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101.
Ryo Kawasaki Yoko Akune Yoshimune Hiratsuka Shunichi Fukuhara Masakazu Yamada 《Ophthalmic epidemiology》2015,22(1):4-12
ABSTRACTPurpose: To evaluate the cost-effectiveness for a screening interval longer than 1 year detecting diabetic retinopathy (DR) through the estimation of incremental costs per quality-adjusted life year (QALY) based on the best available clinical data in Japan.Methods: A Markov model with a probabilistic cohort analysis was framed to calculate incremental costs per QALY gained by implementing a screening program detecting DR in Japan. A 1-year cycle length and population size of 50,000 with a 50-year time horizon (age 40–90 years) was used. Best available clinical data from publications and national surveillance data was used, and a model was designed including current diagnosis and management of DR with corresponding visual outcomes. One-way and probabilistic sensitivity analyses were performed considering uncertainties in the parameters.Results: In the base-case analysis, the strategy with a screening program resulted in an incremental cost of 5,147 Japanese yen (¥; US$64.6) and incremental effectiveness of 0.0054 QALYs per person screened. The incremental cost-effectiveness ratio was ¥944,981 (US$11,857) per QALY. The simulation suggested that screening would result in a significant reduction in blindness in people aged 40 years or over (?16%). Sensitivity analyses suggested that in order to achieve both reductions in blindness and cost-effectiveness in Japan, the screening program should screen those aged 53–84 years, at intervals of 3 years or less.Conclusions: An eye screening program in Japan would be cost-effective in detecting DR and preventing blindness from DR, even allowing for the uncertainties in estimates of costs, utility, and current management of DR. 相似文献
102.
Microvascular resistance in response to iodinated contrast media in normal and functionally impaired kidneys 下载免费PDF全文
Osamu Kurihara Masamichi Takano Saori Uchiyama Isamu Fukuizumi Tetsuro Shimura Masato Matsushita Hidenori Komiyama Toru Inami Daisuke Murakami Ryo Munakata Takayoshi Ohba Noritake Hata Yoshihiko Seino Wataru Shimizu 《Clinical and experimental pharmacology & physiology》2015,42(12):1245-1250
Contrast‐induced nephropathy (CIN) is considered to result from intrarenal vasoconstriction, and occurs more frequently in impaired than in normal kidneys. It was hypothesized that iodinated contrast media would markedly change renal blood flow and vascular resistance in functionally impaired kidneys. Thirty‐six patients were enrolled (32 men; mean age, 75.3 ± 7.6 years) undergoing diagnostic coronary angiography and were divided into two groups based on the presence of chronic kidney disease (CKD), defined as an estimated glomerular filtration rate (eGFR) of < 60 mL/min per 1.73 m2 (CKD and non‐CKD groups, n = 18 in both). Average peak velocity (APV) and renal artery resistance index (RI) were measured by Doppler flow wire before and after administration of the iodinated contrast media. The APV and the RI were positively and inversely correlated with the eGFR at baseline, respectively (APV, R = 0.545, P = 0.001; RI, R = ?0.627, P < 0.001). Mean RI was significantly higher (P = 0.015) and APV was significantly lower (P = 0.026) in the CKD than in the non‐CKD group. Both APV (P < 0.001) and RI (P = 0.002) were significantly changed following contrast media administration in the non‐CKD group, but not in the CKD group (APV, P = 0.258; RI, P = 0.707). Although renal arterial resistance was higher in patients with CKD, it was not affected by contrast media administration, suggesting that patients with CKD could have an attenuated response to contrast media. 相似文献
103.
104.
Toshio Kinoshita Hitomi Yuzawa Kazuhiko Natori Ryo Wada Shintaro Yao Kensuke Yano Katsuya Akitsu Hideki Koike Masaya Shinohara Tadashi Fujino Hideaki Shimada Takanori Ikeda 《Journal of cardiology》2021,77(4):388-394
BackgroundDealing with chemotherapy-related cardiac dysfunction (CTRCD) remains a significant problem complicated by the difficulty in early detection of cardiotoxicity. Electrocardiogram (ECG) is expected to be the most realistic methodology due to lower cost-performance and non-invasiveness. We investigated the long-term visual fluctuations in the ECG waveforms in patients with chronic doxorubicin (DOX)-induced cardiotoxicity to identify ECG indices for the early detection of cardiotoxicity.MethodsWe conducted a retrospective case series study by reviewing the medical records of 470 consecutive patients with malignant lymphoma who were treated with DOX at our institute between January 2010 and December 2017. Of them, 23 (4.9%) patients developed left ventricular dysfunction and were diagnosed with CTRCD using echocardiography. We assessed the ECG indices on 12-lead ECG recordings before and after treatment in 15 patients; eight patients were excluded due to conduction disturbances or atrial fibrillation.ResultsCTRCD was detected at a median of 475 (interquartile range, IQR: 341–1333) days after initiating chemotherapy. The evaluation of ECG indices preceding CTRCD development was performed 93 (IQR: 52–232) days before the detection of CTRCD. In the stage of CTRCD, the most significant ECG change was T-wave flattening in leads V3–V6 (12 patients, 80%). Additionally, QTa prolongation was observed in leads I and aVL (n = 10, 66%), leads II, III, and aVF (n = 9, 60%), and leads V3–V6 (n = 10, 73%). These ECG changes were not observed before the treatment but were detected mildly in the pre-CTRCD stage, which subsequently worsened in the CTRCD stage.ConclusionsThis study indicated that T-wave changes and QTa prolongation may be useful as an early indicator before the onset of CTRCD in patients with DOX-induced cardiotoxicity. 相似文献
105.
Shiro Ono Kiyomi Yoshimoto Nobushiro Nishimura Ryo Yoneima Hiromasa Kawashima Tadanao Kobayashi Yoshiaki Tai Makiko Miyamoto Emiko Tsushima Noritaka Yada Kenji Nishio 《Internal medicine (Tokyo, Japan)》2021,60(8):1303
TAFRO syndrome is a systemic inflammatory, lymphoproliferative disorder, but the pathophysiology of the disease is unknown. It is typically characterized by thrombocytopenia, anasarca, a fever, reticulin fibrosis, renal dysfunction, and organomegaly. However, other manifestations have been also reported. We encountered a 43-year-old man with TAFRO syndrome who showed mediastinal panniculitis, liver damage, and adrenal lesions in addition to the core signs. He achieved complete remission with combination therapy of corticosteroids, tocilizumab, and cyclosporin, and remission was maintained even after drug discontinuation at 15 months. Atypical manifestations and complete remission of TAFRO syndrome were remarkable features of our case. 相似文献
106.
Miyoshi Jun Ozaki Ryo Yonezawa Hiromi Mori Hideaki Kawamura Naohiro Matsuura Minoru Hisamatsu Tadakazu 《Journal of gastroenterology》2022,57(2):82-89
Journal of Gastroenterology - The development of feasible, reliable parameters and criteria for intestinal ultrasound (IUS) to estimate endoscopic remission of ulcerative colitis (UC) is a crucial... 相似文献
107.
Takeshi Suda Ryo Iguchi Takaaki Ishiyama Tsutomu Kanefuji Takahiro Hoshi Satoshi Abe Shinichi Morita Kazuyoshi Yagi 《Internal medicine (Tokyo, Japan)》2021,60(11):1717
A 47-year-old Japanese man was referred to our hospital because of a sustained high fever with diarrhea 12 days after a flight from India. Liver enzymes were elevated with rose spots, hepatosplenomegaly, relative bradycardia, and acute cholecystitis. A liver biopsy depicted the dense infiltration of lymphocytes and Kupffer cells in sinusoids and the granulomatous formation in the parenchyma. The liver damage was initially resolved with the administration of ceftriaxone for 16 days but flared up 1 week later. Laboratory tests yielded positive reactions for Salmonella typhi and hepatitis E virus RNA. The pathophysiological presentations of concurrent typhoid and type E hepatitis are discussed. 相似文献
108.
Toyonaga Takahiko Kobayashi Taku Kuronuma Satoshi Ueno Aito Kiyohara Hiroki Okabayashi Shinji Takeuchi Osamu Redfern Christopher P. F. Terai Hideki Ozaki Ryo Sagami Shintaro Nakano Masaru Coulthard Sally A. Tanaka Yoichi Hibi Toshifumi 《Journal of gastroenterology》2021,56(11):999-1007
Journal of Gastroenterology - Polymorphisms in the nucleotide diphosphate-linked moiety X-type motif 15 (NUDT15) gene are associated with thiopurine-induced leukopenia in patients with inflammatory... 相似文献
109.
110.
Dr. Hideho Takada M.D. Kazuhiko Yoshioka M.D. Tsunehiko Boku M.D. Ryo Yoshida M.D. Kuniyuki Nakagawa M.D. Tadashi Matsuda M.D. Koshiro Hioki M.D. 《Diseases of the colon and rectum》1995,38(12):1325-1326
An easy and simple method for constructing a urinary diversion in patients undergoing pelvic exenteration for advanced rectal cancer is described. This procedure features double-barreled colostomy with a segment of the sigmoid colon 8 to 10 cm distal to the stoma as a urinary conduit.Read at the meeting of the Japanese Research Society for Cancer of the Colon and Rectum, Tokyo, Japan, July 29, 1994. 相似文献