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1.
Cureus ; 16(4): e57941, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38738157

RESUMO

A patient who received a loop sigmoid colostomy was diagnosed with ulcerative colitis (pancolitis type) and treated with infliximab. Thereafter, he relapsed with intestinal inflammation only on the rectal side of the loop sigmoid colostomy and not on the oral side. Autologous fecal microbiota transplantation from the proximal intestine to the distal intestine was performed to treat the inflammation but was ineffective. He was treated with oral prednisolone and induced into remission. After analyzing fecal samples from the patient, we observed an alteration of the composition of the intestinal microbiota with intestinal inflammation, including a reduction of phylum Firmicutes in the inflamed distal intestine, whereas Firmicutes was conserved in the proximal non-inflamed intestine and recovered in the distal intestine after induction of remission. Thus, our results indicated that the inflammation was associated with an alteration of the intestinal microbiota.

2.
J Surg Case Rep ; 2024(4): rjae212, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38572290

RESUMO

Nonbacterial thrombotic endocarditis (NBTE) on the aortic valve involves fibrin and platelet aggregate formation, potentially leading to embolic events. We present a case of NBTE on the aortic valve following coronary angiography (CAG) in a 54-year-old man with multiple comorbidities. Surgical thrombectomy was performed owing to acute cerebral infarcts. This case highlights the significance of considering that mechanical trauma from catheterization during CAG can trigger thrombus formation.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38602553

RESUMO

BACKGROUND: Mother-to-infant bonding (MIB) is foundational for nurturing behaviors and an infant's development. Identifying risk factors for difficulties or problems in MIB is vital. However, traditional research often dichotomizes MIB using cutoff thresholds, overlooking its underlying complexities. This research utilizes latent profile analysis (LPA) to discern MIB subtypes in a nationwide Japanese dataset. METHODS: We conducted LPA on data from the Mother-to-Infant Bonding Scale (MIBS), collected from 3,877 postpartum women within one year of childbirth. To empirically validate the derived profiles, we examined their associated risk factors, focusing on sociodemographic, health, and perinatal variables. RESULTS: Four distinct MIB profiles emerged. Profile 1 indicated minimal difficulties, while Profile 4 exhibited severe multifaceted difficulties. Profiles 2 and 3 showed moderate difficulties distinguished by lack of positive affection and presence of negative affection (especially indifference), respectively. Compared to Profile 1, women in Profiles 2-4 had a higher likelihood of postpartum depression and low family support. Each profile also presented unique risk factors: medium family support in Profile 2, maternal working status in Profile 3, and pre-pregnancy underweight status in Profile 4. Notably, both Profiles 3 and 4 were also linked to increased feelings of loneliness since the onset of the COVID-19 pandemic. CONCLUSION: This study represents the first application of LPA to MIB, revealing distinct subtypes and their respective risk profiles. These insights promise to enhance and personalize early interventions for difficulties in MIB, affirming the necessity of acknowledging MIB's heterogeneity.

4.
Biopsychosoc Med ; 18(1): 8, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448990

RESUMO

BACKGROUND: This study aimed to evaluate the association of COVID-19 preventive behavior and job-related stress with sleep quality among healthcare workers (HCWs). We conducted a cross-sectional survey using a questionnaire at the National Center of Neurology and Psychiatry, Tokyo, Japan. METHODS: A total of 586 participants who completed the questionnaire were eligible for the study. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. We examined the level of engagement between poor sleep and COVID-19-related infection preventive behaviors, such as avoiding closed spaces, crowded places, and close contact (three Cs), a distance of at least one meter from others, wearing a face mask regularly, washing hands regularly, and working remotely, as well as job-related stress in the work environment, exposure to patients, potential risk of infection, fear of infecting others, need for social confinement, and financial instability. We conducted a hierarchical logistic regression analysis to examine the relationship between poor sleep and COVID-19 preventive behavior, job-related stress, and other covariates, including age, sex, and the Kessler Psychological Distress Scale (K6), which was used to measure non-specific psychological distress. RESULTS: Poor sleep was observed in 223 (38.1%) participants. Adherence to COVID-19 preventive measures was relatively high: 84.1% of participants answered "always" for wearing a face mask regularly and 83.4% for washing hands regularly. In the multivariate logistic regression analysis, stress in the work environment (odds ratio [OR] = 2.09, 95% confidence interval [CI], 1.37-3.20; p < 0.001), financial instability (OR = 1.73, 95% CI, 1.12-2.67; p < 0.05), and low adherence to working remotely (OR = 1.65, 95% CI, 1.06-2.57; p < 0.05) were independently and significantly associated with poor sleep after controlling for the covariates. CONCLUSIONS: One year into the COVID-19 pandemic, the poor sleep rates of HCWs remained high. These results emphasize the need to protect HCWs from work environment stress and financial concerns.

5.
J Surg Case Rep ; 2024(3): rjae187, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38549722

RESUMO

We report the case of a 76-year-old woman with an incomplete atrioventricular septal defect and severe congestive heart failure who underwent surgical repair. Surgical intervention involved mitral valve repair and patch closure of the ostium primum defect, resulting in a favorable postoperative course. Successful outcomes support surgery as a reasonable treatment option owing to its significant improvement in postoperative quality of life, even in elderly patients with left atrioventricular valve degeneration.

6.
Asian J Psychiatr ; 95: 104003, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38518537

RESUMO

AIM: Patients with schizophrenia can have significant subjective difficulties in social cognition, but few undergo testing or treatment for social cognition. The Social Cognition Psychometric Evaluation (SCOPE) study recommends six social cognitive measures; however, the reliability and validity of these measures in different cultural and linguistic areas has not been adequately examined. We examined the psychometric properties of nine social cognitive measures and the relationship to social function, with the aim of determining the level of recommendation for social cognitive measures in clinical practice in Japan. METHODS: For our test battery, an expert panel previously selected nine measures: the Bell Lysaker Emotion Recognition Task (BLERT); Facial Emotion Selection Test (FEST); Hinting Task (Hinting); Metaphor and Sarcasm Scenario Test (MSST); Intentionality Bias Task (IBT); Ambiguous Intentions and Hostility Questionnaire (AIHQ); Social Attribution Task-Multiple Choice (SAT-MC); SAT-MCII; and Biological Motion (BM) task. In total, 121 outpatients with schizophrenia and 70 healthy controls were included in the analysis, and the results were provided to an expert panel to determine the recommendations for each measure. The quantitative psychological indices of each measure were evaluated for practicality, tolerability, test-retest reliability, correlation with social function, and the incremental validity of social function. RESULTS: Hinting and FEST received the highest recommendations for use in screening, severity assessment, and longitudinal assessment, followed by BLERT, MSST AIHQ, SAT-MC, and SAT-MCII, with IBT and BM receiving the lowest recommendations. CONCLUSION: This study provides a uniform assessment tool that can be used in future international clinical trials for social cognitive impairment.


Assuntos
Psicometria , Esquizofrenia , Cognição Social , Humanos , Psicometria/normas , Psicometria/instrumentação , Japão , Feminino , Masculino , Adulto , Esquizofrenia/diagnóstico , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , Percepção Social , Testes Neuropsicológicos/normas
7.
Cancers (Basel) ; 16(4)2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38398125

RESUMO

BACKGROUND: Since gastric cancers (GCs) detected after Helicobacter pylori (HP) eradication present with different morphological characteristics from conventional HP-positive GCs, delayed detection of early-stage GCs may be observed. This study aimed to investigate the clinical impact of HP eradication on diagnosing GC during screening endoscopy. METHODS: Eleven health checkup institutions in Japan participated in the present study. All GC cases newly diagnosed by screening endoscopy between January 2016 and December 2020 were included. After propensity score matching, multivariable regression analysis was performed to estimate the effect of HP eradication on deep tumor invasion among HP-eradicated and HP-positive GC cases. RESULTS: A total of 231 patients with GCs (134 HP-eradicated and 97 HP-positive cases) were enrolled. After propensity score matching, there were 81 cases in each group. The distribution of the depth of tumor invasion (pT1a, pT1b1, pT1b2, and pT2) between the HP-eradicated group and HP-positive group was similar (p = 0.82). In the propensity analysis, with HP-positive as the reference value, HP eradication was not significantly associated with T1b-T4-GCs and T1b2-T4-GCs, with odds ratios (95% confidence intervals) of 1.16 (0.48-2.81) and 1.16 (0.42-3.19), respectively. CONCLUSIONS: HP eradication does not adversely affect the clinical course of GCs, supporting the recommendation of HP eradication in screening programs to reduce the total number of GC cases without delaying diagnosis.

8.
J Vasc Surg Cases Innov Tech ; 10(2): 101411, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38379609

RESUMO

Inadvertent renal artery obstruction during endovascular aortic repair is a rare but serious complication. In such cases, endovascular recanalization is typically attempted; however, it can be challenging, leading to many severe cases. Moreover, if treatment is delayed, the blockage time of the renal artery poses a problem. We encountered a case of inadvertent renal artery occlusion during endovascular aortic repair. In this case, bailout stent implantation through a gap between the aortic wall and a stent graft made by a balloon catheter was effective in reducing the renal ischemia time and facilitating the revascularization procedure.

9.
Psychiatry Res ; 334: 115814, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38412713

RESUMO

BACKGROUND: Mother-to-infant bonding difficulties (MIBD) are considered risk factors for postpartum depression and child-maltreatment behaviors. However, few longitudinal studies have examined this hypothesis. This study aims to explore the relationship between MIBD and subsequent maternal depression and child-maltreatment behaviors using longitudinal data from a 2021 Japanese nationwide survey. METHODS: We studied 658 first-time mothers who had given birth within the past year and had not reported postpartum depression or child-maltreatment behaviors at baseline. The Japanese version of Mother-to-Infant Bonding Scale (MIBS) was used to measure MIBD. Subjects were monitored for six months and subsequently completed the Edinburgh Postnatal Depression Scale and responded to inquiries about child-maltreatment behaviors. RESULTS: After adjusting for covariates, MIBD was associated with higher odds of maternal depression (OR=1.737, 95 % CI [1.078, 2.797]) and child-maltreatment behaviors (OR=2.040, 95 % CI [1.401, 2.970]) six months later. Further analysis indicated that MIBD was particularly associated with a heightened risk of emotional abuse (OR=2.172, 95 % CI [1.486, 3.176]). Sensitivity analysis confirmed these findings through multiple approaches, such as applying inverse probability weighting to mitigate selection bias, using an alternative MIBS cutoff score of 5, and adopting a time-varying model to account for the dynamic nature of depressive symptoms and child-maltreatment behaviors. CONCLUSION: Proactive screening for MIBD could serve as a valuable tool in the early detection of maternal depression and potential child-maltreatment behaviors.


Assuntos
Depressão Pós-Parto , Mães , Lactente , Feminino , Humanos , Mães/psicologia , Depressão Pós-Parto/diagnóstico , Estudos Longitudinais , Japão/epidemiologia , Depressão , Fatores de Risco
10.
Heart Vessels ; 39(6): 475-485, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38381169

RESUMO

Low-density lipoprotein cholesterol (LDL-C) levels are recommended according to the patient's risk factors based on guidelines. In patients achieving low LDL-C levels, the need for statins is uncertain, and the plaque characteristics of patients not treated with statins are unclear. In addition, the difference in plaque characteristics with and without statins is unclear in similarly high LDL levels. We evaluate the impact of statins on plaque characteristics on optical coherence tomography (OCT) in patients with very low LDL-C levels and high LDL-C levels. A total of 173 stable angina pectoris patients with 173 lesions undergoing OCT before percutaneous coronary intervention were evaluated. We divided the LDL-C levels into three groups: < 70 mg/dL (n = 48), 70 mg/dL ≤ LDL-C < 100 mg/dL (n = 71), and ≥ 100 mg/dL (n = 54). Among patients with LDL-C < 70 mg/dL, patients not treated with statins showed a significantly higher C-reactive protein level (0.27 ± 0.22 mg/dL vs. 0.15 ± 0.19 mg/dL, p = 0.049), and higher incidence of thin-cap fibroatheromas (TCFAs; 44% [7/16] vs. 13% [4/32], p = 0.021) than those treated with statins. Among patients with LDL-C level ≥ 100 mg/dL, patients treated with statins showed a significantly higher prevalence of familial hypercholesterolemia (FH) (38% [6/16] vs. 5% [2/38], p = 0.004), lower incidence of TCFAs (6% [1/16] vs. 39% [15/38], p = 0.013), healed plaques (13% [2/16] vs. 47% [18/38], p = 0.015), and higher incidence of fibrous plaques (75% [12/16] vs. 42% [16/38], p = 0.027) than patients not treated with statins. While patients achieved a low LDL-C, patients not treated with statins had high plaque vulnerability and high systemic inflammation. While patients had a high LDL-C level with a high prevalence of FH, patients treated with statins had stable plaque characteristics.


Assuntos
Angina Estável , LDL-Colesterol , Doença da Artéria Coronariana , Vasos Coronários , Inibidores de Hidroximetilglutaril-CoA Redutases , Placa Aterosclerótica , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Masculino , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Feminino , LDL-Colesterol/sangue , Angina Estável/tratamento farmacológico , Angina Estável/sangue , Angina Estável/diagnóstico , Pessoa de Meia-Idade , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Idoso , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/tratamento farmacológico , Intervenção Coronária Percutânea/métodos , Estudos Retrospectivos , Fatores de Risco , Biomarcadores/sangue , Resultado do Tratamento , Angiografia Coronária
11.
Artigo em Inglês | MEDLINE | ID: mdl-38279068

RESUMO

PURPOSE: The COVID-19 pandemic has intensified feelings of loneliness, especially among postpartum women. This nationwide Japanese longitudinal study assessed the impact of such feelings on depressive symptoms and mother-to-infant bonding difficulties (MIBD), two pivotal determinants of maternal and infant well-being. METHODS: Starting with a baseline survey conducted between July and August 2021, we tracked 1254 postpartum Japanese women who initially reported minimal depressive symptoms (i.e., Edinburgh Postnatal Depression Scale < 9) and MIBD (i.e., Mother-to-Infant Bonding Scale < 5), over a follow-up period of approximately 6 months. Baseline loneliness was evaluated with the UCLA Loneliness Scale Short-Form (UCLA-LS3-SF3). RESULTS: Forty-nine percent of the sample reported the presence of baseline feelings of loneliness. After propensity score matching on sociodemographics and various pregnancy, childbirth, and COVID-19-related aspects, baseline loneliness was associated with increased risks of later depressive symptoms but not MIBD. Using restricted cubic spline logistic regression and considering loneliness as a continuous variable, we found a positive increasing quadratic relationship with depressive symptoms. As loneliness increased, so did the risk of later depressive symptoms. However, there was no significant association between loneliness and MIBD. These results were confirmed through a sensitivity analysis using inverse probability weighting to address attrition bias. CONCLUSION: Feelings of postpartum loneliness are associated with future risks of depressive symptoms. The data suggests that addressing loneliness in postpartum women early is crucial to safeguarding their well-being and that of their infants.

12.
Sci Rep ; 14(1): 4, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172498

RESUMO

This study aimed to verify whether an eHealth-based self-management program can reduce irritable bowel syndrome (IBS) symptom severity. An open-label simple randomized controlled trial was conducted that compared an intervention group (n = 21) participating in an eHealth self-management program, which involved studying IBS-related information from an established self-help guide followed by in-built quizzes, with a treatment-as-usual group (n = 19) that, except for pharmacotherapy, had no treatment restrictions. Participants were female Japanese university students. The eHealth group received unlimited access to the self-management program for 8 weeks on computers and mobile devices. The primary outcome, participants' severity of IBS symptoms assessed using the IBS-severity index (IBS-SI), and the secondary outcomes of participants' quality of life, gut bacteria, and electroencephalography alpha and beta power percentages were measured at baseline and 8 weeks. A significant difference was found in the net change in IBS-SI scores between the eHealth and treatment-as-usual groups, and the former had significantly lower IBS-SI scores following the 8-week intervention than at baseline. Moreover, there was a significant difference in the net change in phylum Cyanobacteria between the eHealth and treatment-as-usual groups. Thus, the eHealth-based self-management program successfully reduced the severity of IBS symptoms.


Assuntos
Síndrome do Intestino Irritável , Autogestão , Telemedicina , Feminino , Humanos , Síndrome do Intestino Irritável/terapia , Qualidade de Vida , Resultado do Tratamento
13.
J Affect Disord ; 349: 370-376, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38199402

RESUMO

BACKGROUND: The quality of mother-to-infant bonding (MIB) is a crucial determinant of nurturing behaviors and infant development, with bonding difficulties (MIBD) posing a substantial threat. While it is essential to identify MIBD risk factors, previous studies have generally examined MIBD at one time point, leaving the contributors to persistent MIBD uncertain. This study aims to discern longitudinal risk factors for persistent versus episodic MIBD. METHODS: We evaluated 1833 postpartum Japanese women who delivered in the past twelve months, utilizing the Mother-to-Infant Bonding Scale (MIBS) and other sociodemographic, health, pregnancy, childbirth, and child-rearing related data (T1). Follow-up data were obtained six months later (T2). MIBD was defined as a MIBS score of five or more, with "persistent" and "episodic" MIBD classified based on its occurrence at both or either one of the time points, respectively. Logistic generalized estimating equations and inverse probability weighting were used to identify risk factors and address selective attribution bias. RESULTS: Of the subjects, 15.8 % reported episodic and 11.3 % reported persistent MIBD. Shared risk factors for both conditions included postpartum depression and low levels of family support (OR = 1.501-6.343). However, pre-pregnancy underweight status (OR = 1.698) was a unique risk factor for episodic MIBD, while first-time motherhood, no or discontinuation of breastfeeding, and later postpartum months (OR = 1.540-3.179) were distinctive risk factors for persistent MIBD. CONCLUSION: We identified both shared and unique risk factors for episodic and persistent MIBD. Particular attention should be afforded to persistent MIBD and early and proactive interventions to mitigate identified risk factors are recommended.


Assuntos
Depressão Pós-Parto , Mães , Humanos , Lactente , Feminino , Gravidez , Estudos Longitudinais , Relações Mãe-Filho , Japão/epidemiologia , Inquéritos e Questionários , Período Pós-Parto , Depressão Pós-Parto/epidemiologia , Fatores de Risco , Apego ao Objeto
15.
J Surg Case Rep ; 2023(12): rjad648, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38076320

RESUMO

Although total arch replacement would be performed in a patient with acute type A aortic dissection and concomitant aortic aneurysm in the distal aortic arch, total arch replacement may be too invasive in elderly patients with significant morbidities. A 92-year-old female with acute type II DeBakey aortic dissection and concomitant distal aortic arch aneurysm was successfully treated with hemi-arch replacement followed by thoracic endovascular aortic repair. Hybrid two-stage repair of DeBakey type II aortic dissection complicated by distal arch aneurysm using thoracic endovascular aortic repair after hemi-arch replacement may be effective.

16.
J Cardiol ; 2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-37949315

RESUMO

BACKGROUND: Although computed tomography-derived fractional flow reserve (FFRCT) has been reimbursed in a few countries, its impacts on daily practice of coronary artery diseases are not fully elucidated. We evaluated the clinical impacts of FFRCT under the real Japanese insurance reimbursement. METHODS: In the multicenter prospective registry: DYNAMIC-FFRCT study, a total of 410 patients who underwent FFRCT analysis under reimbursement were prospectively enrolled at 6 Japanese sites from October 2019 to November 2021. Coronary CT angiography and FFRCT findings, treatment plans, and 90-day outcomes were recorded. The primary endpoint was the redirection rate from the tests that might be expected without FFRCT [invasive coronary angiography (ICA)-selected group, myocardial perfusion single photon emission CT (MPS)-selected group, optimal medical therapy (OMT)-selected group, and others-selected group] to those that were actually performed based on FFRCT. RESULTS: ICA could be avoided in 39.5 % in the ICA-selected group (N = 233). In particular, in 94.3 % of patients with an FFRCT value of >0.80, additional examinations, such as ICA, were avoided. In addition, in the MPS-selected group (N = 133), 92.6 % had no additional tests with FFRCT > 0.80, while only 2 cases with FFRCT ≤ 0.80 underwent additional MPS examination. On the contrary, 33.3 % of the OMT-selected group (N = 33) had FFRCT ≤ 0.80. Approximately, 35 % medical cost reduction was also finally expected. CONCLUSION: Introduction of FFRCT could not only reduce unnecessary ICA and be a test that replaces the conventional non-invasive functional assessment modality but also result in medical cost reduction even when used under real Japanese insurance reimbursement.

17.
Atherosclerosis ; 386: 117363, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37944269

RESUMO

BACKGROUND AND AIMS: Artificial intelligence quantitative CT (AI-QCT) determines coronary plaque morphology with high efficiency and accuracy. Yet, its performance to quantify lipid-rich plaque remains unclear. This study investigated the performance of AI-QCT for the detection of low-density noncalcified plaque (LD-NCP) using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS). METHODS: The INVICTUS Registry is a multi-center registry enrolling patients undergoing clinically indicated coronary CT angiography and IVUS, NIRS-IVUS, or optical coherence tomography. We assessed the performance of various Hounsfield unit (HU) and volume thresholds of LD-NCP using maxLCBI4mm ≥ 400 as the reference standard and the correlation of the vessel area, lumen area, plaque burden, and lesion length between AI-QCT and IVUS. RESULTS: This study included 133 atherosclerotic plaques from 47 patients who underwent coronary CT angiography and NIRS-IVUS The area under the curve of LD-NCP<30HU was 0.97 (95% confidence interval [CI]: 0.93-1.00] with an optimal volume threshold of 2.30 mm3. Accuracy, sensitivity, and specificity were 94% (95% CI: 88-96%], 93% (95% CI: 76-98%), and 94% (95% CI: 88-98%), respectively, using <30 HU and 2.3 mm3, versus 42%, 100%, and 27% using <30 HU and >0 mm3 volume of LD-NCP (p < 0.001 for accuracy and specificity). AI-QCT strongly correlated with IVUS measurements; vessel area (r2 = 0.87), lumen area (r2 = 0.87), plaque burden (r2 = 0.78) and lesion length (r2 = 0.88), respectively. CONCLUSIONS: AI-QCT demonstrated excellent diagnostic performance in detecting significant LD-NCP using maxLCBI4mm ≥ 400 as the reference standard. Additionally, vessel area, lumen area, plaque burden, and lesion length derived from AI-QCT strongly correlated with respective IVUS measurements.


Assuntos
Doença da Artéria Coronariana , Placa Aterosclerótica , Humanos , Placa Aterosclerótica/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Inteligência Artificial , Espectroscopia de Luz Próxima ao Infravermelho , Ultrassonografia de Intervenção/métodos , Tomografia Computadorizada por Raios X/métodos , Angiografia Coronária/métodos , Angiografia por Tomografia Computadorizada , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/patologia , Lipídeos , Valor Preditivo dos Testes
18.
J Psychiatr Res ; 168: 149-156, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37913741

RESUMO

Antipsychotic medications increase the risk of abnormal glucose metabolism. However, in clinical practice, it is difficult to predict this risk because it is affected by medication-related and background factors. This study aimed to identify the risk factors for abnormal glucose metabolism during antipsychotic treatment. We conducted a multicenter, prospective, cohort study in patients with schizophrenia, schizoaffective disorder, or bipolar disorder. Of these patients, those with prediabetes or possible diabetes were excluded. Finally, 706 patients were included in the analysis. The hazard ratio (HR) for each factor was calculated for events of progression to hyperglycemia using time-dependent Cox regression analysis stratified according to facility type and adjusted for available background and drug-related factors. Treatments with olanzapine (HR = 2.06, 95% confidence interval [CI] = 1.05-4.05), clozapine (HR = 4.25, 95% CI = 1.56-11.60), and chlorpromazine (HR = 4.48, 95% CI = 1.21-16.57), overweight and obesity (HR = 1.57, 95% CI = 1.02-2.41), and hypertriglyceridemia (HR = 1.72, 95% CI = 1.02-2.88) were associated with a significantly higher occurrence of hyperglycemic progression. The number and daily dose of antipsychotics were not associated with their occurrence. Our study demonstrated that more careful monitoring is necessary during olanzapine, clozapine, and chlorpromazine treatment because of the higher occurrence of abnormalities in glucose metabolism. Furthermore, patients with obesity or hypertriglyceridemia warrant monitoring for the occurrence of abnormal glucose metabolism, regardless of the type of antipsychotic medication.


Assuntos
Antipsicóticos , Clozapina , Hipertrigliceridemia , Humanos , Antipsicóticos/efeitos adversos , Olanzapina/efeitos adversos , Clozapina/uso terapêutico , Estudos Prospectivos , Estudos de Coortes , Glucose , Clorpromazina , Benzodiazepinas/efeitos adversos , Fatores de Risco , Obesidade/induzido quimicamente , Hipertrigliceridemia/induzido quimicamente , Hipertrigliceridemia/tratamento farmacológico
19.
Heliyon ; 9(11): e22176, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38034695

RESUMO

Objective: Health anxiety (HA), defined as excessive worry about having a serious medical condition, may affect preventive behaviors during the coronavirus disease 2019 (COVID-19) pandemic. We examined the distinct role of two dimensions of HA-perceived likelihood (probability dimension) and awfulness of illness (awfulness dimension)-in self-protection, as reflected in preventive behaviors during the pandemic. Methods: Participants comprised 657 healthcare workers. Data were collected between February 24 and 26, 2021. The Short Health Anxiety Inventory determined the HA dimensions. Adherence to the government's recommendations for COVID-19 preventive behaviors was self-rated. An independent association between each HA dimension and participants' adherence to the recommendations was examined using multivariable regression. Results: Within the analyzed sample of 560 subjects, severe HA was observed in 9.1 %. The more the participants felt awful, the less frequently they engaged in the recommended preventive behaviors (adjusted odds ratio = 0.993, 95 % confidence interval: 0.989, 0.998, p = 0.003) regardless of their profession, working position, psychological distress, sleep disturbance, and current physical diseases. However, the probability dimension was not associated with their preventive behaviors. Conclusion: The awfulness dimension of HA could be a more sensitive marker of preventive behaviors than the probability dimension. Paying particular attention to the awfulness dimension may help optimize self-protection strategies during the COVID-19 pandemic. A two-dimensional understanding of HA may be useful for the maintenance of the healthcare system and public health as well as healthcare workers' own health.

20.
Front Psychol ; 14: 1251945, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37881216

RESUMO

Background: Recent studies have shown an association between psychological distress and emotion malleability beliefs, meaning mindsets about whether one's emotions are fixed or changeable. However, most studies have not examined the association between these beliefs and sociodemographic factors. Methods: A nationwide cross-sectional Internet survey of residents of Japan aged 15-79 years was conducted using sampling weights for national estimates to investigate the association between emotion malleability beliefs and sociodemographic factors and between fixed beliefs and severe psychological distress (SPD). SPD was defined as a Kessler 6 Scale score of ≥13. Adjusted odds ratios for SPD were calculated considering potential confounders. Further analyses were stratified by sex, age and presence of any psychiatric disorder. Results: The analysis included 23,142 participants (female, 48.64%). Fixed beliefs were associated with female sex, age < 45 years, and presence of psychiatric disorders. These beliefs were associated with SPD, and additional analysis showed stronger associations with SPD among female respondents, respondents aged 45-59 years, and those aged ≥60 years. Conclusion: Results indicate that female sex, age < 45 years, and current mental disorders were associated with fixed emotion malleability beliefs. Associations between fixed emotion malleability beliefs and SPD were particularly strong among female respondents and people aged ≥45 years compared with the general population. Our study extends the association between emotion malleability beliefs and psychological health to the general population. Future studies should explore mechanisms underlying individual differences in emotion beliefs.

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