著者

Moritake Iguchi Yuji Tezuka Hisashi Ogawa Yasuhiro Hamatani Daisuke Takagi Yoshimori An Takashi Unoki Mitsuru Ishii Nobutoyo Masunaga Masahiro Esato Hikari Tsuji Hiromichi Wada Koji Hasegawa Mitsuru Abe Gregory Y.H. Lip Masaharu Akao

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1155, (Released:2018-03-09)

参考文献数

32

被引用文献数

27

---

Background:Heart failure (HF) is a heterogeneous syndrome, but the effect of the type and severity of HF on the incidence of stroke or systemic embolism (SE) in atrial fibrillation (AF) patients is unclear.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients in Fushimi-ku, Kyoto, Japan. Follow-up data were available for 3,749 patients. We defined pre-existing HF as having one of the following: prior hospitalization for HF, presence of HF symptoms (NYHA ≥2), or reduced ejection fraction (<40%). At baseline, 1,008 (26.9%) patients had pre-existing HF. On multivariate analysis, the incidence of stroke/SE was not associated with pre-existing HF (hazard ratio (HR), 1.24; 95% confidence interval (CI), 0.92–1.64) or each criterion for the definition of pre-existing HF, but was associated with high B-type natriuretic peptide (BNP) or N-terminal proBNP levels (above the median of the pre-existing HF group) at baseline (HR, 1.65; 95% CI, 1.06–2.53). Stroke/SE was markedly increased in the initial 30-day period following hospital admission for HF (HR, 12.0; 95% CI, 4.59–31.98).Conclusions:The effect of HF on the incidence of stroke/SE may depend on the stage or severity of HF in patients with AF. The incidence of stroke/SE was markedly increased in the 30 days after admission for HF, but compensated ‘stable’ HF did not appear to confer an independent risk.

著者

Mami Hirasaki Daisuke Takagi Yoshiko Umeda Motoki Moriwaki Norimasa Katagiri Akiko Nomoto Tomohisa Ohno Ichiro Fujishima

出版者

The Japanese Association of Rehabilitation Medicine

雑誌

Progress in Rehabilitation Medicine (ISSN:24321354)

巻号頁・発行日

vol.8, pp.20230006, 2023 (Released:2023-03-01)

参考文献数

20

---

Background: Palatal augmentation prosthesis (PAP) and palatal lift prosthesis (PLP) have been used to improve dysphagia and dysarthria. However, to date, there are few reports on their combined use. We report a quantitative evaluation of the effectiveness of a flexible-palatal lift/augmentation combination prosthesis (fPL/ACP) based on videofluoroscopic swallowing study (VFSS) and speech intelligibility testing.Case: An 83-year-old woman was admitted to our hospital with a hip fracture. She developed aspiration pneumonia at 1 month after partial hip replacement. Oral motor function tests revealed a motor deficit of the tongue and soft palate. VFSS showed delayed oral transit, nasopharyngeal reflux, and excessive pharyngeal residue. The cause of her dysphagia was assumed to be pre-existing diffuse large B-cell lymphoma and sarcopenia. To improve the dysphagia, an fPL/ACP was fabricated and applied. It improved the patient’s oral and pharyngeal swallowing and speech intelligibility. In addition to prosthetic treatment, rehabilitation and nutritional support allowed her to be discharged.Discussion: The effects of fPL/ACP in the present case were similar to those of flexible-PLP and PAP. f-PLP assists in elevation of the soft palate and improved the nasopharyngeal reflux and hypernasal speech. PAP promotes tongue movement and results in improved oral transit and speech intelligibility. Therefore, fPL/ACP may be effective in patients with motor deficits in both the tongue and soft palate. To maximize the effect of the intraoral prosthesis, a transdisciplinary approach with concurrent swallowing rehabilitation, nutritional support, and physical and occupational therapy is necessary.

著者

Miwa Yamaguchi Yosuke Inoue Tomohiro Shinozaki Masashige Saito Daisuke Takagi Katsunori Kondo Naoki Kondo

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.29, no.10, pp.363-369, 2019-10-05 (Released:2019-10-05)

参考文献数

46

被引用文献数

40

---

Background: This study aimed to examine the contextual effects of community-level social capital on the onset of depressive symptoms using a longitudinal study design.Methods: We used questionnaire data from the 2010 and 2013 waves of the Japan Gerontological Evaluation Study that included 14,465 men and 14,600 women aged over 65 years from 295 communities. We also used data of a three-wave panel (2006–2010–2013) to test the robustness of the findings (n = 7,424). Using sex-stratified multilevel logistic regression, we investigated the lagged associations between three scales of baseline community social capital and the development of depressive symptoms.Results: Community civic participation was inversely associated with the onset of depressive symptoms (men: adjusted odds ratio [AOR] 0.93; 95% confidence interval [CI], 0.88–0.99 and women: AOR 0.94; 95% CI, 0.88–0.997 per 1 standard deviation unit change in the score), while no such association was found in relation to the other two scales on social cohesion and reciprocity. This association was attenuated by the adjustment of individual responses to the civic participation component. Individual-level scores corresponding to all three community social capital components were significantly associated with lower risks for depressive symptoms. The results using the three-wave data set showed statistically less clear but similar associations.Conclusions: Promoting environment and services enhancing to community group participation might help mitigate the impact of late-life depression in an aging society.