The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Dec 2024
Association between Maternal LDL Level during Pregnancy and Offspring LDL Level at Age 8.
The pathological process of atherosclerosis begins in childhood and increases the risk of myocardial infarction, other cardiac diseases, and subsequent stroke. To investigate the relationship between maternal low-density lipoprotein cholesterol (LDL-C) level during pregnancy and LDL-C level in offspring at 8 years old. The Japan Environment and Children's Study (JECS) is an ongoing birth cohort study to elucidate the effects of environmental factors on health from the fetal period to early childhood. ⋯ Mean (SD) serum LDL-C levels were 107.0 (25.6) mg/dL for mothers, 116.5 (27.4) mg/dL for fathers, and 89.9 (21.4) mg/dL for offspring. LDL-C level in mothers whose offspring had above-normal LDL-C levels (≥ 110 mg/dL) was significantly higher than that in mothers whose offspring had normal LDL-C levels (< 110 mg/dL). If a mother has a high LDL-C level during pregnancy, her offspring might also have a high LDL-C at age 8.
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The case report highlights the potential intracranial complications associated with otitis media, particularly cholesteatoma and mastoiditis, including meningitis, brain abscesses, epi- and subdural empyema, and sigmoid sinus thrombophlebitis. Pyogenic ventriculitis (PV), an inflammation of the ependymal lining of cerebral ventricles, is a rare but serious complication often secondary to factors such as meningitis, cerebral abscesses, or neurosurgery. ⋯ Despite initial challenges in diagnosis, timely antibiotic therapy and surgical intervention resulted in successful treatment. The study emphasizes the importance of considering ear diseases as potential sources of intracranial infection, particularly in cases of delayed symptom presentation or history of head trauma.
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Tohoku J. Exp. Med. · Dec 2024
Pediatric Intravenous Anesthesia in Japan-Where are Anesthesiologists?
Most pediatric intravenous anesthesia in Japan is performed outside the operating theatre by non-anesthetists. The 2020 revision increased reimbursement for long-term intravenous anesthesia (Category 3) by anesthesiologists, but its impact on practice behavior is unknown. We analyzed the annual number of calculations for each category of intravenous anesthesia and their age distribution from the national reimbursement data for the three-year period fiscal years (FY) 2018-20 to elucidate trends in the pediatric age group. ⋯ Long-term total intravenous anesthesia by anesthesiologists is rarely performed in Japan. Improvements in reimbursement are not sufficient to enable total intravenous anesthesia by a specialized anesthesiologist. A system for safe intravenous anesthesia by non-anesthesiologists is needed.
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Tohoku J. Exp. Med. · Dec 2024
Background Factors that Hospital-Based Geriatricians and General Practitioners Associate with Difficulty in Treating Older People with Multimorbidity: A Cross-Sectional Survey.
In recent years, hospital-based geriatricians and general practitioners in Japan who frequently manage older people with multimorbidity in an acute setting have often found treating these patients difficult. In this study, we surveyed geriatricians and general practitioners who treat older people with multimorbidity in hospitals to identify patient characteristics that make treatment provision difficult in these patients. In June 2022, we mailed an anonymous questionnaire to 3,300 family medicine specialists, primary care-certified physicians, and geriatric specialists in Japan. ⋯ In total, 490 cases were included in the analysis. The factors that were associated with difficulty in treating older people with multimorbidity were experience as a physician (adjusted odds ratio [AOR]: 0.935; 95% confidence interval [95% CI]: 0.905-0.965), the overall scores for difficult disease (AOR: 1.028; 95% CI: 1.004-1.053) and difficult background (AOR: 1.065; 95% CI: 1.005-1.129), and the lack of emphasis on general practice guidelines (AOR: 2.91; 95% CI: 1.305-6.491). To facilitate the treatment of older people with multimorbidity, it is desirable to enhance education and training and strengthen support systems within Japan's healthcare system based on the characteristics of hospital physicians who find treating these patients difficult.