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1.
Vaccine ; 38(10): 2361-2367, 2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32037227

RESUMO

Okinawa Prefecture, Japan, experienced a large measles outbreak from March to May 2018. During this outbreak, there were 99 laboratory-confirmed cases and 14 vaccine-associated measles cases. In addition to the reinforcement of routine immunization, Okinawa prefectural government introduced emergent measles-containing vaccination recommendations for infants aged 6-11 months as part of the outbreak response. Increased concern exists in Okinawa about measles in infants following a previous outbreak from 1998 to 2001, when nine children including four infants died. Of 8062 infants aged 6-11 months who received measles-containing vaccine (MCV), six developed vaccine-associated measles; incidence was 0.74 per 1000 doses (95%CI 0.27-1.62). This was similar to that of first dose routine immunization recipients at one year of age (IR 0.60, 95%CI 0.20-1.78). Among 14 vaccine-associated measles cases, throat swab samples showed the highest positive rate (92.9%) by real-time reverse transcription polymerase chain reaction (RT-qPCR), followed by urine (25.0%) and whole blood (7.7%) samples. Furthermore, one throat swab sample classified as equivocal by RT-qPCR was positive by conventional RT-PCR (RT-PCR). During an outbreak, it is critical to distinguish between cases with measles-like symptoms caused by wild circulating virus and those caused by vaccine-derived virus as accurately and urgently as possible because the public health response will be quite different. No infant deaths were observed during this outbreak, and no severe adverse events following immunization were seen among infants 6-11 months old who were given MCV as a public health response. Thus, we conclude that introduction of emergent MCV was effective and describing the characteristics of vaccine-associated measles cases during a measles outbreak will be helpful for future outbreak response efforts.

2.
Surg Today ; 50(3): 232-239, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31407166

RESUMO

PURPOSE: Inflammation-based markers predict the long-term outcomes of various malignancies. We investigated the relationship between the modified Glasgow prognostic score (mGPS) and the long-term outcomes of obstructive colorectal cancer in patients who underwent self-expandable metallic colonic stent placement and subsequently received curative surgery. METHODS: We retrospectively analyzed 63 consecutive patients with pathological stage II and III obstructive colorectal cancer from 2013 to 2018. The mGPS was calculated before stenting and surgery, and the difference of the scores was defined as the d-mGPS. RESULTS: All d-mGPS = 2 patients were > 70 years of age (p = 0.01). Postoperative complications were more common in the preoperative mGPS = 2 group (p = 0.02). The postoperative hospital stay was significantly longer in the mGPS = 2 group (p = 0.007). Multivariate analyses revealed that d-mGPS was an independent prognostic factor for overall survival (OS) (hazard ratio [HR] = 9.18, p = 0.004) and cancer-specific survival (HR = 9.98, p = 0.01). Preoperative mGPS = 2 was significantly associated with poor OS (HR = 5.53, p = 0.04). CONCLUSION: The results indicated that mGPS might serve as a valuable indicator of the immunonutritional status of preoperative patients, and a preoperative change of the status might affect the long-term outcomes of patients with obstructive colorectal cancer.

3.
Ann Gastroenterol Surg ; 3(2): 209-216, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30923791

RESUMO

Aim: Endoscopic decompression using the self-expandable metallic colonic stent (SEMS) or transanal decompression tube (TDT) can convert emergency surgery into elective one-stage surgery for obstructive colorectal cancer (OCRC). The aim of the present study was to clarify the effect of SEMS and TDT on long-term oncological outcomes. Methods: We retrospectively analyzed 76 consecutive pathological stage II and III OCRC patients who were inserted with SEMS or TDT as a bridge to curative surgery between 2009 and 2018. Results: There were 53 SEMS cases and 23 TDT cases. The tumor was located in the left colon in 58 cases and in the right colon in 18 cases. The interval between the decompression and the surgery was 16.5 days in the SEMS group and 13.0 days in the TDT group (P = 0.09). Technical and clinical success rates were 100% and 100% for SEMS, and 95% and 91% for TDT, respectively. Stoma was created in four patients in the SEMS group, and in five in the TDT group (P = 0.08). Three-year overall survival rates of the SEMS and TDT groups were 82% and 86% (P = 0.94), and disease-free survival rates were 68% and 62% (P = 0.79), respectively. The recurrence pattern was not significantly different. Conclusion: This study found no statistically significant differences between the effects of SEMS and TDT for OCRC as a bridge to surgery on long-term outcomes.

4.
Heliyon ; 4(4): e00616, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29862373

RESUMO

Leptospirosis, caused by spirochetes of the genus Leptospira, is a globally widespread, neglected and emerging zoonotic disease. The currently used diagnostic tests are time-consuming, require technical expertise or require the use of sophisticated equipment. Clinicians have pointed out the urgent need to develop a rapid test for the diagnosis of acute leptospirosis with a non-invasive and easy sampling method. In this study, we have focused on a leptospiral enzyme, 3-hydroxyacyl-CoA dehydrogenase (3-HADH), as a urinary biomarker of acute leptospirosis. A specific antiserum for pathogenic Leptospira spp. was produced, targeting a peptide corresponding to amino acids 410 to 424 of 3-HADH. The antiserum was used to investigate whether 3-HADH is excreted in the urine by Western blotting. Among 70 suspected leptospirosis patients, 40 were laboratory confirmed by microscopic agglutination test (MAT) using paired sera samples and/or polymerase chain reaction (PCR). In the acute phase of the laboratory-confirmed leptospirosis cases, sensitivity for 3-HADH, blood PCR and urine PCR were 52.5%, 57.5% and 12%, respectively. 3-HADH was detected from 2 days post-onset of illness (p.o) and could be detected at least until 9 days p.o. The combination of PCR and 3-HADH detection increased sensitivity of diagnosis to 100% in samples collected between 1 and 3 days p.o., and to 82% in samples collected between 4 and 9 days p.o. Our results suggested that the detection of 3-HADH can support a clinical diagnosis of leptospirosis, especially when serological methods are negative during the acute phase.

5.
PLoS Negl Trop Dis ; 12(3): e0006294, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29518084

RESUMO

Leptospirosis is considered underdiagnosed because of its nonspecific presentation and lack of proper understanding of its epidemiology. Early diagnosis and treatment are crucial. However, few data are available on confirmed leptospirosis cases in children in industrialized countries. We therefore aimed to describe epidemiologic and clinical characteristics of laboratory-confirmed childhood leptospirosis in Okinawa, Japan. We reviewed the national surveillance data of pediatric leptospirosis in Okinawa, Japan from January 2003 through December 2015. The database included all of laboratory-confirmed leptospirosis diagnosed at the only central laboratory for leptospirosis in the region. There were 44 children (0-20 years of age) with laboratory-confirmed leptospirosis. Of these, 90% were male, 91% were 10-20 years of age, and 96% of cases occurred in August and September. The number of laboratory-confirmed patients ranged from 0 to 11 per year (mean: 3.3 per year), and the estimated annual rate was 1.0 per 100,000 pediatric populations. In all cases, the presumed infection route was recreational exposure to river water. Commonly observed manifestations include fever (95%), myalgia (52%), and conjunctival suffusion (52%). Childhood leptospirosis in Okinawa, Japan occurred predominantly in teenage boys after freshwater exposure in summer, and most patients had characteristic conjunctival suffusion. Cohort studies would be helpful to better understand more detailed clinical manifestations in association with prognosis.


Assuntos
Leptospirose/epidemiologia , Vigilância da População , Adolescente , Fatores Etários , Criança , Pré-Escolar , Técnicas de Laboratório Clínico , Países Desenvolvidos , Feminino , Febre , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Leptospirose/diagnóstico , Leptospirose/microbiologia , Masculino , Mialgia/epidemiologia , Mialgia/microbiologia , Prognóstico , Estudos Retrospectivos , Rios/microbiologia , Estações do Ano , Fatores Sexuais , Adulto Jovem
6.
Int J Clin Oncol ; 21(6): 1085-1090, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27306219

RESUMO

BACKGROUND: Nutritional therapy is used to reduce the adverse events (AEs) of anticancer drugs. Here, we determined whether the amino acids cystine and theanine, which provide substrates for glutathione, attenuated the AEs of S-1 adjuvant chemotherapy. METHODS: Patients scheduled to receive S-1 adjuvant chemotherapy were randomized to the C/T or the control groups. The C/T group received 700 mg cystine and 280 mg theanine orally 1 week before the administration of S-1, which then continued for 5 weeks. Each group received S-1 for 4 weeks. Blood sampling was performed and AEs were evaluated (CTCAE ver. 4.0) before and after the administration of S-1. S-1 was discontinued when AEs ≥ grade 2 occurred. RESULTS: The incidences of AEs of any grade and those over grade 2 were lower in the C/T group than in the controls. The incidence of diarrhea (G ≥ 2) was significantly less (p < 0.05) in the C/T group (3.1 %) than in the controls (25.8 %). The duration and completion rate of the S-1 adjuvant chemotherapy were significantly longer (p < 0.01) and higher (p < 0.01), respectively, in the C/T group (complete ratio: 75.0 %, duration: 24.8 ± 5.8 days) than in the controls (complete ratio: 35.5 %, duration: 20.0 ± 7.7 days). CONCLUSIONS: The oral administration of cystine and theanine attenuated the AEs of S-1 adjuvant chemotherapy and increased the S-1 completion rate, suggesting that cystine and theanine is a useful supportive care for chemotherapy.


Assuntos
Cistina/administração & dosagem , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Neoplasias Gastrointestinais , Glutamatos/administração & dosagem , Ácido Oxônico , Tegafur , Administração Oral , Adulto , Idoso , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/efeitos adversos , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/métodos , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Monitoramento de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Feminino , Neoplasias Gastrointestinais/tratamento farmacológico , Neoplasias Gastrointestinais/patologia , Glutationa/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Ácido Oxônico/administração & dosagem , Ácido Oxônico/efeitos adversos , Substâncias Protetoras/administração & dosagem , Tegafur/administração & dosagem , Tegafur/efeitos adversos , Resultado do Tratamento
7.
Gan To Kagaku Ryoho ; 37(11): 2199-201, 2010 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-21084827

RESUMO

The patient was a 65-year-old male, who underwent low anterior resection for rectal cancer. The pathological diagnosis showed mucinous adenocarcinoma, pSS, and pN0. He complained of diarrhea and melena 4 months after the surgery. Abdominal computed tomography and colonofiberscopy showed a local recurrence of rectal cancer. Because the tumor was diagnosed as unresectable, combined chemotherapy of S-1 (100 mg/day, per os, 4 weeks of treatment and 2 weeks of rest) and PSK (3 g/day, per os, the same schedule as S-1) was started. After the 2 courses of chemotherapy, computed tomography and colonofiberscopy showed a complete disappearance of the tumor. The chemotherapy was continued until the 9th course and then stopped. Five years and 4 months since the induction of a complete response, the patient is still alive without disease recurrence. Combined chemotherapy of S-1 and PSK may be one of useful choices for recurrent colorectal cancer.


Assuntos
Adenocarcinoma Mucinoso/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Retais/tratamento farmacológico , Idoso , Antibióticos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/administração & dosagem , Combinação de Medicamentos , Humanos , Masculino , Recidiva Local de Neoplasia , Ácido Oxônico/administração & dosagem , Proteoglicanas/administração & dosagem , Tegafur/administração & dosagem , Resultado do Tratamento
8.
J Gastrointest Surg ; 8(5): 604-15, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15239999

RESUMO

Ischemia-reperfusion injury causes oxidative stress producing reactive oxygen species, which is a serious problem linked to morbidity and mortality in liver surgery. We investigated the effects of edaravone, a new free radical scavenger, on liver oxidative stress in vitro and in vivo. We employed a hypoxia-reoxygenation model of primary cultured hepatocytes using an AnaeroPack (Mitsubishi Gas Chemical Co., Tokyo, Japan). Hepatocytes were exposed to 3 or 4 hours of hypoxia and then returned to oxygenation. We analyzed the time course changes of aspartate aminotransferase (AST), phosphatidylcholine hydroperoxide (PCOOH), and adenosine triphosphate (ATP) content in hepatocytes of edaravone-treated groups or nontreated groups after reoxygenation. Edaravone significantly attenuated the elevation of the AST level of the medium and hepatocellular PCOOH and preserved the hepatocellular ATP level. In vivo, male Sprague-Dawley rats were subjected to 45 minutes of hepatic ischemia and 120 minutes of reperfusion. The rats were intravenously injected with vehicle or edaravone (3 mg/kg or 10 mg/kg) before reperfusion and 1 hour after reperfusion. Serum AST levels and hepatic PCOOH and energy charge were significantly improved in both edaravone groups compared with control. In conclusion, edaravone has the ability to eliminate intra-hepatocellular superoxide species and attenuate oxidative liver damage in liver surgery.


Assuntos
Antipirina/análogos & derivados , Antipirina/uso terapêutico , Depuradores de Radicais Livres/uso terapêutico , Hepatopatias/prevenção & controle , Traumatismo por Reperfusão/prevenção & controle , Animais , Antipirina/farmacologia , Morte Celular/efeitos dos fármacos , Células Cultivadas , Edaravone , Depuradores de Radicais Livres/farmacologia , Hepatócitos/efeitos dos fármacos , Hepatócitos/metabolismo , Hepatopatias/etiologia , Masculino , Modelos Animais , Estresse Oxidativo/efeitos dos fármacos , Proteínas/efeitos dos fármacos , Proteínas/metabolismo , Ratos , Traumatismo por Reperfusão/complicações
9.
J Hepatobiliary Pancreat Surg ; 9(2): 249-55, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12140615

RESUMO

BACKGROUND/PURPOSE: The peroxidation of membranous phospholipids induced by ischemia reperfusion was inhibited in Cu/Zn superoxide dismutase (SOD) overexpressing mice, suggesting a detrimental role for intracellular reactive oxygen species (ROS) in reoxygenated cell injury. To ascertain the in-vitro relevance of this hypothesis, the present study examined the participation of intracellular ROS in reoxygenation injury. METHODS: This examination was done in two experimental models: Cu/Zn-SOD transgenic (Tg) mice that underwent hypoxia-reoxygenation in vitro and normal mice pretreated with a specific inhibitor of xanthine oxidase, BOF-4272, followed by in vitro hypoxia-reoxygenation. RESULTS: The release of aspartate aminotransferase (AST) and the peroxidation of phospholipids were both ameliorated in hepatocytes from the Tg mice compared with findings in hepatocytes from normal mice. Similar findings were seen in the BOF-4272-pretreated cells, in which there was a decrease in AST and phospholipid peroxides. CONCLUSIONS: These results support the pivotal role of intracellular ROS generated by xanthine oxidase in reoxygenated cell injury, and suggest the viability of using an intracellular antioxidative therapy for reperfusion injury of the liver.


Assuntos
Hepatócitos/metabolismo , Peroxidação de Lipídeos , Fígado/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/metabolismo , Xantina Oxidase/fisiologia , Trifosfato de Adenosina/análise , Animais , Aspartato Aminotransferase Citoplasmática/análise , Inibidores Enzimáticos/farmacologia , Depuradores de Radicais Livres , Hepatócitos/efeitos dos fármacos , Técnicas In Vitro , Peroxidação de Lipídeos/efeitos dos fármacos , Camundongos , Camundongos Transgênicos , Modelos Biológicos , Fosfatidilcolinas/análise , Traumatismo por Reperfusão/prevenção & controle , Traumatismo por Reperfusão/terapia , Superóxido Dismutase/genética , Triazinas/farmacologia , Xantina Oxidase/antagonistas & inibidores
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