The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Oct 2020
Guideline-Based Medications for Older Adults Discharged after Percutaneous Coronary Intervention in a Suburban City of Japan: A Cohort Study Using Claims Data.
Secondary prevention with medications is essential for the better prognosis of patients who have experienced cardiovascular events. We aimed to evaluate the use of guideline-based medications for secondary prevention in older adults in the community settings after discharge following percutaneous coronary intervention (PCI). A retrospective cohort study was conducted using anonymized claims data of older beneficiaries in a suburban city of Japan between April 2012 and March 2015. ⋯ The prescription rates for antiplatelets, statins, ACEi/ARB, and β-blockers after discharge were 94.6%, 65.0%, 59.3%, and 32.9%, respectively. The adjusted analysis indicated that statins were less likely to be prescribed for the old group (adjusted odds ratio [aOR], 0.70; 95% confidence interval [CI], 0.51-0.95; p = 0.023) and for men (aOR, 0.64; 95% CI, 0.45-0.89; p = 0.008). β-blockers were more likely to be prescribed for men (aOR, 1.66; 95% CI, 1.17-2.33; p = 0.004). Our results suggest the potential for improvements in secondary prevention by increasing the prescription rates of guideline-based medications in this population.
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Tohoku J. Exp. Med. · Oct 2020
Double Burden of Excess Weight and Anemia in Latin American Children up to 2019.
The double burden of malnutrition is the coexistence of two different conditions, mainly reflected as excess or deficit in weight. Anemia is a specific nutritional deficit not always included in the double burden assessment. We reviewed overweight and/or obesity (OW/OB) and anemia studies from Latin-American Children over the last ten years up to 2019. ⋯ These heterogeneous data, before the 2020 (COVID-19 pandemic), reflect the vast inequities between countries and within each country. Food insecurity linked to poverty and the induced change in eating habits and lifestyles threaten optimal child nutrition in ongoing and future scenarios. The existence of OW/OB and anemia and their simultaneous coexistence in the community, home, and individual levels, indicates that interventions should be comprehensive to face the double burden of malnutrition.
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Tohoku J. Exp. Med. · Oct 2020
Development and Validity of the Japanese Version of the Pre-Sleep Arousal Scale.
Hyperarousal, defined as increased levels of cortical activity and cognitive-emotional reactivity induced by stress, is suggested to be a key factor in insomnia. In particularly, pre-sleep arousal constitutes one of the major features of insomnia. The Pre-Sleep Arousal Scale is the best-known measure used to evaluate pre-sleep arousal. ⋯ Discriminant validity showed that the PSAS-J was distinct from the Ford Insomnia Response to Stress Test and Dysfunctional Beliefs and Attitudes about Sleep Scale. The PSAS-J scores were significantly higher in insomniacs than in normal sleepers. Our results suggest that the PSAS-J has high reliability and validity and that this scale is adequate for assessing pre-sleep arousal.
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Tohoku J. Exp. Med. · Oct 2020
Clinical Factors Associated with New-Onset Glucose Intolerance among Patients with Schizophrenia during Clozapine Treatment: All-Case Surveillance in Japan.
Clozapine (CLZ), an antipsychotic with a unique mechanism of action, is known to be superior to any other antipsychotic for schizophrenia. However, CLZ is also known to be associated with the development of lethal side effects, which include agranulocytosis and glucose intolerance (GI). Regular measurement and registration of blood test results have been mandatory for all CLZ users; however, these risks may still prevent therapists from prescribing CLZ. ⋯ Multivariate logistic regression analysis revealed that the development of new-onset GI was significantly associated with older age, higher baseline HbA1c levels, and longer treatment duration. In patients with GI at baseline, HbA1c levels were maintained or improved over 18 months, while in the other patients, CLZ administration gradually elevated HbA1c levels. The findings of this study suggest that, although adequate monitoring and intervention is required, CLZ induction and maintenance therapy may be safe, even for patients with impaired glucose tolerance.
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Tohoku J. Exp. Med. · Oct 2020
Case ReportsConcomitant Nephrotic Syndrome with Diffuse Large B-cell Lymphoma: A Case Report.
Membranous nephropathy (MN) is a common glomerular disease that is characterized by diffuse thickening of the glomerular basement membrane, and a common cause of nephrotic syndrome (NS). MN is often accompanied with malignant disease; The solid tumors are commonly associated with MN, whereas hematological malignancies are rarely found in patients with MN. A 68-year-old man with a history of diabetes mellitus visited a hospital with a chief complaint of general fatigue. ⋯ We report the rare case of a patient co-existing NS and DLBCL. DLBCL might be pathogenesis of NS; the findings are supported by the presence of MN, an underlying malignancy (DLBCL), and the lack of anti-PLA2R antibodies. Although further investigation is warranted, our case suggests that DLBCL is a possible cause of secondary MN.