K, Suzuki S, Haruyama Y, Funakoshi K, Fujita H, Sakuramoto H, Hamaguchi M, Kobashi G, Hirata K. Associations between the burdens of comorbid sleep problems, central sensitization, and headache-related disability in patients with migraine. Front Neurol 2024; 15:1373574. [PMID: 38601337 PMCID: PMC11006273 DOI: 10.3389/fneur.2024.1373574] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 02/15/2024] [Indexed: 04/12/2024] Open
Abstract
Objective Sleep disturbances are common in migraine patients and affect quality of life. Central sensitization (CS) is likely to play a role in the increased severity and chronicity of migraine. We hypothesized that the number of comorbid sleep problems would affect headache-related disability through the effects of central sensitization (CS). Methods We performed a cross-sectional study including 215 consecutive patients with migraine. Insomnia was defined as a Pittsburgh Sleep Quality Index (PSQI) global score greater than 5. Probable REM sleep behavior disorder (pRBD) was defined as an RBD screening score of 5 or greater. Excessive daytime sleepiness (EDS) was defined as an Epworth Sleepiness Scale score of 10 or higher. Suspected sleep apnea (SA) was defined as patients with snoring or sleep apnea witnessed 3 or more nights a week. CS was assessed by the Central Sensitization Inventory (CSI). Results Restless legs syndrome, insomnia, EDS, SA and pRBD were observed in 25.6%, 71.6%, 34.4%, 10.2%, and 21.4%, respectively, of the patients. At least one sleep problem was present in 87.0% of the patients. According to the results of the multinomial logistic regression analysis with no sleep problems as a reference, after we corrected for adjustment factors, the Migraine Disability Assessment (MIDAS) score significantly increased when three or more comorbid sleep problems were present. According to our mediation analysis, an increased number of sleep problems had a direct effect on the MIDAS score after we adjusted for other variables, and the CSI score was indirectly involved in this association. Conclusion The present study showed an association between migraine-related disability and the burden of multiple sleep problems, which was partially mediated by CS.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Japan
| | - Kei Funakoshi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | | | - Mai Hamaguchi
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Gen Kobashi
- Department of Public Health, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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Fujita H, Ogaki K, Shiina T, Sakuramoto H, Nozawa N, Suzuki K. Impact of autonomic symptoms on the clinical course of Parkinson's disease. Neurol Sci 2024:10.1007/s10072-024-07422-x. [PMID: 38400889 DOI: 10.1007/s10072-024-07422-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE Patients with Parkinson's disease (PD) exhibit various degrees of autonomic symptoms, which may be associated with Lewy body pathology distributed extensively in the autonomic nervous system. We hypothesized that the severity of autonomic symptoms reflects the severity of PD-related pathology, resulting in poor outcomes. The purpose of this study was to evaluate the impact of autonomic symptoms on PD progression. METHODS We conducted a follow-up study among consecutive patients with PD at Dokkyo Medical University Hospital. Patients underwent comprehensive baseline evaluations and were classified into high and low autonomic symptom groups using the Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT). The Kaplan‒Meier survival curves were used to analyze the time to discontinuation of their visits because of PD-related endpoints and to evaluate the association with high SCOPA-AUT scores. RESULTS Of the 101 patients, 74 (73%) met the inclusion criteria. During the follow-up period (mean 1654 days), 22/74 patients reached PD-related endpoints (death, 4; hospitalization, 9; nursing home institutionalization, 9). PD patients with high SCOPA-AUT scores reached the endpoints faster than those with low SCOPA-AUT scores. A high SCOPA-AUT score, including gastrointestinal, urinary, and thermoregulation domains; high motor symptom scores; and low specific binding ratios (SBRs) on 123I FP-CIT-SPECT (DAT-SPECT) were associated with reaching PD-related endpoints. A high SCOPA-AUT score was associated with reaching the endpoints even after adjustment for covariates. CONCLUSIONS Patients with high autonomic symptom scores had a greater risk of reaching PD-related endpoints than patients with low autonomic symptom scores.
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Affiliation(s)
- Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
| | - Keitaro Ogaki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Hirotaka Sakuramoto
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Narihiro Nozawa
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
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Suzuki K, Morishita K, Adachi T, Suekane A, Nakatsutsumi K, Teeratakulpisarn P, Kojima M, Coimbra R, Otomo Y. PROSTAGLANDIN E-MAJOR URINARY METABOLITES AS A NEW BIOMARKER FOR ACUTE MESENTERIC ISCHEMIA. J Trauma Acute Care Surg 2024:01586154-990000000-00633. [PMID: 38315046 DOI: 10.1097/ta.0000000000004267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Acute mesenteric ischemia (AMI) is an emergent vascular disease caused by cessation of the blood supply to the small intestine. Despite advances in the diagnosis, intervention, and surgical procedures, AMI remains a life-threatening condition. Prostaglandin E2 Major Urinary Metabolite (PGE-MUM), the urinary metabolite of Prostaglandin E2, is known to be stable in urine and has been suggested to be a valuable biomarker for intestinal mucosal inflammation, such as ulcerative colitis. We therefore investigated whether or not PGE-MUM levels reflect the degree of ischemia in an intestinal ischemia-reperfusion (IR) model. METHODS Male rats were used to establish a superior mesenteric artery occlusion (SMAO) group, in which the superior mesenteric artery was clamped, and a sham group. The clamping times in the SMAO group were either 30 or 60 min, and reperfusion times were either 3 or 6 h, after which PGE-MUM values were measured. RESULTS The histological injury score of the SMAO (30-min ischemia and 6-h reperfusion group: 1.8 ± 0.4 and 60-min ischemia and 6-h reperfusion group: 4.7 ± 0.5) and were significantly greater than that of the sham group (0.4 ± 0.7, p < 0.05). The PGE-MUM levels in the SMAO group (30-min ischemia and 6-h reperfusion group:483 ± 256 and 60-min ischemia and 6-h reperfusion group:889 ± 402 ng/mL) were significantly higher than in the sham group (30-min and 6-h observation group:51 ± 20, and 60-min and 6-h observation group:73 ± 32 ng/mL p < 0.05). Furthermore, the PGE-MUM value was corrected by the concentration of urinary creatinine (Cr). The PGE-MUM/urinary Cr levels in the SMAO group were also significantly higher than in the sham group (p < 0.05). CONCLUSIONS We found that intestinal IR increased urinary PGE-MUM levels depending on the ischemic time. This suggests the potential utility of PGE-MUM as a noninvasive marker of intestinal ischemia.
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Kobayashi Y, Suzuki K, Tateno M, Nakamura Y, Ishimaru K, Nagasaka Y, Sakurai D, Ohashi-Doi K, Nakao A. Cha o 3, a cypress pollen allergen, does not activate basophils in Japanese cypress pollinosis. J Allergy Clin Immunol Glob 2024; 3:100198. [PMID: 38155861 PMCID: PMC10753085 DOI: 10.1016/j.jacig.2023.100198] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/24/2023] [Accepted: 10/02/2023] [Indexed: 12/30/2023]
Abstract
Background In Japan, pollinosis caused by the Japanese cypress (JCy) Chamaecyparis obtusa is among the very common seasonal allergies. In JCy pollinosis, Cha o 1 is the first major allergen, and Cha o 2 is the second major allergen. Recently, Cha o 3 was identified as a new JCy pollen allergen in JCy pollinosis. However, the relative contribution of Cha o 3 to JCy pollinosis compared with that of Cha o 1 and that of Cha o 2 has not been fully elucidated. Objective This study aimed to clarify the allergenicity of Cha o 3 compared with that of Cha o 1 and Cha o 2 in JCy pollinosis. Methods We recruited 27 patients with JCy pollinosis and performed the basophil activation test (BAT) with native (n) Cha o 1, Cha o 2, and Cha o 3 purified from JCy pollen. In addition, we a performed JCy-specific IgE suppression test. Results In the BAT, 26 of 27 patients (96%) and 18 of 27 patients (67%) showed positive basophil activation in response to n Cha o 1 and n Cha o 2, respectively, as judged by CD203c expression. Little CD203c expression in response to n Cha o 3 was seen. The presence of n Cha o 3 marginally reduced the titer levels of JCy-specific IgE. Conclusion Cha o 3 showed little ability to activate basophils and suppress JCy-specific IgE titers compared with Cha o 1 or Cha o 2 in patients with JCy pollinosis. Thus, Cha o 3 may not be a major allergen in JCy pollinosis.
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Affiliation(s)
- Yoshiaki Kobayashi
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | | | | | - Yuki Nakamura
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kayoko Ishimaru
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Yuka Nagasaka
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Yamanashi, Yamanashi, Japan
| | | | - Atsuhito Nakao
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
- Yamanashi GLIA Center, University of Yamanashi, Yamanashi, Japan
- Atopy Research Center, Juntendo University School of Medicine, Tokyo, Japan
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19
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Nagashima K, Maruyama M, Kaneko Y, Sakai S, Sekihara T, Kawaji T, Iwakawa H, Egami Y, Ota C, Nagase S, Yagi T, Suzuki K, Fukaya H, Nakamura H, Mori H, Ueda A, Soejima K, Watanabe R, Wakamatsu Y, Hirata S, Hirata M, Okumura Y. Systematic observation-based diagnosis of atrioventricular nodal reentrant tachycardia with a bystander concealed nodoventricular pathway. J Arrhythm 2024; 40:131-142. [PMID: 38333409 PMCID: PMC10848616 DOI: 10.1002/joa3.12976] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 02/10/2024] Open
Abstract
Background This study aimed to establish a systematic method for diagnosing atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed nodoventricular pathway (cNVP). Methods We analyzed 13 cases of AVNRT with a bystander cNVP, 11 connected to the slow pathway (cNVP-SP) and two to the fast pathway (cNVP-FP), along with two cases of cNVP-related orthodromic reciprocating tachycardia (ORT). Results The diagnostic process was summarized in three steps. Step 1 was identification of the presence of an accessory pathway by resetting the tachycardia with delay (n = 9) and termination without atrial capture (n = 4) immediately after delivery of a His-refractory premature ventricular contraction (PVC). Step 2 was exclusion of ORT by atrio-His block during the tachycardia (n = 4), disappearance of the reset phenomenon after the early PVC (n = 7), or dissociation of His from the tachycardia during ventricular overdrive pacing (n = 1). Moreover, tachycardia reset/termination without the atrial capture (n = 2/2) 1 cycle after the His-refractory PVC was specifically diagnostic. Exceptionally, the disappearance of the reset phenomenon was also observed in the two cNVP-ORTs. Step 3 was verification of the AVN as the cNVP insertion site, evidenced by an atrial reset/block preceding the His reset/block in fast-slow AVNRT with a cNVP-SP and slow-fast AVNRT with a cNVP-FP or His reset preceding the atrial reset in slow-fast AVNRT with a cNVP-SP. Conclusion AVNRT with a bystander cNVP can be diagnosed in the three steps with few exceptions. Notably, tachycardia reset/termination without atrial capture one cycle after delivery of a His-refractory PVC is specifically diagnostic.
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Affiliation(s)
- Koichi Nagashima
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
| | - Mitsunori Maruyama
- Department of Cardiovascular MedicineNippon Medical School Musashikosugi HospitalKanagawaJapan
| | - Yoshiaki Kaneko
- Department of Cardiovascular MedicineGunma University Graduate School of MedicineGunmaJapan
| | - Satoshi Sakai
- Department of CardiologyNara Prefecture General Medical CenterNaraJapan
| | - Takayuki Sekihara
- Department of Cardiovascular MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Tetsuma Kawaji
- Department of CardiologyMitsubishi Kyoto HospitalKyotoJapan
| | - Hidehiro Iwakawa
- Department of Cardiovascular MedicineAkita University Graduate School of MedicineAkitaJapan
| | | | - Chisato Ota
- Department of Cardiovascular MedicineNational Cerebral and Cardiovascular CenterOsakaJapan
| | - Satoshi Nagase
- Department of Advanced Arrhythmia and Translational Medical ScienceNational Cerebral and Cardiovascular CenterOsakaJapan
| | - Tetsuo Yagi
- Department of CardiologySendai City HospitalMiyagiJapan
| | | | - Hidehira Fukaya
- Department of Cardiovascular MedicineKitasato University School of MedicineKanagawaJapan
| | - Hironori Nakamura
- Department of Cardiovascular MedicineKitasato University School of MedicineKanagawaJapan
| | - Hitoshi Mori
- Department of CardiologySaitama Medical University International Medical CenterSaitamaJapan
| | - Akiko Ueda
- Division of Advance Arrhythmia ManagementKyorin University HospitalTokyoJapan
| | - Kyoko Soejima
- Department of Cardiovascular MedicineKyorin University HospitalTokyoJapan
| | - Ryuta Watanabe
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
| | - Yuji Wakamatsu
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
| | - Shu Hirata
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
| | - Moyuru Hirata
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
| | - Yasuo Okumura
- Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
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20
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Suzuki K, Seth AK, Schwartzman DJ. Modelling phenomenological differences in aetiologically distinct visual hallucinations using deep neural networks. Front Hum Neurosci 2024; 17:1159821. [PMID: 38234594 PMCID: PMC10791985 DOI: 10.3389/fnhum.2023.1159821] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 09/11/2023] [Indexed: 01/19/2024] Open
Abstract
Visual hallucinations (VHs) are perceptions of objects or events in the absence of the sensory stimulation that would normally support such perceptions. Although all VHs share this core characteristic, there are substantial phenomenological differences between VHs that have different aetiologies, such as those arising from Neurodegenerative conditions, visual loss, or psychedelic compounds. Here, we examine the potential mechanistic basis of these differences by leveraging recent advances in visualising the learned representations of a coupled classifier and generative deep neural network-an approach we call 'computational (neuro)phenomenology'. Examining three aetiologically distinct populations in which VHs occur-Neurodegenerative conditions (Parkinson's Disease and Lewy Body Dementia), visual loss (Charles Bonnet Syndrome, CBS), and psychedelics-we identified three dimensions relevant to distinguishing these classes of VHs: realism (veridicality), dependence on sensory input (spontaneity), and complexity. By selectively tuning the parameters of the visualisation algorithm to reflect influence along each of these phenomenological dimensions we were able to generate 'synthetic VHs' that were characteristic of the VHs experienced by each aetiology. We verified the validity of this approach experimentally in two studies that examined the phenomenology of VHs in Neurodegenerative and CBS patients, and in people with recent psychedelic experience. These studies confirmed the existence of phenomenological differences across these three dimensions between groups, and crucially, found that the appropriate synthetic VHs were rated as being representative of each group's hallucinatory phenomenology. Together, our findings highlight the phenomenological diversity of VHs associated with distinct causal factors and demonstrate how a neural network model of visual phenomenology can successfully capture the distinctive visual characteristics of hallucinatory experience.
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Affiliation(s)
- Keisuke Suzuki
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
- Center for Human Nature, Artificial Intelligence and Neuroscience (CHAIN), Hokkaido University, Sapporo, Japan
| | - Anil K. Seth
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
- Program on Brain, Mind, and Consciousness, Canadian Institute for Advanced Research, Toronto, ON, Canada
| | - David J. Schwartzman
- Sussex Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Department of Informatics, University of Sussex, Brighton, United Kingdom
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21
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Miyamoto K, Takayasu H, Katsuki S, Maeda A, Suzuki K, Nakamura M, Hida N, Sambe T, Yagi M, Sasaki J, Hayashi M, Dohi K. Laryngopharyngeal Mucosal Injury Due to Nasogastric Tube Insertion during Cardiopulmonary Resuscitation: A Retrospective Cohort Study. J Clin Med 2024; 13:261. [PMID: 38202269 PMCID: PMC10780124 DOI: 10.3390/jcm13010261] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 12/24/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Patients under cardiopulmonary resuscitation (CPR) are at high risk of aspirating gastric contents. Nasogastric tube insertion (NGTI) after tracheal intubation is usually performed blindly. This sometimes causes laryngopharyngeal mucosal injury (LPMI), leading to severe bleeding. This study clarified the incidence of LPMI due to blind NGTI during CPR. METHODS We retrospectively analyzed 84 patients presenting with cardiopulmonary arrest on arrival, categorized them into a Smooth group (Smooth; blind NGTI was possible within 2 min), and Difficult group (blind NGTI was not possible), and consequently performed video laryngoscope-assisted NGTI. The laryngopharyngeal mucosal condition was recorded using video laryngoscope. Success rates and insertion time for the Smooth group were calculated. Insertion number and LPMI scores were compared between the groups. Each regression line of outcome measurements was obtained using simple regression analysis. We also analyzed the causes of the Difficult group, using recorded video laryngoscope-assisted videos. RESULTS The success rate was 78.6% (66/84). NGTI time was 48.8 ± 4.0 s in the Smooth group. Insertion number and injury scores in the Smooth group were significantly lower than those in the Difficult group. The severity of LPMI increased with NGT insertion time and insertion number. CONCLUSIONS Whenever blind NGTI is difficult, switching to other methods is essential to prevent unnecessary persistence.
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Affiliation(s)
- Kazuyuki Miyamoto
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
- Department of Emergency, Critical care and Disaster Medicine, Showa University Fujigaoka Hospital, Fujigaoka Aoba-ku, Yokohama City 2278501, Japan
| | - Hiromi Takayasu
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
- Department of Emergency, Critical care and Disaster Medicine, Showa University Fujigaoka Hospital, Fujigaoka Aoba-ku, Yokohama City 2278501, Japan
| | - Shino Katsuki
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
- Department of Emergency, Critical care and Disaster Medicine, Showa University Fujigaoka Hospital, Fujigaoka Aoba-ku, Yokohama City 2278501, Japan
| | - Atsuo Maeda
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
- Department of Emergency, Critical care and Disaster Medicine, Showa University Fujigaoka Hospital, Fujigaoka Aoba-ku, Yokohama City 2278501, Japan
| | - Keisuke Suzuki
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
| | - Motoyasu Nakamura
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
| | - Noriko Hida
- Department of Clinical Pharmacy, Division of Clinical Research and Development, School of Pharmacy, Showa University, Kita-karasuyama, Setagaya-ku, Tokyo 1578577, Japan;
| | - Takehiko Sambe
- Department of Pharmacology, Clinical Pharmacology, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan;
| | - Masaharu Yagi
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
| | - Jun Sasaki
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
| | - Munetaka Hayashi
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
- Department of Emergency, Critical care and Disaster Medicine, Showa University Fujigaoka Hospital, Fujigaoka Aoba-ku, Yokohama City 2278501, Japan
| | - Kenji Dohi
- Department of Emergency, Critical care and Disaster Medicine, School of Medicine, Showa University, Hatanodai, Shinagawa-ku, Tokyo 1428666, Japan; (H.T.); (S.K.); (A.M.); (K.S.); (M.N.); (M.Y.); (J.S.); (M.H.); (K.D.)
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22
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Sato K, Niimi Y, Ihara R, Suzuki K, Iwata A, Iwatsubo T. Usability of a Web-Based Registry for Preclinical Alzheimer's Disease: Implications from a Cross-Sectional Online Survey. J Prev Alzheimers Dis 2024; 11:661-671. [PMID: 38706282 DOI: 10.14283/jpad.2024.48] [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: 05/07/2024]
Abstract
BACKGROUND We have been conducting a Japanese trial-ready cohort web study since 2019 as a web-based online registry to enroll individuals with preclinical Alzheimer's disease to facilitate trials on Alzheimer's disease prevention. The usability of a website might be an important factor in determining user participation and retention. OBJECTIVES We conducted a user questionnaire survey to analyze the usability of the Japanese trial-ready cohort website and user characteristics for future website improvement. DESIGN This was a cross-sectional prospective observational study. SETTING Online survey using Google Forms. PARTICIPANTS Among the Japanese trial-ready cohort web study participants, we enrolled those who provided consent to participate in the study and had completed one or more Cognitive Function Instrument tests before May 2, 2023. We sent an invitation e-mail, including the questionnaire web address, to eligible participants on July 21 and 22, 2023. MEASUREMENTS We analyzed the questionnaire answers, including the system usability scale score and time of response (in 24 h). We also compared the respondents' characteristics with that of all the Japanese trial-ready cohort web study participants to identify features associated with an increased/decreased response rate to the questionnaire. RESULTS Among the 10,112 Japanese trial-ready cohort web study participants that we sent invitation e-mails, we received 1,574 eligible responses (15.6%) within three weeks of the response acceptance period. The mean system usability scale score was 67.6, and no difference in system usability scale scores was observed in terms of age or sex. Approximately half of the respondents of the Japanese trial-ready cohort web study heard about it online, whereas one-fourth heard about it via newspapers. Contribution to drug development for dementia treatment was the most frequent motivation for participating in the Japanese trial-ready cohort web study (51.5%), followed by participation in the latest research (48.1%), concerns about self-memory (43.4%), and a family history of dementia (34.6%). Female respondents responded approximately 1.5 h later than male respondents. Lastly, those who had participated in the Japanese trial-ready cohort onsite study, were in their 70's, or had a larger number of Cognitive Function Instrument or Cogstate tests completion history were more likely to respond to the current online survey (relative risk of response > 1). CONCLUSIONS We conducted an online survey using Google Forms for participants in the Japanese trial-ready cohort web study to determine the usability. The results of this study might help to improve the user experience of the Japanese trial-ready cohort website itself, increase the web study registrants, maintain user retention, facilitate future online surveys, and serve as a reference for other web-based registries of presymptomatic disease status.
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Affiliation(s)
- K Sato
- Kenichiro Sato and Takeshi Iwatsubo, Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan, 113-8655, E-mail: ; , Phone: +81-03-3815-5411
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23
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Suzuki K. Link between insomnia, cognitive impairment and stroke. Sleep Biol Rhythms 2024; 22:3-4. [PMID: 38476854 PMCID: PMC10899993 DOI: 10.1007/s41105-023-00501-0] [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: 03/14/2024]
Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293 Japan
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24
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Zhang J, Suzuki K, Ohmori K. Total Syntheses of Sparsomycin and Sparoxomycins A 1 and A 2 via Sulfenate-Anion-Mediated Iterative C-S Bond Formation. Org Lett 2023; 25:9036-9040. [PMID: 38090756 DOI: 10.1021/acs.orglett.3c03791] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The total synthesis of the pyrimidinylpropenamide antibiotics sparsomycin and sparoxomycins A1 and A2 has been achieved. The synthesis of sparsomycin relies on the iterative nucleophilic attack of sulfenate anions on alkyl halides to construct the dithioacetal monoxide chain with high diastereoselectivity. Subsequently, the reagent-controlled diastereoselective oxidation of the terminal sulfide moiety of sparsomycin directly provides sparoxomycins A1 and A2.
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Affiliation(s)
- Jian Zhang
- Department of Chemistry, Tokyo Institute of Technology, 2-12-1, O-okayama, Meguro-ku, Tokyo 152-8551, Japan
| | - Keisuke Suzuki
- Department of Chemistry, Tokyo Institute of Technology, 2-12-1, O-okayama, Meguro-ku, Tokyo 152-8551, Japan
| | - Ken Ohmori
- Department of Chemistry, Tokyo Institute of Technology, 2-12-1, O-okayama, Meguro-ku, Tokyo 152-8551, Japan
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25
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Suzuki S, Suzuki K, Shiina T, Kobayashi S, Shioda M, Hirata K. Switching from calcitonin gene-related peptide monoclonal antibody monthly to fremanezumab quarterly based on the patient's preferred dosing schedule. J Neurol Sci 2023; 455:122786. [PMID: 37993359 DOI: 10.1016/j.jns.2023.122786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Japan.
| | | | - Saro Kobayashi
- Department of Neurology, Dokkyo Medical University, Japan
| | - Mukuto Shioda
- Department of Neurology, Dokkyo Medical University, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Japan
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26
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Hirata K, Yamamoto Y, Hatanaka K, Kinoshita K, Abiko S, Suzuki K, Tanaka T, Ishibe E, Nakajima K, Naruse H, Umehara M, Tsuruga Y, Nakanishi K, Munakata S, Shimoyama N. Hepatobiliary and pancreatic: Tiny pigmented intra-hepatic ducts stones as the cause of jaundice and liver failure. J Gastroenterol Hepatol 2023; 38:2052. [PMID: 37680105 DOI: 10.1111/jgh.16350] [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] [Received: 05/10/2023] [Revised: 07/26/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023]
Affiliation(s)
- K Hirata
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Kinoshita
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Abiko
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Suzuki
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - T Tanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - E Ishibe
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakajima
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Umehara
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Tsuruga
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakanishi
- Department of Gastroenterological Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Munakata
- Department of Cancer Pathology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Shimoyama
- Department of Cancer Pathology, Hakodate Municipal Hospital, Hakodate, Japan
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27
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Saito S, Suzuki K, Ohtani R, Maki T, Kowa H, Tachibana H, Washida K, Kawabata N, Mizuno T, Kanki R, Sudoh S, Kitaguchi H, Shindo K, Shindo A, Oka N, Yamamoto K, Yasuno F, Kakuta C, Kakuta R, Yamamoto Y, Hattori Y, Takahashi Y, Nakaoku Y, Tonomura S, Oishi N, Aso T, Taguchi A, Kagimura T, Kojima S, Taketsuna M, Tomimoto H, Takahashi R, Fukuyama H, Nagatsuka K, Yamamoto H, Fukushima M, Ihara M. Efficacy and Safety of Cilostazol in Mild Cognitive Impairment: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2344938. [PMID: 38048134 PMCID: PMC10696485 DOI: 10.1001/jamanetworkopen.2023.44938] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/15/2023] [Indexed: 12/05/2023] Open
Abstract
Importance Recent evidence indicates the efficacy of β-amyloid immunotherapy for the treatment of Alzheimer disease, highlighting the need to promote β-amyloid removal from the brain. Cilostazol, a selective type 3 phosphodiesterase inhibitor, promotes such clearance by facilitating intramural periarterial drainage. Objective To determine the safety and efficacy of cilostazol in mild cognitive impairment. Design, Setting, and Participants The COMCID trial (A Trial of Cilostazol for Prevention of Conversion from Mild Cognitive Impairment to Dementia) was an investigator-initiated, double-blind, phase 2 randomized clinical trial. Adult participants were registered between May 25, 2015, and March 31, 2018, and received placebo or cilostazol for up to 96 weeks. Participants were treated in the National Cerebral and Cardiovascular Center and 14 other regional core hospitals in Japan. Patients with mild cognitive impairment with Mini-Mental State Examination (MMSE) scores of 22 to 28 points (on a scale of 0 to 30, with lower scores indicating greater cognitive impairment) and Clinical Dementia Rating scores of 0.5 points (on a scale of 0, 0.5, 1, 2, and 3, with higher scores indicating more severe dementia) were enrolled. The data were analyzed from May 1, 2020, to December 1, 2020. Interventions The participants were treated with placebo, 1 tablet twice daily, or cilostazol, 50 mg twice daily, for up to 96 weeks. Main Outcomes and Measures The primary end point was the change in the total MMSE score from baseline to the final observation. Safety analyses included all adverse events. Results The full analysis set included 159 patients (66 [41.5%] male; mean [SD] age, 75.6 [5.2] years) who received placebo or cilostazol at least once. There was no statistically significant difference between the placebo and cilostazol groups for the primary outcome. The least-squares mean (SE) changes in the MMSE scores among patients receiving placebo were -0.1 (0.3) at the 24-week visit, -0.8 (0.3) at 48 weeks, -1.2 (0.4) at 72 weeks, and -1.3 (0.4) at 96 weeks. Among those receiving cilostazol, the least-squares mean (SE) changes in MMSE scores were -0.6 (0.3) at 24 weeks, -1.0 (0.3) at 48 weeks, -1.1 (0.4) at 72 weeks, and -1.8 (0.4) at 96 weeks. Two patients (2.5%) in the placebo group and 3 patients (3.8%) in the cilostazol group withdrew owing to adverse effects. There was 1 case of subdural hematoma in the cilostazol group, which may have been related to the cilostazol treatment; the patient was successfully treated surgically. Conclusions and Relevance In this randomized clinical trial, cilostazol was well tolerated, although it did not prevent cognitive decline. The efficacy of cilostazol should be tested in future trials. Trial Registration ClinicalTrials.gov Identifier: NCT02491268.
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Affiliation(s)
- Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Keisuke Suzuki
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ryo Ohtani
- Department of Neurology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Takakuni Maki
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hisatomo Kowa
- Division of Neurology, Kobe University Hospital, Kobe, Japan
| | | | - Kazuo Washida
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Toshiki Mizuno
- Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Rie Kanki
- Department of Neurology, Osaka City General Hospital, Osaka, Japan
| | - Shinji Sudoh
- Department of Neurology, National Hospital Organization, Utano National Hospital, Kyoto, Japan
| | - Hiroshi Kitaguchi
- Department of Neurology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Katsuro Shindo
- Department of Neurology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Akihiro Shindo
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Nobuyuki Oka
- Department of Neurology, National Hospital Organization Minami Kyoto Hospital, Joyo, Japan
| | - Keiichi Yamamoto
- Internal Medicine and Neurology, Nara Midori Clinic, Nara, Japan
| | - Fumihiko Yasuno
- Department of Psychiatry, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Chikage Kakuta
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ryosuke Kakuta
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yumi Yamamoto
- Department of Molecular Innovation in Lipidemiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yukako Takahashi
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yuriko Nakaoku
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Tonomura
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoya Oishi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshihiko Aso
- Laboratory for Brain Connectomics Imaging, RIKEN Center for Biosystems Dynamics Research, Kobe, Japan
| | - Akihiko Taguchi
- Department of Regenerative Medicine Research, Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Tatsuo Kagimura
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Shinsuke Kojima
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Masanori Taketsuna
- Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hidenao Fukuyama
- Research and Educational Unit of Leaders for Integrated Medical System, Kyoto University, Kyoto, Japan
| | - Kazuyuki Nagatsuka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Haruko Yamamoto
- Department of Data Science, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Watanabe S, Liu K, Kozu R, Yasumura D, Yamauchi K, Katsukawa H, Suzuki K, Koike T, Morita Y. Association Between Mobilization Level And Activity of Daily Living Independence in Critically Ill Patients. Ann Rehabil Med 2023; 47:519-527. [PMID: 37990499 PMCID: PMC10767217 DOI: 10.5535/arm.23056] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/11/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70. METHODS This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL. RESULTS Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07-1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69). CONCLUSION These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
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Affiliation(s)
- Shinichi Watanabe
- Department of Rehabilitation, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Australia
| | - Ryo Kozu
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Daisetsu Yasumura
- Department of Rehabilitation, Naha City Hospital, Naha, Japan
- Department of Healthcare Administration, The University of Kyushu, Fukuoka, Japan
| | - Kota Yamauchi
- Department of rehabilitation, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | | | - Keisuke Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Takayasu Koike
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Yasunari Morita
- Department of Critical Care Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
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Ogaki K, Fujita H, Nozawa N, Shiina T, Sakuramoto H, Suzuki K. Impact of diabetes and glycated hemoglobin level on the clinical manifestations of Parkinson's disease. J Neurol Sci 2023; 454:120851. [PMID: 37931442 DOI: 10.1016/j.jns.2023.120851] [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] [Received: 08/03/2023] [Revised: 09/21/2023] [Accepted: 10/22/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND The coexistence of diabetes mellitus (DM) has been suggested to accelerate the progression of Parkinson's disease (PD) and make the phenotype more severe. In this study, we investigated whether DM or glycated hemoglobin (HbA1c) levels affect the differences in motor and nonmotor symptoms. METHODS We conducted a cross-sectional study including 140 consecutive Japanese patients with PD for whom medical history and serum HbA1c records were available. The PD patients with a DM diagnosis were classified into the diabetes-complicated group (PD-DM) and the nondiabetes-complicated group (PD-no DM). Next, patients were classified based on a median HbA1c value of 5.7, and clinical parameters were compared. The correlations between HbA1c levels and other clinical variables were analyzed. RESULTS Of 140 patients, 23 patients (16%) had DM. Compared to PD-no DM patients, PD-DM patients showed lower MMSE scores. Compared to the lower HbA1c group, the higher HbA1c group showed a higher MDS-UPDRS part III score and a lower metaiodobenzylguanidine (MIBG) scintigraphy heart-to-mediastinum (H/M) ratio. HbA1c levels were positively correlated with age and the MDS-UPDRS part III score and negatively correlated with the MMSE score and H/M ratio on cardiac MIBG scintigraphy. Binary logistic regression analysis, which included age, sex, disease duration, and MMSE and MDS-UPDRS part III scores as independent variables, revealed that a lower MMSE score was an independent contributor to PD-DM and PD with high HbA1c levels. CONCLUSIONS DM complications and high HbA1c levels may affect cognitive function in patients with PD.
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Affiliation(s)
- Keitaro Ogaki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
| | - Narihiro Nozawa
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | | | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
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Shintani K, Hosomi R, Suzuki K, Hidaka N, Nakagawa K, Kitano T. Diagnostic imaging for elbow TRASH lesions in children and usefulness of ultrasonography using standard planes. J Pediatr Orthop B 2023; 32:557-564. [PMID: 36847196 DOI: 10.1097/bpb.0000000000001062] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Fractures around the elbow in children should be carefully evaluated because the main portion is cartilaginous, and radiographs are not completely reliable. This study aimed to assess the diagnostic imaging for pediatric elbow fractures that require special attention and consider the usefulness of ultrasonography with seven standard planes for the diagnosis. Patients diagnosed with elbow fractures wherein TRASH (The Radiographic Appearance Seemed Harmless) lesions were evaluated retrospectively. The diagnoses on initial radiographs, final diagnoses, additional imaging excluding radiographs, and the treatments were investigated. The standard planes for ultrasonography to detect elbow fractures included an anterior transverse scan at the level of the capitellum and proximal radioulnar joint, an anterior longitudinal scan at the level of the humeroradial and humeroulnar joints, a longitudinal scan along the lateral and medial border of the distal humerus, and a posterior longitudinal scan at the level of the distal humerus. A total of 107 patients with an average age of 5.8 years (range, 0-12 years) at the time of diagnosis were included. Of 46 (43.0%) patients misdiagnosed at the initial radiograph, 19 (17.8%) needed additional treatments due to inappropriate initial management. Ultrasonography using the standard planes was useful for prompt diagnosis and appropriate treatment. Prompt and appropriate evaluation with ultrasonography can prevent the mismanagement of pediatric elbow injuries. Level of evidence: Level IV-retrospective case series.
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Affiliation(s)
- Kosuke Shintani
- Department of Pediatric Orthopaedic Surgery, Children's Medical Center, Osaka City General Hospital, Miyakojimahondori, Miyakojima-ku
- Department of Orthopaedic Surgery, Osaka City Juso Hospital, Nonakakita Yodogawa-ku
| | - Ryo Hosomi
- Department of Pediatric Orthopaedic Surgery, Children's Medical Center, Osaka City General Hospital, Miyakojimahondori, Miyakojima-ku
| | - Keisuke Suzuki
- Department of Orthopaedic Surgery, Miyakojimahondori, Miyakojima-ku
| | - Noriaki Hidaka
- Department of Orthopaedic Surgery, Miyakojimahondori, Miyakojima-ku
| | - Keisuke Nakagawa
- Department of Orthopaedic Surgery, Osaka Metropolitan University Graduate School of Medicine, Asahimachi Abeno-ku, Osaka, Japan
| | - Toshio Kitano
- Department of Pediatric Orthopaedic Surgery, Children's Medical Center, Osaka City General Hospital, Miyakojimahondori, Miyakojima-ku
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Baltieri M, Iizuka H, Witkowski O, Sinapayen L, Suzuki K. Hybrid Life: Integrating biological, artificial, and cognitive systems. Wiley Interdiscip Rev Cogn Sci 2023; 14:e1662. [PMID: 37403661 DOI: 10.1002/wcs.1662] [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] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
Artificial life is a research field studying what processes and properties define life, based on a multidisciplinary approach spanning the physical, natural, and computational sciences. Artificial life aims to foster a comprehensive study of life beyond "life as we know it" and toward "life as it could be," with theoretical, synthetic, and empirical models of the fundamental properties of living systems. While still a relatively young field, artificial life has flourished as an environment for researchers with different backgrounds, welcoming ideas, and contributions from a wide range of subjects. Hybrid Life brings our attention to some of the most recent developments within the artificial life community, rooted in more traditional artificial life studies but looking at new challenges emerging from interactions with other fields. Hybrid Life aims to cover studies that can lead to an understanding, from first principles, of what systems are and how biological and artificial systems can interact and integrate to form new kinds of hybrid (living) systems, individuals, and societies. To do so, it focuses on three complementary perspectives: theories of systems and agents, hybrid augmentation, and hybrid interaction. Theories of systems and agents are used to define systems, how they differ (e.g., biological or artificial, autonomous, or nonautonomous), and how multiple systems relate in order to form new hybrid systems. Hybrid augmentation focuses on implementations of systems so tightly connected that they act as a single, integrated one. Hybrid interaction is centered around interactions within a heterogeneous group of distinct living and nonliving systems. After discussing some of the major sources of inspiration for these themes, we will focus on an overview of the works that appeared in Hybrid Life special sessions, hosted by the annual Artificial Life Conference between 2018 and 2022. This article is categorized under: Neuroscience > Cognition Philosophy > Artificial Intelligence Computer Science and Robotics > Robotics.
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Affiliation(s)
- Manuel Baltieri
- Araya Inc., Tokyo, Japan
- Department of Informatics, University of Sussex, Brighton, UK
| | - Hiroyuki Iizuka
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
- Center for Human Nature, Artificial Intelligence and Neuroscience (CHAIN), Hokkaido University, Sapporo, Japan
| | - Olaf Witkowski
- Center for Human Nature, Artificial Intelligence and Neuroscience (CHAIN), Hokkaido University, Sapporo, Japan
- Cross Labs, Cross Compass, Kyoto, Japan
- College of Arts and Sciences, University of Tokyo, Tokyo, Japan
| | - Lana Sinapayen
- Sony Computer Science Laboratories, Kyoto, Japan
- National Institute for Basic Biology, Okazaki, Japan
| | - Keisuke Suzuki
- Center for Human Nature, Artificial Intelligence and Neuroscience (CHAIN), Hokkaido University, Sapporo, Japan
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Higuchi M, Suzuki K, Kaminishi Y. Acute limb ischemia due to arterial dissection caused by mechanical compression of vascular tissue by the robotic arm during robot-assisted surgery: a case report. QJM 2023; 116:789-791. [PMID: 37225399 DOI: 10.1093/qjmed/hcad105] [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] [Received: 05/19/2023] [Indexed: 05/26/2023] Open
Affiliation(s)
- M Higuchi
- Department of Cardiology, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki Prefecture 311-4145, Japan
| | - K Suzuki
- Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito Ibaraki Prefecture 311-4145, Japan
| | - Y Kaminishi
- Department of Cardiovascular Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito Ibaraki Prefecture 311-4145, Japan
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Suzuki K, Kamo T, Momosaki R, Kimura A, Koike T, Watanabe S, Kondo T. Rehabilitation contributes to lower readmission rates for individuals with peripheral arterial disease: A retrospective observational study. Ann Phys Rehabil Med 2023; 66:101768. [PMID: 37883830 DOI: 10.1016/j.rehab.2023.101768] [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] [Received: 08/03/2022] [Revised: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Non-pharmacological interventions, such as rehabilitation, are crucial for the treatment of people with peripheral arterial disease (PAD). Although several studies have shown rehabilitation is effective in improving the functional prognosis of PAD, there is currently insufficient evidence regarding its effect on readmission rates. OBJECTIVES To examine the impact of rehabilitation on readmission rates for people with PAD. METHODS A retrospective analysis of the JMDC hospital database was performed on data from two groups of people aged ≥20 years who were hospitalized between 2014 and 2020 with PAD, as based on a previous diagnosis. Participants were divided according to whether they did, or did not, receive any form of rehabilitation as part of their treatment in hospital. The primary outcome was readmission rates at 30, 60, 90, and 180 days after initial admission. A one-to-one propensity score matching was used to compare readmission rates between rehabilitation and non-rehabilitation groups. RESULTS We included 13,453 people with PAD, of whom 2701 pairs (5402 subjects) were selected after being matched in the rehabilitation and non-rehabilitation groups. The rehabilitation group participants had significantly lower mortality and readmission rates at 30, 60, 90, and 180 days. The odds ratios (95% confidence interval) for both groups were 0.79 (0.69-0.91; 30 days), 0.81 (0.71-0.91; 60 days), 0.78 (0.69-0.88; 90 days), and 0.79 (0.71-0.88; 180 days). CONCLUSIONS This large, nationwide study found that rehabilitation treatment during hospitalization was associated with lower readmission rates and mortality for people following hospitalization with PAD and supports its inclusion as a standard PAD treatment.
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Affiliation(s)
- Keisuke Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, Gifu, Japan.
| | - Tomohiko Kamo
- Department of Physical Therapy, Faculty of Health Science, Gunma Paz University, Gunma, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan
| | - Akira Kimura
- Department of Physical Therapy, Faculty of Health Science, Gunma Paz University, Gunma, Japan
| | - Takayasu Koike
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, Gifu, Japan
| | - Shinichi Watanabe
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, Gifu, Japan
| | - Takashi Kondo
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Sciences, Gifu, Japan
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Morimoto R, Iijima M, Okuma Y, Suzuki K, Yoshii F, Nogawa S, Osada T, Kitagawa K. Associations between non-motor symptoms and patient characteristics in Parkinson's disease: a multicenter cross-sectional study. Front Aging Neurosci 2023; 15:1252596. [PMID: 37744394 PMCID: PMC10511748 DOI: 10.3389/fnagi.2023.1252596] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Objective Parkinson's disease (PD) is characterized by various non-motor symptoms (NMS), such as constipation, olfactory disturbance, sleep disturbance, mental disorders, and motor symptoms. This study aimed to investigate factors associated with NMS in patients with PD. Methods Symptoms of PD were evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parts I-IV. NMS was assessed using the MDS-UPDRS Part I (self-assessment of NMS) and rapid eye movement sleep behavior disorder (RBD) questionnaires. Patients were categorized by age into <70 years and ≥ 70 years (older adults) groups, according to disease duration into early-stage and advanced-stage groups with a cut-off value of 5 years for motor symptoms, and by sex into male and female groups. Results A total of 431 patients with PD (202 males and 229 females) with a mean age of 67.7 years, a mean disease duration of 6.4 years, and a mean Part I total score of 9.9 participated in this study. The Part I total score was significantly positively correlated (p < 0.01) with disease duration and Part II, III, and IV scores. For Part I sub-item scores, the older group had significantly higher scores for cognitive impairment, hallucinations, sleep problems, urinary problems, and constipation than the <70 years group, whereas the advanced-stage group had significantly higher scores for hallucinations, sleep problems, daytime sleepiness, pain, urinary problems, and constipation (p < 0.05) than the early-stage group. Anxiety was higher in female patients than in male patients, whereas daytime sleepiness, urinary problems, and RBD were higher in male patients than in female patients (p < 0.05). Factors affecting Part I included disease duration, Part II total scores, Part IV total scores, and RBD. Conclusion According to the self-questionnaire assessment, NMS was highly severe in older adult patients, those with longer illness duration, subjective and objective motor function impairments, and RBD. Sex-based differences were also observed.
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Affiliation(s)
- Remi Morimoto
- Department of Neurology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Mutsumi Iijima
- Department of Neurology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Yasuyuki Okuma
- Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Tochigi, Japan
| | - Fumihito Yoshii
- Department of Neurology, Saiseikai Shonan Hiratsuka Hospital, Kanagawa, Japan
| | - Shigeru Nogawa
- Department of Neurology, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Takashi Osada
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kazuo Kitagawa
- Department of Neurology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Suzuki K, Suzuki S, Shiina T, Haruyama Y, Fujita H, Funakoshi K, Hirata K. Could efficacy at 1 week after galcanezumab administration for patients with migraine predict responders at 3 months? A real world study. J Neurol 2023; 270:4377-4384. [PMID: 37219606 DOI: 10.1007/s00415-023-11788-x] [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] [Received: 04/25/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND In real-world studies, it is unclear whether galcanezumab has a significant effect in the first week after administration. METHODS We retrospectively assessed 55 high-frequency episodic migraine (HFEM) and chronic migraine patients who received three galcanezumab doses. Mean changes in the numbers of weekly migraine days (WMDs) during month 1 and migraine days per month (MMDs) after 1-3 months of treatment were obtained. Clinical factors related to a ≥ 50% response rate (RR) at month 3 were analyzed. The prediction of ≥ 50% responders at month 3 using different weekly RRs at week 1 (W1) was evaluated. The RR at W1 was calculated with the following formula: RR (%) = 100 - [(WMDs at W1/baseline WMD) × 100]. RESULTS The number of MMDs significantly improved from baseline to 1, 2 and 3 months. The ≥ 50% RR was 50.9% at 3 months. The number of WMDs decreased significantly from baseline to week 1 (- 1.6 ± 1.7 days), week 2 (- 1.2 ± 1.6 days), week 3 (- 1.0 ± 1.3 days), and week 4 (- 1.1 ± 1.6 days) during month 1. The RR at W1 was largest (44.6 ± 42.2%). The ≥ 30%, ≥ 50% and ≥ 75% RRs at W1 were significantly predictive of a ≥ 50% RR at 3 months. Logistic regression analysis predicting a ≥ 50% RR at month 3 showed that the RR at W1 was the sole contributing factor. CONCLUSION In our study, galcanezumab showed a significant effect in the first week after administration, and the RR at W1 could predict the RR at 3 months.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Kei Funakoshi
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
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Tanaka H, Mizuma K, Nakamura Y, Hirata A, Miyazaki J, Suzuki K, Seta H, Watanabe H, Suzuki T, Watanabe R, Murayama N, Okamura T, Nakamura S. Predicting habitual water intake from lifestyle questions. Eur Rev Med Pharmacol Sci 2023; 27:8829-8841. [PMID: 37782192 DOI: 10.26355/eurrev_202309_33803] [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: 10/03/2023]
Abstract
OBJECTIVE Previous studies have used selective recall and descriptive dietary record methods, requiring considerable effort for assessing food and water intake. This study created a simplified lifestyle questionnaire to predict habitual water intake (SQW), accurately and quickly assessing the habitual water intake. We also evaluated the validity using descriptive dietary records as a cross-sectional study. SUBJECTS AND METHODS First, we used crowdsourcing and machine learning to collect data, predict water intake records, and create questionnaires. We collected 305 lifestyle-related questions as predictor variables and selective recall methods for assessing water intake as an outcome variable. Random forests were used for the machine learning models because of their interpretability and accurate estimation. Random forest and single regression correlation analysis were augmented by the synthetic minority oversampling that trained the model. We separated the data by sex and evaluated our model using unseen hold-out testing data, predicting the individual and overall habitual water intake from various sources, including non-alcoholic beverages, alcohol, and food. RESULTS We found a 0.60 Spearman's correlation coefficient for total water intake between the predicted and the selective recall method values, reflecting the target value to be achieved. This question set was then used for feasibility tests. The descriptive dietary record method helped to obtain a ground-truth value. We categorized the data by gender, season, and source: non-alcoholic beverages, alcohol, food, and total water intake, and the correlation was confirmed. Consequently, our results showed a Pearson's correlation coefficient of 0.50 for total water intake between the predicted and the selective recall method values. CONCLUSIONS We hypothesize that dissemination of SQW can lead to better health management by easily determining the habitual water intake.
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Affiliation(s)
- H Tanaka
- Division of Information Science, Nara Institute of Science and Technology, Ikoma, Nara, Japan.
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Akutsu T, Endo A, Sonobe H, Suzuki K, Murata K, Otomo Y. A case of fulminant myocarditis with full recovery after a 38-h sustained asystole. Clin Case Rep 2023; 11:e7722. [PMID: 37529125 PMCID: PMC10387519 DOI: 10.1002/ccr3.7722] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 07/09/2023] [Indexed: 08/03/2023] Open
Abstract
Key Clinical Message Even if cardiac rhythm deteriorated to asystole in the clinical course of fulminant myocarditis, cardiac function may recover, and the patient may be discharged without brain damage, if circulation could be maintained by appropriate mechanical cardiac supports. Abstract A 69-year-old man was diagnosed with fulminant myocarditis with circulatory collapse. His cardiac rhythm deteriorated to asystole on the second day; however, circulatory status was maintained through extracorporeal membrane oxygenation and intra-aortic balloon pumping. After 38 h-lasting asystole, his heart resumed beating. He was discharged without neurological deficits on Day 25.
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Affiliation(s)
- Tomohiro Akutsu
- Department of Acute Critical Care MedicineTsuchiura Kyodo General HospitalTsuchiuraJapan
- Department of Acute Critical Care MedicineMatsudo General HospitalMatsudoJapan
| | - Akira Endo
- Department of Acute Critical Care MedicineTsuchiura Kyodo General HospitalTsuchiuraJapan
- Department of Acute Critical Care and Disaster MedicineTokyo Medical and Dental University Graduate School of MedicineBunkyo‐kuJapan
| | - Hiroyuki Sonobe
- Department of Acute Critical Care MedicineMatsudo General HospitalMatsudoJapan
| | - Keisuke Suzuki
- Department of Acute Critical Care MedicineTsuchiura Kyodo General HospitalTsuchiuraJapan
| | - Kiyoshi Murata
- Department of Acute Critical Care MedicineMatsudo General HospitalMatsudoJapan
| | - Yasuhiro Otomo
- Department of Acute Critical Care and Disaster MedicineTokyo Medical and Dental University Graduate School of MedicineBunkyo‐kuJapan
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Amadutsumi T, Urashima Y, Urashima K, Suzuki K, Kurachi K, Nishihara M, Neo M, Myotoku M, Kobori T, Obata T. Semisolid Enteral Nutrients Alter the Pharmacokinetics of Orally Administered Levetiracetam in Rats. Pharmazie 2023; 78:117-121. [PMID: 37592422 DOI: 10.1691/ph.2023.3575] [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: 08/19/2023]
Abstract
Enteral nutrients (ENs) affect the plasma drug concentration of orally co-administered drugs, particularly those of antiepileptic drugs, such as phenytoin and carbamazepine. However, few studies have reported the interactions of levetiracetam (LEV), an upcoming antiepileptic drug, with ENs. In this study we aimed to investigate the pharmacokinetics of LEV in 55 rats after oral co-administration of LEV with liquid or semisolid ENs. Compared with the control group, co-administration with Terumeal ® Soft significantly decreased the plasma LEV concentration at 0.5, 1, and 2 h and area under the plasma concentration-time curve from 0 to 3 h (AUC0→3h) (P < 0.01). However, the AUC0→3h of LEV remained unchanged following the administration of Terumeal ® Soft 2 h after the initial LEV administration. Moreover, co-administration with semisolid Racol® NF delayed the absorption of LEV without decreasing the AUC0→3h, whereas liquid Racol ® NF did not alter LEV pharmacokinetics. Thus, co-administration of LEV with Terumeal® Soft reduced the absorption of LEV from the gastrointestinal tract, which was prevented by administering Terumeal ® Soft 2 h after LEV administration. Semisolid Racol ® NF altered LEV pharmacokinetics without decreasing its gastrointestinal absorption. Our findings suggested that careful monitoring of the plasma LEV levels is necessary when co-administering LEV with Terumeal ® Soft, semisolid Racol ® NF, or any other semisolid ENs, to prevent the inadvertent effects of the interaction between LEV and ENs.
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Affiliation(s)
| | - Y Urashima
- Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan Tokio Obata, Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan ,
| | | | | | | | | | | | | | | | - T Obata
- Laboratory of Clinical Pharmaceutics, Faculty of Pharmacy, Osaka Ohtani University, 3-11-1 Nishikiorikita, Tondabayashi, Osaka 584-8540, Japan
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Suzuki K, Sato E, Yamashina Y, Ishida A, Yagi T. A case of retractable helix lead auto-retraction: A possible cause of deep septal lead dislodgement. J Arrhythm 2023; 39:630-633. [PMID: 37560287 PMCID: PMC10407186 DOI: 10.1002/joa3.12891] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 08/11/2023] Open
Abstract
This paper explains the phenomenon where the helix lead automatically retracts because of residual torque during deep septal pacing.
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Affiliation(s)
- Keisuke Suzuki
- Department of Cardiovascular MedicineSendai City HospitalSendaiJapan
| | - Eiji Sato
- Department of Cardiovascular MedicineSendai City HospitalSendaiJapan
| | | | - Akihiko Ishida
- Department of Cardiovascular MedicineSendai City HospitalSendaiJapan
| | - Tetsuo Yagi
- Department of Cardiovascular MedicineSendai City HospitalSendaiJapan
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Watanabe S, Yamauchi K, Yasumura D, Suzuki K, Koike T, Katsukawa H, Morita Y, Scheffenbichler FT, Schaller SJ, Eikermann M. Reliability and Effectiveness of the Japanese Version of the Mobilization Quantification Score. Cureus 2023; 15:e43440. [PMID: 37711928 PMCID: PMC10499052 DOI: 10.7759/cureus.43440] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2023] [Indexed: 09/16/2023] Open
Abstract
Background The mobilization quantification score (MQS) provides an opportunity to quantify the duration and intensity of mobilization therapy in the intensive care unit (ICU) and predict functional outcomes in ICU patients after surgery and stroke. MQS is a numerical measurement of early mobilization dose in the ICU, and its relationship with activities of daily living (ADL) dependence has been shown. We created and validated the Japanese version of the MQS using the endpoint ADL in a mixed population of patients in the ICU. Materials and methods In this prospective study, consecutive patients who were admitted to one of three ICUs of a tertiary care hospital in Japan, aged ≥18 years, and who received mechanical ventilation for >48 hours were enrolled. The Japanese version of the MQS was applied twice daily by an ICU physiotherapist and data recorded for analysis. The primary outcome was ADL dependence at hospital discharge, defined as a Barthel index (BI) of <70 or in-hospital death. The reliability among assessors was verified by calculating the interclass correlation coefficient (ICC) (2.1) for the average daily MQS. We performed a multiple logistic regression analysis to examine and identify a binary cutoff point for high-/low-dose rehabilitation. Results Of the 340 target patients, eight were aged <18 years, 109 had neurological complications, 11 had a BI <70 before admission, 79 had a lack of communication skills, 16 were terminally ill, eight did not complete the assessment during their ICU stay, 18 died in the ICU, and 53 denied consent. After 302 patients were excluded, 38 were included in the study. Six assessors, two at each hospital, measured the MQS in 38 patients. The ICC (2.1) for the MQS mean value was 0.98 (0.96-0.99) during the ICU stay. Logistic regression analysis using the mean MQS on admission to ICUs as an explanatory variable showed a significant association between increased MQS and decreased ADL dependence at discharge (odds ratio (OR): 0.76, confidence interval (CI): 0.61-0.96, adjusted p = 0.009). Logistic regression analysis using a high MQS on admission to ICUs as an explanatory variable showed a significant association between increased MQS and decreased ADL dependence at hospital discharge (OR: 0.14, CI: 0.03-0.66, adjusted p = 0.013). Conclusions We present a validated version of the Japanese MQS with a high inter-rater reliability that predicts ADL dependence at hospital discharge. The instrument can be used in future clinical trials in the ICU to control for the mobilization level in the ICU. The increased utilization of mobilization acutely in the ICU setting as quantified by the MQS may improve patient outcomes.
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Affiliation(s)
- Shinichi Watanabe
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Medical Science, Gifu, JPN
- Department of Rehabilitation Medicine, Nagoya Medical Center, National Hospital Organization, Nagoya, JPN
| | - Kota Yamauchi
- Department of Rehabilitation Medicine, Steel Memorial Yawata Hospital, Kitakyushu, JPN
| | - Daisetsu Yasumura
- Department of Rehabilitation Medicine, Naha City Hospital, Okinawa, JPN
| | - Keisuke Suzuki
- Department of Physical Therapy, Gifu University of Health Science, Gifu, JPN
| | - Takayasu Koike
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, JPN
| | - Hajime Katsukawa
- Physical Medicine and Rehabilitation, Japanese Society for Early Mobilization, Tokyo, JPN
| | - Yasunari Morita
- Department of Emergency Medicine, Nagoya Medical Center, Nagoya, JPN
| | | | - Stefan J Schaller
- Department of Anesthesiology and Intensive Care, Technical University of Munich, Munich, DEU
- Department of Anesthesiology and Operative Intensive Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, DEU
| | - Matthias Eikermann
- Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA
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Inoue G, Ohtaki Y, Satoh K, Odanaka Y, Katoh A, Suzuki K, Tomita Y, Eiraku M, Kikuchi K, Harano K, Yagi M, Uchida N, Dohi K. Sedation Therapy in Intensive Care Units: Harnessing the Power of Antioxidants to Combat Oxidative Stress. Biomedicines 2023; 11:2129. [PMID: 37626626 PMCID: PMC10452444 DOI: 10.3390/biomedicines11082129] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
In critically ill patients requiring intensive care, increased oxidative stress plays an important role in pathogenesis. Sedatives are widely used for sedation in many of these patients. Some sedatives are known antioxidants. However, no studies have evaluated the direct scavenging activity of various sedative agents on different free radicals. This study aimed to determine whether common sedatives (propofol, thiopental, and dexmedetomidine (DEX)) have direct free radical scavenging activity against various free radicals using in vitro electron spin resonance. Superoxide, hydroxyl radical, singlet oxygen, and nitric oxide (NO) direct scavenging activities were measured. All sedatives scavenged different types of free radicals. DEX, a new sedative, also scavenged hydroxyl radicals. Thiopental scavenged all types of free radicals, including NO, whereas propofol did not scavenge superoxide radicals. In this retrospective analysis, we observed changes in oxidative antioxidant markers following the administration of thiopental in patients with severe head trauma. We identified the direct radical-scavenging activity of various sedatives used in clinical settings. Furthermore, we reported a representative case of traumatic brain injury wherein thiopental administration dramatically affected oxidative-stress-related biomarkers. This study suggests that, in the future, sedatives containing thiopental may be redeveloped as an antioxidant therapy through further clinical research.
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Affiliation(s)
- Gen Inoue
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Yuhei Ohtaki
- Department of Emergency Medicine, School of Medicine, The Jikei University, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Kazue Satoh
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Yuki Odanaka
- Center for Instrumental Analysis, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
| | - Akihito Katoh
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Keisuke Suzuki
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Yoshitake Tomita
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Manabu Eiraku
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Kazuki Kikuchi
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Kouhei Harano
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Masaharu Yagi
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
| | - Naoki Uchida
- Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University Karasuyama Hospital, 6-11-11 Kitakarasuyama, Setagaya-ku, Tokyo 157-8577, Japan
| | - Kenji Dohi
- Department of Emergency, Disaster and Critical Care Medicine, School of Medicine, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; (G.I.)
- Department of Emergency Medicine, School of Medicine, The Jikei University, 3-25-8 Nishishinbashi, Minato-ku, Tokyo 105-8461, Japan
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Suzuki K, Komura M, Satake R, Terawaki K, Kodaka T, Gohara T, Yonekawa H. The First Application of Intraumbilical Longitudinal Incision to Pyloromyotomy for Hypertrophic Pyloric Stenosis. Tokai J Exp Clin Med 2023; 48:67-71. [PMID: 37356972] [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] [Received: 01/04/2023] [Accepted: 04/12/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE There are several approaches to pyloromyotomy for the treatment of hypertrophic pyloric stenosis including open transumbilical pyloromyotomy and laparoscopic pyloromyotomy. Beginning in 2012, we adopted intraumbilical longitudinal incision as a new transumbilical approach for pyloromyotomy. We describe details of the operative technique and results of this new approach. METHODS We reviewed records of patients undergoing transumbilical pyloromyotomy from 2005 to 2018. Perioperative outcomes were compared between intraumbilical longitudinal incision and supraumbilical incision, the latter of which is the conventional incision for transumbilical pyloromyotomy. RESULTS Twenty-four patients underwent pyloromyotomy with intraumbilical longitudinal incision (intraumbilical group) and 28 patients with supraumbilical incision (supraumbilical group). The median operative time was longer in the intraumbilical group (58.0 vs. 43.5 min, p = 0.002). However, the time to full feeding did not differ significantly between the two groups, and the median postoperative stay was shorter in the intraumbilical group (3 vs. 5.5 days, p = 0.003). There was no difference in the rate of complications (4.2% vs. 7.1%, p = 1.0). Scars after intraumbilical longitudinal incision were localized inside the umbilicus. CONCLUSION Pyloromyotomy can be performed through intraumbilical longitudinal incision as safely as supraumbilical incision and intraumbilical longitudinal incision may improve cosmetic results. This approach can be an alternative technique for pyloromyotomy.
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Affiliation(s)
| | - Makoto Komura
- Department of Pediatric Surgery, Saitama Medical University, 38 Morohongo, Moroyama-cho, Irumagun, Saitama 350-0495, Japan.
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Suzuki S, Suzuki K, Shiina T, Haruyama Y, Hirata K. Real-world experience with monthly and quarterly dosing of fremanezumab for the treatment of patients with migraine in Japan. Front Neurol 2023; 14:1220285. [PMID: 37483436 PMCID: PMC10359132 DOI: 10.3389/fneur.2023.1220285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Background The effectiveness of fremanezumab in treating migraine has been demonstrated in randomized controlled trials. However, real-world study results are still limited. Methods We conducted a single-center, observational study that included patients with episodic migraine (EM) and chronic migraine (CM) who received fremanezumab monthly or quarterly over 6-month periods. The primary outcome of this study was to evaluate changes in monthly migraine days (MMD) and responder achievement after treatment with fremanezumab. The secondary aim was to characterize the predictors of responder at 6 months. We also evaluated the effectiveness of fremanezumab in the patients who switched from other calcitonin gene-related peptide (CGRP) monoclonal antibodies, and compared the effectiveness of fremanezumab between the monthly and quarterly dosing groups. One hundred twenty-seven patients with migraine (age, 45.2 ± 12.6 years; 96 women) who received at least one dose of fremanezumab with ≥3 months of follow-up were included. The number of MMD was assessed by headache diary. Results The changes in MMD from baseline at 1, 3, and 6 months were -6.1 ± 4.7, -7.7 ± 4.4, and - 8.5 ± 4.5 days in the total cohort, respectively (p < 0.001). The ≥50%, ≥ 75 and 100% responder rates at 6 months were 67.6, 22.5, and 5.4% in the total cohort, 90.4, 36.5, and 9.6% in the EM group, and 52.2, 14.9, and 1.5% in the CM group, respectively. Fremanezumab was also effective in 35 patients who switched from other CGRP monoclonal antibodies. Quarterly and monthly fremanezumab doses were equally effective in MMD reduction in the EM and CM groups. In the CM group, 65.1% experienced remission to EM after 6 months. Adverse reactions were mild and occurred in 9.5% of total patients. An at least ≥50% reduction in MMD from months 1 to 3 better predicted a ≥ 50% reduction in MMD at 6 months with 90.5% sensitivity and 80.6% specificity (p < 0.001). Conclusion In our real-world study, quarterly and monthly fremanezumab dosing showed both favorable effectiveness and tolerability in patients with migraine.
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Affiliation(s)
- Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Tochigi, Japan
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Suzuki K, Miyamoto K, Kanai T, Kurihara M, Kikuchi K, Harano K, Kato A, Yagi M, Ohgiya Y, Dohi K. Single-photon emission computed tomography (SPECT) predicted neurological prognosis in heat stroke: A case report. Heliyon 2023; 9:e18285. [PMID: 37539227 PMCID: PMC10393623 DOI: 10.1016/j.heliyon.2023.e18285] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/29/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Heat stroke may cause multi-organ dysfunction and death. Some patients with neurological abnormalities in the acute phase have neurological sequelae, particularly cerebellar ataxia, in the recovery phase. However, there is no method to predict the neurological prognosis, and the usefulness of imaging has not yet been established. We report the case of an 86-year-old woman with dementia brought to our emergency department in a coma and hyperthermia. The patient was diagnosed with heat stroke and promptly treated in the ICU but remained unconscious. The patient gained consciousness on day 19, but difficulty with stillness associated with cerebellar ataxia in her right upper extremity became apparent. On day 1, head magnetic resonance imaging (MRI) showed no obvious abnormality. However, on day 6, high-signal areas, suggestive of edema, were seen in the bilateral cerebellar hemispheres. Single-photon emission computed tomography (SPECT) on day 9 revealed significant hypoperfusion in the right cerebellum. These changes improved at the time of hospital discharge. This was a case of persistent cerebellar ataxia due to heat stroke, in which imaging findings improved over time. In most cases, MRI findings do not match clinical symptoms. However, the low cerebral blood flow in the early SPECT images was consistent with the clinical symptoms. MRI may not be a prognostic indicator; however, SPECT images may be useful for predicting sequelae.
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Affiliation(s)
- Keisuke Suzuki
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kazuyuki Miyamoto
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Takahiro Kanai
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Mariko Kurihara
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kazuki Kikuchi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kohei Harano
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Akihito Kato
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
- Department of Emergency and Disaster Medicine, Showa University, Yokohama Northern Hospital, 35-1 Chigasaki Chuo Tsuzuki-ku, Yokohama 224-8503, Japan
| | - Masaharu Yagi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Yoshimitsu Ohgiya
- Department of Radiology, Division of Radiology, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kenji Dohi
- Department of Emergency and Disaster Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
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Watanabe S, Iida Y, Hirasawa J, Naito Y, Mizutani M, Uemura A, Nishimura S, Suzuki K, Morita Y. Impact of Extra-Corporeal Membrane Oxygenation and Blood Purification Therapy on Early Mobilization in the Intensive Care Unit: Retrospective Cohort Study. Ann Rehabil Med 2023:arm.22153. [PMID: 37317793 DOI: 10.5535/arm.22153] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 05/15/2023] [Indexed: 06/16/2023] Open
Abstract
Objective To investigate the effect on early mobilization in patients undergoing extra-corporeal membrane oxygenation (ECMO) and acute blood purification therapy in the intensive care unit (ICU). Methods We conducted this multicenter retrospective cohort study by collecting data from six ICUs in Japan. Consecutive patients who were admitted to the ICU, aged ≥18 years, and received mechanical ventilation for >48 hours were eligible. The analyzed were divided into two groups: ECMO/blood purification or control group. Clinical outcomes; time to first mobilization, number of total ICU rehabilitations, mean and highest ICU mobility scale (IMS); and daily barrier changes were also investigated. Results A total of 204 patients were included in the analysis, 43 in the ECMO/blood purification group and 161 in the control group. In comparison of clinical outcome, the ECMO/blood purification group had a significantly longer time to first mobilization: ECMO/blood purification group 6 vs. control group 4 (p=0.003), higher number of total ICU rehabilitations: 6 vs. 5 (p=0.042), lower mean: 0 vs. 1 (p=0.043) and highest IMS: 2 vs. 3 (p=0.039) during ICU stay. Circulatory factor were most frequently described as barriers to early mobilization on days 1 (51%), 2 (47%), and 3 (26%). On days 4 to 7, the most frequently described barrier was consciousness factors (21%, 16%, 19%, and 21%, respectively). Conclusion The results of this study comparing the ECMO/blood purification group and the untreated group in the ICU showed that the ECMO/blood purification group had significantly longer days to mobilization and significantly lower mean and highest IMS.
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Affiliation(s)
- Shinichi Watanabe
- Department of Rehabilitation Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Yuki Iida
- Department of Physical Therapy, School of Health Sciences, Toyohashi Sozo University, Toyohashi, Japan
| | - Jun Hirasawa
- Department of Rehabilitation Medicine, Tosei General Hospital, Seto, Japan
| | - Yuji Naito
- Department of Rehabilitation Medicine, National Hospital Organization, Shizuoka Medical Center, Shizuoka, Japan
| | - Motoki Mizutani
- Department of Rehabilitation Medicine, Ichinomiyanishi Hospital, Ichinomiya, Japan
| | - Akihiro Uemura
- Department of Rehabilitation, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Shogo Nishimura
- Department of Rehabilitation Medicine, Kainan Hospital, Yatomi, Japan
| | - Keisuke Suzuki
- Department of Physical Therapy, Faculty of Rehabilitation, Gifu University of Health Science, Gifu, Japan
| | - Yasunari Morita
- Department of Emergency Medicine, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
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Otani N, Hoshiyama E, Ouchi M, Takekawa H, Suzuki K. Uric acid and neurological disease: a narrative review. Front Neurol 2023; 14:1164756. [PMID: 37333005 PMCID: PMC10268604 DOI: 10.3389/fneur.2023.1164756] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023] Open
Abstract
Hyperuricemia often accompanies hypertension, diabetes, dyslipidemia, metabolic syndrome, and chronic renal disease; it is also closely related to cardiovascular disease. Moreover, several epidemiological studies have linked hyperuricemia and ischemic stroke. However, uric acid may also have neuroprotective effects because of its antioxidant properties. An association between low uric acid levels and neurodegenerative diseases has been suggested, which may be attributed to diminished neuroprotective effects as a result of reduced uric acid. This review will focus on the relationship between uric acid and various neurological diseases including stroke, neuroimmune diseases, and neurodegenerative diseases. When considering both the risk and pathogenesis of neurological diseases, it is important to consider the conflicting dual nature of uric acid as both a vascular risk factor and a neuroprotective factor. This dual nature of uric acid is important because it may help to elucidate the biological role of uric acid in various neurological diseases and provide new insights into the etiology and treatment of these diseases.
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Affiliation(s)
- Naoyuki Otani
- Department of Cardiology, Dokkyo Medical University Nikkyo Medical Center, Mibu, Japan
| | - Eisei Hoshiyama
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Motoshi Ouchi
- Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Hidehiro Takekawa
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
- Stroke Center, Dokkyo Medical University, Mibu, Japan
| | - Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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Suzuki K, Tsuchiya T, Hirata K. [Pharmacological Treatment for Restless Legs Syndrome]. Brain Nerve 2023; 75:557-560. [PMID: 37194531 DOI: 10.11477/mf.1416202378] [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: 05/18/2023]
Abstract
Restless legs syndrome (RLS) is a neurological disorder that causes insomnia and daytime functional disability due to an urge to move the legs usually accompanied by uncomfortable sensations. Non-pharmacologic treatment includes regular sleep habits and exercise. Iron supplementation is indicated for patients with low serum ferritin levels. Antidepressants, antihistaminergics, and dopamine antagonists should be reduced or discontinued because they induce RLS symptoms. Dopamine agonists and alpha 2-delta ligands are the first-line pharmacological treatments for RLS.
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Suzuki K, Suzuki S, Shiina T, Tatsumoto M, Fujita H, Haruyama Y, Hirata K. Effectiveness of three calcitonin gene-related peptide monoclonal antibodies for migraine: A 12-month, single-center, observational real-world study in Japan. Cephalalgia 2023; 43:3331024231177649. [PMID: 37231663 DOI: 10.1177/03331024231177649] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Real-world data on the effectiveness of calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) in migraine patients are needed. METHODS We performed a single-center, real-world study with an observation period of up to 12 months (mean 7.5 ± 3.4 months) after CGRP mAb administration. A total of 228 Japanese patients with episodic or chronic migraine (age, 45.9 ± 13.2 years; 184F; 45 erenumab; 60 galcanezumab; 123 fremanezumab) who were treated with CGRP mAbs for at least three months were ultimately included in this study. RESULTS In the total cohort, after CGRP mAb treatment, mean monthly migraine days decreased by 7.2 ± 4.8, 8.3 ± 4.7, and 9.5 ± 5.0 at three, six and 12 months, respectively. The ≥50% monthly migraine day reduction rates at three, six and 12 months were 48.2%, 61.0% and 73.7%, respectively. In the logistic regression analysis, the presence of osmophobia and fewer baseline monthly migraine days contributed to ≥50% responders at three, six and 12 months. The ≥50% responders at three or six months were useful in predicting ≥50% responders at 12 months. In subgroups of patients with difficult-to-treat migraine (those with medication overuse headache or psychiatric comorbidities) and previous CGRP mAb users, monthly migraine days were substantially reduced over 12 months. There was no difference in monthly migraine day reduction over 12 months among three different CGRP mAbs. Adverse reactions were observed in 28 (12.3%) patients, with injection site reactions being the most common (n = 22) though generally mild in severity. CONCLUSION This real-world study confirmed the efficacy and safety of three different CGRP mAbs for prophylactic treatment of patients with migraine.
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Affiliation(s)
- Keisuke Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Shiho Suzuki
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Tomohiko Shiina
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Muneto Tatsumoto
- Medical Safety Management Center, Dokkyo Medical University Hospital, Mibu, Japan
| | - Hiroaki Fujita
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
| | - Yasuo Haruyama
- Integrated Research Faculty for Advanced Medical Sciences, Dokkyo Medical University, Mibu, Japan
| | - Koichi Hirata
- Department of Neurology, Dokkyo Medical University, Mibu, Japan
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Hattori M, Hiraga K, Satake Y, Tsuboi T, Tamakoshi D, Sato M, Yokoi K, Suzuki K, Arahata Y, Hori A, Kawashima M, Shimizu H, Matsuda H, Kato K, Washimi Y, Katsuno M. Clinico-imaging features of subjects at risk of Lewy body disease in NaT-PROBE baseline analysis. NPJ Parkinsons Dis 2023; 9:67. [PMID: 37100802 PMCID: PMC10133289 DOI: 10.1038/s41531-023-00507-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Individuals with prodromal symptoms of Lewy body disease (LBD), such as rapid eye movement sleep behavior disorder (RBD), often showed imaging defects similar to patients with Parkinson's disease and dementia with Lewy bodies. We examined dopamine transporter (DaT) single-photon-emission computed tomography (SPECT) and metaiodobenzylguanidine (MIBG) scintigraphy in 69 high-risk subjects with ≥2 prodromal symptoms (dysautonomia, hyposmia, and probable RBD) and 32 low-risk subjects without prodromal symptoms, whom were identified through a questionnaire survey of health checkup examinees. The high-risk subjects had significantly worse scores on Stroop test, line orientation test, and the Odor Stick Identification Test for Japanese than the low-risk subjects. The prevalence of abnormalities on DaT-SPECT was higher in the high-risk group than in the low-risk group (24.6% vs. 6.3%, p = 0.030). A decreased uptake on DaT-SPECT was associated with motor impairment, and MIBG scintigraphy defects were associated with hyposmia. The simultaneous evaluation of DaT-SPECT and MIBG scintigraphy may capture a wide range of individuals with prodromal LBD.
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Affiliation(s)
- Makoto Hattori
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keita Hiraga
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuki Satake
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Tsuboi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Daigo Tamakoshi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Maki Sato
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Katsunori Yokoi
- Department of Neurology and Center for Comprehensive Care and Research Center on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Keisuke Suzuki
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Yutaka Arahata
- Department of Neurology and Center for Comprehensive Care and Research Center on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | | | | | | | - Hiroshi Matsuda
- Department of Biofunctional Imaging, Fukushima Medical University, Fukushima, Japan
| | - Katsuhiko Kato
- Functional Medical Imaging, Biomedical Imaging Sciences, Division of Advanced Information Health Sciences, Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukihiko Washimi
- Department of Neurology and Center for Comprehensive Care and Research Center on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
- Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Watanabe S, Hirasawa J, Naito Y, Mizutani M, Uemura A, Nishimura S, Suzuki K, Morita Y, Iida Y. Association Between Intensive Care Unit-Acquired Weakness and Early Nutrition and Rehabilitation Intensity in Mechanically Ventilated Patients: A Multicenter Retrospective Observational Study. Cureus 2023; 15:e37417. [PMID: 37182030 PMCID: PMC10174679 DOI: 10.7759/cureus.37417] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Muscle weakness in the intensive care unit (ICU), referred to as ICU-acquired weakness (ICUAW), is a common complication observed in patients receiving mechanical ventilation. This study aimed to investigate whether rehabilitation intensity and nutrition during ICU admission are associated with the incidence of ICUAW. MATERIALS AND METHODS Consecutive patients aged ≥18 years who were admitted to the ICU between April 2019 and March 2020 and who received mechanical ventilation for >48 h were eligible. The included patients were divided into two groups: the ICUAW group and the non-ICUAW group. ICUAW was designated by a Medical Research Council score of less than 48 during discharge from the ICU. Patient characteristics, time to achieve ICU mobility scale (IMS) 1 and IMS 3, calorie and protein deliveries, and blood creatinine and creatine kinase levels were evaluated as study data. In this study, the target dose for the first week after admission to the ICU at each hospital was set at 60-70% of the energy requirement calculated by the Harris-Benedict formula. Univariate and multivariate analyses were used to determine the odds ratios (OR) for each factor and to explain the risk factors for the occurrence of ICUAW at ICU discharge. RESULTS During the study period, 206 patients were enrolled; 62 of the 143 included patients (43%) had ICUAW. The results of multivariate regression analysis showed that low time to IMS 3 achievement (OR 1.19, 95% confidence interval (CI) 1.01-1.42, p=0.033), and high mean calorie (OR 0.83, 95% CI 0.75-0.93, p<0.001) and protein deliveries (OR 0.27, 95% CI 0.13-0.56, p<0.001) were independently associated with the occurrence of ICUAW. CONCLUSIONS Increase in rehabilitation intensity and mean calorie and protein deliveries were associated with a decrease in the occurrence of ICUAW at ICU discharge. Further research is required to validate our results. Our observations, increasing the intensity of physical rehabilitation and the average calorie and protein delivery levels during ICU stay, appear to be the preferred strategies for achieving non-ICUAW.
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Affiliation(s)
- Shinichi Watanabe
- Department of Physical Therapy, Gifu University of Health Science, Gifu, JPN
| | - Jun Hirasawa
- Department of Rehabilitation Medicine, Tosei General Hospital, Seto, JPN
| | - Yuji Naito
- Department of Rehabilitation Medicine, Shizuoka Medical Center, Shizuoka, JPN
| | - Motoki Mizutani
- Department of Rehabilitation Medicine, Ichinomiya Nishi Hospital, Ichinomiya, JPN
| | - Akihiro Uemura
- Department of Rehabilitation Medicine, Toyohashi Municipal Hospital, Toyohashi, JPN
| | - Shogo Nishimura
- Department of Rehabilitation Medicine, Kainan Hospital, Yatomi, JPN
| | - Keisuke Suzuki
- Department of Physical Therapy, Gifu University of Health Science, Gifu, JPN
| | - Yasunari Morita
- Department of Emergency Medicine, Nagoya Medical Center, Nagoya, JPN
| | - Yuki Iida
- Department of Physical Therapy, Toyohashi Sozo University, Toyohashi, JPN
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