Background: Previous studies have reported that high-dose strong statin therapy reduces the incidence of contrast-induced nephropathy (CIN) in statin naïve patients; however, the efficacy of high-dose strong statins for preventing CIN in real-world clinical practice remains unclear. The aim of this study was to evaluate the efficacy of strong statin therapy in addition to fluid hydration for preventing CIN after cardiovascular catheterization.Methods and Results: This prospective, multicenter, randomized controlled trial included 420 patients with chronic kidney disease who underwent cardiovascular catheterization. They were assigned to receive high-dose pitavastatin (4 mg/day × 4 days) on the day before and of the procedure and 2 days after the procedure (Statin group, n=213) or no pitavastatin (Control group, n=207). Isotonic saline hydration combined with a single bolus of sodium bicarbonate (20 mEq) was scheduled for administration to all patients. In the control group, statin therapy was continued at the same dose as that before randomization. CIN was defined as a ≥0.5 mg/dL increase in serum creatinine or ≥25% above baseline at 48 h after contrast exposure. Before randomization, 83% of study participants were receiving statin treatment. The statin group had a higher incidence of CIN than the control group (3.0% vs. 0%, P=0.01). The 12-month rate of major adverse cardiovascular events was similar between the 2 groups.Conclusions: High-dose pitavastatin increases the incidence of CIN in this study population.
[Purpose] The purpose of this study was to analyze the characteristics of the elderly people who participated in the "group recminiscence therapy".[Method] The group reminiscence therapy was carried out for the elderly people of S area of A city from May to August 2018. The documents written by students who participated in the recollecting method as co-leaders was analyzed. The analytic theme was taken as "the meaning in which elderly people look back upon their life." The concepts was generated by qualitative research according to the Grounded Theory Approach (M-GTA).[Results] Altogether, 19 concepts were generated.The core concept was "perception about own existence realized through support of the surrounding people". The three core categories constituting the core concept were generated as "review of own life," "pride to self," "composing mind to the future."[Discussion] "Review of own life," like the flow in a river, makes one aware of the path traversed in life and proud of one's ability to handle events at the turning points in life with support from others, which in turn leads to "pride to self" "Things to accomplish in the future" relates to the approach to the end of life through cherishing the current way of living and building smooth relationships with others.