Medicine
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Although automobile driving is often necessary in daily life, most package inserts for psychotropic drugs in Japan prohibit patients from driving under the influence of medication. This may be partially because no system to evaluate the influence of drugs on driving performance has been established. Standardized evaluation methods have been established in the Netherlands and the United States, but these cannot be implemented in Japan because of differences in road situations, traffic laws, and ethnicities. Therefore, to establish a method to evaluate the influence of drugs on driving performance in Japan, we planned a validation study using alcohol and a driving simulator (DS) and set a clinically meaningful threshold involving the standard deviation of lateral position (SDLP), which is a criterion standard evaluation item. ⋯ Ethics approval was obtained from the Ethics Committee at Hakata Clinic and the Nagoya University Medical School Hospital Bioethics Review Committee. The trial results will be disseminated through peer-reviewed publications and international conferences.
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Randomized Controlled Trial
Tobramycin/dexamethasone eye drops as a better choice for lacrimal duct probing in persistent congenital nasolacrimal duct obstruction: A consort study.
Congenital nasolacrimal duct obstruction (CNLDO) is common and. lacrimal duct probing is the major treatment. But persistent CNLDO in older children makes the success rate rapidly decreased due to long-term chronic inflammation. To improve the success rate, probing combined with tobramycin/dexamethasone ointment is considered effective. But in practice, we found a lot of problems in using the ointment. So we tried tobramycin/dexamethasone eye drops as a replacement. The results is surprising, so we hope to do some further research in order to prove it is worth to clinical application. ⋯ Probing combined with tobramycin/dexamethasone eye drops was effective and easy-to-perform in the clinic, and it may be a better choice for persistent CNLDO.
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Previous clinical trials have reported that cyclophosphamide can be used for the treatment of acute lymphoblastic leukemia (ALL). However, its efficacy is still unclear. In this systematic review study, we aim to evaluate its efficacy and safety for ALL. ⋯ PROSPERO CRD42018119333.
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Lymphomatosis cerebri is a rare form of PCNSL, characterized by diffuse infiltration of lymphoma cells in cerebral parenchyma, without mass-formation and mild or no contrast enhancement on magnetic resonance (MR) imaging. There are less than 50 cases described in the literature under the term Lymphomatosis cerebri. ⋯ We described the diagnostic dilemma we faced with an elderly man with rapid cognitive impairment and a myriad of differential diagnoses, diagnosed with primary CNS diffuse large B-cell lymphoma with a lymphomatosis cerebri-like pattern.
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Comparative Study Observational Study
A comparative analysis of clinicopathological factors between esophageal small cell and basaloid squamous cell carcinoma.
Esophageal small cell carcinoma (E-SmCC) and basaloid squamous cell carcinomas (BSCCs) are both highly aggressive malignancies, but their detailed differences in clinical behaviors have remained virtually unknown. In addition, treatment strategies of the patients with E-SmCC have not been established. 29 cases of E-SmCC and 39 with BSCC were examined in this study to clarify the clinical features and outcome of the patients with E-SmCC and to compare the findings with those of BSCC. E-SmCCs presented a more advanced status than BSCC (TNM Stage: P = .002). ⋯ E-SmCC was a more aggressive neoplasm than BSCC. However, early detection could possibly improve the clinical outcome of patients with E-SmCC. Systemic therapy could also benefit the patients with advanced disease (Stage II-IV).