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1.
Brain Nerve ; 72(10): 1023-1030, 2020 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-33051387

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide peril. The PCR tests are widely used to detect infections. However, multiple regression analysis revealed no correlation between the examination rate among population (ER) and the success of containment, which is achieved by social distancing. ER and fatality rate were even positively correlated. Japan has been criticized for its very low ER, but it achieved better containment than other major countries with much higher ER on 29 May. The estimation of the true infection rate (TIR) among population revealed that the low fatality rate in Japan and other Asian countries is partly due to low TIR. Fatality of COVID-19 is highly accentuated in aged persons. Despite having the highest aging rate in the world, the fatality rate in Japan is relatively low. The corrected fatality rate of Japan is the second-lowest among the G20 countries. Mimicking the attenuation of viral virulence due to natural selection would be a promising strategy to overcome pandemic. The prevention of in-hospital transmission, especially from severe cases, would be the key to achieve this. Attenuation of the viral virulence in the second wave is evident in many European countries, and also in Tokyo.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Infecções por Coronavirus/epidemiologia , Humanos , Japão/epidemiologia , Pneumonia Viral/epidemiologia
2.
PLoS One ; 15(10): e0240396, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031476

RESUMO

During the past 6 months, the world has lost almost 950,000 lives because of the outbreak of COVID-19, with more than 31 million individuals diagnosed with COVID-19 worldwide. In response, lockdowns, and various other policies have been implemented. Unfortunately, many individuals are violating those policies and governments have been urging people to comply with the behavioral guidelines. In this paper, we argue that personality traits need to be considered to understand and encourage more effective public compliance with COVID 19 transmission mitigation behavioral guidelines. Using a sample of 8,548 individuals from Japan, we show that certain personality traits are related to the tendency to comply with COVID-19 transmission mitigation behavioral guidelines. We emphasize the importance of understanding why people respond differently to the same authority's messages and provide actionable insights for government policy makers and those who implement policies.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Política de Saúde , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adulto , Betacoronavirus/fisiologia , Comportamentos Relacionados com a Saúde , Humanos , Japão/epidemiologia , Pessoa de Meia-Idade , Personalidade , Adulto Jovem
3.
Medicine (Baltimore) ; 99(38): e22248, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957372

RESUMO

With the advance of medical care, the duration of dependency on nursing care in later life has increased worldwide. There is a question of whether farm work could extend or shorten the dependency duration. We investigated the association between farm work experience and the duration of dependency on nursing support or care in late life.We randomly selected 600 adults aged ≥65 years, who were independent and not hospitalized, as part of the Yamanashi Healthy-Active Life Expectancy cohort and followed them for 13 years. We defined the duration of dependency as the time from reception of long-term care insurance benefits to death, and we adjusted for multiple covariates.We analyzed data from 225 adults (139 men and 86 women) who died during the follow-up period. Ninety four had received long-term care benefits. Mean age was 79.6 years (standard deviation [SD]: 6.3) in individuals with farm work experience and 80.1 years (SD: 7.2) in individuals without farm work experience. The estimated duration of dependency on long-term care was 1.3 years (standard error [SE]: 0.4) in individuals with farm work experience vs 2.1 years (SE: 0.5) in individuals without farm work experience (P = .01). The estimated duration of dependency in individuals with farm work experience and without farm work experience was 0.4 years (SE: 0.5) vs 1.3 years (SE: 0.6) in men respectively (P = .03) and 1.6 years (SE: 0.9) vs 2.4 years (SE: 0.9) in women, respectively (P = .16). The sensitivity analysis yielded an estimated duration of 1.2 years (SE: 0.5) in those with farm work experience and 2.3 years (SE: 0.5) in those without farm work experience (P = .004).Individuals with farm work experience required less long-term care prior to death, suggesting that agricultural and physical activities promote health. Policymakers focusing on preventing the need for nursing care in older populations could consider promoting farming or gardening.


Assuntos
Utilização de Instalações e Serviços , Fazendeiros/psicologia , Envelhecimento Saudável , Vida Independente , Assistência de Longa Duração/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Japão/epidemiologia , Expectativa de Vida , Masculino , Fatores de Tempo
4.
Medicine (Baltimore) ; 99(36): e22060, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899071

RESUMO

The phase III West Japan Oncology Group (WJOG) 4407G study showed noninferiority of folinic acid, bolus/continuous fluorouracil, and irinotecan plus bevacizumab to modified folinic acid, bolus/continuous fluorouracil, and oxaliplatin 6 plus bevacizumab in progression-free survival (PFS) as first-line chemotherapy for patients with metastatic colorectal cancer. The aim of this study was to evaluate the predictive and prognostic value of morphologic response in patients with colorectal liver metastases (CLM) as a post hoc analysis of the WJOG4407G study.Morphologic response was assessed by comparing contrast-enhanced computed tomography (CT) images at baseline and week 8. Three blinded radiologists evaluated CT images and classified their response as optimal, incomplete, or no response according to the morphologic criteria. Response evaluation criteria in solid tumors (RECIST) response, early tumor shrinkage (ETS), and depth of response (DpR) were also evaluated.Among 395 patients who were eligible for efficacy analysis in the WJOG4407G study, 70 patients had liver-limited disease. We finally evaluated 55 of these patients. Optimal morphologic response was identified in 19 of 55 patients (34.5%). The median PFS was 10.7 months for patients with optimal response and 10.1 months in those with incomplete/no response (log-rank, P = .96). The median overall survival (OS) was 26.2 and 35.5 months, respectively (log-rank, P = .062). According to univariate analysis, morphologic response was not associated with PFS or OS, whereas RECIST response was significantly associated with both PFS and OS, with ETS and DpR being associated with significantly longer PFS.Morphologic response might be neither a predictive nor a prognostic factor in patients with CLM undergoing chemotherapy containing bevacizumab, whereas RECIST response was significantly associated with both PFS and OS.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Bevacizumab/uso terapêutico , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Adulto , Idoso , Antimetabólitos Antineoplásicos , Antineoplásicos Imunológicos/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Bevacizumab/administração & dosagem , Feminino , Fluoruracila/uso terapêutico , Humanos , Infusões Intravenosas/métodos , Irinotecano/uso terapêutico , Japão/epidemiologia , Leucovorina/administração & dosagem , Leucovorina/uso terapêutico , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/tratamento farmacológico , Metástase Neoplásica/patologia , Oxaliplatina/uso terapêutico , Valor Preditivo dos Testes , Prognóstico , Intervalo Livre de Progressão , Critérios de Avaliação de Resposta em Tumores Sólidos , Tomografia Computadorizada por Raios X/métodos , Inibidores da Topoisomerase I/uso terapêutico , Resultado do Tratamento , Complexo Vitamínico B/administração & dosagem , Complexo Vitamínico B/uso terapêutico
5.
Medicine (Baltimore) ; 99(36): e22061, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899072

RESUMO

INTRODUCTION: Nilotinib is a selective inhibitor of the BCR-ABL tyrosine kinase receptor and is used in the management of chronic myelogenous leukemia (CML). Nilotinib therapy at high doses is associated with elevated serum bilirubin levels. If the serum bilirubin level exceeds 3 times the upper limit of normal, the recommendation is to either adjust nilotinib dosage or temporarily discontinue the treatment. However, it is unclear whether hyperbilirubinemia indicates obvious liver histology damage. PATIENT CONCERNS: A 24-year-old man with confirmed CML was treated with nilotinib therapy and developed hyperbilirubinemia after the treatment. Although the first remission of the hyperbilirubinemia was achieved after dose adjustment, the hematological parameters deteriorated. Thus, we initiated an antineoplastic therapy (at the standard dose) until complete remission of the CML was achieved. The pathogenic mechanism of hyperbilirubinemia may be related to the inhibition of uridine diphosphate-glucuronosyltransferase (UGT1A1) activity. Liver histological analysis revealed no significant liver damage. In addition, the patient had no family history of hyperbilirubinemia and liver disease. DIAGNOSIS: The patient was admitted to our hospital under the diagnosis of hyperbilirubinemia, and histopathology by liver biopsy showed no obvious damage. We also detected a UGT1A1 mutation [ex1 c.686C > A (p.Pro229Gln)] in the patient and his mother. INTERVENTIONS: When the nilotinib dose was decreased to 300 mg daily, the total bilirubin (TBIL) level decreased to 30 to 50 µmol/L for 1 month. However, because the Bcr-Abl/Abl ratio did not correspond to the major molecular response (MMR; <0.1%), the nilotinib dose was readjusted to 400 mg daily. One week later, the TBIL and indirect bilirubin levels increased to 89 and 79 µmol/L, respectively. The levels of alanine transaminase and other liver functional indicators were normal. OUTCOMES: A Naranjo Adverse Drug Reaction (ADR) Probability Scale score of 13 indicates that hyperbilirubinemia is attributed to ADR caused by nilotinib rather than by drug-induced liver injury. CONCLUSION: Although reducing the nilotinib dose can alleviate the occurrence of hyperbilirubinemia, the effect of MMR is also reduced. Treatment of CML without dose adjustment or discontinuation of nilotinib therapy may be more advantageous.


Assuntos
Doença Hepática Crônica Induzida por Substâncias e Drogas/diagnóstico , Proteínas de Fusão bcr-abl/antagonistas & inibidores , Leucemia Mielogênica Crônica BCR-ABL Positiva/complicações , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Idoso , Antineoplásicos/uso terapêutico , Doença Hepática Crônica Induzida por Substâncias e Drogas/patologia , China/epidemiologia , Feminino , Glucuronosiltransferase/efeitos dos fármacos , Glucuronosiltransferase/genética , Humanos , Hiperbilirrubinemia/induzido quimicamente , Japão/epidemiologia , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mães , Mutação , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Indução de Remissão , Adulto Jovem
6.
Int Heart J ; 61(5): 888-895, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32921675

RESUMO

Although B-type natriuretic peptide (BNP) has gradually gained recognition as an indicator in risk stratification for patients with acute myocardial infarction (AMI), the prognostic impact on long-term clinical outcomes in patients with non-ST-segment elevation acute myocardial infarction (NSTEMI) without creatine kinase (CK) elevation remains unclear.This prospective multicenter study assessed 3,283 consecutive patients with AMI admitted to 28 institutions in Japan between 2012 and 2014. We analyzed 218 patients with NSTEMI without CK elevation (NSTEMI-CK) for whom BNP was available. In the NSTEMI-CK group, patients were assigned to high- and low-BNP groups according to BNP values (cut-off BNP, 100 pg/mL). The primary endpoint was defined as a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, cardiac failure, and urgent revascularization for unstable angina up to 3 years. Primary endpoints were observed in 60 (33.3%) events among patients with NSTEMI-CK. Kaplan-Meier analysis revealed a significantly higher event rate for primary endpoints among patients with high BNP (log-rank P < 0.001). After adjusting for covariates, a higher BNP level was significantly associated with long-term clinical outcomes in NSTEMI-CK (adjusted hazard ratio, 4.86; 95% confidence interval, 2.18-12.44; P < 0.001).The BNP concentration is associated with adverse long-term clinical outcomes among patients with NSTEMI-CK who are considered low risk. Careful clinical management may be warranted for secondary prevention in patients with NSTEMI-CK with high BNP levels.


Assuntos
Angina Instável/epidemiologia , Creatina Quinase/sangue , Insuficiência Cardíaca/epidemiologia , Mortalidade , Infarto do Miocárdio/epidemiologia , Peptídeo Natriurético Encefálico/sangue , Infarto do Miocárdio sem Supradesnível do Segmento ST/sangue , Acidente Vascular Cerebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Angina Instável/cirurgia , Causas de Morte , Feminino , Humanos , Japão/epidemiologia , Masculino , Revascularização Miocárdica/estatística & dados numéricos , Infarto do Miocárdio sem Supradesnível do Segmento ST/terapia , Prognóstico , Modelos de Riscos Proporcionais
7.
Western Pac Surveill Response J ; 11(1): 22-28, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963888

RESUMO

Objective: To identify individual characteristics related to the development of pulmonary tuberculosis (PTB) among residents in the Airin area (Airin), Osaka City, Japan. Methods: We conducted a retrospective case-control study of individual characteristics potentially related to the development of PTB by comparing PTB patients and residents without tuberculosis (TB) in Airin. The following binominal data of characteristics were compared: age (< 65 or > 65); body mass index (BMI) (< 18.5 or > 18.5); diabetes mellitus (diagnosed or not diagnosed); smoking (currently smoking any amount or not smoking); and alcohol use (currently drinking any amount or not drinking). Results: We compared the individual characteristics of 192 PTB patients notified from January 2015 to December 2018 and 190 residents of supportive houses who attended a health education programme from April 2016 to March 2018.Univariable analysis showed that the following characteristics were significantly related with PTB: BMI < 18.5 (odds ratio [OR]: 6.54, 95% confidence interval [CI]: 3.58-11.97, P < 0.001) and current alcohol use (OR: 1.88; 95% CI: 1.24-2.85, P = 0.003). Multivariable analysis showed similar results: BMI < 18.5 (adjusted odds ratio [aOR]: 6.90, 95% CI: 3.72-12.79, P < 0.001) and current alcohol use (aOR: 2.15, 95% CI: 1.36-3.42, P = 0.001). Discussion: Undernutrition and alcohol use are individual characteristics associated with PTB among residents in Airin, Osaka City. To strengthen the TB control programme further, it is suggested to develop new programmes for primary prevention.


Assuntos
Pobreza/estatística & dados numéricos , Tuberculose Pulmonar/epidemiologia , População Urbana/estatística & dados numéricos , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
8.
Medicine (Baltimore) ; 99(35): e21576, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871874

RESUMO

BACKGROUND: Cellular energetics play an important role in Parkinsons disease etiology, but no treatments directly address this deficiency. Our past research showed that treatment with febuxostat and inosine increased blood hypoxanthine and ATP in healthy adults, and a preliminary trial in 3 Parkinson's disease patients suggested some symptomatic improvements with no adverse effects. METHODS: To examine the efficacy on symptoms and safety in a larger group of Parkinsons disease patients, we conducted a single-arm, open-label trial at 5 Japanese neurology clinics and enrolled thirty patients (nmales = 11; nfemales = 19); 26 patients completed the study (nmales = 10; nfemales = 16). Each patient was administered febuxostat 20 mg and inosine 500 mg twice-per-day (after breakfast and dinner) for 8 weeks. The primary endpoint was the difference of MDS-UPDRS Part III score immediately before and after 57 days of treatment. RESULTS: Serum hypoxanthine concentrations were raised significantly after treatment (Pre = 11.4 µM; Post = 38.1 µM; P < .0001). MDS-UPDRS Part III score was significantly lower after treatment (Pre = 28.1 ±â€Š9.3; Post = 24.7 ±â€Š10.8; mean ±â€ŠSD; P = .0146). Sixteen adverse events occurred in 13/29 (44.8%) patients, including 1 serious adverse event (fracture of the second lumbar vertebra) that was considered not related to the treatment. CONCLUSIONS: The results of this study suggest that co-administration of febuxostat and inosine is relatively safe and effective for improving symptoms of Parkinsons disease patients. Further controlled trials need to be performed to confirm the symptomatic improvement and to examine the disease-modifying effect in long-term trials.


Assuntos
Febuxostat/uso terapêutico , Supressores da Gota/uso terapêutico , Inosina/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Trifosfato de Adenosina/sangue , Administração Oral , Idoso , Estudos de Casos e Controles , Quimioterapia Combinada , Febuxostat/administração & dosagem , Febuxostat/efeitos adversos , Feminino , Supressores da Gota/administração & dosagem , Supressores da Gota/efeitos adversos , Humanos , Hipoxantina/sangue , Inosina/administração & dosagem , Inosina/efeitos adversos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Doença de Parkinson/metabolismo , Doença de Parkinson/fisiopatologia , Segurança , Resultado do Tratamento , Xantina Desidrogenase/antagonistas & inibidores
9.
Anticancer Res ; 40(10): 5829-5835, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32988912

RESUMO

BACKGROUND: Preoperative chemotherapy with surgery is the most effective treatment modality in Japan for advanced oesophageal squamous cell carcinoma (OSCC). We evaluated the long-term outcomes associated with preoperative docetaxel/cisplatin/5-fluorouracil (DCF) administration followed by oesophagectomy in OSCC. PATIENTS AND METHODS: Overall, 76 consecutive patients with cStage IB-IIIC OSCC were enrolled. After two cycles of preoperative DCF, oesophagectomy was performed. Survival monitoring was performed and relevant risk factors were analysed. RESULTS: The median follow-up period was 88.3 months. The 5-year overall and recurrence-free survival rates were 51% and 43%, respectively. In the multivariable analysis, cT3 stage [hazard ratio (HR)=1.81, 95% confidence interval (CI)=1.08-6.16], incomplete chemotherapy (HR=2.35, 95% CI=1.37-4.02), poor clinical response (HR=1.82, 95% CI=1.01-3.29), and postoperative complications (HR=2.11, 95% CI=1.14-3.90) were independent predictors of poorer overall survival. CONCLUSION: The 5-year outcomes of preoperative DCF with oesophagectomy were favourable. Our findings can aid in the formulation of strategies aimed at improving prognosis in OSCC.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Esofágicas/tratamento farmacológico , Metástase Linfática/tratamento farmacológico , Prognóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Cisplatino/uso terapêutico , Docetaxel/uso terapêutico , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Feminino , Fluoruracila/uso terapêutico , Humanos , Japão/epidemiologia , Metástase Linfática/patologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Resultado do Tratamento
10.
F1000Res ; 9: 334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32934802

RESUMO

The COVID-19 outbreak is a worldwide medical and epidemiological catastrophe, and the number of psychological studies concerning COVID-19 is growing daily. Such studies need baseline data from before the COVID-19 outbreak for comparison, but such datasets have not yet been accumulated and shared. Here, we provide a dataset on the perceived vulnerability to disease scale for 1382 Japanese participants obtained through an online survey conducted in 2018 that will be useful for comparison with current or post-COVID-19 perceived vulnerability to disease data.


Assuntos
Infecções por Coronavirus/epidemiologia , Suscetibilidade a Doenças , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Conjuntos de Dados como Assunto , Feminino , Humanos , Japão/epidemiologia , Masculino , Pandemias
13.
BMC Infect Dis ; 20(1): 712, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993511

RESUMO

BACKGROUND: Japan's National Immunization Program does not cover rotavirus vaccine and no government subsidies are available. This study aimed to measure the uptake of and determinants that influenced self-paid rotavirus vaccination, including socioeconomic status and relative poverty. METHODS: We conducted a cross-sectional study at health check-ups for all children aged 18 months in Kanazawa, Japan, between December 2017 and July 2018. Community nurses collected information on self-paid vaccination history, parents' perceptions of and recommendations for rotavirus vaccine, and socioeconomic status in interviews using a unified questionnaire. We used multivariable logistic regression to assess vaccine uptake and possible determinants. RESULTS: In total, 1282 participants were enrolled. The estimated rotavirus vaccine coverage was 72.9%. Perceptions that rotavirus gastroenteritis was serious and that the rotavirus vaccine was effective, pediatricians' recommendations, information from the city office, magazine and Internet articles, and higher parental education level were associated with higher rotavirus vaccine uptake. Lower household income was associated with decreased rotavirus vaccine uptake. Vaccine expense, fear of adverse reactions to the vaccine, number of household members and siblings, and children's characteristics were not correlated with rotavirus vaccination. Poverty was associated with decreased rotavirus vaccine uptake, even after adjustment for other determinants (adjusted odds ratio 0.49, 95% confidence interval: 0.26-0.90). CONCLUSION: Parents' perceptions, socioeconomic status, relative poverty, and pediatricians' recommendations are determinants of vaccination. This study suggests that appropriate information about rotavirus vaccine, subsidies for those of lower socioeconomic status, and national recommendations are necessary to achieve higher coverage.


Assuntos
Pais/psicologia , Percepção , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/economia , Rotavirus/imunologia , Classe Social , Vacinação/economia , Adulto , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Renda , Lactente , Japão/epidemiologia , Modelos Logísticos , Masculino , Razão de Chances , Pobreza , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/imunologia , Inquéritos e Questionários
14.
PLoS One ; 15(9): e0237961, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915804

RESUMO

Foot-and-mouth disease (FMD) models-analytical models for tracking and analyzing FMD outbreaks-are known as dominant tools for examining the spread of the disease under various conditions and assessing the effectiveness of countermeasures. There has been some remarkable progress in modeling research since the UK epidemic in 2001. Several modeling methods have been introduced, developed, and are still growing. However, in 2010 when a FMD outbreak occurred in the Miyazaki prefecture, a crucial problem reported: Once a regional FMD outbreak occurs, municipal officials in the region must make various day-to-day decisions throughout this period of vulnerability. The deliverables of FMD modeling research in its current state appear insufficient to support the daily judgments required in such cases. FMD model can be an efficient support tool for prevention decisions. It requires being conversant with modeling and its preconditions. Therefore, most municipal officials with no knowledge or experience found full use of the model difficult. Given this limitation, the authors consider methods and systems to support users of FMD models who must make real-time epidemic-related judgments in the infected areas. We propose a virtual sensor, designated "FMD-VS," to index FMD virus scattering in conditions where there is once a notion of FMD; and (2) shows how we apply the developed FMD-VS technique during an outbreak. In (1), we show our approach to constructing FMD-VS based on the existing FMD model and offer an analysis and evaluation method to assess its performance. We again present the results produced when the technique applied to 2010 infection data from the Miyazaki Prefecture. For (2), we outline the concept of a method that supports the prevention judgment of municipal officials and show how to use FMD-VS.


Assuntos
Doenças dos Bovinos/prevenção & controle , Febre Aftosa/prevenção & controle , Modelos Teóricos , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/patologia , Surtos de Doenças , Febre Aftosa/epidemiologia , Febre Aftosa/patologia , Japão/epidemiologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-32927829

RESUMO

Psychological distress caused by decreased physical activity (PA) is a growing concern among the elderly due to public health measures since the coronavirus disease (COVID-19). We aimed to (1) assess how public health restrictions impact PA, subjective well-being (SWB), and health-related quality of life (HRQoL) of community-dwelling elderly, and (2) investigate risk factors that lead to a decline in PA. Self-administered questionnaires assessed the changes in PA, SWB, HRQoL. Multivariate logistic regression analysis was performed to identify significant associated risk factors for decreased PA. Of 165 participants (valid response rate, 41.3%; mean age, 78.5 ± 8.0 years), 47.3% became less active, 23.0% became more active, and 29.7% maintained PA levels. There was a significant decrease in SWB at baseline and follow-up after COVID-19 restrictions in the less active group (p < 0.01). Higher levels of moderate or strenuous exercise/sports activity at baseline (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.01-1.24), and lower mental component HRQoL scores at baseline (OR, 0.96; 95% CI, 0.93-0.99) were associated with an increased risk of decreased PA. Public health restrictions impact the PA of the elderly, especially those who had higher levels of exercise/sports activity and lower HRQoL before COVID-19. Decreased PA was strongly associated with lower SWB.


Assuntos
Infecções por Coronavirus/epidemiologia , Exercício Físico , Pneumonia Viral/epidemiologia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Nível de Saúde , Humanos , Japão/epidemiologia , Pandemias , Fatores de Risco , Inquéritos e Questionários
16.
J Alzheimers Dis ; 77(2): 539-541, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925073

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic has substantially affected patients with dementia and their caregivers. However, we found not all Alzheimer's disease (AD) patients were afraid of COVID-19 infection. Therefore, we investigated the association between rate of awareness of COVID-19 and depressive tendency in AD. 126 consecutive outpatients with AD were enrolled in this study from May 25, on the day when the declaration of emergency was lifted in Japan, through June 30, 2020. In addition to routine psychological tests, the participants were asked the following two questions: "Do you know COVID-19?" and "Why are you wearing a face mask?". Moderate to severe AD patients were found to have a low COVID-19 recognition rate and did not fully understand why they were wearing face masks. In addition, because they did not understand the seriousness of the COVID-19 outbreak, their Geriatric Depression Scale scores were also substantially lower. These results may appear to simply indicate that people with severe dementia are unaware of current events. However, these results provide insights into how to care for patients with dementia and how to allocate the time and support of our limited staff during the COVID-19 outbreak.


Assuntos
Doença de Alzheimer , Conscientização , Infecções por Coronavirus , Competência Mental , Pandemias , Assistência ao Paciente , Pneumonia Viral , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Doença de Alzheimer/virologia , Betacoronavirus , Cuidadores/psicologia , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pandemias/prevenção & controle , Assistência ao Paciente/métodos , Assistência ao Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Sistemas de Apoio Psicossocial , Índice de Gravidade de Doença
17.
Environ Health Prev Med ; 25(1): 52, 2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912144

RESUMO

OBJECTIVE: This study estimated the effects of weekend and off-hour childbirth and the size of perinatal medical care center on the incidence of cerebral palsy. METHODS: The cases were all children with severe cerebral palsy born in Japan from 2009 to 2012 whose data were stored at the Japan Obstetric Compensation System for Cerebral Palsy database, a nationally representative database. The inclusion criteria were the following: neonates born between January 2009 and December 2012 who had a birth weight of at least 2000 g and gestational age of at least 33 weeks and who had severe disability resulting from cerebral palsy independent of congenital causes or factors during the neonatal period or thereafter. Study participants were restricted to singletons and controls without report of death, scheduled cesarean section, or ambulance transportation. The controls were newborns, randomly selected by year and type of delivery (normal spontaneous delivery without cesarean section and emergency cesarean section) using a 1:10 case to control ratio sampled from the nationwide Japan Society of Obstetrics and Gynecology database. RESULTS: A total of 90 cerebral palsy cases and 900 controls having normal spontaneous delivery without cesarean section were selected, as were 92 cerebral palsy cases and 920 controls with emergent cesarean section. A significantly higher risk for cerebral palsy was found among cases that underwent emergent cesarean section on weekends (odds ratio [OR] 1.72, 95% confidence interval [CI] 1.06-2.81) and during the night shift (OR 2.29, 95% CI 1.30-4.02). No significant risk was found among normal spontaneous deliveries on weekends (OR 1.63, 95% CI 0.97-2.73) or during the quasi-night shift (OR 1.26, 95% CI 0.70-2.27). Regional perinatal care centers showed significantly higher risk for cerebral palsy in both emergent cesarean section (OR 2.35, 95% CI 1.47-3.77) and normal spontaneous delivery (OR 2.92, 95% CI 1.76-4.84). CONCLUSION: Labor on weekends, during the night shift, and at regional perinatal medical care centers was associated with significantly elevated risk for cerebral palsy in emergency cesarean section.


Assuntos
Paralisia Cerebral/epidemiologia , Parto Obstétrico/estatística & dados numéricos , Instalações de Saúde/estatística & dados numéricos , Assistência Perinatal/estatística & dados numéricos , Estudos de Casos e Controles , Paralisia Cerebral/etiologia , Humanos , Incidência , Recém-Nascido , Japão/epidemiologia , Parto , Estudos Retrospectivos , Fatores de Tempo
18.
PLoS One ; 15(8): e0237509, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810157

RESUMO

Limited data are available regarding treatment patterns, healthcare resource utilization (HCRU), treatment costs and clinical outcomes for patients with diffuse large B-cell lymphoma (DLBCL) in Japan. This retrospective database study analyzed the Medical Data Vision database for DLBCL patients who received treatment during the identification period from October 1 2008 to December 31 2017. Among 6,965 eligible DLBCL patients, 5,541 patients (79.6%) received first-line (1L) rituximab (R)-based therapy, and then were gradually switched to chemotherapy without R in subsequent lines of therapy. In each treatment regimen, 1L treatment cost was the highest among all lines of therapy. The major cost drivers i.e. total direct medical costs until death or censoring across all regimens and lines of therapy were from the 1L regimen and inpatient costs. During the follow-up period, DLBCL patients who received a 1L R-CHOP regimen achieved the highest survival rate and longest time-to-next-treatment, with a relatively low mean treatment cost due to lower inpatient healthcare resource utilization and fewer lines of therapy compared to other 1L regimens. Our retrospective analysis of clinical practices in Japanese DLBCL patients demonstrated that 1L treatment and inpatient costs were major cost contributors and that the use of 1L R-CHOP was associated with better clinical outcomes at a relatively low mean treatment cost.


Assuntos
Custos de Cuidados de Saúde , Linfoma Difuso de Grandes Células B , Padrões de Prática Médica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/economia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Pré-Escolar , Análise Custo-Benefício , Ciclofosfamida/economia , Ciclofosfamida/uso terapêutico , Bases de Dados Factuais , Doxorrubicina/economia , Doxorrubicina/uso terapêutico , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Hospitalização/economia , Hospitalização/estatística & dados numéricos , Humanos , Formulário de Reclamação de Seguro/estatística & dados numéricos , Japão/epidemiologia , Linfoma Difuso de Grandes Células B/economia , Linfoma Difuso de Grandes Células B/mortalidade , Linfoma Difuso de Grandes Células B/terapia , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/economia , Terapia Neoadjuvante/estatística & dados numéricos , Padrões de Prática Médica/economia , Padrões de Prática Médica/estatística & dados numéricos , Prednisona/economia , Prednisona/uso terapêutico , Estudos Retrospectivos , Rituximab/administração & dosagem , Rituximab/economia , Rituximab/uso terapêutico , Análise de Sobrevida , Vincristina/economia , Vincristina/uso terapêutico , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-32751311

RESUMO

This study analyzed the morbidity and mortality rates of the coronavirus disease (COVID-19) pandemic in different prefectures of Japan. Under the constraint that daily maximum confirmed deaths and daily maximum cases should exceed 4 and 10, respectively, 14 prefectures were included, and cofactors affecting the morbidity and mortality rates were evaluated. In particular, the number of confirmed deaths was assessed, excluding cases of nosocomial infections and nursing home patients. The correlations between the morbidity and mortality rates and population density were statistically significant (p-value < 0.05). In addition, the percentage of elderly population was also found to be non-negligible. Among weather parameters, the maximum temperature and absolute humidity averaged over the duration were found to be in modest correlation with the morbidity and mortality rates. Lower morbidity and mortality rates were observed for higher temperature and absolute humidity. Multivariate linear regression considering these factors showed that the adjusted determination coefficient for the confirmed cases was 0.693 in terms of population density, elderly percentage, and maximum absolute humidity (p-value < 0.01). These findings could be useful for intervention planning during future pandemics, including a potential second COVID-19 outbreak.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Densidade Demográfica , Tempo (Meteorologia) , Idoso , Infecções por Coronavirus/virologia , Surtos de Doenças , Previsões , Humanos , Umidade , Japão/epidemiologia , Morbidade , Pandemias , Pneumonia Viral/virologia , Temperatura
20.
Medicine (Baltimore) ; 99(34): e21889, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846850

RESUMO

Electromyographic biofeedback (EMG-BF) therapy provides information on the state of contraction of the targeted muscles and relaxation of their antagonists, which can facilitate early active range of motion (RoM) after elbow surgery. Our aim in this study was to calculate the minimum detectable change (MDC) during EMG-BF therapy, initiated in the early postoperative period after elbow surgery.This study is an observational case series. EMG-BF of muscle contraction and relaxation was provided during active elbow flexion and extension exercises. Patients completed 3 sets of 10 trials each of flexion and extension over 4 weeks. The total range of flexion-extension motion and scores on the Japanese Society for Surgery of the Hand version of the disability of the arm, shoulder, and hand questionnaire and the Japanese version of the Patient-Rated Elbow Evaluation were obtained at baseline and weekly during the 4-week intervention period. A prediction formula was developed from the time-series data obtained during the intervention period, using the least-squares method. The estimated value was calculated by removing the slope from the prediction formula and adding the initial scores to residuals between the measured scores and predicted scores individually. Systematic error, MDC at the 95th percentile cutoff (MDC95), repeatability of the measures, and the change from the baseline to each time-point of intervention were assessed.The MDC95 was obtained for all 3 outcome measures and the range of values was as follows: RoM, 8.3° to 22.5°; Japanese version of the Patient-Rated Elbow Evaluation score, 17.6 to 30.6 points; and disability of the arm, shoulder, and hand questionnaire subscale: disability and symptoms score, 14.2 to 22.9 points.The efficacy of EMG-BF after elbow surgery was reflected in earlier initiation of elbow RoM after surgery and improvement in patient-reported upper limb function scores. The calculated MDC95 cut-offs could be used as reference values to assess the therapeutic effects of EMG-BF in individuals.


Assuntos
Biorretroalimentação Psicológica/métodos , Cotovelo/cirurgia , Amplitude de Movimento Articular/fisiologia , Reabilitação/métodos , Adulto , Idoso , Avaliação da Deficiência , Cotovelo/patologia , Eletromiografia , Terapia por Exercício/métodos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Relaxamento Muscular/fisiologia , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Reabilitação/tendências , Reprodutibilidade dos Testes , Inquéritos e Questionários , Resultado do Tratamento
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