- 著者
- Hirofumi Tomita Ken Okumura Hiroshi Inoue Hirotsugu Atarashi Takeshi Yamashita Hideki Origasa Eiki Tsushima on behalf of the J-RHYTHM Registry Investigators
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-15-0095, (Released:2015-05-13)
- 参考文献数
- 35
- 被引用文献数
- 9 42
Background:Because the current Japanese guideline recommends CHADS2score-based risk stratification in nonvalvular atrial fibrillation (NVAF) patients and does not list female sex as a risk for thromboembolic events, we designed the present study to compare the CHA2DS2-VASc and CHA2DS2-VA scores in the J-RHYTHM Registry.Methods and Results:We prospectively assessed the incidence of thromboembolic events for 2 years in 997 NVAF patients without warfarin treatment (age 68±12 years, 294 females). The predictive value of the CHA2DS2-VASc and CHA2DS2-VA scores for thromboembolic events was evaluated by c-statistic difference and net reclassification improvement (NRI). Thromboembolic events occurred in 7/294 females (1.2%/year) and 23/703 males (1.6%/year) (odds ratio 0.72 for female to male, 95% confidence interval (CI) 0.28–1.62, P=0.44). No sex difference was found in patient groups stratified by CHA2DS2-VASc and CHA2DS2-VA scores. There were significant c-statistic difference (0.029, Z=2.3, P=0.02) and NRI (0.11, 95% CI 0.01–0.20, P=0.02), with the CHA2DS2-VA score being superior to the CHA2DS2-VASc score. In patients with CHA2DS2-VASc scores 0 and 1 (n=374), there were markedly significant c-statistic difference (0.053, Z=6.6, P<0.0001) and NRI (0.11, 95% CI 0.07–0.14, P<0.0001), again supporting superiority of CHA2DS2-VA to CHA2DS2-VASc score.Conclusions:In Japanese NVAF patients, the CHA2DS2-VA score, a risk scoring system excluding female sex from CHA2DS2-VASc, may be more useful in risk stratification for thromboembolic events than CHA2DS2-VASc score, especially in identifying truly low-risk patients.
- 著者
- Yuichi Jyumonji Eiki Tsushima
- 出版者
- Hirosaki University Graduate School of Medicine,Hirosaki Medical Society
- 雑誌
- 弘前医学 (ISSN:04391721)
- 巻号頁・発行日
- vol.72, no.1-4, pp.24-33, 2022 (Released:2022-03-30)
- 参考文献数
- 32
Objective: Icing is the most common care method for Japanese baseball players to prevent secondary tissue damage. However, because of reports that icing causes decrease in muscle strength and reduction in training effect, currently there is no standard post-pitching care. The purpose of this study was to longitudinally investigate whether different post-pitching care methods are associated with different effects on shoulder joint function. Method: Aerobic exercise, stretch training, and icing were administered, at intervals of more than a week, to nine high school baseball pitchers after each of them pitched 100 throws. A comparative study was performed by measuring shoulder joint function after pitching, after care completion, and at 24 hours, 48 hours, and 72 hours post pitching. Results: Significant differences were observed in shoulder rotation range of motion and external rotation muscle strength due to differences in care. Icing was the most selected care method in the questionnaire survey as well. Conclusion: Depending on differences in post-pitching care, the shoulder joint function changes. Awareness about changes in shoulder joint function due to different care methods will help prevent pitching disorders through the selection of appropriate care depending on circumstances such as pitching day intervals.
- 著者
- Kazuya HIRAYAMA Eiki TSUSHIMA Hiroki ARIHARA Yoichi OMI
- 出版者
- Japanese Society of Physical Therapy
- 雑誌
- Physical Therapy Research (ISSN:21898448)
- 巻号頁・発行日
- vol.22, no.1, pp.9-16, 2019-06-20 (Released:2019-06-20)
- 参考文献数
- 34
Objective: To develop a clinical prediction rule (CPR) that predicts treatment responses to mechanical lumbar traction (MLT) among patients with lumbar disc herniation (LDH). Method: This study was an uncontrolled prospective cohort study. The subjects included 103 patients diagnosed with LDH for which they underwent conservative therapy. The subjects received MLT for 2 weeks, and the application of any other medication was left at the discretion of the attending physician. The initial evaluation was performed prior to the initiation of treatment. The independent variables from the initial evaluation were imaging diagnosis, Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire score, visual analog scale, medical interview, physical examination. The patients whose ODI after 2 weeks of treatment improved by ≥50% of that at the initial evaluation were defined as responders. Results: Of the 103 subjects, 24 were responders, and the five predictors selected for the CPR were limited lumbar extension range of motion, low-level fear-avoidance beliefs regarding work, no segmental hypomobility in the lumbar spine, short duration of symptoms, and sudden onset of symptoms. For the patients with at least three of the five predictors, the probability of their ODI greatly improving increased from 23.3% to 48.7% compared with the patients without these predictors (positive likelihood ratio, 3.13). Conclusion: Five factors were selected for the CPR to predict whether patients with LDH would demonstrate short-term improvement following conservative therapy with MLT.