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1.
Nihon Koshu Eisei Zasshi ; 67(1): 3-14, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32023592

RESUMO

Objective This report aimed to present policy recommendations on the regulation of heated tobacco products based on a review of the literature on the use of heated tobacco products, component analysis of harmful chemical substances, and product characteristics as nicotine delivery device, and on an examination of the influence of the product's increasing usage to the main measures of tobacco control.Methods The literature search was performed using Japan Centra Revuo Medicina and PubMED database. The search yielded 11 articles that examined the use of heated tobacco products, component analysis of harmful chemical substances, and product characteristics as nicotine delivery device. Eight articles were additionally collected from reports of public health research in Japan and public reports in foreign countries. The six main policies advocated by World Health Organization as MPOWER (Monitor, Protect, Offer, Warn, Enforce, Raise) were adopted in considering the expected influence of this product's increasing usage this product epidemic on tobacco control. In addition to the abovementioned 19 articles, 26 documents and materials related to the status of tobacco control were collected and used to examine the influence of the product's increasing usage to the main measures of tobacco control.Results In Japan, heated tobacco products have been available since December 2013, and the spread of use has risen remarkably since 2016. As of October 2016, Japan consumed more than 90% of the heated tobacco products sold internationally. Compared with cigarettes, heated tobacco products can reduce exposure to harmful substances except nicotine. However, their use does not lead to reduced risk of illness. The reduction of exposure to harmful substances cannot be expected when used in combination with cigarettes. Heated tobacco products and cigarettes have similar nicotine exposure levels and pharmacokinetics; thus, use of the former results in nicotine dependence and exacerbates the difficulty in discontinuing tobacco consumption. The popularity of heated tobacco products could adversely affect any of the six main measures of tobacco control.Conclusion Although public health concerns have been identified for the popularity of heated tobacco products, evidence remains insubstantial for the formulation of regulatory implications. Additional research is needed on the health effects to users and bystanders, effects on cigarettes use, and influence on tobacco control policy. From the perspective of the precautionary principle of public health, the same regulation as for cigarettes should be implemented as regards heated tobacco products until their health effects are fully elucidated.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32070097

RESUMO

Highly oriented thin films of poly[2,5-bis(3-tetradecylthiophen-2-yl)thieno[3,2-b]thiophene] (PBTTT) were prepared by friction-transfer technique followed by their characterization using polarized absorption spectroscopy, angle-dependent polarized Raman spectroscopy, and X-ray diffraction (XRD) techniques. Orientation in high-molecular-weight (MW) polymers is hampered by chain folding or entanglements, which limit their macromolecular orientation. Interestingly, utilizing high-molecular-weight PBTTT (MW > 50 kDa) and friction-transfer technique, successful fabrication of highly oriented thin films with very high dichroic ratio (∼30) was demonstrated. The role of the substrate's surface energy and its impact on the field-effect mobility (µ) of the oriented thin films were comprehensively investigated. The influence of annealing the thin films as prepared on the bare and self-assembled monolayer (SAM)-treated SiO2 surfaces exhibiting differential trends of µ was systematically investigated. This was explained by partial and complete conformational transformation of macromolecules on bare and SAM-treated SiO2 surfaces, respectively, after annealing them beyond liquid crystalline phase transition temperature, as revealed by in-plane and out-of-plane XRD results. On bare SiO2, optimum µ up to 0.03 cm2 V-1 s-1 along the backbone orientation was obtained for the thin films annealed to 120 °C; whereas, it reached up to 0.36 cm2 V-1 s-1 on SAM-treated SiO2 after annealing at 200 °C. Finally, a charge transport mechanism was proposed taking evidence from the anisotropic optical and electrical characteristics of the friction-transferred PBTTT films into consideration.

4.
Jpn J Nurs Sci ; 17(1): e12288, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31642605

RESUMO

AIM: In Japan, public health nurses play a major role in tobacco control at the local government level. However, the competencies required are not clear. This study aimed to identify competencies of public health nurses working on local tobacco control in Japan. METHODS: Twelve expert public health nurses from nine local governments in Japan participated in semi-structured interviews using the Behavioral Event Interview. Data analysis used the Iceberg Model and qualitative descriptive methods. RESULTS: The competencies of the public health nurses were driven by three "motives": strong motivation to pioneer and change tobacco control; unwavering determination to remove barriers to tobacco control; and strong drive to achieve tobacco control. Public health nurses also showed three "attitudes": a partnership-oriented stance to delivering tobacco control; enthusiasm for evidence-based goals; and commitment to developing expertise and roles. These underpinned eight "skills": advocating to raise awareness of the need for tobacco control; positioning tobacco control as a policy issue based on regional and social situations; creating an organizational system for tobacco control; pioneering opportunities for intervention and delivering effective and locally appropriate activities; evaluating and improving the quality of tobacco control measures; developing and establishing community-based measures for tobacco-free communities; expanding activities by strategically collaborating with stakeholders; and coordinating and negotiating to avoid conflicts. CONCLUSIONS: Public health nurses who promote tobacco control share characteristics, despite barriers such as resistance inside and outside the organization. In the future, these could be used as indicators of the competency of public health nurses working on local tobacco control.

5.
Nihon Koshu Eisei Zasshi ; 66(9): 560-573, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31588092

RESUMO

Objectives Preventing frailty is a crucial issue in aging societies such as Japan. In 2011, we launched an action research project in Yabu City, Hyogo Prefecture, to develop effective community-based strategies to prevent frailty in the elderly. We attempted to introduce community-based frailty prevention classes in every administrative district with the help of the senior workforce at Silver Human Resources Centers. This study aimed to evaluate the effectiveness and the applicability to different communities of this strategy, which will be called the "Yabu model."Methods Using PAIREM (Plan, Adoption, Implementation, Reach, Effectiveness, Maintenance) framework, we evaluated the effectiveness and the applicability to different communities of the Yabu model. To evaluate its effectiveness, we conducted a baseline and follow-up survey of residents aged 65 years or older in 2012 (n=7,287, 90.7% response rate) and 2017 (n=8,157, 85.7%), using a mailed self-administered questionnaire.Results (1) Plan: The idea was to establish a frailty prevention class (60 min/session, once a week) consisting of resistance exercises and nutritional or psychosocial programs (standard course, six months, 20 sessions/course; short course, one and a half months, 6 sessions/course; after the course, residents continued with the activities themselves). We planned to launch three classes in the first year (2014) and then to increase the number of classes by ten each year after the second year. (2) Adoption: Out of 154 administrative districts, 36 (23.4%) held frailty prevention classes between 2014 and 2017. (3) Implementation: The median attendance rate for the standard or short course (number of times each participant attended/number of frailty prevention class sessions held) was 75.0%. (4) Reach: A total of 719 older people participated in the standard or short course. The participation rate in the administrative districts, where each frailty prevention class was held, was 32.8%, while at the city level it was 8.1%. (5) Effectiveness: Propensity score matching after multiple imputations were performed. While the prevalence of frailty in non-participants increased by 13.7% in the five years from 2012 to 2017, it only increased by 6.8% in participants. Compared to non-participants, program participants had a significantly lower prevalence odds ratio of frailty at the time of the follow-up survey (OR=0.65, 95% confidence interval 0.46-0.93). (6) Maintenance: After the standard or short course, 25 out of 26 communities (96.2%) continued the frailty prevention activities once a week.Conclusion The frailty prevention classes were adopted across many districts and lowered the participants' risk of frailty. Moreover, participants continued to engage in frailty prevention activities even after the course. These results indicate the Yabu model's effectiveness and its applicability for a different community.


Assuntos
Centros Comunitários de Saúde , Idoso Fragilizado , Fragilidade/prevenção & controle , Educação em Saúde/métodos , Idoso , Idoso de 80 Anos ou mais , Eficiência Organizacional , Educação em Saúde/estatística & dados numéricos , Humanos , Japão
6.
Sci Rep ; 9(1): 10853, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31350448

RESUMO

Hole transport layers (HTL) are crucial materials to improve the power conversion efficiency in organohalide hybrid perovskite-based solar-cell applications. Two important physical properties are required in HTL materials: good hole mobility and air-protection. After HTL solution-based deposition, an intermixed chemical state at the interface between HTL and hybrid perovskite is key to confirming the physical property of HTL. We performed high-resolution x-ray photoelectron spectroscopy to investigate the chemical states at the interface between an ultra-thin P3 polymer and CH3NH3PbI3 hybrid perovskite thin film. At the interface, we found no apparent intermixed chemical state. Furthermore, we confirmed that the P3 HTL with the ultra-thin layer (7 nm) protected the hybrid perovskite material against air-exposure for 2 weeks.

7.
Nat Commun ; 10(1): 2455, 2019 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-31165729

RESUMO

Artificial molecular switches and machines that enable the directional movements of molecular components by external stimuli have undergone rapid advances over the past several decades. Particularly, overcrowded alkene-based artificial molecular motors are highly attractive from the viewpoint of chirality switching during rotational steps. However, the integration of these molecular switches into solid-state devices is still challenging. Herein, we present an example of a solid-state spin-filtering device that can switch the spin polarization direction by light irradiation or thermal treatment. This device utilizes the chirality inversion of molecular motors as a light-driven reconfigurable spin filter owing to the chiral-induced spin selectivity effect. Through this device, we found that the flexibility at the molecular scale is essential for the electrodes in solid-state devices using molecular machines. The present results are beneficial to the development of solid-state functionalities emerging from nanosized motions of molecular switches.

8.
Sci Rep ; 9(1): 5811, 2019 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-30967593

RESUMO

The valid strong THz absorption at 1.58 THz was probed in the organic-inorganic hybrid perovskite thin film, CH3NH3PbI3, fabricated by sequential vacuum evaporation method. In usual solution-based methods such as 2-step solution and antisolvent, we observed the relatively weak two main absorption peaks at 0.95 and 1.87 THz. The measured absorption spectrum is analyzed by density-functional theory calculations. The modes at 0.95 and 1.87 THz are assigned to the Pb-I vibrations of the inorganic components in the tetragonal phase. By contrast, the origin of the 1.58 THz absorption is due to the structural deformation of Pb-I bonding at the grain boundary incorporated with a CH3NH2 molecular defect.

10.
J Atheroscler Thromb ; 26(5): 432-441, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-30318492

RESUMO

AIMS: To investigate the relative contribution of on-treatment low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) to the risk of recurrent stroke and transient ischemic attack (TIA) in patients with history of ischemic stroke. METHODS: A total of 1095 patients with non-cardioembolic ischemic stroke were randomized into two groups: control and patients receiving 10 mg of pravastatin per day. After excluding 18 patients who did not have baseline CRP data, the effects of LDL cholesterol and CRP on recurrent stroke and TIA were prospectively assessed in 1077 patients. RESULTS: During the follow-up of 4.9±1.4 years, there were 131 recurrent stroke or TIA cases. Patients with ontreatment LDL cholesterol <120 mg/dL showed 29% reduction in recurrent stroke and TIA than those with LDL cholesterol ≥ 120 mg/dL (event rate 2.20 vs. 3.11 per 100 person-years, hazard ratio [HR] 0.71, 95% confidence interval (CI) 0.50-0.99, p=0.048). Patients with CRP <1 mg/L had 32% reduction compared with that of patients with CRP ≥ 1 mg/L (event rate 2.26 vs. 3.40 per 100 person-years; HR 0.68, 95% CI 0.48-0.96, p=0.031). Although LDL cholesterol and CRP levels were not correlated in individual patients, those who achieved both LDL cholesterol <120 mg/dL and CRP <1 mg/L showed 51% reduction compared with that of patients with LDL cholesterol ≥ 120 mg/dL and CRP ≥ 1 mg/L (event rate 2.02 vs. 4.19 per 100 person-years; HR 0.49, 95% CI 0.31-0.79). CONCLUSIONS: The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke.


Assuntos
Biomarcadores/sangue , Proteína C-Reativa/análise , LDL-Colesterol/sangue , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Ataque Isquêmico Transitório/sangue , Pravastatina/uso terapêutico , Acidente Vascular Cerebral/sangue , Idoso , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Incidência , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/prevenção & controle , Japão , Masculino , Prognóstico , Estudos Prospectivos , Recidiva , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle
11.
J Epidemiol ; 29(11): 444-450, 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-30318495

RESUMO

BACKGROUND: Japan became the first country where heat-not-burn tobacco products were sold. Therefore, there was no information for actual status on the actual use status or the harms of heat-not-burn tobacco products. The objectives of the study profile are to generate data that can be freely available to external researchers, and to create collaborative research projects in the future. METHODS: The Japan "Society and New Tobacco" Internet Survey (JASTIS) is a longitudinal internet cohort study which investigates perception, attitude, and use of heat-not-burn tobacco, electronic cigarettes (e-cigarettes), and conventional tobacco products in Japan. The survey also includes demographic, health-related, and socioeconomic factors. Participants were randomly selected and invited from internet panelists. The baseline survey was closed when the target number of respondents who had answered the questionnaire was met. RESULTS: The study includes three cohorts (1-3) from the 2015 baseline survey and a cohort (4) from the 2017 baseline survey: cohorts 1 and 4 were recruited based on sex and age: men and women aged 15-69 years (n = 8,240 for cohort 1 and n = 5,897 for cohort 4); cohorts 2 and 3 were created using status-based recruiting: e-cigarette and/or heat-not-burn tobacco ever users (n = 2,188; cohort 2) and combustible cigarette smokers without e-cigarette/heat-not-burn tobacco experience (n = 724; cohort 3). The completion rates were 8.5% to 9.9%. All subjects were followed and assessed annually. Response rates for the follow-up survey were 65.5% in 2016, 55.3% in 2017, and 50.9% in 2018. Because Internet-based responders are not a representative sample of the general population of Japan, we conducted adjustment to account for "being an internet survey respondent" and reported tobacco product use in Japan. A recent JASTIS study reported that prevalence of IQOS current-use among Japanese adults had rapidly increased from 0.3% in 2015 to 3.6% in 2017. CONCLUSION: The JASTIS study provides the first estimates for heat-not-burn tobacco use in the world and e-cigarette use in Japan. For information on collaboration, please contact the corresponding author.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar/epidemiologia , Fumar/psicologia , Produtos do Tabaco/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Internet , Japão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
12.
Nihon Koshu Eisei Zasshi ; 65(11): 655-665, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-30518704

RESUMO

Objectives Because smoking presents various health hazards, smoking cessation is important for health promotion. It is known that awareness of the harm of smoking to smokers themselves is associated with attempts to quit. However, the association between smoking cessation and awareness of harm to others from secondhand smoke has not been well examined. Therefore, in this research, we examined the association between smokers' awareness of the harm to others from secondhand smoke and their interest in smoking cessation, focusing on current smokers in an Internet survey of the general population of Japan.Methods We conducted a cross-sectional Internet survey of the general population of Japan between January 27 and March 13, 2017. A total of 1,586 respondents aged 15-71 years (1,128 men and 458 women) who were current smokers were analyzed. We used multivariable-adjusted logistic regression to examine the association among awareness of smoking's harm to smokers themselves, awareness of harm to others from secondhand smoke, and the smokers' interest in smoking cessation.Results Of current smokers, 81.6% of men and 88.2% of women were aware of the harm caused to others by secondhand smoke; 52.7% of men and 64.6% of women were interested in smoking cessation. Using awareness of harm to smokers themselves and awareness of harm to others from secondhand smoke as predictor variables in multivariable-adjusted logistic regression, odds ratios were 2.53 and 2.92, respectively. In the model using both awareness of harm to smokers themselves and harm to others from secondhand smoke, both have a significant independent positive association with smokers' interest in quitting.Conclusions Current smokers aware of the harm caused to others by secondhand smoke were more interested in quitting than those who were not. Awareness of the harm caused to smokers themselves by smoking and awareness of the harm caused to others by secondhand smoke have a significant independent positive association with smokers' interest in quitting. Although this study is a cross-sectional study and did not investigate causal relationships, the findings suggest that raising awareness of the harm to other people from secondhand smoke may lead to more interest in smoking cessation, and the data can be used to promote tobacco control in the future.


Assuntos
Conscientização , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/prevenção & controle , Adolescente , Adulto , Idoso , Feminino , Humanos , Internet , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
14.
Ann Behav Med ; 52(9): 752-761, 2018 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30124760

RESUMO

Background: There is evidence that training health professionals in behavioral counseling skills can lead to greater success in helping their smokers to quit. However, it is still unknown how counseling skills relate to counseling effects. Purpose: We established a method of skills evaluation of health professionals for smoking cessation counseling based on videotaped counseling sessions with a standardized smoker, and examined the relationship between skill levels and smoking cessation outcomes. Methods: Twenty-three health professionals at Japanese workplaces underwent a training program. Their counseling skills were evaluated before and after the program using a structured evaluation form-based analysis of videotaped interactions between participants and a standardized smoker. A total of 858 smokers then received individual smoking cessation counseling by the trained health professionals at an annual health checkup. These patients were followed-up through surveys after 1 year. Results: On a scale from 0 to 24, Total skill scores, which ranged from 0 to 24, were significantly higher after the training than before the training (p < .001). Multiple two-level logistic regression analysis adjusted for smokers' characteristics showed that the odds ratios of skill scores after the training for point prevalence and sustained abstinence rates among smokers who received counseling were 1.21 (95% confidence interval: 1.03-1.42) and 1.26 (1.05-1.50), respectively. Conclusions: This study demonstrates that higher behavioral counseling skills were associated with better smoking cessation outcomes. This research is of clinical importance in that it provides a tool for assessing counselling skills in a way that is demonstrably relevant to outcomes.


Assuntos
Competência Clínica , Aconselhamento , Abandono do Hábito de Fumar , Adulto , Idoso , Aconselhamento/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Gravação em Vídeo , Adulto Jovem
15.
J Phys Chem Lett ; 9(9): 2293-2297, 2018 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-29667412

RESUMO

To understand the instability of Sn-based perovskite, CH3NH3SnI3, photoelectron spectroscopy with synchrotron radiation and theoretical calculations, such as density functional theory and ab initio molecular dynamics, were performed. Findings from this experimental and theoretical study highlight the crucial changes of surface-chemical states, the broken chemical bondings in Sn-I, and the depletion of a CH3-NH3+ cation on the surface region. The material instability origin of Sn-based perovskite can be explained by the chemical state instability in the surface.

16.
Neurol Neuroimmunol Neuroinflamm ; 5(3): e456, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29616233

RESUMO

Objective: To examine cases with a clinical course, signs, and symptoms mimicking MS, but without abnormalities on conventional MRI. Methods: Among 550 people with a tentative diagnosis of MS or neuromyelitis optica spectrum disorder (NMOSD), we selected patients, who met the 2010 McDonald diagnosis criteria for MS, but did not show abnormal findings on conventional brain and spinal cord MRI. After evaluating their clinical data, we analyzed fractional anisotropy (FA) values in the brain white matter on diffusion tensor MRIs and the frequencies of B-cell subsets in the peripheral blood in the corresponding cases as compared to healthy controls. Results: Eleven patients (age: 41.1 ± 8.0 years, 9 women and 2 men) met the selection criteria. They were functionally disabled, with a median expanded disability status scale score of 6.0 (2.0-8.0). CSF oligoclonal bands were negative in all cases. IV methylprednisolone and plasmapheresis (PP) were found to be efficacious. Diffusion tensor MRI analysis revealed extensive white matter abnormalities characterized by significantly decreased FA values. The frequency of plasmablasts in the peripheral blood was significantly increased in these patients similar to NMOSD. Conclusions: The neurologic disabilities in these patients could be ascribed to brain white matter damage, as revealed by MRI analysis, whereas the efficacy of PP and B-cell abnormalities in the patients suggested an autoimmune-mediated pathogenesis. In the differential diagnosis of MS, we propose that this condition be referred to as, "Normal-appearing Imaging-associated, Neuroimmunologically Justified, Autoimmune encephalomyelitis."

17.
Clin Immunol ; 187: 95-101, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29079163

RESUMO

Patients with multiple sclerosis (MS) who are treated with fingolimod have an increased proportion of transitional B cells in the circulation, but the underlying mechanism is not known. We hypothesized that B cell-activating factor of the tumor necrosis factor family (BAFF) is involved in the process. Compared with healthy controls and untreated MS patients, fingolimod-treated MS patients had significantly higher serum concentrations of BAFF, which positively correlated with the proportions and the absolute numbers of transitional B cells in blood. Despite the elevated concentrations of BAFF in fingolimod-treated MS patients, serum levels of soluble transmembrane activator and calcium-modulating cyclophilin ligand interactor, and B cell maturation antigen were not elevated. Our results show that fingolimod induces BAFF in the circulation and expands transitional B cells, but does not activate memory B cells or plasma cells in MS, which is favorable for the treatment of this disease.


Assuntos
Fator Ativador de Células B/imunologia , Linfócitos B/imunologia , Cloridrato de Fingolimode/uso terapêutico , Memória Imunológica/imunologia , Imunossupressores/uso terapêutico , Esclerose Múltipla/tratamento farmacológico , Adulto , Antígeno de Maturação de Linfócitos B/imunologia , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/imunologia , Plasmócitos/imunologia , Células Precursoras de Linfócitos B/imunologia , Proteína Transmembrana Ativadora e Interagente do CAML/imunologia , Adulto Jovem
18.
Ann Clin Biochem ; 55(1): 128-135, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28135841

RESUMO

Background The Japan Statin Treatment Against Recurrent Stroke (J-STARS) is a clinical trial that administered pravastatin for secondary stroke prevention. Lipid concentrations are a well-established risk factor for cerebrovascular diseases. Elevated high-sensitivity C-reactive protein (hs-CRP) indicates a high risk of inflammatory reactions. In clinical trials, internationally approved standardization is essential for obtaining study results that are comparable with those from overseas. Therefore, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and hs-CRP were standardized throughout a 10-year study period. Methods J-STARS specified a single clinical laboratory for blood analyses. Four lipids were evaluated by calculating the total error: accuracy (absolute mean %bias vs. reference value) + precision (1.96 among-run coefficient of variation [CV, %]). Accuracy for hs-CRP was ensured using a calibrator traceable to the international plasma protein reference material and precision was evaluated by CV. Results Average total errors (standard deviation, %) throughout the study period were as follows: TC 1.35% (0.290%), HDL-C 2.45% (1.087%), LDL-C 2.65% (0.956%) and TG 3.70% (0.559%). Four lipids met the performance criteria of the US Centers for Disease Control and Prevention (CDC). The precision of hs-CRP was 3.28% (0.627%), which met the performance criterion established by the American Heart Association/CDC. Conclusions Based on standardization, the results of J-STARS appear to be comparable with those of similar intervention-based clinical studies on statins overseas. These study results will contribute to the establishment of preventive measures against recurrent stroke in Japanese patients. J-STARS is registered in ClinicalTrials.gov under NCT00221104.


Assuntos
Proteína C-Reativa/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Lipídeos/sangue , Acidente Vascular Cerebral/prevenção & controle , Idoso , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Limite de Detecção , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Prevenção Secundária
19.
Clin Ther ; 39(4): 863-872, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28365035

RESUMO

PURPOSE: This prospective analysis of the Japanese subpopulation of the varenicline reduce to quit study was conducted to evaluate whether results for Japanese participants were consistent with the full study population. METHODS: Patients received varenicline or placebo for a 24-week treatment period (12-week smoking reduction phase then a 12-week smoking abstinence phase) followed by a 28-week nontreatment, follow-up phase. Participants were to reduce the daily number of cigarettes smoked by at least 50% by week 4 and by a further 50% by week 8, with the goal of achieving complete abstinence by week 12. The primary efficacy end point was the carbon monoxide-confirmed continuous abstinence during weeks 15 to 24. FINDINGS: Overall, 210 Japanese patients were randomly assigned to 1 of the 2 study groups (varenicline, 107; placebo, 103). Continuous abstinence rates for weeks 15 to 24 were higher for participants in the varenicline group versus the placebo group (46.7% vs 12.6%; odds ratio = 14.68; 95% CI, 5.38-40.05), and the 7-day point prevalence of abstinence rates were higher for varenicline versus placebo at week 12 (odds ratio = 13.76; 95% CI, 5.28-35.86). The number of participants with a ≥50% reduction in the number of daily cigarettes smoked from baseline to week 4 and a ≥75% reduction by week 8 was greater in the varenicline group versus the placebo group (week 4: 59.8% vs 30.1%; week 8: 38.3% vs 12.6%). Serious adverse events were reported in 3.7% of varenicline participants and 1.0% of placebo participants. IMPLICATIONS: The efficacy and tolerability results of this analysis are consistent with those of the full varenicline reduce to quit study. Varenicline treatment and cigarette reduction before quitting may provide an alternative approach to smoking cessation in Japanese smokers who are not ready to quit immediately. ClinicalTrials.gov identifier: NCT01370356.


Assuntos
Agonistas Nicotínicos/uso terapêutico , Tabagismo/tratamento farmacológico , Vareniclina/uso terapêutico , Adulto , Grupo com Ancestrais do Continente Asiático , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Abandono do Hábito de Fumar , Resultado do Tratamento
20.
J Atheroscler Thromb ; 24(10): 1039-1047, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28302952

RESUMO

AIMS: The pleiotropic effects of statins on recurrent stroke remain unclear. We investigated the effects of pravastatin on high-sensitivity C-reactive proteins (Hs-CRP) in ischemic stroke, and explored the impact of Hs-CRP on recurrent stroke and vascular events. METHODS: This randomized open-label trial was ancillary to the J-STARS trial. One thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin (n=545) or control groups (n=550). The primary and secondary endpoints were serum Hs-CRP reduction and stroke recurrence, including both ischemic and hemorrhagic ones, respectively. Onset of vascular events and each stroke subtype in relation to Hs-CRP levels were also determined. RESULTS: In the pravastatin treatment group, Hs-CRP levels (median 711 µg/L, IQR 344-1500) significantly decreased 2 months later (median 592 µg/L, IQR 301-1390), and they remained significantly lower until the end of the study. However, in the control group, baseline Hs-CRP levels were similar to those 2 months later. The reduction of Hs-CRP levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control (p=0.007). One SD increase in log-transformed Hs-CRP increased the risk of stroke recurrence (HR 1.17, 95% CI 0.97-1.40) and vascular events (HR 1.30, 95% CI 1.12-1.51). With an Hs-CRP cut-off of 1000 µg/L, higher Hs-CRP significantly increased the risk of recurrent stroke (HR 1.50, 95% CI 1.03-2.17)and vascular events (HR 1.68, 95% CI 1.23-2.29). CONCLUSION: In non-cardiogenic ischemic stroke, pravastatin treatment may reduce vascular inflammation as assessed by Hs-CRP, and higher Hs-CRP levels appeared to increase the risk of recurrent stroke and vascular events.


Assuntos
Isquemia Encefálica/sangue , Isquemia Encefálica/tratamento farmacológico , Proteína C-Reativa/análise , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Pravastatina/uso terapêutico , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Incidência , Inflamação , Masculino , Pessoa de Meia-Idade , Recidiva , Risco
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