- 著者
- Katsutoshi Nakayama Mitsutoshi Shinkawa Takashi Ohrui Hisao Hirai Hidetada Sasaki
- 出版者
- Elsevier
- 雑誌
- The Lancet (ISSN:01406736)
- 巻号頁・発行日
- vol.360, no.9342, pp.1335, 2002-10-26
- 被引用文献数
- 6
- 著者
- Takashi Ohrui Hidenori Takahashi Satoru Ebihara Toshifumi Matsui Katsutoshi Nakayama Hidetada Sasaki
- 出版者
- Tohoku University Medical Press
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.192, no.1, pp.81-86, 2000 (Released:2005-04-21)
- 参考文献数
- 11
- 被引用文献数
- 16 16
This report presents the cases of two patients with rapidly progressive hypoxemia associated with influenza A(H3N2) virus infection, who were diagnosed with influenza related acute pulmonary microthromboembolism by serum D-dimer, lung perfusion and ventilation scans and computed-tomography scan of the chest, and were successfully treated by anti-coagulant therapy. The present cases suggest that acute onset pulmonary microthromboembolism should be considered in some patients with sudden, unexplained dyspnea during an outbreak of influenza infection and prompt diagnosis is essential to save the patient from acute death associated with influenza.
- 著者
- James P. Butler Masahiko Fujii Hidetada Sasaki
- 出版者
- 東北ジャーナル刊行会
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.227, no.3, pp.203-210, 2012 (Released:2012-06-27)
- 参考文献数
- 96
- 被引用文献数
- 12 17
Our new lessons of nurturing life to make happiness and well-being of geriatric patients suggest comprise several important steps. First, geriatric patient care should not be delegated to specialists who focus on individual organ system. Instead, we should respond to the patient's condition based on comprehensive assessment to identify the single pathogenesis. Second, we should appreciate that the behavioral and psychological symptoms of dementia (BPSD) often reflect the behavioral and psychological symptoms of the caregiver (BPSC), and in particular the caregiver's attitude. Third, pleasant stimulations to the limbic system should receive more emphasis than attempting brain training in atrophied portions of the neocortex. Fourth, we should aim not for “successful aging,” but for “balanced aging.” Fifth, we should rely less on drug-based therapy and utilize more non-pharmacologic approaches to appropriate therapy. Geriatric patients should be cared for based on our new lessons of nurturing life rather than the heavily medicalized treatment modalities that are in wide use today.
- 著者
- Yusaku Maeda Keita Fukushima Satomi Kyoutani James P. Butler Masahiko Fujii Hidetada Sasaki
- 出版者
- Tohoku University Medical Press
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.252, no.3, pp.263-267, 2020 (Released:2020-11-10)
- 参考文献数
- 22
- 被引用文献数
- 4
Behavioral and psychological symptoms of dementia (BPSD) challenge caregivers, leading to caregiver burden and subsequent nursing home or inpatient placement in a psychiatric hospital for dementia. Favorable positive emotions should be an important goal for the treatment of negative emotions of BPSD. Arts are one of the most profound areas to stimulate favorable emotions. We have asked a professional actor, who was not involved in the daily care and regular rehabilitations, to give a dramatic performance by reading selected stories as if the patients with BPSD felt to be in the audiences of a theater. We wondered whether a dramatic performance by the actor might be a way to respond to the complex needs of inpatients with BPSD, especially focused on favorable emotions. New inpatients (Alzheimer’s disease, vascular dementia, or dementia with Lewy bodies) were randomly assigned to a control group (n = 20) and a dramatic performance group (n = 14) in Sendai Tomizawa Hospital, a psychiatric hospital for dementia, in Japan. Dramatic performances were performed for one and half hours once per week for 3 months. Neuropsychiatric Inventory for BPSD decreased in both groups and delightful emotional index (DEI) for favorable emotions increased in the intervention group but not in the control group after 3 months. At 3 months, there was an increase of DEI in intervention group compared with control group. We conclude that dramatic performance may be one of the appropriate interventions in patients with BPSD, as it appears to help in their favorable emotional state.
- 著者
- Etsuo HORIKAWA Toshifumi MATSUI Hiroyuki ARAI Takashi SEKI Koh IWASAKI Hidetada SASAKI
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.44, no.7, pp.717-721, 2005 (Released:2005-08-06)
- 参考文献数
- 16
- 被引用文献数
- 64 85
Objective Falls are common in patients with Alzheimer’s disease (AD). Identification of the potential risk factors and developing preventive strategies for falls will have a significant impact in maintaining the quality of life in AD.Patients Clinical follow-up of 124 (74.1±6.1 years, range 62-88) mild to moderate AD patients in an outpatient memory clinic.Methods Postural sway, cognitive function, use of neuroleptics, severity of periventricular and deep white matter lesions, and the presence or absence of silent brain infarctions on magnetic resonance imaging were assessed at baseline.Results A total of 104 patients (84%) completed the study. Fall events were confirmed in 42.3% (44/104). After adjustment for age, gender, and cognitive status, a high grade of periventricular white matter lesions (odds ratio 8.7 [95%CI 1.5 to 51.8], p=0.017) and neuroleptic drug use (odds ratio 3.5 [95%CI 1.2 to 10.5], p=0.027) were significantly associated with an increased risk of falls.Conclusion Our results suggest that periventricular white matter lesions and the use of neuroleptics may be related to falls in mild to moderate AD. A comprehensive risk management of brain ischemia as well as the use of the smallest efficacious dose of neuroleptics in the treatment of behavioral and psychiatric symptoms of AD should be recommended to help reduce the risk of unexpected falls.
- 著者
- Hiroyuki Arai Mutsuo Yamaya Takashi Ohrui Satoru Ebihara Takae Ebihara Kazushi Nakajo Hidetada Sasaki
- 出版者
- The Japan Society of Logopedics and Phoniatrics
- 雑誌
- The Japan Journal of Logopedics and Phoniatrics (ISSN:00302813)
- 巻号頁・発行日
- vol.43, no.4, pp.467-472, 2002-10-20 (Released:2010-06-22)
- 参考文献数
- 19
- 被引用文献数
- 1 2
誤嚥性肺炎を発症する高齢者では, 高率に脳血管障害, 特に大脳基底核領域に脳梗塞が見出される.この場合の脳梗塞は, 新しいものであっても陳旧性のものであっても, また症候性であっても無症候性であっても構わない.このような患者では, 嚥下反射と咳反射の両者の低下により, 誤嚥特に夜間の不顕性誤嚥により肺炎の成立にいたると考えられる.嚥下反射と咳反射は, 少なくとも2つの神経伝達物質, すなわちドーパミンとサブスタンス-Pによって支えられている.進行したアルツハイマー病患者も大脳基底核障害などにより誤嚥性肺炎を発症する.進行したアルツハイマー病患者において, major tranquilizerの使用と無症候性脳梗塞の合併は誤嚥性肺炎を誘発する危険因子であるため問題行動に対するmajor tranquilizerの使用には細心の注意が要求される.塩酸アマンタジン, ACE阻害薬, 抗血小板剤の使用また歯ブラシなどによる簡便な口腔ケアは肺炎の予防に役立つばかりでなく高齢者医療費削減にも貢献すると思われる.