Impact of a Novel Smartphone App (CureApp Smoking Cessation) on Nicotine Dependence: Prospective Single-Arm Interventional Pilot Study.

BACKGROUND: Mobile apps have been considered to provide active and continuous support for smoking cessation. However, it is yet to be known whether a smoking cessation smartphone app improves long-term abstinence rates in nicotine-dependent patients. OBJECTIVE: This study aimed to evaluate the long-term abstinence effect of a novel smartphone app, CureApp Smoking Cessation (CASC), in patients with nicotine dependence. METHODS: In this prospective, interventional, multicenter, single-arm study, we provided the CASC app to all the participants, who used it daily for 24 weeks. The CASC app includes features to maximize the therapeutic effect of pharmacological therapies and counseling at outpatient clinics for smoking cessation. The primary endpoint was a continuous abstinence rate (CAR) from weeks 9 to 24, whereas secondary endpoints were CARs from weeks 9 to 12 and 9 to 52. RESULTS: Of the 56 adult smokers recruited, 1 did not download the app; therefore, 55 participants constituted the full analysis sample. The CAR from weeks 9 to 24 was 64% (35/55, 95% CI 51%-76%), whereas the CARs from weeks 9 to 12 and 9 to 52 were 76% (42/55, 95% CI 65%-88%) and 58% (32/55, 95% CI 46%-71%), respectively. These CARs were better than the results of the national survey on outpatient clinics with regard to smoking cessation under the National Health Insurance Program and that of the varenicline phase 3 trial in Japan and the United States. There was only 1 participant who dropped out during the 12 weeks of the treatment period. This treatment decreased the scores related to withdrawal and craving symptoms. CONCLUSIONS: The addition of CASC to usual smoking cessation therapies resulted in high CARs, high patient retention rates, and improvement of cessation-related symptoms. The smartphone app CASC is a feasible and useful tool to help long-term continuous abstinence that can be combined with a standard smoking cessation treatment program.

A case of the "cellular variant" of focal segmental glomerulosclerosis with acute renal failure that remitted completely with oral steroid administration.

A 73-year-old man with systemic edema and oliguria, which appeared within several days, was referred to our hospital. Urinalysis showed massive proteinuria, and the blood examination results indicated nephrotic syndrome. Renal biopsy revealed the existence of focal segmental glomerulosclerosis (FSGS), and further investigation indicated that the microscopic features were consistent with the "cellular variant (CELL)" according to the Columbia Classification. After biopsy, 40 mg per day of oral prednisolone was administered daily. With steroid therapy, the abnormal values of the blood examination and urinalysis gradually reached normal, and complete remission was achieved on day 43 after initiating steroid administration. Microscopic investigation by follow-up renal re-biopsy revealed several sclerosing glomeruli; however, other intact glomeruli had no endothelial proliferation, which is a hallmark of CELL. The patient was discharged after biopsy and observed as an outpatient, with maintenance of clinical remission.

[A case of Sjogren syndrome coexistent with MALT lymphoma occurring along the parotid gland and trachea].

A 62-year-old woman with Sjogren syndrome was admitted for computed tomographic (CT) evaluation of a thickened trachea and parotid tumor. She had been given a diagnosis of mucosa-associated lymphoid tissue (MALT) lymphoma 6 years previously, and had undergone surgical resection of the parotid tumor. Endoscopic examination revealed an annular tumor that had formed a stricture in the mid-trachea. Pathologic specimens were obtained by surgical resection of the parotid tumor and bronchoscopic biopsy of the tracheal tumor. Both histological examinations revealed MALT-type marginal zone B-cell lymphoma. Because CD20 immunostaining was positive, the patient received 6 cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) without any signs of major toxicity. All lesions disappeared after treatment, and this patient remained disease-free for 40 months.