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1.
J Artif Organs ; 22(4): 300-306, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31372775

RESUMO

This study proposes that a polytetrafluoroethylene (PTFE) electret tube charged by frictional electricity can prevent the solidification of the indwelling catheter in blood vessels. Coagulation in intravascular indwelling catheters may discontinue the treatment because of thrombus-derived bacteria-adhesion infections or poor blood removal. Current commercially available intravascular catheters lack complete antithrombotic measures, even with heparin or urokinase antithrombotic coatings. Herein, we tested the effectiveness of an antithrombotic treatment that prevents coagulation using a static electric charge on the interior of the PTFE tube via the triboelectric effect by rubbing the tube's inner wall with a round glass rod. The anticoagulation properties were evaluated by enclosing a sample of blood in an electret tube and observing the coagulase adhering to the inner wall using a microscope. To confirm the effectiveness of this treatment, the charge-distribution on the inner surface of the electret tube was measured, surface irregularities were observed, and the elements on the surface were analyzed. The surface potential inside the electret tube was - 366.4 V, which proved effective for an antithrombotic treatment, as it discouraged coagulation, and the triboelectric charging process caused neither surface element denaturation nor significant surface irregularities. The nearly uniform negative surface charge on the inside of the tube was responsible for the antithrombotic effect because no surface irregularities or change in the surface element denaturation was observed. Triboelectrically charged PTFE electret tubes are highly useful for intravascular indwelling catheters.


Assuntos
Infecções Relacionadas a Cateter/prevenção & controle , Cateteres de Demora , Heparina/farmacologia , Politetrafluoretileno , Trombose/prevenção & controle , Desenho de Equipamento , Fibrinolíticos/farmacologia , Humanos , Propriedades de Superfície
2.
J Hypertens ; 37(6): 1301-1307, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31022110

RESUMO

OBJECTIVE: We examined whether the efficacy of low-dose acetylsalicylic acid (aspirin) for primary prevention of cardiovascular events is influenced by blood pressure (BP) using data from patients aged 60-85 years with hypertension, dyslipidemia, and/or diabetes, but without cardiovascular disease of the Japanese Primary Prevention Project. METHODS: All patients had received aspirin (100 mg/day) or no aspirin. BP subgroups were defined as low (average SBP from the baseline to the year of the events <130 mmHg), moderate (≥130 and <140 mmHg), and high (≥140 mmHg). The mean duration of follow-up was 5.02 years. RESULTS: In hypertensive patients (n = 12 278) aspirin had no significant impact on the primary outcome of death from cardiovascular disease, nonfatal stroke, and nonfatal myocardial infarction. On the other hand, aspirin increased the incidence of serious extracranial hemorrhage [hazard ratio, 1.81; 95% confidence interval (CI), 1.18-2.77; P = 0.0064] and tended to increase hemorrhagic stroke (hazard ratio, 1.75; CI, 0.99-3.07; P = 0.053). Aspirin had no effect on the primary outcome in any of the BP subgroups, and was associated with increased hemorrhagic stroke in the high BP group (hazard ratio, 3.51; CI, 1.29-9.51; P = 0.014); serious extracranial hemorrhage was elevated or tended to elevate in the moderate (hazard ratio, 2.53; CI, 1.18-5.45; P = 0.017) and high (hazard ratio, 2.14; CI, 1.00-4.56; P = 0.050) BP groups. CONCLUSION: In aged Japanese hypertensive patients, these data demonstrated no overall benefit of low-dose aspirin therapy although treatment was associated with an elevated risk of hemorrhagic events.

3.
Am J Cardiovasc Drugs ; 19(3): 299-311, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30565155

RESUMO

INTRODUCTION: This post hoc subanalysis of the randomized Japanese Primary Prevention Project investigated whether once-daily low-dose aspirin versus no aspirin reduced the risk of cardiovascular events (CVEs) in patients aged ≥ 70 years with atherosclerotic risk factors. METHODS: Patients aged < 70 years (young-old) or ≥ 70 years (old) with hypertension, dyslipidemia, or diabetes participated between 2005 and 2007. Patients were randomized 1:1 to receive 100 mg enteric-coated aspirin once daily or no aspirin plus standard of care. The primary outcome was a composite of death from cardiovascular causes plus nonfatal stroke and nonfatal myocardial infarction. The secondary outcome was a composite of the primary outcome plus transient ischemic attack, angina pectoris, and arteriosclerotic disease requiring medical or surgical intervention. Old (n = 7971) and young-old (n = 6493) patients were followed up for a median 5.02 years. RESULTS: Aspirin did not reduce the risk of primary (hazard ratio [HR] 0.92 [95% confidence interval {CI} 0.74-1.16]; P = 0.50) or secondary (0.85 [0.70-1.04]; P = 0.11) outcomes in patients aged ≥ 70 years. In old men with high-density lipoprotein < 40 mg/dL, treatment with low-dose aspirin was associated with a reduction in the incidence of the primary endpoint compared with the group not receiving aspirin (10/260 vs 22/250; HR 0.44 [95% CI 0.20-0.93]; P = 0.03). This subgroup was also found to contain significant larger proportions of patients with elevated body mass index, patients with diabetes mellitus, and smokers (P < 0.001). Old patients also showed differences in bleeding outcomes. Serious extracranial hemorrhage requiring transfusion or hospitalization occurred significantly more frequently in the aspirin-treated group than in the non-aspirin-treated group (35 [0.88%] vs 18 [0.45%]; HR 1.96 [1.11-3.46]; P = 0.020). Gastrointestinal hemorrhage occurred significantly more frequently in the aspirin-treated group than the non-aspirin-treated group (63 [1.58%] vs 18 [0.45%]; relative risk [RR] 3.5 [2.08-5.90]; P < 0.0001). Cerebral hemorrhage (intracranial hemorrhage) tended to occur more frequently in the aspirin-treated group than the non-aspirin-treated group (22 [0.55%] vs 11 [0.28%]; RR 2.01 [0.97-4.14]; P = 0.058). Cerebral hemorrhage occurred significantly more frequently in old patients than in young-old patients (33 [0.41%] vs 10 [0.15%]; HR 2.7 [1.34-5.53]; P = 0.0055). Gastrointestinal hemorrhage occurred in a slightly higher proportion of old patients compared with young-old patients (81 [1.02%] vs 53 [0.82%]; RR 1.2 [0.88-1.76]; P = 0.21). DISCUSSION/CONCLUSIONS: Aspirin did not reduce the risk of the primary or secondary outcomes in old patients. Aspirin treatment may have reduced CVEs within a high CVE risk elderly population subgroup. Aspirin treatment in such a group requires caution, because of the increased risk of intracranial hemorrhage, severe extracranial hemorrhage requiring hospitalization or transfusion, and gastrointestinal bleeding in old patients receiving aspirin therapy. CLINICAL TRIAL REGISTRATION: The study is registered at ClinicalTrials.gov [NCT00225849].


Assuntos
Aspirina/administração & dosagem , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Inibidores da Agregação de Plaquetas/administração & dosagem , Idoso , Grupo com Ancestrais do Continente Asiático , Aspirina/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/prevenção & controle , Inibidores da Agregação de Plaquetas/efeitos adversos , Prevenção Primária , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/prevenção & controle
4.
Res Pract Thromb Haemost ; 2(2): 274-281, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30046729

RESUMO

Background: Long-term follow-up of studies to investigate preventive effects of aspirin on arterial thrombosis indicate that aspirin reduces the incidence and mortality of some cancers in Western populations. Objectives: To explore the effects of aspirin on cancer incidence and mortality in the elderly Japanese. Patients/Methods: Patients aged 60 to 85 years, presenting with hypertension, dyslipidemia, or diabetes mellitus (n = 14 601, 7297 in the aspirin group and 7304 in the no-aspirin group) participated the Japanese Primary Prevention Project (JPPP), a multicenter, open-label, randomized, parallel-group trial. A subanalysis of JPPP was performed to analyze the incidence of newly diagnosed cancer and death related to cancer. Results: The cumulative incidence of newly diagnosed cancer was 5.60% (4.65-6.64%) in the aspirin group and 4.14% (3.67-4.66%) in the no-aspirin group. The hazard ratio for newly diagnosed cancer was 1.24 (1.06-1.46), and the cancer incidence was significantly higher in the aspirin group. The cumulative cancer mortality was 1.96% (1.65-2.31%) in the aspirin group and 1.87% (1.56-2.22%) in the no-aspirin group, with no statistically significant difference. The Fine and Gray model suggested that the difference in the incidence of newly diagnosed cancer between the two groups decreased year by year. Conclusions: Low-dose aspirin use did not reduce the cancer incidence or cancer mortality during a 5-year-average study period in the elderly Japanese. The cancer incidence in the aspirin group might decrease, however, to less than that in the no-aspirin group after the study period. Aspirin use might have led to earlier cancer diagnosis in our study.

5.
Knee Surg Sports Traumatol Arthrosc ; 26(12): 3810-3817, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30019074

RESUMO

PURPOSE: To compare clinical outcome and rotator cuff integrity after arthroscopic rotator cuff repair (ARCR) in patients with and without diabetes mellitus. METHODS: This retrospective study involved 264 consecutive patients who underwent ARCR from 2012 to 2015. Inclusion criteria were a medium or large-sized tear and a minimum of 1-year follow-up. Clinical outcome measures included range of motion (ROM) and the Japanese Orthopaedic Association (JOA) and University of California, Los Angeles (UCLA) scores preoperatively and at final follow-up. Rotator cuff retear was evaluated with magnetic resonance imaging at 3 months post-surgery and final follow-up. Diabetic patients with poor control were pre-operatively hospitalized for intensive diabetic control. RESULTS: Our inclusion criteria were met by 30 diabetic patients and 126 non-diabetic patients. Demographic data were not significantly different between the groups, except body mass index (p = 0.021). Preoperative JOA and UCLA scores of the diabetic patients were significantly lower than those of the non-diabetic patients (p < 0.001, and p = 0.006, respectively); however, the scores at final follow-up were not different. ROM was significantly restricted in the diabetic patients before surgery (forward flexion, abduction, internal rotation: p < 0.001, external rotation: p = 0.035), but at the final follow-up, there was no significant difference except for internal rotation (p = 0.005). The retear rate in diabetic patients (23.3%) was not significantly different from that in non-diabetic patients (15.1%). CONCLUSIONS: Diabetic patients who had good perioperative glycemic control showed clinical and structural outcomes comparable to non-diabetic patients after ARCR. Intensive perioperative glycemic control and patient education are recommended for preoperative uncontrolled diabetic patients. LEVEL OF EVIDENCE: III.


Assuntos
Diabetes Mellitus Tipo 2 , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Idoso , Artroplastia/métodos , Artroscopia/métodos , Feminino , Humanos , Escala de Gravidade do Ferimento , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Amplitude de Movimento Articular , Estudos Retrospectivos , Manguito Rotador/diagnóstico por imagem , Ruptura/cirurgia , Resultado do Tratamento , Cicatrização
6.
Rinsho Ketsueki ; 59(6): 755, 2018.
Artigo em Japonês | MEDLINE | ID: mdl-29973456
7.
J Foot Ankle Surg ; 57(5): 997-999, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29631968

RESUMO

We encountered a case of an accessory bone in the foot in the distal portion of the tarsal navicular and the proximal portion of the intermediate cuneiform, namely an os intercuneiform. The patient presented with a history of pain on the dorsal aspect of the left foot, with tenderness and swelling. Perioperative findings revealed a synfibrotic connection between the accessory bone and the navicular and intermediate cuneiform. After unsuccessful conservative treatment, the accessory bone was excised, leading to postoperative symptomatic relief.


Assuntos
Deformidades Congênitas do Pé/diagnóstico , Deformidades Congênitas do Pé/cirurgia , Ossos do Tarso/anormalidades , Ossos do Tarso/cirurgia , Feminino , Deformidades Congênitas do Pé/complicações , Humanos , Radiografia , Ossos do Tarso/diagnóstico por imagem , Adulto Jovem
9.
Arthroscopy ; 34(1): 105-110, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28866343

RESUMO

PURPOSE: To evaluate the clinical outcomes of arthroscopic treatment in adolescent baseball players with posteromedial elbow impingement. METHODS: This retrospective study evaluated the clinical outcome of arthroscopic treatment for posteromedial elbow impingement in adolescent baseball players. Patients were eligible for participation if they had undergone surgery at least 2 years earlier and excluded if they had arthritis, loose bodies, osteochondritis dissecans, ulnar collateral ligament tear, flexor/pronator injuries or medial epicondylitis, or nerve problems. Patients were also excluded if they had undergone prior elbow surgery, were younger than 13 years, or were older than 19 years. Arthroscopic treatment included debridement of posteromedial synovitis, fragment removal, and olecranon spur excision. At a mean follow-up of 26.7 (range 24-42) months, patients were evaluated based on a questionnaire, examination, and the previously reported elbow outcome score. RESULTS: This retrospective study involved 15 male patients, comprising 6 pitchers, 3 catchers, and 6 fielders, of mean age 15.7 (range 14-17) years. Mean time from onset of symptoms to surgery was 4.9 (range 3-18) months. Intraoperative findings included posteromedial synovitis and olecranon spurs in all patients and fragments in 10. The elbow outcome score was considered excellent in 11 patients and good in 2, with a mean score of 92 points (maximum 100 points). The mean postoperative range of motion at the elbow was 5° to 139.7° of flexion. All patients were able to return to their previous level of play after an average of 3.4 (range 2.5-4.5) months. No patient developed medial instability that later required reconstructive surgery. CONCLUSIONS: Arthroscopic debridement, excision of the olecranon spur, and removal of fragments yield reliable subjective and objective results and allow a return to baseball in adolescent patients. LEVEL OF EVIDENCE: Level IV, therapeutic case series.


Assuntos
Artralgia/cirurgia , Artroscopia/métodos , Traumatismos em Atletas/cirurgia , Beisebol/lesões , Ligamento Colateral Ulnar/lesões , Desbridamento/métodos , Articulação do Cotovelo/cirurgia , Adolescente , Artralgia/etiologia , Articulação do Cotovelo/lesões , Feminino , Humanos , Masculino , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
10.
J Med Invest ; 64(3.4): 313-316, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28955005

RESUMO

A 21-year-old woman who was high-level college softball player presented with a 6-month history of low back pain that had been treated unsuccessfully by medication at local clinics. There was tenderness in the left paravertebral muscle at the lower lumbar level. X-ray and computed tomography revealed congenital scoliosis and an L6 hemivertebra. Short tau inversion recovery magnetic resonance imaging showed a fluid collection at the left L6-S1 facet joint. We performed a diagnostic facet injection, consisting of 1% lidocaine and steroids, that was infiltrated into the left facet joint at L6-S1. Her persistent low back pain disappeared immediately after the facet block. We diagnosed left-sided facet arthritis at L6-S1. Due to her multiple congenital anomalies, excessive loading occurred at the facet joint. Therefore, we opted for conservative management, including mobilization of the thoracic spine and stretching of hamstrings and quadriceps. This case report underscores the importance of accurate diagnosis of low back pain and of the diagnostic utility of short tau inversion recovery magnetic resonance imaging and lumbar facet block in young athletes with chronic spinal pain. J. Med. Invest. 64: 313-316, August, 2017.


Assuntos
Dor Lombar/diagnóstico , Adulto , Atletas , Doença Crônica , Feminino , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/terapia , Imagem por Ressonância Magnética , Articulação Zigapofisária
11.
Skeletal Radiol ; 46(11): 1499-1505, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28730294

RESUMO

OBJECTIVE: To determine whether subchondral surface irregularities of the capitellum on ultrasonography in baseball players under the age of 10 years are indicative of early osteochondritis dissecans (OCD) of the capitellum. MATERIALS AND METHODS: A total of 321 players aged 6-9 years underwent ultrasonographic examination, and the findings for the subchondral bone of the capitellum on the throwing side were graded as 0, 1a, 1b, 2, or 3. Subjects classified as grade 1a or 1b showed irregularities of the subchondral bone surface and were investigated radiographically for OCD. All players continued to throw and were re-examined by ultrasonography after 1 and 2 years. RESULTS: At the first examination, 11/321 (3.4%) had irregularities at the subchondral surface of the capitellum [grade 1a in 7/321 (2.2%); grade 1b in 4/321 (1.2%)]. The seven players with grade 1a showed no evidence of OCD or Panner's disease on radiography and were reclassified as grade 0 at the 2-year follow-up. All four players with grade 1b were reclassified as grade 0 at follow-up 1 and 2 years later. CONCLUSION: Subchondral bone surface irregularities of the capitellum on ultrasonography in children under the age of 10 years may not be indicative of disease, but rather represent variation of ossification during normal development.


Assuntos
Beisebol/lesões , Articulação do Cotovelo/diagnóstico por imagem , Osteocondrite Dissecante/diagnóstico por imagem , Ultrassonografia/métodos , Idade de Início , Criança , Comportamento Competitivo , Seguimentos , Humanos , Masculino
12.
ACS Omega ; 2(4): 1660-1665, 2017 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-30023641

RESUMO

Flavin adenine dinucleotide (FAD)-dependent glucose dehydrogenase (GDH) was identified and cloned from thermophilic filamentous fungi Talaromyces emersonii using the homology cloning method. A direct electron transfer bioanode composed of T. emersonii FAD-GDH and a single-walled carbon nanotube was produced. Enzymes from thermophilic microorganisms generally have low activity at ambient temperature; however, the T. emersonii FAD-GDH bioanode exhibits a large anodic current due to the enzymatic reaction (1 mA cm-2) at ambient temperature. Furthermore, the T. emersonii FAD-GDH bioanode worked at 70 °C for 12 h. This is the first report of a bioanode with a glucose-catalyzing enzyme from a thermophilic microorganism that has potential for biosensor and biofuel cell applications. In addition, we demonstrate how the glycoforms of T. emersonii FAD-GDHs expressed by various hosts influence the electrochemical properties of the bioanode.

13.
Nihon Jinzo Gakkai Shi ; 59(2): 79-84, 2017.
Artigo em Inglês, Japonês | MEDLINE | ID: mdl-30549917

RESUMO

A 20-year-old woman, who was suffering from appetite loss, weight loss and livedo reticularis for one and half months, was referred to our hospital. On admission, laboratory studies demonstrated proteinuria (1.0 g/g Cr), hematuria (erythrocytes': 50 - 99/HPF), ,.enal dysfunction (Cr : 2.09 mg/dL), elevated C reactive protein (CRP: 10.82 mg/dL), elevated MPO-ANCA titer (11.6 U/mL) and elevated pentraxin3 (PTX3: 24.05 ng/mL). Her kidney and skin biopsy revealed massive crescentic necrotizing glomerulonephritis and leukocytoclastic vasculitis, respectively. She was diagnosed with microscopic polyangiitis (MPA), and treated with 500 mg/day of intravenous methyl-prednisolone (mPSL) for 3 days followed by 40 mg/day of oral PSL, rituximab (375 mg/m² once a week for a month) and plasma exchange. When PSL tapered to 30 mg/day in 4 weeks, her renal function was only partially recovered, while the CRP level had been normalized and the MPO-ANCA titer was almost negative (3.6 IU/mL). To evaluate histological activity, a second renal biopsy was conducted, which showed fibrocellular crescents in 32% of her glomeruli. The PTX3 level remained high (14.82 ng/mL) at that point. Taken together, the vasculitis was considered to be active still. Steroid pulse therapy for 3 days was administered again, followed by oral PSL 30 mg/day. Her renal function completely recovered in 70 days. The PTX3 level also normalized in 161 days. PTX3 is one of the short pentraxins, produced by a variety of cell types in response to pro-inflammatory signals such as IL-1 and TNF-α. It was reported that PTX3 reflects activity of vasculitis independently from CRP. In the presenting case, when the second renal biopsy revealed a histologically active lesion of the vasculitis, PTX3 was elevated independently from CRP and MPO-ANCA, suggesting that PTX3 may be a more sensitive marker of the disease activity than other tests.


Assuntos
Biomarcadores , Proteína C-Reativa , Poliangiite Microscópica , Componente Amiloide P Sérico , Biomarcadores/metabolismo , Proteína C-Reativa/metabolismo , Feminino , Humanos , Glomérulos Renais , Metilprednisolona/uso terapêutico , Poliangiite Microscópica/sangue , Poliangiite Microscópica/tratamento farmacológico , Poliangiite Microscópica/metabolismo , Troca Plasmática , Rituximab/uso terapêutico , Componente Amiloide P Sérico/metabolismo , Adulto Jovem
14.
Case Rep Orthop ; 2017: 8451797, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29318072

RESUMO

Vertebral bone bruise (VBB) in children commonly occurs following a fall from a height, and more than one vertebral body may be affected. We encountered 6 children each with a single VBB caused by mild physical activity. All the children had tenderness on the corresponding spinous process with no neurologic findings. Magnetic resonance imaging (MRI) showed typical findings of VBB in all cases. The children were treated conservatively with a soft thoracolumbar brace and instructed to rest with no physical activity for a month. At follow-up 1 month later, the back pain had diminished, and the signal changes seen on MRI had disappeared in all cases. We conclude that mild physical activity may be a cause of VBB in children and good clinical results can be achieved by using a soft thoracolumbar brace and rest.

15.
Appl Microbiol Biotechnol ; 101(1): 173-183, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27510979

RESUMO

FAD-dependent glucose dehydrogenase (FAD-GDH), which contains FAD as a cofactor, catalyzes the oxidation of D-glucose to D-glucono-1,5-lactone, and plays an important role in biosensors measuring blood glucose levels. In order to obtain a novel FAD-GDH gene homolog, we performed degenerate PCR screening of genomic DNAs from 17 species of thermophilic filamentous fungi. Two FAD-GDH gene homologs were identified and cloned from Talaromyces emersonii NBRC 31232 and Thermoascus crustaceus NBRC 9129. We then prepared the recombinant enzymes produced by Escherichia coli and Pichia pastoris. Absorption spectra and enzymatic assays revealed that the resulting enzymes contained oxidized FAD as a cofactor and exhibited glucose dehydrogenase activity. The transition midpoint temperatures (T m) were 66.4 and 62.5 °C for glycosylated FAD-GDHs of T. emersonii and T. crustaceus prepared by using P. pastoris as a host, respectively. Therefore, both FAD-GDHs exhibited high thermostability. In conclusion, we propose that these thermostable FAD-GDHs could be ideal enzymes for use as thermotolerant glucose sensors with high accuracy.


Assuntos
Fungos/enzimologia , Glucose Desidrogenase/isolamento & purificação , Glucose Desidrogenase/metabolismo , Temperatura Alta , Talaromyces/enzimologia , Thermoascus/enzimologia , Clonagem Molecular , Coenzimas/análise , Estabilidade Enzimática , Escherichia coli/genética , Escherichia coli/metabolismo , Flavina-Adenina Dinucleotídeo/análise , Fungos/genética , Expressão Gênica , Glucose Desidrogenase/química , Glucose Desidrogenase/genética , Pichia/genética , Pichia/metabolismo , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/isolamento & purificação , Proteínas Recombinantes/metabolismo , Análise Espectral , Talaromyces/genética , Thermoascus/genética
16.
Intern Med ; 55(16): 2295-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27523012

RESUMO

A 61-year-old Japanese woman with anemia, submandibular gland swelling, and enlarged lymph nodes was diagnosed with IgG4-related disease (IgG4-RD) by lymph node biopsy. Bone marrow involvement of IgG4-RD was detected by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and immunohistochemically proven by bone marrow biopsy in this patient. Anemia progressed gradually, and prednisolone treatment was initiated. Anemia and submandibular gland swelling improved soon after prednisolone treatment was initiated. We report a rare case of IgG4-RD involving the bone marrow. FDG-PET/CT and bone marrow biopsy were useful for diagnosis in this case.


Assuntos
Doenças Autoimunes/diagnóstico , Medula Óssea/patologia , Imunoglobulina G/sangue , Doenças Autoimunes/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos
17.
Stroke ; 47(6): 1605-11, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27165949

RESUMO

BACKGROUND AND PURPOSE: The effect of aspirin in primary prevention of stroke is controversial among clinical trials conducted in Western countries, and no data are available for Asian populations with a high risk of intracranial hemorrhage. The objective of this study was to evaluate the effect of aspirin on the risk of stroke and intracranial hemorrhage in the Japanese Primary Prevention Project (JPPP). METHODS: A total of 14 464 patients (age, 60-85 years) with hypertension, dyslipidemia, and diabetes mellitus participated and were randomized into 2 treatment groups: 100 mg of aspirin or no aspirin. The median follow-up period was 5.02 years. RESULTS: The cumulative rate of fatal or nonfatal stroke was similar for the aspirin (2.068%; 95% confidence interval [CI], 1.750-2.443) and no aspirin (2.299%; 95% CI, 1.963-2.692) groups at 5 years; the estimated hazard ratio was 0.927 (95% CI, 0.741-1.160; P=0.509). Aspirin nonsignificantly reduced the risk of ischemic stroke or transient ischemic attack (hazard ratio, 0.783; 95% CI, 0.606-1.012; P=0.061) and nonsignificantly increased the risk of intracranial hemorrhage (hazard ratio, 1.463; 95% CI; 0.956-2.237; P=0.078). A Cox regression adjusted by the risk factors for all stroke, which were age >70 years, smoking, and diabetes mellitus, supported the above result. CONCLUSIONS: Aspirin did not show any net benefit for the primary prevention of stroke in elderly Japanese patients with risk factors for stroke, whereas age >70 years, smoking, and diabetes mellitus were risk factors for stroke regardless of aspirin treatment. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00225849.


Assuntos
Aspirina/uso terapêutico , Isquemia Encefálica/prevenção & controle , Diabetes Mellitus , Dislipidemias , Hipertensão , Hemorragias Intracranianas/epidemiologia , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Inibidores da Agregação de Plaquetas/uso terapêutico , Prevenção Primária/estatística & dados numéricos , Acidente Vascular Cerebral/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Aspirina/efeitos adversos , Isquemia Encefálica/epidemiologia , Comorbidade , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Hemorragias Intracranianas/induzido quimicamente , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação de Plaquetas/efeitos adversos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
19.
Int J Hematol ; 102(3): 342-8, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26187695

RESUMO

Tyrosine kinase inhibitor (TKI) treatment has dramatically improved the outcome of chronic myelogenous leukemia in the chronic phase (CML-CP). However, one study has reported a less favorable treatment outcome with TKIs in adolescents and young adults (AYA) when compared with older patients. In the present study, we retrospectively reviewed the response to TKIs in a Japanese population of 133 CML-CP patients divided into an AYA group (n = 19) and an older group (n = 114). At diagnosis, AYA patients presented with higher white blood cell counts and lower percentage of basophils, and with lower Hasford scores, but no difference was observed in EUTOS score. Probability of achieving complete cytogenetic response was not statistically different between the groups. However, the probabilities of achieving major and complete molecular responses were significantly lower in the AYA group compared to the older group (61 vs 87 % and 17 vs. 33 % at 24 months, respectively; P < 0.05). In addition, a 7-year event-free survival was significantly lower in the AYA compared to the older adults (58 vs. 80 %, P < 0.05). These results suggest that AYA Japanese patients with CML-CP tend to have an unfavorable outcome on treatment with TKI.


Assuntos
Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Leucemia Mielogênica Crônica BCR-ABL Positiva/mortalidade , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Adolescente , Adulto , Idoso , Grupo com Ancestrais do Continente Asiático , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida
20.
Keio J Med ; 64(3): 37-43, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26212069

RESUMO

The risk of venous thromboembolism (VTE) in patients with cancer is several-fold higher than that in individuals without cancer. Recent studies demonstrated a high incidence of VTE in patients with hematologic malignancies as well as in patients with solid cancers. The reported incidence of VTE in lymphoma is variable, ranging from less than 5% to 59.5%. The incidence of VTE is higher in non-Hodgkin lymphoma than it is in Hodgkin lymphoma. The incidence of VTE also varies according to the disease grade, the disease stage, the performance status of the patient, and the site of disease. Most VTE cases occur at the diagnosis of cancer or early in the course of cancer treatment. An elevated incidence of VTE is also reported in cases of myeloma. VTE occurs in approximately 5% of myeloma patients treated with conventional chemotherapy, and treatment of myeloma patients with immunomodulatory drugs (IMid)-based therapy increases the risk of VTE. Prophylactic aspirin or anticoagulant is used in myeloma patients treated with IMid-based therapy. Several reports have indicated that the incidence of VTE is relatively low in Asian patients treated with IMid-based therapy, and concomitant use of bortezomib reduces the risk of VTE. The incidence of arterial thrombosis is also increased in patients with myeloma and monoclonal gammopathy of undetermined significance. Further studies are needed to develop a predictive model for identifying patients with lymphoma and myeloma who are at high risk for developing thrombosis.


Assuntos
Linfoma/complicações , Mieloma Múltiplo/complicações , Trombose/fisiopatologia , Tromboembolia Venosa/fisiopatologia , Anticoagulantes/uso terapêutico , Aspirina/uso terapêutico , Feminino , Humanos , Incidência , Linfoma/sangue , Masculino , Mieloma Múltiplo/sangue , Estudos Retrospectivos , Transplante de Células-Tronco , Trombose/complicações , Trombose/prevenção & controle , Tromboembolia Venosa/complicações , Tromboembolia Venosa/prevenção & controle
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