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1.
Cureus ; 15(11): e49569, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38156186

RESUMO

BACKGROUND AND OBJECTIVES: Japanese women face many female-specific health problems in the workplace, especially menstruation-related issues, which can adversely affect their quality of life and productivity. This study aims to examine how female employees in a male-dominated company in Hiroshima, Japan, cope with menstruation-related health issues in the workplace and the factors that influence their coping strategies. MATERIALS AND METHODS: This study used a cross-sectional survey research method. The survey investigated age, health, and menstrual-related issues, as well as women's active participation support and health literacy (HL) levels. The sample population included employees of a manufacturer in Hiroshima prefecture. The data were collected from February 20 to March 10, 2023. The analysis subjects were 171 women who had experienced menstruation-related, women-specific health issues in the workplace. Their attitudes toward menstruation-related issues could influence their experiences. They were categorized into positive and negative groups based on their attitudes toward coping with women's health issues. Chi-square tests and logistic regression analysis were used to compare the two groups. RESULTS: The study found that 50.3% (N = 296) of female employees had experienced women's menstruation-related health issues at work. As many as 62.6% (N = 171) of female employees showed a positive attitude, and the study also found that female employees with a positive attitude toward menstruation-related health issues had higher HL (odds ratio (OR) = 1.216, 95% CI: 1.007-0.1.468) and were more likely to be able to predict menstruations (OR = 4.528, 95% CI: 1.618-12.670).  Conclusions: In male-dominated companies, many female employees are affected by menstruation-related problems in the workplace. A positive attitude toward women's health issues was positively associated with HL and predictive ability. Male-dominated companies should pay attention to women's menstruation-related health issues in the workplace, implement interventions to improve their health literacy and predictive ability, strengthen communication with them, and encourage them to actively participate in women's health initiatives.

2.
Nutrients ; 15(5)2023 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-36904274

RESUMO

Excessive consumption of caffeine negatively affects individuals' health. Therefore, we studied the use of energy drinks and the conditions associated with it among Japanese secondary school students. Participants were 236 students in grades 7-9 who completed anonymous questionnaires at home in July 2018. We measured the basic attributes and dietary, sleeping, and exercise habits. We used Chi-squared tests to compare differences between users and non-users of energy drinks. Logistic regression analyses were used to elucidate the complex association between the variables. The results showed that boys were more willing to consume energy drinks than girls. The reasons were 'feeling fatigued', 'needing to stay awake', 'for curiosity', and 'to quench one's thirst'. Among boys, the following were associated with the use of EDs. Buying their own snacks , not understanding nutritional labels on foods, high caffeinated beverage intake, late bed-times on weekdays, always waking up at about the same time, and weight. Health guidance is needed to prevent overconsumption and dependence on energy drinks. The cooperation of parents and teachers is needed to achieve these goals.


Assuntos
Cafeína , Bebidas Energéticas , Masculino , Feminino , Humanos , Estudos Transversais , População do Leste Asiático , Inquéritos e Questionários , Estudantes
3.
Curr Oncol ; 30(2): 2073-2087, 2023 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-36826122

RESUMO

Breast cancer is the most commonly diagnosed female cancer and the leading cause of cancer death. Early detection and treatment are important to reduce the number of deaths. Japan recommends mammography every two years for women over 40 years of age. However, in recent years, an increasing number of younger women have been undergoing breast cancer screening (BCS). To reduce the harms of BCS among young adults, our study extracted data from an online survey conducted in 2018 and applied χ2 tests and logistic analysis to identify the influencing factors regarding interest in undergoing BCS. The results of our analysis support the need for a reduction in the BCS rate through awareness regarding the harms of health screening among young people. In particular, for those who receive BCS through occupational screening, we believe that improving education on breast awareness, the accuracy of occupational screening, and breast self-examination methods could reduce the harms from BCS in younger age groups.


Assuntos
Neoplasias da Mama , Feminino , Adulto Jovem , Humanos , Adulto , Pessoa de Meia-Idade , Adolescente , Neoplasias da Mama/diagnóstico , Estudos Transversais , Japão , Detecção Precoce de Câncer/métodos , Mamografia
4.
Public Health Nurs ; 40(1): 105-113, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36128933

RESUMO

OBJECTIVE: The study aimed to examine life situations and perceptions related to the recognition of mutual support among Japanese people. DESIGN: A quantitative, correlational, cross-sectional analysis. SAMPLE: Nine hundred and nine participants who provided complete questionnaire responses. MEASUREMENTS: As a disaster prevention measure, a community center conducted a "questionnaire survey evaluating the recognition of mutual support and several potentially related factors". In our study, these data from a self-administered questionnaire were used secondarily. RESULTS: The perceptions that differed with regard to the sense of mutual support included family structure; satisfaction with support, security, and disaster prevention in the district; being able to ask for help with shopping; closeness of the relationship with one's neighbors; seeing oneself as providing or needing protection; and recognition of existing worries regarding evacuation. In a logistic regression model, the factors predicting the sense of mutual support included being younger than 70 years, being able to ask for help with shopping, and the closeness of the association with one's neighbors. CONCLUSIONS: The study identified situations that might predict the sense of mutual support in individuals in Japanese communities.


Assuntos
Desastres , População do Leste Asiático , Humanos , Projetos Piloto , Estudos Transversais , Inquéritos e Questionários
5.
J Family Med Prim Care ; 12(12): 3380-3386, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38361877

RESUMO

Context: Given the dramatic decline in Japan's labor force, promoting women's participation in the workforce is essential. Aims: We aimed to take a Hiroshima company as an example and analyze the influencing factors of health literacy (HL) to clarify the issues of the active participation of female employees. Methods and Materials: From February to March 2023, a cross-sectional study was conducted by a company in Hiroshima prefecture that contained many male employees. A total of 1,114 valid respondents were received. Employees' demographics, menstrual-related concerns, women's activity promotion support, and HL were investigated in this study. Statistical Analysis Used: The Chi-square test and logistic regression using SPSS statistical software version 25 were used. Results: There were significant differences between high and low HL with age, women's menstrual problems, and women's activity promotion support. The participants who were unaware of women's menstrual-related problems and their company's implementation of women's activity promotion support were more likely to have high HL. In addition, female employees (including female management) and male management have significantly different cognitions about women's activity promotion support. Conclusions: This study found that overall HL among employees in male-dominated companies is low, even among participants who were aware of women's menstruation-related health issues and the company's women's activity promotion support. Increased women's representation in management can bridge policy perception gaps. Male-dominated companies should enhance HL via career programs, health education, and improved communication for active female engagement.

6.
Viruses ; 14(5)2022 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-35632698

RESUMO

In Japan, healthcare workers (HCWs) are vaccinated against measles, rubella, chickenpox, mumps, and hepatitis B to prevent nosocomial infection; however, some do not produce sufficient antibodies ("suboptimal responders"). This study compared immune responses to a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 mRNA) vaccine among HCWs with normal and suboptimal responses to conventional vaccines. In this prospective cohort study, 50 HCWs received two doses of BNT162b2 mRNA vaccine 3 weeks apart. SARS-CoV-2 anti-spike antibodies were measured 11 times, starting before the first vaccination and ending 5 months after the second vaccination. Antibody titers of four suboptimal and 46 normal responders were compared. SARS-CoV-2 neutralizing antibody activity was measured twice in suboptimal responders, 1 week/1 month and 5 months after the second vaccination. The SARS-CoV-2 anti-spike antibody was detectable in the samples from suboptimal and normal responders at each timepoint after vaccination. Suboptimal responders exhibited SARS-CoV-2 neutralizing antibody activity 1 week/1 month as well as 5 months after the second vaccination; however, activity was slightly reduced at 5 months. Our findings show that suboptimal responders do acquire adequate SARS-CoV-2 anti-spike and SARS-CoV-2 neutralizing antibodies from vaccination to prevent SARS-CoV-2. SARS-CoV-2 mRNA vaccines should thus be recommended for both normal and suboptimal responders to conventional vaccines.


Assuntos
COVID-19 , Vacinas Virais , Anticorpos Neutralizantes , Anticorpos Antivirais , Formação de Anticorpos , Antivirais , Vacina BNT162 , COVID-19/prevenção & controle , Humanos , Estudos Prospectivos , RNA Mensageiro , SARS-CoV-2/genética , Vacinação , Vacinas Sintéticas , Vacinas de mRNA
7.
Artigo em Inglês | MEDLINE | ID: mdl-35564856

RESUMO

Students' interests help determine their learning effectiveness and knowledge acquisition and retention. It is necessary to confirm whether there is a difference in the way in which content being learned is remembered by the content type. In this study, we examined the characteristics of nursing students' retention of physiological knowledge and environmental knowledge by utilizing scores obtained in class. The participants comprised 57 nursing students who had taken a class twice-once in their second year and once in their third year. Before and after each class, students completed an 11-question survey with human health and comfort items based on nursing core competencies and Sphere standards. The correct answer rate was calculated using a logistic regression model to account for inter- and intra-individual variations. The estimated correct answer rate per individual showed one of three trends: (1) increasing and decreasing depending on the lesson topic (knowledge type), (2) increasing overall after decreasing, and (3) increasing gradually. Physiological knowledge was retained well, whereas knowledge pertaining to the environment was retained poorly. Even with knowledge of the environment, the knowledge that students apply to their daily lives and social events was maintained.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Aprendizagem , Inquéritos e Questionários
8.
Children (Basel) ; 9(4)2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35455562

RESUMO

Changes in serum cholesterol levels during childhood may affect the risk of cardiovascular disease in adulthood. However, cholesterol level changes in Japanese children and adolescents and the factors that influence them have not been completely elucidated. This study aimed to determine whether cholesterol levels changed due to the effects of growth and identify factors. This cohort study included elementary-school children in the fourth grade (9−10-year-old) who underwent assessments of cholesterol levels and demographic and lifestyle characteristics. The participants were followed up in their first year of junior high school with the same laboratory, demographic, and lifestyle assessments. From the fourth year of elementary school to the first year of junior high school, children's cholesterol levels decreased (p < 0.0001). Regarding bowel movements, cholesterol level reduction was significant in individuals with regular bowel movements but not significant in those with infrequent bowel movements. Weight was the factor that most strongly negatively predicted cholesterol level reduction (p < 0.001). The study demonstrated the significance of lifestyle factors for growth-related changes of total cholesterol levels and identified weight as the factor that most strongly influenced total cholesterol level changes. Guidance regarding lifestyle improvements should be imparted to children from the fourth grade of elementary school.

9.
Medicine (Baltimore) ; 101(9): e28999, 2022 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-35244075

RESUMO

ABSTRACT: The local economy is often supported by small and medium-sized enterprises. There is a need to consider effective promotion methods for mental health measures in these enterprises in depopulated mountainous areas. It is important to understand managers' awareness when considering effective mental health measures in these enterprises. The study's aim is to explore managers' awareness of mental health measures for employees in small and medium-sized enterprises in depopulated mountainous areas in Japan.Qualitative semi-structured interviews were conducted with 6 managers in 2019. The primary issues addressed by the interview were regarding the awareness among managers about mental health promotion measures for employees. These are the primary prevention measures. The interview also addressed issues related to the awareness of measures for mental health problems that are fundamental to the secondary and tertiary prevention measures. A qualitative descriptive analysis was conducted.Three categories and 8 subcategories emerged regarding the managers' awareness of mental health promotion measures for employees. The 3 categories were: "Individual support, including their life's aspect, while taking advantage of formal and informal relationships," "The difficulty of drawing out an employees' motivation to work, due to the changes over time in the work size or in their working relationships," and "Creating a comfortable working environment for employees, by complying with the labor standards and adjusting relationships." Regarding managers' awareness of the measures for mental health problems, four categories and 8 subcategories emerged. The 4 categories were: "Prevention and awareness of the incidence of mental health problems," "Individual support based on the enterprise's or employee's characteristics," "A lack of support for the manager to address employees' mental health problems," and "Employees quitting the job, due to the lack of appropriate support."Though managers in depopulated mountainous areas were well aware of the mental health activities offered, the categories showed the need to foster social capital. It also showed the need to collaborate with external support organizations, and the difficulties faced by small and medium-sized enterprises.


Assuntos
Pessoal Administrativo/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/métodos , Saúde Mental , Local de Trabalho , Humanos , Entrevistas como Assunto , Japão , Setor Privado , Pesquisa Qualitativa , População Rural
10.
Metab Syndr Relat Disord ; 20(3): 148-155, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34962149

RESUMO

Background: Accumulation of adipose tissue progresses to metabolic diseases. Sonography is a convenient modality for measuring the thickness of adipose tissue. The present study aimed to clarify the site of adipose tissue thickness that correlated best with laboratory test values reflecting metabolic abnormalities. Methods: Subjects comprised 37 elderly women with metabolic diseases or an almost healthy state (median age, 71 years; interquartile range, 62-78 years). Abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue, peritoneal adipose tissue, perirenal adipose tissue, and epicardial adipose tissue (EAT) thicknesses were measured. Correlations were evaluated between laboratory test values and these adipose tissue thicknesses. Results: VAT thickness measured at the level of the umbilicus correlated positively with values of triglycerides (TGs) (r = 0.593, P = 0.0009) and hemoglobin A1c (r = 0.490, P = 0.0081) and negatively with the value of high-density lipoprotein cholesterol (r = -0.521, P = 0.0045), even after adjusting for body mass index. Significant positive correlations were also found between EAT thickness and TGs (r = 0.542, P = 0.0029). Conclusions: Among the adipose tissue thicknesses measured at several sites by sonography, VAT thickness correlated most closely with laboratory test values representing metabolic abnormalities in elderly women.


Assuntos
Tecido Adiposo , Gordura Intra-Abdominal , Tecido Adiposo/diagnóstico por imagem , Idoso , Índice de Massa Corporal , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Pericárdio , Triglicerídeos
11.
Artigo em Inglês | MEDLINE | ID: mdl-34948516

RESUMO

Due to the COVID-19 pandemic, many nursing students are being taught remotely. Remote learning has drawbacks, such as decreased motivation for learning and difficulties conveying the instructor's intentions. Strategies that compensate for the shortcomings of remote learning should be identified. This study aimed to evaluate the understanding of the knowledge use and awareness of negotiation methods through cases and teaching tools in nursing student classes on environmental assessment and daily life support, and to examine whether supplementary assistance can compensate for the drawbacks of remote learning. This study used a mixed-method design, and included 59 second-year nursing students attending an environmental assessment course in 2021. Students' knowledge use and awareness of negotiation methods were evaluated using self-assessment worksheets before and after the class. The pre- and post-class scores were compared using the Wilcoxon signed-rank test. The mean knowledge score increased significantly during the study period (p < 0.001). Students acquired awareness of how to use the knowledge gained during class and negotiation awareness by observing role play, factors that strengthen motivation when learning alone. This study provides insight into the potential of class supplements to compensate for the deficits of remote learning. Supplementing the shortcomings of remote learning should be a priority and may be a focal point of hybrid learning.


Assuntos
COVID-19 , Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Pandemias , SARS-CoV-2
12.
J Clin Lab Anal ; 35(11): e23998, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34599840

RESUMO

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the coronavirus disease 2019 (COVID-19), is detected using real-time RT-PCR. However, there are limitations pertaining to quality control, particularly with respect to establishing quality control measures for extraction of viral nucleic acids. Here, we investigated the quality control measures for the various processes using an extrinsic quality control substance and quality control charts. METHODS: An extrinsic quality control substance was added to the sample, and then, real-time RT-PCR was performed. Samples with negative test results and the corresponding data were analyzed; a quality control chart was created and examined. RESULTS: Data analysis and the quality control charts indicated that SARS-CoV-2 could be reliably detected using real-time RT-PCR, even when different nucleic acid extraction methods were used or when different technicians were employed. CONCLUSION: With the use of quality control substances, it is possible to achieve quality control throughout the process-from nucleic acid extraction to nucleic acid detection-even upon using varying extraction methods. Further, generating quality control charts would guarantee the stable detection of SARS-CoV-2.


Assuntos
Teste de Ácido Nucleico para COVID-19/normas , COVID-19/diagnóstico , Ácidos Nucleicos/isolamento & purificação , Controle de Qualidade , SARS-CoV-2/genética , Humanos , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação
13.
Iran J Public Health ; 50(4): 701-709, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34183919

RESUMO

BACKGROUND: Type A behavior pattern has been presented as a risk for coronary heart disease and defined as a psychological-behavioral construct. This study aimed to identify the influence of type A behavior pattern on blood pressure in the current cultural context of Japan. METHODS: This study utilized a cross-sectional design. Self-administered questionnaires were distributed to community residents aged 40-59 yr in western Japan from Aug to Sep 2017. The data included participant's demographic information (including socioeconomic variables); information related to blood pressure, type A behavior pattern, psychological factors, and health-related behaviors. Logistic regression was used to identify the influence of type A behavior pattern on systolic blood pressure after adjusting for behavioral, psychological, and socioeconomic factors. RESULTS: The sample included 362 participants with a mean age of 51.5 years (SD = 5.96); 148 (41.2%) men. A logistic regression demonstrated that type A behavior pattern was negatively associated with systolic blood pressure (OR = 0.43, 95% CI [0.22, 0.83]) after adjusting for sex and age. Similar results were observed after adjusting for other covariates. CONCLUSION: There may be a negative association between type A behavior pattern and systolic blood pressure among adults living in the current cultural context of Japan.

14.
Medicine (Baltimore) ; 100(19): e25735, 2021 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-34106600

RESUMO

ABSTRACT: There is a need to comprehensively identify depression-related factors, including individual and socioeconomic factors, in each country or cultural area, to consider effective measures to address depression within communities. However, there are not enough studies on middle-aged residents in Japan or other Eastern countries to currently achieve this. Thus, the aim of this study was to comprehensively identify factors related to depression in middle-aged residents in Japan, an Eastern country.The study design was cross-sectional. A questionnaire survey was conducted among all community residents aged 40 to 59 in a rural municipality in Western Japan. The questionnaire contained items on demographic characteristics, psychological factors, health-related behaviors, and socioeconomic factors. A Chi-Squared test or Fisher exact test was used to analyze the relationships between depression and each assessed factor. Next, a logistic regression analysis was performed to identify comprehensive relationships between depression and its related factors.Data from 362 participants were analyzed. The average age was 51.5 years; 148 were male. A Chi-Squared test or Fisher exact test demonstrated that many psychological factors, health-related behaviors, and socioeconomic factors ware significantly related to depression. A logistic regression analysis showed that depression was significantly associated with male gender, low sense of coherence, high cognitive stress levels, low help-seeking behavior, poor quality sleep, and a lack of hobbies. Nagelkerke R2 was 51%.This study revealed through multivariate analysis that depression was primarily associated with personal behavioral and psychological factors in Japan, an Eastern country with a holistic cultural background. This result is consistent with findings from Western countries. This study can contribute the promotion and evaluation of preventive measures for depression in Eastern culture that focus on individual behavioral and psychological factors.


Assuntos
Depressão/epidemiologia , Adulto , Estudos Transversais , Depressão/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Angústia Psicológica , Senso de Coerência , Sono , Fatores Socioeconômicos , Inquéritos e Questionários
15.
Artigo em Inglês | MEDLINE | ID: mdl-33800909

RESUMO

Universities have quickly shifted to remote learning due to the COVID-19 pandemic. This study compared two versions-emergency remote teaching (ERT) and conventional face-to-face class (FFC)-of a course design based on the instructional design ARCS model for effectiveness and issues. The current study comprised 46 third-year nursing students who attended an FFC course in 2019, and 56 third-year students who took the ERT version in 2020. Students' self-rated goal attainment and knowledge of genetics scores were compared before and after taking the courses. Scores between the two class types were compared using the Wilcoxon rank sum test. The students' worksheets were evaluated using keyword frequency and content analyses. Both classes achieved their goals satisfactorily, and this study confirmed that for this course, ERT was as effective as FFC. A comparison of the increase in domain goal attainment scores per student showed that only the psychomotor domain item, "I can fully explain human diversity using genomic information", was significantly different, as it was significantly higher for ERT (p = 0.003). This higher item in the ERT group suggests that ERT can pose a lack of practice caution in acquiring nursing skills.


Assuntos
COVID-19 , Estudantes de Enfermagem , Humanos , Aprendizagem , Pandemias , SARS-CoV-2 , Ensino
16.
Artigo em Inglês | MEDLINE | ID: mdl-33092176

RESUMO

After the 2011 Fukushima Daiichi accident, demands regarding nursing staff's management of nuclear disasters have increased. This study aimed to evaluate a basic training program to teach undergraduate nursing students on how to deal with public anxiety following a nuclear disaster. We analyzed the data of 111 third-year nursing students attending a Japanese university. We set attainment goals in three domains (cognitive, affective, psychomotor) regarding their acquisition of consultation techniques for radiation-related health concerns. We compared pre- and post-class response scores on a knowledge test and calculated word frequencies in health consultation scenarios. The pre-class mean score was 12.2 out of 27 points and the post-class mean score (directly after the course) was 21.0, a significant increase (p < 0.001). The mean level of attainment in each of the three domains increased significantly from pre-test to post-test (p < 0.001). The variety and number of words in the health consultations also increased. Students attained the program goals for radiation-related health concerns in all domains. During disasters, there is a great need for nursing staff to administer physical and mental care to the public. This program was evaluated to be one wherein nursing staff can acquire fundamental knowledge about radiation in a short time.


Assuntos
Ansiedade , Bacharelado em Enfermagem , Acidente Nuclear de Fukushima , Radiação , Estudantes de Enfermagem , Desastres , Humanos , Estudantes de Enfermagem/psicologia
17.
J Med Ultrason (2001) ; 47(4): 617-623, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32960385

RESUMO

PURPOSE: Well-differentiated liposarcoma, the most common subtype of liposarcoma, should be discriminated from benign lipoma. However, features on sonography for discriminating these two types of tumor have not been fully investigated. The present study was therefore aimed at clarifying differences in sonographic findings between well-differentiated liposarcoma and lipoma. METHODS: The study population comprised 23 cases of well-differentiated liposarcoma and 181 cases of lipoma. We investigated differences in sonographic appearance and pathological findings between the two types of tumor. RESULTS: Well-differentiated liposarcoma tended to develop more frequently in older patients and in the lower extremities including the gluteal region, compared with lipoma. Concerning sonographic findings, both tumors exhibited well-defined margins and heterogeneous internal echogenicity, including typical tiny striated hyperechoic lines. Well-differentiated liposarcoma was characterized by a higher frequency of the following findings compared with lipoma: (1) deep location, (2) irregular shape, (3) large diameter, (4) hyperechogenicity compared to surrounding tissue, and (5) presence of vascularity on Doppler sonography (p < 0.01 each). Notably, hyperechogenicity corresponded to the intermingled sclerosing component within the adipocytic component when sonographic findings were compared with those of pathology. CONCLUSION: The present study suggests that several sonographic findings including hyperechogenicity and presence of vascularity might be key features for discriminating well-differentiated liposarcoma from lipoma.


Assuntos
Lipoma/diagnóstico por imagem , Lipossarcoma/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Distribuição por Idade , Idoso , Nádegas/diagnóstico por imagem , Nádegas/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lipossarcoma/patologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Digestion ; 101(4): 450-457, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31129673

RESUMO

BACKGROUND/AIMS: The present study was performed to compare the safety of sedation with propofol during endoscopic submucosal dissection (ESD) for gastric tumors under sedation in the endoscopy room by an endoscopist versus sedation in the operation room by an anesthesiologist. METHODS: In total, 638 patients with gastric tumors who underwent ESD from January 2011 to August 2017 at Ureshino Medical Center and Saga Medical Center Koseikan were retrospectively reviewed. The patients were divided into 2 groups: those who underwent ESD in the endoscopy room (Group E, n = 532) and those who underwent ESD in the operation room (Group O, n = 106). Propensity score matching was applied for evaluation. The treatment outcome of ESD and the adverse events of sedation during ESD (desaturation, hypotension, bradycardia, and arrhythmia) were compared between the 2 groups to consider the safety of ESD. RESULTS: The propensity score-matching analysis created 82 matched pairs. Adjusted comparisons between Groups E and O showed similar treatment outcomes of ESD for gastric tumors. There were no significant differences in the treatment outcomes, anesthesia time, and mean propofol dose between the 2 groups. With respect to adverse events, desaturation occurred more often in Group E than Group O (18.3 vs. 3.7%, respectively; p = 0.005). There were no significant differences in other adverse events (hypotension, bradycardia, and arrhythmia) between the 2 groups. CONCLUSION: Sedation with propofol in the operation room might be required to ensure safer application of ESD for gastric tumors. However, a decrease in the desaturation rate was the only disadvantage of sedation in the endoscopy room.


Assuntos
Anestesiologistas/estatística & dados numéricos , Ressecção Endoscópica de Mucosa/métodos , Gastroenterologistas/estatística & dados numéricos , Hipnóticos e Sedativos/administração & dosagem , Propofol/administração & dosagem , Neoplasias Gástricas/cirurgia , Idoso , Feminino , Mucosa Gástrica/cirurgia , Humanos , Masculino , Salas Cirúrgicas , Pontuação de Propensão , Estudos Retrospectivos , Resultado do Tratamento
19.
Ultrasound Med Biol ; 45(9): 2568-2574, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31202456

RESUMO

Liposarcoma is the second most common malignant soft-tissue tumor. This entity is pathologically categorized into 4 subtypes: well-differentiated, myxoid, dedifferentiated and pleomorphic. Although features on magnetic resonance imaging and computed tomography for these 4 subtypes have been reported quite precisely, those on sonography have not been fully investigated. The present study was therefore aimed at clarifying the sonographic appearances of each liposarcoma subtype and assessing correlations with histopathology. The study population was made up of 35 cases, including 21 cases of well-differentiated liposarcoma, 6 cases of myxoid liposarcoma, 6 cases of dedifferentiated liposarcoma and 2 cases of pleomorphic liposarcoma. Compared with the other subtypes, well-differentiated liposarcoma was characterized by the high frequency of the following findings: isoechogenicity, tiny hyperechoic lines and hypovascularity (p < 0.01, in each). Myxoid liposarcomas were characterized by low echogenicity, intermingled with anechoic areas and moderate vascularity (p < 0.01, in each). Dedifferentiated liposarcomas showed a specific biphasic pattern of hyperechoic and hypoechoic areas and hypervascularity (p < 0.01, in each). Pleomorphic liposarcomas showed a specific gyrus-like mixture of hyperechoic and hypoechoic areas (p < 0.01). In conclusion, the present study revealed different characteristics of sonographic appearance among the 4 histopathologic subtypes of liposarcoma.


Assuntos
Lipossarcoma/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Sci Rep ; 9(1): 4352, 2019 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-30867433

RESUMO

Acute kidney injury (AKI) is associated with poor prognosis among patients with acute heart failure (AHF). Early documentation of impaired kidney function through simple examination may provide risk reduction in such patients. The present study aims to reveal an association between cellular casts and hospital-acquired AKI in AHF. This study included patients with AHF who underwent urinalysis, including urinary sediment analysis within 24 hours post admission. AKI was defined as an increase of ≥0.3 mg/dL within 48 hours or ≥1.5 times in serum creatinine level in contrast to baseline creatinine level. In this study, 114 patients with AHF (age, 75 ± 14 years; male, 59.7%) were included. Of them, 40 (35%) developed hospital-acquired AKI. Cellular casts were detected in 30 patients (26%) prior to AKI development and related to hospital-acquired AKI in the multivariate logistic regression analysis (odds ratio, 2.80; 95% confidence interval, 1.04-7.49; P = 0.041). In conclusion, cellular casts are observed occasionally in patients with AHF and potentially useful markers for development of AKI during hospitalization.


Assuntos
Injúria Renal Aguda/etiologia , Injúria Renal Aguda/urina , Biomarcadores/urina , Insuficiência Cardíaca/complicações , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Insuficiência Cardíaca/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Modelos de Riscos Proporcionais , Sensibilidade e Especificidade , Urinálise/métodos
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