Prognostic value of objective nutritional status after transcatheter aortic valve replacement.

BACKGROUND: This study aimed to elucidate the prognostic value of objective nutritional status after transcatheter aortic valve replacement (TAVR). METHODS: This study enrolled 150 consecutive patients who underwent TAVR between February 2014 and March 2017. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score before TAVR. Patients were divided into a high CONUT score (malnutrition status >4 points, n=30) or low CONUT score (normal nutritional status 1-4 points, n=120) group. The primary endpoint was mortality within 1-year post-TAVR. RESULTS: Patients in the high CONUT group were characterized by low body mass index (kg/m2) (20.3±2.4 vs. 22.8±3.5, p<0.001), a higher prevalence of atrial fibrillation (43% vs. 23%, p=0.03), and more common frailty [median (interquartile range) Clinical Frailty Scale (CFS) score, 4.5 (3.75-6) vs. 4 (3-5), p<0.001]. Mortality rate within 1-year post-TAVR was significantly higher in the high CONUT group (43.6% vs. 6.7%, p<0.001). High CONUT score was independently associated with poor prognosis post-TAVR [adjusted hazard ratio, 8.20; 95% confidence interval (CI), 3.10-22.6; p<0.001]. On integrated discrimination improvement (IDI) analysis, malnutrition status improved CFS for predicting mortality post-TAVR (IDI, 0.15; 95% CI, 0.07-0.23; p<0.001). CONCLUSIONS: Objective malnutrition status was predictive of mortality post-TAVR and provided complementary prognostic information to the CFS. Thus, objective nutritional status may refine the clinical risk stratification of patients who undergo TAVR.

A Strategy of Kampo Therapy that use Eatable Crude Drugs to Allergic Disease of Pregnant / 日本東洋医学雑誌

The drug therapies for pregnant woman should consider the safety of the mother, and the embryo. And safety during pregnancy has not been well-established with Kampo therapies.Therefore, it would be best to refrain from administering these medicines except when there is serious disease, or when a pregnant woman's QOL might be degraded. Even so, it would be advantageous if there were still a way to treat pregnant women with no risk.Thus, we treated6pregnant women suffering from allergic conditions such as allergic rhinitis, urticaria or atopic dermatitis, by using herbs which are also used as foods, in an attempt to offer Kampo treatments which were also safe. As a result, efficacy was demonstrated, and no problems were caused.Accordingly, we propose the use of edible Kampo herbs as a safety standard. The safety of each herb used in this report was examined clinically, and in the literature.Other edible herbs not used in this report are tabulated and shown.

The Kampo Therapy of Early-Stage Diabetes Mellitus / 日本東洋医学雑誌

Upon Oriental medical diagnosis of three patients with early-stage diabetes mellitus, they were found to have white, greasy tongue fur and a slippery or slow pulse. Stagnated water and stagnated blood were thought to be causal or aggravating factors. Stagnated water was thought to arise from deficient spleen, or from spleen deficiency and dampness stemming from congealed liver ki.<br>After administering Kampo formulas in accordance with the Oriental medical diagnosis, the blood sugar values in all three cases improved.<br>These results indicated that the common term for diabetes “extreme thirst” does not apply to early-stage mild NIDDM. It was surmised that the treatment methods for tonifying Yin fluids that are typical for thirst and copious urination may not be sufficiently effective in these cases.

Kampo Therapy for Bronchial Asthma. (2). A Study of the Efficacy of a New Formula / 日本東洋医学雑誌

A Kampo formula which had been formulated for its pharmacological effect was administered to 44 out-patients for approximately three years.<br>Including cases which did not complete the program, the formula proved to be remarkably effective in 39% of the cases, effective in 36% of the cases and somewhat effective in 20% of the cases. Thus, the percent of cases for which this treatment was considered somewhat effective or better was 95%. Although traditional Kampo diagnosis was not used, and all of the cases were given the same formula with only minor adjustments being made for variations in complaints, very high treatment effectiveness was achieved.

Kampo Therapy of Bronchial Asthma. Its Effects and Pharmacology / 日本東洋医学雑誌

Concepts concerning the nature of bronchial asthma have changed along with advancements in immunology. Recently, the idea of a delayed asthmatic response has permeated thought on this condition. However, the narrowing of the airway due to immediate response is an important factor.<br>The results of a study of the formulas considered to be effective for these conditions from the viewpoint of Chinese medicine suggested that the efficacy of the formulas in common use is insufficient.<br>A new formula created from an analysis of the pharmacological effects was used for treatment. Although the ‘Sho’, or Kampo diagnostic pattern or the Chinese medical diagnosis were not used, the new formula proved to be very effective.