著者

Shin Takayama Tetsuhiro Yoshino Sayaka Koizumi Yasuhito Irie Tomoko Suzuki Susumu Fujii Rie Katori Mosaburo Kainuma Seiichi Kobayashi Tatsuya Nogami Kenichi Yokota Mayuko Yamazaki Satoko Minakawa Shigeki Chiba Norio Suda Yoshinobu Nakada Tatsuya Ishige Hirofumi Maehara Yutaka Tanaka Mahiko Nagase Akihiko Kashio Kazuhisa Komatsu Makoto Nojiri Osamu Shimooki Kayo Nakamoto Ryutaro Arita Rie Ono Natsumi Saito Akiko Kikuchi Minoru Ohsawa Hajime Nakae Tadamichi Mitsuma Masaru Mimura Tadashi Ishii Kotaro Nochioka Shih-Wei Chiu Takuhiro Yamaguchi Takao Namiki Akito Hisanaga Kazuo Mitani Takashi Ito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0027-22, (Released:2022-11-02)

参考文献数

41

被引用文献数

3

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Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

著者

Masato Nakamura Munenori Takata Hiroyoshi Yokoi Takafumi Ueno Yuka Suzuki Koji Ikeda Takuhiro Yamaguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0171, (Released:2021-04-29)

参考文献数

30

被引用文献数

2

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Background:The effect of treatment with paclitaxel-containing devices (PTXD) on mortality in patients with peripheral artery disease remains controversial.Methods and Results:An independent patient-level meta-analysis of 12 clinical trials (1,389 PTXD patients and 1,192 non-PTXD patients) was conducted. This study included 7 pivotal trials and 5 post-marketing surveillance studies on endovascular treatment for femoropopliteal artery by 6 companies. The primary endpoint was all-cause death, and 5-year cumulative mortality was estimated by a Kaplan-Meier curve. Cox proportional hazard model was used to calculate the hazard ratio (HR) and confidential interval (CI). During the median follow up of 3.0 years, 459 patients died. The cumulative 5-year mortality for the entire cohort was significantly lower in the PTXD than in the non-PTXD group (24.4% vs. 27.4%, respectively; HR, 0.81; 95% CI, 0.67–0.97; P=0.023), but this difference was no longer significant after adjustment for relevant covariates (HR, 1.01; 95% CI, 0.39–2.58; P=0.987). The Cox proportional hazard model revealed that sex, hyperlipidemia, Type 2 diabetes, hemodialysis, Rutherford category, and age above 75 years were significantly associated with 5-year mortality, but treatment with PTXD was not.Conclusions:This large individual meta-analysis of patients with femoropopliteal artery disease found that the use of PTXD does not have a negative effect on 5-year mortality.

著者

Akira Inoue Takuhiro Yamaguchi Keiko Tanaka Akihiro Sakashita Keisuke Aoe Nobuhiko Seki Koichi Hagiwara

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0872-18, (Released:2019-02-01)

参考文献数

18

被引用文献数

7

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Introduction The early integration of palliative care into standard cancer treatment has become a global standard. The Palliative care Emphasis program on symptom management and Assessment for Continuous medical Education (PEACE) has been conducted in Japan, and previous studies have reported that the PEACE workshop was able to improve various palliative care skills of participants. However, whether or not the effects of the program are long-lasting and if the program consequently changed physicians' practice with regard to lung cancer patients have been unclear. Methods Web-based surveys, including the palliative care knowledge test (PEACE-Q), the Palliative Care self-reported Practice Scale (PCPS), and the Palliative Care Difficulties Scale (PCDS), were conducted among lung cancer physicians in Japan. The differences in the survey results between participants and non-participants of the PEACE workshop were examined. Results Among 923 respondents (455 respiratory physicians, 345 pulmonary surgeons, and 123 others), 519 had participated in the PEACE workshop. The total PEACE-Q score was significantly higher in the PEACE workshop participants than in non-participants (28.0 versus 24.5, p<0.0001). The score was significantly higher in respiratory physicians than in pulmonary surgeons (27.4 versus 25.5). The total PCPS and PCDS scores were also significantly better in workshop participants than in non-participants (71.8 versus 67.1 and 34.3 versus 36.9, respectively), although some domains of PCDS were similar between the groups. Conclusion The PEACE program improved the knowledge and practices with regard to palliative care and resolved difficulties associated therewith among lung cancer physicians. In regions where palliative care specialists are insufficient, such educational programs may be effective. Mini Abstract The PEACE program improved the knowledge and practices with regard to palliative care and resolved difficulties associated therewith among lung cancer physicians in Japan.

著者

Takashi Kawaguchi Kanako Azuma Takuhiro Yamaguchi Satoru Iwase Tadaharu Matsunaga Kimito Yamada Hironobu Miyamatsu Hironori Takeuchi Norio Kohno Takao Akashi Sakae Unezaki

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

pp.b14-00452, (Released:2014-09-09)

参考文献数

47

被引用文献数

13

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With the shift of a large proportion of cancer chemotherapy recipients to ambulatory care, the role of hospital pharmacists has changed, and their provision of information is essential care for cancer patients. There is little research on pharmacist–patient relations, particularly about pharmacist counselling, in Japan. To meet patients' needs, pharmacist counselling should be optimized. Here, breast cancer patients' preferences for pharmacist counselling were assessed using a discrete choice experiment. Bayesian nonlinear optimal methodology was employed to obtain six attributes (attitude of pharmacist, quality of information, explanation of side effects, frequency of pharmacist counselling before starting chemotherapy, cost of pharmacist counselling, and follow-up with the pharmacist after starting chemotherapy) of two to three levels each. The attributes and levels were used to create 12 hypothetical scenarios that were divided into two questionnaires of six choice sets each. Two hundred eighty participants were randomly assigned to complete one of these questionnaires (blocks). Attributes were analyzed by conditional logit model to determine significant predictors of patient preferences. The responses of 278 patients to 1667 scenarios were analyzed. Attitude of pharmacist, quality of information, cost of pharmacist counselling, and follow-up with the pharmacist after starting chemotherapy were significant predictors of patient preferences, with quality of information receiving the highest priority. Thus patients receiving pharmacist counselling before starting chemotherapy prefer to interact with a pharmacist with a friendly, interested attitude who provides individualized information. Further research is needed to elucidate the information that Japanese patients consider most important and to enhance pharmacist–patient communication.