Use of the Japanese health insurance claims database to assess the risk of acute pancreatitis in patients with diabetes: comparison of DPP-4 inhibitors with other oral antidiabetic drugs.

This study was initiated to evaluate the association of acute pancreatitis (AP) with the use of dipeptidyl peptidase-4 (DPP-4) inhibitors among patients with diabetes in Japan. A retrospective cohort study of a large medical and pharmacy claims database was performed to compare the incidence of AP among those receiving DPP-4 inhibitors and those receiving other oral antidiabetic drugs. The incidence of all AP and hospitalizations for AP was similar between the two groups. Previous exposure to DPP-4 inhibitors did not affect occurrence of AP in patients on other oral antidiabetic drugs. The Kaplan-Meier curve for time to AP was similar between the two groups, and was not affected by previous exposure to DPP-4 inhibitors. The Cox proportional hazard models showed the incidence of AP was not significantly higher in those receiving DPP-4 inhibitors. Despite numerous, important limitations related to claims database-based analyses, our results indicate that there is no increased risk of AP with use of DPP-4 inhibitors among patients with diabetes in Japan.

[Assessment of regional wall motion of the hypertrophic heart by phase analysis of thallium-201 images].

Combined technique with gated planner thallium (Tl)-201 images and gated cardiac pool images were applied to evaluate cardiac hypertrophy and regional wall motion for 13 persons. These subjects consisted of four normal persons, four patients with hypertrophic obstructive cardiomyopathy (HOCM) and five patients with asymmetrical apical hypertrophy (AAH). The Tl-201 image and cardiac pool image were obtained using the gated technique, in which the R-R interval was divided into 16 parts, in the 30 degree left anterior oblique projection. The region of interest (ROI) in the left ventricle was defined by the threshold method and radially divided into 16 segments in the center of the left ventricular area. The count ratio, considered as an indicator of regional myocardial contractility, was calculated using the formula (EDC-ESC/EDC) in each ROI. The functional image and histogram, an indicators of the synchronization of left ventricular wall motion, were constructed by the fluctuation of the phase distribution in volume curves of Tl-201. These indicators were evaluated for the normals and the two groups of patients. The count ratio indicated a higher value in the region of the left ventricular free wall and the cardiac apex in the normals, HOCM and AAH. The count ratio at the septal region indicated a lower value in HOCM, in spite of marked septal hypertrophy. A significant fluctuation of the phase distribution was demonstrated in the septal region in HOCM, and also at the apical region in AAH.(ABSTRACT TRUNCATED AT 250 WORDS)