- 著者
- Shinji Okayasu Kiyoyuki Kitaichi Akina Hori Tetsuya Suwa Yukio Horikawa Mayumi Yamamoto Jun Takeda Yoshinori Itoh
- 出版者
- 公益社団法人日本薬学会
- 雑誌
- Biological and Pharmaceutical Bulletin (ISSN:09186158)
- 巻号頁・発行日
- vol.35, no.6, pp.933-937, 2012-06-01 (Released:2012-06-01)
- 参考文献数
- 26
- 被引用文献数
- 6 35
Metformin is a drug to improve glycemic control by reducing insulin resistance and is currently considered to be one of the first-choice drugs for type 2 diabetes mellitus (T2DM). However, during metformin use, adverse drug reactions (ADRs) including gastrointestinal adverse events were frequently observed. Thus, in the present study, we investigated the incidence of ADRs induced by metformin and further analyzed risk factors for ADRs in Japanese patients with type 2 diabetes mellitus who initially administered metformin (500–750 mg). One hundred and one hospitalized patients receiving metformin during September 1, 2009 and August 31, 2010 were studied. The incidence of ADRs and changes in laboratory data including hemoglobin A1c (HbA1c) were monitored retrospectively. The anti-glycemic effect of metformin was successfully observed as indicated by decreased HbA1c. Among ADRs, diarrhea was most frequently occurred during metformin use (26.7% of patients) although the symptom of diarrhea was mild in most cases and disappeared within 3 d after the initial use. A logistic regression analysis showed the existence of six risk factors, including initial dose (750 mg), female, age (≦65), body mass index (≧25), aspartate aminotransferase (≧30 IU/L) and alkaline phosphatase (≧270 IU/L). The incidence of diarrhea increased linearly as the number of risk factors increased. In conclusion, in order to avoid ADRs, especially diarrhea, subsequently improving the quality of life during metformin use, the optimization of the dose of metformin by considering risk factors would be beneficial for patients with T2DM.
- 著者
- Takashi Yorifuji Jun Takeda Shintaro Makino Toshitaka Tanaka Atsuo Itakura Satoru Takeda
- 出版者
- Japan Society for the Study of Hypertension in Pregnancy
- 雑誌
- Hypertension Research in Pregnancy (ISSN:21875987)
- 巻号頁・発行日
- pp.HRP2018-001, (Released:2018-07-31)
- 参考文献数
- 24
- 被引用文献数
- 6
Aim: Several devices are used for balloon tamponade. In Japan, metreurynters are widely used for cervical ripening; however, there is little evidence for their use in hemostatic uterine balloon tamponade. This study aimed to assess the non-inferiority of metreurynters as the balloon device for obstetric hemorrhage.Methods: Medical charts of all patients with obstetric hemorrhage of more than 1,000 ml who underwent balloon tamponade with metreurynters were retrospectively reviewed for five years at a tertiary referral university hospital.Results: A total of 89 uterine balloon tamponade cases were identified from medical records. Of these, 66 cases involved term postpartum hemorrhage (PPH) within 24 h after delivery (PPH group) and 23 involved other types of cases (other group), including cesarean scar pregnancy, cervical pregnancy, retained placenta, and others. In the PPH group, the average hemostasis rate was 93.9%, whereas the rate was 91.3% in the other group. Seven cases failed to achieve hemostasis with balloon tamponade only and required additional treatment. There were no adverse events related to balloon tamponade using metreurynters.Conclusions: Metreurynters used for balloon tamponade were non-inferior to Bakri balloons in hemostasis and complication rates, suggesting they are effective and appropriate for the management of obstetrical hemorrhage.
- 著者
- Satoru Takeda Jun Takeda Taro Koshiishi Shintaro Makino Katsuyuki Kinoshita
- 出版者
- 日本妊娠高血圧学会
- 雑誌
- Hypertension Research in Pregnancy (ISSN:21875987)
- 巻号頁・発行日
- vol.2, no.2, pp.65-71, 2014 (Released:2015-02-06)
- 参考文献数
- 17
- 被引用文献数
- 9
The precise reporting of fetal station is important in the decision-making regarding whether instrumental vaginal delivery or cesarean section should be performed. However, accurate evaluation of fetal station is difficult because it is defined on the basis of a hypothetical vertical midline to the ischial spines. Moreover, during delivery, the fetal head descends anteriorly into the pelvis along the pelvic axis and not in the vertical direction. DeLee’s concept of fetal station, first reported in 1924, has been revised by taking into account the fetal head descent along the pelvic axis, and this concept has been in clinical use at the University of Tokyo Hospital since the 1970s.In this review, we assess the problems associated with conventional fetal station and explain the new concept of fetal station based on the trapezoidal plane and assessment of head descent upon instrumental delivery.