著者

Nobuyasu Awano Nene Oyama Keiko Akiyama Minoru Inomata Naoyuki Kuse Mari Tone Kohei Takada Yutaka Muto Kazushi Fujimoto Yu Akagi Momoko Mawatari Akihiro Ueda Junko Kawakami Junko Komatsu Takehiro Izumo

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.59, no.21, pp.2693-2699, 2020-11-01 (Released:2020-11-01)

参考文献数

25

被引用文献数

1 81

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Objective Coronavirus disease 2019 (COVID-19) is spreading around the world. The aim of this study was to assess the degree of anxiety, depression, resilience, and other psychiatric symptoms among healthcare workers in Japan during the COVID-19 pandemic. Methods This survey involved medical healthcare workers at the Japanese Red Cross Medical Center (Tokyo, Japan) between April 22 and May 15, 2020. The degree of symptoms of anxiety, depression, and resilience was assessed using the Japanese versions of the 7-item Generalized Anxiety Disorder Scale (GAD-7), Center for Epidemiologic Studies Depression Scale (CES-D), and 10-item Connor-Davidson Resilience Scale. Furthermore, we added original questionnaires comprising three factors: (i) anxiety and fear of infection and death; (ii) isolation and unreasonable treatment; and (iii) motivation and escape behavior at work. Results In total, 848 healthcare workers participated in this survey: 104 doctors, 461 nurses, 184 other co-medical staff, and 99 office workers. Among all participants, 85 (10.0%) developed moderate-to-severe anxiety disorder, and 237 (27.9%) developed depression. Problems with anxiety and fear of infection and death, isolation and unreasonable treatment, and motivation and escape from work were higher in the depression group than in the non-depression group (total CES-D score ≥ 16 points). Being a nurse and high total GAD-7 scores were risk factors of depression. Older workers and those with higher resilience were less likely to develop depression than others. Conclusion During the COVID-19 epidemic, many healthcare workers suffered from psychiatric symptoms. Psychological support and interventions for protecting the mental health of them are needed.

著者

Yuwa Oka Akihiro Ueda Tomokazu Nakagawa Yujiro Kikuchi Daiki Inoue Satoshi Marumo Sadayuki Matsumoto

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8123-21, (Released:2021-08-06)

参考文献数

9

被引用文献数

5

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We herein report a 49-year-old man with a fever, diagnosed with SARS-CoV-2 infection. After two weeks of hospitalization, he suddenly mentioned visual field impairment. Computed tomography and magnetic resonance imaging revealed white matter damage and vasogenic edema. Cerebrospinal fluid showed increased levels of IL-6. His symptoms and white matter lesion deteriorated. After treatment with intravenous methylprednisolone therapy and plasmapheresis, his symptoms and white matter lesion improved gradually. We suspect that our patient was affected by a secondary hyperinflammatory syndrome related to cytokines, alone or in combination with direct viral injury through endothelial cell damage. The IL-6 levels were elevated only in the cerebrospinal fluid, suggesting focal central nervous system inflammation.

著者

Yoshinobu Kondo Hiroshi Yatsuya Atsuhiko Ota Shoji Matsumoto Akihiro Ueda Hirohisa Watanabe Hideaki Toyoshima

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.33, no.1, pp.23-30, 2023-01-05 (Released:2023-01-05)

参考文献数

36

被引用文献数

2

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Background: No studies have examined the associations between adult height and ischemic stroke subtypes.Methods: We conducted a population-based case-control study that included 2,451 thrombotic and 687 embolic stroke cases, as well as 1,623 intracerebral and 768 subarachnoid hemorrhage cases without history of stroke aged 40–79 years, and the same number of sex- and age-matched controls. Cases and controls were grouped according to the quintile cut-off values of height in controls, and the third quintile, which was approximately the average height group, was used as the reference group. Height divided by one standard deviation of height in controls was also examined as a continuous variable. The analyses were carried out separately for participants aged 40–59 years and 60–79 years.Results: In both younger and older men, height was linearly inversely associated with total and thrombotic strokes, and the shortest quintile compared to the reference group was associated with increased risks of these strokes. Although height was linearly inversely associated with embolic stroke and intracerebral hemorrhage in younger men, the shortest quintile did not show increased risks of these strokes. Height did not seem to be associated with total stroke and any stroke subtypes in younger women. In contrast, the tallest quintile was significantly associated with increased risks of total stroke and intracerebral hemorrhage, and height tended to be positively associated with these strokes in older women.Conclusion: We reported the associations between adult height and ischemic stroke subtypes for the first time, which differed according to sex and age group.

著者

Yoshiki Niimi Sayuri Shima Yasuaki Mizutani Akihiro Ueda Shinji Ito Tatsuro Mutoh

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

vol.5, no.2, pp.45-48, 2019 (Released:2019-05-08)

参考文献数

19

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Background: Although fatigue is an important nonmotor symptom in Parkinson’s Disease (PD) patients, little is known about the pathophysiological details of fatigue in PD, and it is still unknown whether fatigue correlates with PD prognosis. In this study, we investigated whether fatigue in PD correlates with clinical manifestations, treatment, or patient prognosis.Methods: We recruited 75 idiopathic PD patients and used the Parkinson Fatigue Scale (PFS-16) to investigate fatigue. We compared PFS-16 scores with clinical details such as age, disease duration, daily levodopa equivalent dosage, and Hoehn & Yahr (H&Y) disease stage in the 56 patients who fully completed the questionnaire.Results: In total, 62% of subjects suffered from fatigue, as defined by a mean PFS-16 score above 3.3. There was no correlation between PFS-16 scores and disease duration or levodopa equivalent daily dose. However, there was a significant correlation between mean PFS-16 scores and a worsening grade of H&Y staging. The comparison between patients who showed stable H&Y grades (n=26) and patients with severely aggravated H&Y grades (n=7) revealed that the most significant differences were in questions 14 and 16 in the PFS-16 (p<0.001).Conclusion: Fatigue is common in PD patients, as demonstrated in the present study. The PFS-16 questionnaire may be helpful to predict disease prognosis.

著者

Mayumi Senda Akihiro Ueda Mizuki Ito Sayuri Shima Yasuaki Mizutani Tatsuro Mutoh Hirohisa Watanabe

出版者

Fujita Medical Society

雑誌

Fujita Medical Journal (ISSN:21897247)

巻号頁・発行日

pp.2021-026, (Released:2022-05-25)

参考文献数

26

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Objective: In this study, we aimed to clarify the relationship between initial treatment response, prednisolone (PSL) dosage, clinical type, and recurrence in patients with hypertrophic pachymeningitis (HP).Methods: The study cohort comprised eight patients with HP who had been admitted to our hospital from April 2015 to June 2020. Diagnostic criteria for HP included neurological abnormalities and dural thickening on magnetic resonance gadolinium-enhanced T1-weighted images.Results: Relevant characteristics of the eight study patients are as follows. There were two men and six women. The average age at onset was 58.3 (range: 29–79) years. Three of them had myeloperoxidase-antineutrophil cytoplasmic antibody-related vasculitis, one immunoglobulin G4-related disease, and one ulcerative colitis. The remaining three patients had idiopathic HP. The average maximum dosage of PSL was 0.79 mg/kg/day, and the average daily maintenance dosage 0.18 mg/kg/day. Three patients needed additional immunosuppressive drugs. Both idiopathic and secondary HP initially responded well to PSL, with improvement in activities of daily living. Six patients had some sequelae related to cranial nerve involvement. No relapses occurred while the patients were taking moderate doses of PSL; however, all patients with idiopathic HP had recurrences when their PSL dosage was reduced.Conclusions: Patients with idiopathic HP and HP associated with immune disorders respond to steroids and immunosuppressive drugs and recover well. However, there is a high rate of relapse after reduction of PSL dosage, mainly in those with idiopathic HP.

著者

Akihiro Ueda Kunihiko Asakura Takateru Mihara Hideo Hara Madoka Ueda Tadayuki Miyashita Tatsuro Mutoh

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.48, no.10, pp.843-846, 2009 (Released:2009-05-15)

参考文献数

10

被引用文献数

5 4

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Acute autonomic, sensory and motor neuropathy (AASMN) is a rare peripheral nerve disorder characterized by prominent dysautonomia with somatic sensory and motor impairment. Dysautonomia in AASMN is intractable even with corticosteroid therapy or plasmapheresis. Here we report a case of AASMN with severe orthostatic hypotension. Although the effectiveness of corticosteroid was insufficient, high dose intravenous immunoglobulin therapy (IVIg) was effective for not only sensorimotor symptoms but also autonomic symptoms. This is the first case of AASMN showing favorable responses to IVIg treatment, suggesting that IVIg should be considered when corticosteroid therapy or plasmapheresis is ineffective or insufficient.