- 著者
- Mitsuru Takami Koji Fukuzawa Kunihiko Kiuchi Makoto Takemoto Toshihiro Nakamura Jun Sakai Atsusuke Yatomi Kazutaka Nakasone Yusuke Sonoda Kyoko Yamamoto Hiroyuki Takahara Yuya Suzuki Kenichi Tani Ken-ichi Hirata
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.3, no.5, pp.294-299, 2021-05-10 (Released:2021-05-10)
- 参考文献数
- 10
- 被引用文献数
- 3
Background:Demand is growing for remote electrocardiogram (ECG) monitoring systems in the COVID-19 era in Japan. This study describes initial experiences with a small wireless ECG monitoring device and the utility of delivery via the postal service for outpatient care in Japan.Methods and Results:Long-term ECG monitoring following postal delivery of the small ECG device was evaluated in 25 patients. The patients had no difficulties with either the postal delivery or self-fitting and wearing the devices. A median of 57 h monitoring per patient was performed. Arrhythmic events were detected in 8 patients. Most patients were satisfied with both the ECG devices and postal delivery.Conclusions:Postal delivery of ECG devices could be used in clinical practice to achieve less or no in-person contact during the COVID-19 era.
- 著者
- Mitsuru Takami Koji Fukuzawa Kunihiko Kiuchi Hiroyuki Takahara Kimitake Imamura Toshihiro Nakamura Yusuke Sonoda Kazutaka Nakasone Kyoko Yamamoto Yuya Suzuki Kenichi Tani Hidehiro Iwai Yusuke Nakanishi Mitsuhiko Shoda Atsushi Murakami Shogo Yonehara Ken-ichi Hirata
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- pp.CR-23-0083, (Released:2023-10-28)
- 参考文献数
- 11
Background: There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation.Methods and Results: In all, 38 patients who underwent catheter ablation were followed up using telehealth. At the 3- and 6-month follow-up, a self-fitted Duranta ECG monitoring device was sent to the patient’s home before the online consultation. Patients attached the devices themselves, and the doctors viewed the patients by video chat and performed real-time ECG monitoring. The frequency of hospital visits and the ECG monitoring duration were compared with conventional in-person follow-up data (n=102). The completion rate for telehealth follow-up was 32 of 38 patients (84%). The number of hospital visits during the 6 months was significantly lower with telehealth follow-up than with conventional follow-up (median [interquartile range] 1 [1–1] vs. 5 [3–5]; P<0.0001). However, the ECG monitoring duration was approximately 4-fold longer for the telehealth follow-up (median [interquartile range] 89 [64–117] vs. 24 [0.1–24] h; P<0.0001). No major adverse events were observed during the telehealth follow-up. Patient surveys showed high satisfaction with telehealth follow-up due to reduced hospital visits.Conclusions: A combination of telehealth follow-up with real-time ECG monitoring increased the ECG monitoring duration and patient satisfaction without any adverse events.
- 著者
- Kyoko Yamamoto Yasuhiro Komatsu Hiroyuki Yamamoto Hiroko Izumo Kyo Sanoyama Masami Monden Kyoko Takeda Fumiko Nakahara Katsumi Yoshida
- 出版者
- Tohoku University Medical Press
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.225, no.3, pp.195-202, 2011 (Released:2011-10-19)
- 参考文献数
- 27
- 被引用文献数
- 6 6
Diabetes and chronic kidney disease (CKD) which are risk facters of cardiovascular disease, are increasing global public health problems. Microalbuminuria is an early sign of progressive cardiovascular and renal disease in individuals with or without diabetes. Screening for microalbuminuria and early treatment are recommended for patients with increased cardiovascular and renal risk factors. However, the procedure used to measure urinary albumin is expensive. Alternatively, the measurement of total urinary protein is simple and inexpensive. Thus, we aimed to establish a method that could predict the presence of microalbuminuria by measuring the total protein-to-creatinine ratio. Spot urine samples were obtained from 150 patients with diabetes mellitus, and the total protein-to-creatinine ratio and the albumin-to-creatinine ratio (ACR) were measured. There was a significant positive correlation between the protein-to-creatinine ratio and the ACR (r = 0.95). The presence of albuminuria (both micro- and macroalbuminuria) could be predicted from the value of the protein-to-creatinine ratio in more than 90% of patients. A receiver-operating characteristic curve analysis revealed that the protein-to-creatinine ratio had a sensitivity and a specificity of 90.8% and 91.9%, respectively, for the detection of albuminuria and a cutoff value of 0.091 g/g creatinine. These results suggest that screening for microalbuminuria can be replaced by the detection of the protein-to-creatinine ratio, which may be cost-effective for patients with cardiovascular risks as well as for the general population.
- 著者
- 松本 佳代 山本 京子 唐沢 康子 日野 徳子 中村 厚 高橋 真介 荒木 博陽 奥山 茂 町支 臣成 杉野 栄一 日比野 俐 吉本 真 マツモト カヨ ヤマモト キョウコ カラサワ ヤスコ ヒノ ノリコ ナカムラ アツシ タカハシ マサヤシ アラキ ヒロアキ オクヤマ シゲル チョウシ トミナリ スギノ エイイチ ヒビノ サトシ ヨシモト マコト Kayo Matsumoto Kyoko Yamamoto Yasuko Karasawa Noriko Hino Atsushi Nakamura Masayashi Takahashi Hiroaki Araki Shigeru Okuyama Tominari Choshi Eiichi Sugino Satoshi Hibino Makoto Yoshimoto
- 雑誌
- 福山大学薬学部研究年報 = Annual report of the Faculty of Pharmacy & Pharmaceutical Sciences, Fukuyama University
- 巻号頁・発行日
- vol.22, pp.40-41, 2004
- 著者
- Hiroyuki Yamamoto Kyoko Yamamoto Katsumi Yoshida Chiyohiko Shindoh Kyoko Takeda Masami Monden Hiroko Izumo Hiroyuki Niinuma Yutaro Nishi Koichiro Niwa Yasuhiro Komatsu
- 出版者
- Tohoku University Medical Press
- 雑誌
- The Tohoku Journal of Experimental Medicine (ISSN:00408727)
- 巻号頁・発行日
- vol.237, no.3, pp.201-207, 2015 (Released:2015-10-24)
- 参考文献数
- 24
- 被引用文献数
- 2 2
Chronic kidney disease (CKD) is a global public health issue, and strategies for its early detection and intervention are imperative. The latest Japanese CKD guideline recommends that patients without diabetes should be classified using the urine protein-to-creatinine ratio (PCR) instead of the urine albumin-to-creatinine ratio (ACR); however, no validation studies are available. This study aimed to validate the PCR-based CKD risk classification compared with the ACR-based classification and to explore more accurate classification methods. We analyzed two previously reported datasets that included diabetic and/or cardiovascular patients who were classified into early CKD stages. In total, 860 patients (131 diabetic patients and 729 cardiovascular patients, including 193 diabetic patients) were enrolled. We assessed the CKD risk classification of each patient according to the estimated glomerular filtration rate and the ACR-based or PCR-based classification. The use of the cut-off value recommended in the current guideline (PCR 0.15 g/g creatinine) resulted in risk misclassification rates of 26.0% and 16.6% for the two datasets. The misclassification was primarily caused by underestimation. Moderate to substantial agreement between each classification was achieved: Cohen’s kappa, 0.56 (95% confidence interval, 0.45-0.69) and 0.72 (0.67-0.76) in each dataset, respectively. To improve the accuracy, we tested various candidate PCR cut-off values, showing that a PCR cut-off value of 0.08-0.10 g/g creatinine resulted in improvement in the misclassification rates and kappa values. Modification of the PCR cut-off value would improve its efficacy to identify high-risk populations who will benefit from early intervention.
- 著者
- Mitsuru Takami Koji Fukuzawa Kunihiko Kiuchi Hiroyuki Takahara Kimitake Imamura Toshihiro Nakamura Yusuke Sonoda Kazutaka Nakasone Kyoko Yamamoto Yuya Suzuki Kenichi Tani Hidehiro Iwai Yusuke Nakanishi Mitsuhiko Shoda Atsushi Murakami Shogo Yonehara Ken-ichi Hirata
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.5, no.11, pp.415-423, 2023-11-10 (Released:2023-11-10)
- 参考文献数
- 11
Background: There is a strong demand for remote monitoring systems to gather health data. This study investigated the safety, usefulness, and patient satisfaction in outpatient care using telehealth with real-time electrocardiogram (ECG) monitoring after catheter ablation.Methods and Results: In all, 38 patients who underwent catheter ablation were followed up using telehealth. At the 3- and 6-month follow-up, a self-fitted Duranta ECG monitoring device was sent to the patient’s home before the online consultation. Patients attached the devices themselves, and the doctors viewed the patients by video chat and performed real-time ECG monitoring. The frequency of hospital visits and the ECG monitoring duration were compared with conventional in-person follow-up data (n=102). The completion rate for telehealth follow-up was 32 of 38 patients (84%). The number of hospital visits during the 6 months was significantly lower with telehealth follow-up than with conventional follow-up (median [interquartile range] 1 [1–1] vs. 5 [3–5]; P<0.0001). However, the ECG monitoring duration was approximately 4-fold longer for the telehealth follow-up (median [interquartile range] 89 [64–117] vs. 24 [0.1–24] h; P<0.0001). No major adverse events were observed during the telehealth follow-up. Patient surveys showed high satisfaction with telehealth follow-up due to reduced hospital visits.Conclusions: A combination of telehealth follow-up with real-time ECG monitoring increased the ECG monitoring duration and patient satisfaction without any adverse events.