著者

Kentaro Iwata Naomi Morishita Masami Nishiwaki Chisato Miyakoshi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.3477-19, (Released:2020-07-14)

参考文献数

10

被引用文献数

2

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Objectives Treating latent tuberculosis infection (LTBI) is essential for eliminating the serious endemicity of tuberculosis. A shorter regimen is preferred to longer regimens because the former has better adherence with a better safety profile. However, lengthy treatment with isoniazid is still recommended in Japan. Based on the latest evidence, we switched from a conventional nine-month isoniazid regimen to a shorter four-month rifampin regimen for the treatment of LTBI. Methods To evaluate the safety and efficacy of the shorter regimen, we conducted Bayesian analyses using a stochastic mathematical model to calculate the posterior probabilities of several parameters. Patients Clinical data of 13 patients in the isoniazid group and 5 in the rifampin group were used for the Bayesian analyses. The outcomes measured were completion of the treatment, adverse effects, number of clinic visits, and medical costs. Results The medial posterior probability of the isoniazid group completing the treatment was 66% [95% credible interval (CrI) 43%-89%], whereas that of the rifampin group was 86% (95% CrI 60%-100%). The probability that the completion rate in the rifampin group was better than that in the isoniazid group was as high as 88% (95% CrI 0%-100%). Other parameters, such as the number of clinical visits and duration of treatment, were better with rifampin therapy than with isoniazid therapy, with comparable medical costs. Conclusion Four months of rifampin therapy might be preferred to isoniazid for treating LTBI in Japan.

著者

Kentaro Iwata Asako Doi Goh Ohji Hideaki Oka Yuichiro Oba Kohei Takimoto Wataru Igarashi David H. Gremillion Toshihiko Shimada

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.49, no.22, pp.2423-2432, 2010 (Released:2010-11-15)

参考文献数

27

被引用文献数

43 132

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Introduction Sivelestat is neutrophil elastase inhibitor, which is widely used in Japan for the treatment of acute lung injury. However, the clinical efficacy of the medication has not been convincingly demonstrated. Methods We conducted a systematic review and meta-analysis of randomized controlled trials on sivelestat for the treatment of acute lung injury and acute respiratory distress syndrome. Studies were identified using MEDLINE, EMBASE, Cochrane library, conference proceedings, and references of included studies. Authors were contacted if necessary. ICHUSHI, the Japanese database for medical literature and conference proceedings was also used for the search, since many studies on sivelestat were published in Japanese language and not registered in major databases such as MEDLINE. The primary outcome was mortality within 28-30 days after randomization. Relative risks were pooled with the random effect model. Results 8 trials were included in the analysis. There was no difference in mortality within 28-30 days after randomization (relative risk 0.95, 95% confidence interval 0.72 to 1.26). Subgroup analysis conducted only on studies conducted in Japan showed the same result (0.59, 0.28 to 1.28). There was no difference in mechanical ventilation days (standardized mean difference -0.43, -1.12 to 0.27), but sivelestat was associated with a better short term PaO2/FiO2 ratio (0.30, 0.05 to 0.56). Heterogeneity was not significant for the main analysis and funnel plot did not suggest publication bias. Conclusion Sivelestat was not associated with decreased mortality, even when including studies published in Japanese language.

著者

Kentaro Iwata Yoshie Takai Nozomi Kitada Naomi Morishita Hiroaki Kiyona

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0595-22, (Released:2022-10-26)

参考文献数

11

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Mycobacterium marinum is a ubiquitous organism inhabiting both fresh and salt water. It can cause human diseases such as skin and soft tissue infection. The organism is also known to cause a false positive reaction to interferon-γ release assay, the test to diagnose latent tuberculosis infection. Here, we present a case of submandibular nodule caused by M. marinum with positive T-SPOT.TB test, which was likely to be false positive.

著者

Kentaro Iwata Tomoko Toma Akihiro Yachie Hideaki Oka Goh Ohji Wataru Igarashi Tatsuyoshi Kitamura Yuichiro Oba

出版者

Japan Primary Care Association

雑誌

General Medicine (ISSN:13460072)

巻号頁・発行日

vol.12, no.1, pp.29-31, 2011 (Released:2011-07-05)

参考文献数

7

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A 23-year old female was referred to our clinic for intermittent fever occurring over a period of eight years. Every time she developed fever, blood examination revealed elevated leukocytes and C-reactive protein (CRP). Antibiotics were always given based on elevated CRP with apparent improvement. However, the pattern of periodicity with absence of symptoms in between suggested periodic fever syndrome, particularly Familial Mediterranean Fever (FMF), which was later confirmed by mutation analysis. In Japan there is a tendency to use antibiotics solely based on "elevated CRP"; however, careful review of patient history is essential to identify FMF while avoiding the use of unnecessary antibiotics.

著者

Miho Fujio Takafumi Watanabe Naomi Morishita Sachiyo Ohtani Kentaro Iwata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.7755-21, (Released:2021-08-13)

参考文献数

15

被引用文献数

1

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Listeria monocytogenes can cause gastrointestinal infections in healthy children and adults, but they tend to be mild and self-limiting. It can, however, cause serious potentially lethal infections, such as meningitis and bacteremia, to those with underlying conditions. A woman in her 60s with liver cirrhosis developed abdominal pain and a fever, and she turned out to have a perianal abscess caused by L. monocytogenes. Perianal abscess is a rare complication of L. monocytogenes, but a recent epidemiological study revealed that the presence of cirrhosis might also be a risk factor for the development of invasive disease.

著者

Kentaro Iwata Wataru Igarashi Midori Honjo Takashi Nishimoto Kyoko Shinya Akiko Makino Kazuo Mitani Yoshiko Tatsumi Hiroyuki Ninomiya Kumi Higasa Seiichiro Usuki Hiroki Kagawa Daisuke Uchida Kohei Takimoto Rei Suganaga Hiroo Matsuo Yuichiro Oba Mami Horigome Hideaki Oka Goh Ohji Yasuhisa Abe Hiroyuki Yoshida Shohiro Kinoshita Midori Hirai

出版者

日本プライマリ・ケア連合学会

雑誌

General Medicine (ISSN:13460072)

巻号頁・発行日

vol.14, no.1, pp.13-22, 2013 (Released:2013-07-05)

参考文献数

34

被引用文献数

3

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Background: Gingyo-gedoku-san (GGGS) is an herbal medicine approved for upper respiratory infections in Japan. We conducted an open-label, multi-center, prospective trial, comparing GGGS with oseltamivir in patients with influenza and influenza-like illness (ILI) as a pilot study.Methods: Subjects were healthy persons aged between 16 and 40, and were enrolled from January 12, 2010 to March 24, 2011. Fifteen patients were enrolled in this trial (8 and 7 for GGGS and oseltamivir, respectively). RT-PCR was positive for pandemic influenza A (H1N1) in 10 patients. The patients were provided with either GGGS or oseltamivir for 5 days. The primary outcome was mortality and/or hospitalization 7 days after the initial diagnosis. Body temperature and other clinical characteristics were also evaluated.Results: All patients recovered from illness without complication or hospitalization. The mean time to resolve symptoms for the GGGS and oseltamivir groups was 3.9 days and 3.3 days, respectively (p=0.43). The GGGS group appeared to have a smaller symptom score AUC than the oseltamivir group, (p=0.26). Time to recover activity level appeared to be shorter in the GGGS group (p=0.10), with shorter time to recover health status (p=0.02). Sub-group analysis on patients with positive PCR showed similar results between the two groups.Conclusion: GGGS was associated with symptom improvements resembling oseltamivir for both influenza and ILI. Randomized controlled trials involving larger sample sizes are needed to confirm these results.

著者

Yuko Nonaka Takayuki Yoshinaga Kentaro Iwata

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.50, no.21, pp.2705, 2011 (Released:2011-11-01)

参考文献数

2

著者

Michitaka KATO Masakazu SAITOH Tomonori KAWAMURA Kentaro IWATA Koji SAKURADA Daisuke OKAMURA Masayuki TAHARA Satoshi YUGUCHI Kenta KAMISAKA Keisuke OURA Yuji MORI Tomoyuki MORISAWA Tetsuya TAKAHASHI

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.1-8, 2019-06-20 (Released:2019-06-20)

参考文献数

31

被引用文献数

1 13

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Objective: Postoperative atrial fibrillation (POAF) is a common complication after cardiac surgery. The aim of this multicenter study was to determine the relationship between POAF and patients' progress in early rehabilitation after heart valve surgery. Methods: We enrolled 302 patients (mean age, 69±10 years) who had undergone heart valve surgery. POAF was monitored using continuous electrocardiogram telemetry, and the Short Physical Performance Battery (SPPB) was used to assess lower-extremity function before surgery and at the time of discharge. Progress in early rehabilitation was evaluated by the duration from the surgery to independent walking. We determined factors associated delayed early rehabilitation and evaluated the interplay of POAF and delayed early rehabilitation in increasing the risk of decline in lower-extremity function from preoperatively to hospital discharge. Results: Multivariate analysis determined POAF to be independent predictors of delayed early rehabilitation after heart valve surgery (OR: 3.906, P =.01). The association between delayed early rehabilitation and decline in lower extremity function was stronger in patients with POAF (OR: 2.73, P =.041) than in those without (OR: 2.22, P =.052). Conclusions: POAF was clinical predictors of delayed early rehabilitation in patients undergoing heart valve surgery. The combination of POAF with delayed early rehabilitation conferred a high risk of decline in lower-extremity function during hospitalization.

著者

Kentaro Iwata Tomoko Toma Akihiro Yachie

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.58, no.21, pp.3185-3188, 2019-11-01 (Released:2019-11-01)

参考文献数

14

被引用文献数

1

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A 38-year-old Japanese man without any significant past medical history was referred to our clinic to undergo further examination for a "refractory infection in his joints". He suffered recurrent migratory polyarthritis starting from bilateral knees to his right elbow. Certain antibiotic therapies appeared to improve his symptoms, but the symptoms recurred due to the migratory nature of arthritis. A diagnosis of familial Mediterranean fever (FMF) was considered and diagnostic tests were performed. Not many differential diagnoses exist for migratory polyarthritis, particularly when it has a recurrent nature. The administration of antibiotics without sufficient diagnostic consideration can cause a delay in making an accurate diagnosis and thereby also cause a delay in administering appropriate treatment.

著者

Kentaro Iwata Tomoko Toma Akihiro Yachie

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.3001-19, (Released:2019-07-10)

参考文献数

14

被引用文献数

1

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A 38-year-old Japanese man without any significant past medical history was referred to our clinic to undergo further examination for a "refractory infection in his joints". He suffered recurrent migratory polyarthritis starting from bilateral knees to his right elbow. Certain antibiotic therapies appeared to improve his symptoms, but the symptoms recurred due to the migratory nature of arthritis. A diagnosis of familial Mediterranean fever (FMF) was considered and diagnostic tests were performed. Not many differential diagnoses exist for migratory polyarthritis, particularly when it has a recurrent nature. The administration of antibiotics without sufficient diagnostic consideration can cause a delay in making an accurate diagnosis and thereby also cause a delay in administering appropriate treatment.