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1.
Int Heart J ; 62(2): 238-245, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731519

RESUMO

The effect of a history of cancer on the prognosis of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) is poorly understood.From the Osaka Acute Coronary Insufficiency Study (OACIS) registry in Osaka, Japan, we enrolled the case data of a total of 3499 patients with AMI treated with PCI between 1998 and 2014, of whom 462 had a cancer history (cancer group, 13.2%) and 3037 did not (non-cancer group, 86.8%). All of the cases were followed for up to five years from discharge.The Kaplan-Meier curve and multivariate analysis using Cox proportional hazards models revealed that all-cause mortality was significantly higher in the cancer group than in the non-cancer group (adjusted hazard ratio [HR], 2.43; P < 0.001). Deaths from cardiac, cancer, and other causes were treated as competing events, and competing analysis using the cumulative incidence function (CIF) and Fine-Gray model revealed that mortality due to cancer was higher in the cancer group than in the non-cancer group, whereas cardiac mortality was similar between the two groups. The incidences of cardiovascular events, including stroke, recurrent infarction, and heart failure requiring readmission, were also similar between the two groups, although the Kaplan-Meier analysis and univariate Cox proportional hazards model revealed that the incidence of stroke was higher in the cancer group than in the non-cancer group.A history of cancer increased all-cause and cancer mortality among patients with AMI treated with PCI, although it was not associated with cardiovascular events.


Assuntos
Infarto do Miocárdio/complicações , Neoplasias/epidemiologia , Intervenção Coronária Percutânea , Sistema de Registros , Medição de Risco/métodos , Idoso , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/cirurgia , Neoplasias/etiologia , Período Pós-Operatório , Prognóstico , Estudos Prospectivos , Fatores de Risco
2.
Cancer Med ; 10(6): 2153-2163, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33650323

RESUMO

Prior studies reported the association of reproductive factors with breast cancer (BC), but the evidence is inconsistent. We conducted a pooled analysis of nine cohort studies in Japan to evaluate the impact of six reproductive factors (age at menarche/age at first birth/number of births/age at menopause/use of female hormones/breastfeeding) on BC incidence. We conducted analyses according to menopausal status at the baseline or at the diagnosis. Hazard ratio (HR) and 95% confidence interval (CI) were estimated by applying Cox proportional-hazards model in each study. These hazard ratios were integrated using a random-effects model. Among 187,999 women (premenopausal: 61,113, postmenopausal: 126,886), we observed 873 premenopausal and 1,456 postmenopausal cases. Among premenopausal women, use of female hormones significantly increased BC incidence (HR: 1.53 [1.04-2.25]). Although P value for trend was not significant for age at first birth and number of births (P for trend: 0.15 and 0.30, respectively), women giving first birth at ages ≥36 experienced significantly higher BC incidence than at ages 21-25 years, and women who had ≥2 births experienced significantly lower BC incidence than nulliparous women. Among postmenopausal women, more births significantly decreased BC incidence (P for trend: 0.03). Although P value for trend was not significant for age at first birth and age at menopause (P for trend: 0.30 and 0.37, respectively), women giving first birth at ages 26-35 years experienced significantly higher BC incidence than at ages 21-25 years, and women with age at menopause: ≥50 years experienced significantly higher BC incidence than age at menopause: ≤44 years. BC incidence was similar according to age at menarche or breastfeeding history among both premenopausal and postmenopausal women. In conclusion, among Japanese women, use of female hormones increased BC incidence in premenopausal women, and more births decreased BC incidence in postmenopausal women.

3.
J Clin Med ; 9(9)2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32927835

RESUMO

Little is known about the epidemiological characteristics of patients with coronavirus disease 2019 (COVID-19) in Japan. This is a retrospective observational study of COVID-19 patients; study was conducted from February 1 to May 31, 2020. We used publicly collected data on cases of COVID-19 confirmed by polymerase chain reaction (PCR) testing in Osaka Prefecture, Japan. We described the patient characteristics. The Cox proportional-hazards model was applied to evaluate the association between factors (sex, onset month, age group, city of residence) and mortality, and hazard ratios (HRs) with 95% confidence intervals were estimated. During the study period, 5.7% (1782/31,152) of individuals who underwent PCR testing for COVID-19 showed positive results. Among 244 patients with information on symptoms, the most common symptom was fever (76.6%), followed by cough (44.3%). Of the 1782 patients, 86 patients died. Compared with those aged 0-59 years, higher mortality was observed among those aged 60-69 years (HR: 12.02 [3.37-42.93]), 70-79 years (HR: 44.62 [15.16-131.30]), 80-89 years (HR: 68.38 [22.93-203.89]), and ≥90 years (HR: 144.71 [42.55-492.15]). In conclusion, in Osaka Prefecture, Japan, the most common symptom was fever, and older adults had higher mortality among COVID-19 patients.

4.
Kyobu Geka ; 73(8): 595-598, 2020 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-32879287

RESUMO

Coronary aneurysms are relatively rare. However, myocardial infarction associated with thrombus formation in the aneurysm and rupture of the aneurysm are clinical problems. There are no specific guidelines for the treatment of coronary aneurysms. Here, we report a case of a 47-year-old female with acute myocardial infarction. She had a history of collagen disease, which was suspected to be Kawasaki disease. She underwent thrombus aspiration supported by intra-aortic balloon pumping( IABP) because of acute thrombosis of coronary aneurysms, followed by coronary artery bypass grafting on 2 stages. The operative course was uneventful.


Assuntos
Aneurisma Coronário , Síndrome de Linfonodos Mucocutâneos , Infarto do Miocárdio , Ponte de Artéria Coronária , Feminino , Humanos , Balão Intra-Aórtico , Pessoa de Meia-Idade
5.
Kyobu Geka ; 73(3): 197-201, 2020 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-32393702

RESUMO

Postoperative chylothorax is known as a possible complication after thoracic surgery, but no treatment strategy has been established. We report a case of successful surgical treatment for postoperative chylothorax after redo aortic arch replacement via median sternotomy. A 48-year-old man, who had undergone redo aortic arch replacement for aortic pseudoaneurysm due to prosthetic vascular graft infection, developed postoperative chylothorax. Despite the conservative treatment with fasting and administration of octreotide for 4 days, there was no effect on reduction in drainage. Surgical repair was performed on postoperative day 13. About 3 hours before surgery, milk was administered from the nasogastric tube to make the drainage milky. After median re-sternotomy, a stump of the thoracic duct was clearly identified and exposed in the posterior mediastinum, and the thoracic duct was easily closed by clipping. There was no recurrence of chylothorax and oral intake was re-started on day 2. Early operation might be effective against postoperative chylothorax.


Assuntos
Quilotórax , Aorta Torácica , Quilotórax/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Complicações Pós-Operatórias , Esternotomia
6.
Methods Protoc ; 3(1)2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-32012965

RESUMO

Early European plucked instruments have recently experienced a great revival, but a few aspects remain unknown (e.g., the gauge of gut strings). Here we report, for the first time, that the electron spin resonance (ESR) signal intensity of oxidized iron, Fe(III), from gut strings at g = 2 increases linearly with age within a few hundred years. The signal increase in the remaining old strings on early instruments can be used to judge if they are as old as or younger than the instrument. Obtaining the authenticity information of gut strings contributes to the revival of the old instruments and the music.

7.
Cancer Epidemiol Biomarkers Prev ; 28(8): 1370-1378, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31113869

RESUMO

BACKGROUND: Detailed prospective evaluation of cigarette smoking associated with pancreatic cancer risk in large Asian populations is limited. The aim of this study was to examine this association in a Japanese population, with a particular focus on evaluating sex differences. METHODS: We performed a pooled analysis of 10 population-based cohort studies. We calculated study-specific HRs and 95% confidence intervals (CI) using Cox proportional hazards regression, and then estimated summary HRs by pooling these estimates with a random effects model. RESULTS: During 4,695,593 person-years of follow-up in 354,154 participants, 1,779 incident pancreatic cancer cases were identified. We observed an increased pancreatic cancer risk for current smoking compared with never smoking in both males [HR (95% CI), 1.59 (1.32-1.91)] and females [HR (95% CI), 1.81 (1.43-2.30)]. Significant risk elevations for former smoking and small cumulative dose of ≤20 pack-years (PY) were observed only among females, regardless of environmental tobacco smoke exposure. Trend analysis indicated significant 6% and nonsignificant 6% increases in pancreatic cancer risk for every 10 PYs in males and females, respectively. Risk became comparable with never smokers after 5 years of smoking cessation in males. In females, however, we observed no risk attenuation by smoking cessation. CONCLUSIONS: This study supports the well-known association between smoking and pancreatic cancer and indicates potential sex differences in a Japanese population. Quitting smoking would be beneficial for pancreatic cancer prevention, especially in males. IMPACT: Pancreatic cancer risk is increased with cumulative smoking exposure and decreased with smoking cessation, with potential sex differences.


Assuntos
Neoplasias Pancreáticas/epidemiologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar Tabaco/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Japão/epidemiologia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/patologia , Prognóstico , Estudos Prospectivos , Fatores de Risco , Sexismo , Abandono do Hábito de Fumar/métodos , Fumar Tabaco/patologia
8.
BMJ Open Sport Exerc Med ; 5(1): e000653, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32206340

RESUMO

Aim: To evaluate mortality among Japanese Olympic athletes compared with the general population and also evaluate their mortality based on total number of Olympics participation and intensity of sports disciplines. Methods: Information on biography, vital status, date of birth, date of death and latest follow-up date on Japanese Olympians was retrieved from six online databases and compared. Standardised mortality ratio (SMR) was estimated according to observation periods and years from last participation in the Olympics. To further evaluate the association between mortality and total number of Olympics participation/intensity of sports disciplines within the study population, rate ratios (RRs) adjusted by sex, observation period and attained age group were estimated by a Poisson regression model. Results: A total of 3381 Olympians were included in the analysis. The total person years was 94 076.82. The deaths of 153 (4.53%) Olympians were confirmed, and the overall SMR was 0.29 (95% CI, 0.25 to 0.34). SMRs categorised by years from last participation did not differ significantly. Higher mortality was observed among those who participated in the Olympics twice (RR: 1.52; 95% CI, 1.04 to 2.23) and three times or more (RR: 1.87; 95% CI, 1.08 to 3.25) compared with those who participated just once. Compared with combination of low static and low dynamic intensity category, higher mortality was observed in most combinations of middle-intensity or high-intensity categories. Conclusion: Japanese Olympians lived longer than the general population. More frequent participation in the Olympics and higher intensity of sports disciplines were associated with higher mortality.

9.
Interact Cardiovasc Thorac Surg ; 28(3): 499-501, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30289458

RESUMO

Ventricular septal rupture is an uncommon fatal complication of acute myocardial infarction. In rare cases, the rupture can extend into the right ventricular free wall and cause intramyocardial dissection. We describe the case of a patient who developed postinfarction right ventricular free wall dissection with left-to-right shunting and successfully underwent patch repair.


Assuntos
Procedimentos Cirúrgicos Cardíacos/métodos , Ruptura Cardíaca Pós-Infarto/diagnóstico , Ventrículos do Coração/diagnóstico por imagem , Idoso de 80 Anos ou mais , Angiografia Coronária , Ecocardiografia , Feminino , Ruptura Cardíaca Pós-Infarto/cirurgia , Ventrículos do Coração/cirurgia , Humanos , Tomografia Computadorizada por Raios X
13.
Ann Thorac Cardiovasc Surg ; 18(5): 485-7, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22446953

RESUMO

An 82-year-old woman, who underwent axillo-bifemoral bypass for infrarenal aortic occlusion and peripheral arterial occlusive disease 9 years before, was admitted to our hospital for swelling in the left subclavicular region. Ultrasound examination revealed a leak in the wall of the bypass graft with the formation of a false aneurysm. No signs of infection, either locally or systemically, were observed. Resection of the aneurismal segment with interposition using a Dacron graft was performed. Macroscopic findings during surgery confirmed an intact anastomotic region of the left axillary artery and Dacron graft. Two possible mechanisms for the formation of this false aneurysm, either cumulative stress on the graft over the years or Dacron graft biodegradation, were hypothesized.


Assuntos
Falso Aneurisma/cirurgia , Doenças da Aorta/cirurgia , Artéria Axilar/cirurgia , Prótese Vascular , Artéria Femoral/cirurgia , Polietilenotereftalatos , Falha de Prótese/efeitos adversos , Idoso de 80 Anos ou mais , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Aorta Abdominal/cirurgia , Artéria Axilar/diagnóstico por imagem , Artéria Axilar/patologia , Feminino , Seguimentos , Humanos , Resultado do Tratamento , Ultrassonografia
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