First of all, high glycated hemoglobin might initially be a contributing factor. ...a diabetes‐related condition that includes the duration of diabetes and the presence of microvascular complications ...is important. ...identifying the presence of lower UTI at the baseline as a risk of developing severe upper UTI would be helpful.
Transition metal-catalyzed dehydrogenation is a clean oxidation method requiring no additional oxidants. We have accomplished a heterogeneous Pd/C-catalyzed aqueous dehydrogenation of ...1,4-cyclohexadienes and cyclohexenes to give the corresponding highly-functionalized arenes. Furthermore, various arenes could be efficiently constructed in a one-pot manner via a Diels–Alder reaction and the following dehydrogenation.
Aims/Introduction
The prevalence and risk of vaginal candidiasis before and after initiating sodium–glucose cotransporter 2 (SGLT2) inhibitors, although some clinical trials have been carried out, ...have not been adequately shown in real‐world practice. We investigated the incidence of vaginal Candida colonization and symptomatic vaginitis, and the clinical risk factors including diabetic microvascular complications.
Materials and Methods
The participants were 114 women with type 2 diabetes who were free of vaginitis symptoms and started SGLT2 inhibitors. Vaginal candidiasis tests through self‐administered swabs were carried out at baseline, 6 and 12 months.
Results
Before starting SGLT2 inhibitors, 17 participants (14.9%) had positive vaginal Candida colonization. Younger age and the presence of microangiopathy were significantly associated with the positive colonization in multivariate analysis. Among all participants, 23 (20.2%, 8 because of vaginitis and 15 for other reasons) discontinued SGLT2 inhibitors before reaching the 6‐month test. Of 65 participants who were negative for Candida at baseline and received the 6‐month test, 24 (36.9%) converted to a positive culture, and multivariate analysis showed older age as an independent risk for developing Candida colonization. There were 18 participants (15.8%) who developed symptomatic vaginitis, and they showed similar characteristics to the 24 participants. Most of those with negative cultures at 6 months showed negative results at 12 months and vice versa.
Conclusions
The rates of developing positive colonization and symptomatic vaginitis after starting SGLT2 inhibitors appear to be higher in real‐world practice than the rates of 31% and 5–10% in clinical trials, respectively. Risk factors of vaginal Candida colonization might be different before and after taking SGLT2 inhibitors.
Risk of vaginal Candidiasis accompanied with taking SGLT2 inhibitors is high in real world practice as compared to clinival trials. Risk factors associated with vaginal Candidiasis is different before and after starting SGLT2 inhibitors.
•Initial micafungin administration can cause immune complex type hemolytic anemia.•A man developed immune complex type hemolytic anemia by initial micafungin administration.•The direct anti-globulin ...test and the immune complex test confirmed the diagnosis.•Prompt cessation of micafungin served as a successful treatment.
We report the first case of immune complex type hemolytic anemia by initial micafungin administration that was given as prophylaxis to a 42-year-old Japanese man receiving chemotherapy for primary amyloidosis. The few cases found in the literature were associated with secondary administration causing immune hemolytic attacks. Despite its rarity, the present case calls for increased awareness of micafungin-induced hemolytic anemia upon initial administration.
Hodgkin lymphoma (HL) and idiopathic multicentric Castleman disease (iMCD) are markedly different conditions. However, in some cases, histological similarities caused by elevated cytokines, including ...interleukin-6, can lead to a misdiagnosis of HL as Castleman disease (CD). We herein report a patient with HL who had been diagnosed with CD by an expert panel and for whom an additional biopsy was useful for determining the correct diagnosis. Furthermore, we analyzed the positron emission tomography/computed tomography findings at the diagnosis and found that the maximum standardized uptake value was useful for distinguishing HL from iMCD.
Ferrofluids containing both micrometer-size spherical magnetic particles and nanometer-size needle-like nonmagnetic hematite particles were newly produced. Average length of long axis of the ...needle-like nonmagnetic particles was 194nm and the aspect ratio was 8.3. Shear stress and viscosity were measured using the rheometer with the additional equipment for viscosity measurements in the presence of magnetic field. When the total volume fraction of particles in the fluid is constant (0.30), there is the specific mixing ratio of the particles to increase viscosity of the fluid drastically in the absence of magnetic field due to the percolation phenomenon. The fluid of the specific mixing ratio shows solid-like behavior even in the absence of magnetic field. Mixing the needle-like nonmagnetic particles causes strong yield stress and strong viscous force in the presence of magnetic field.
•Viscous properties of new magnetic functional fluids were studied experimentally.•The new fluids contain spherical magnetic particles and needle-like particles.•Percolation occurs in the fluid of specific mixing ratio of particles without field.•The fluid of the specific mixing ratio behaves like solid without field.•Mixing needle-like particles causes strong yield stress of the fluid in the field.
Aims/Introduction
Type 2 diabetes mellitus is caused by a relative imbalance between insulin secretion and sensitivity related to the body mass index (BMI). Seven categories of oral antidiabetic ...drugs (OADs) are available in Japan. It is important to assess the OAD utilization patterns based on patients’ BMI levels.
Materials and methods
OAD prescribing patterns from 2002 to 2019 were analyzed using the data collected in the computerized diabetes care database provided by the Japan Diabetes Clinical Data Management Study Group; OAD utilization patterns in 25,751 OAD‐treated type 2 diabetes mellitus patients registered in 2019 were analyzed after classifying them into five categories of BMI.
Results
Comparing OAD usage between 2002 and 2019, sulfonylureas decreased from 44.5 to 23.2%, and biguanides (BGs) increased from 19.3 to 50.3%. Dipeptidyl peptidase‐4 inhibitors (DPP4is) increased to 56.9% in 2019. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) increased to 23.6% in 2019. About 90% of type 2 diabetes mellitus patients had BMI < 30 kg/m2. DPP4is were the most used OADs in 2019. When BMI exceeded 30 kg/m2, use of BGs and sodium–glucose cotransporter 2 inhibitors increased, and use of sulfonylureas and DPP4is decreased. Although DPP4is were the most used OADs for patients with BMI <30 kg/m2, they were the third most prescribed OADs for patients with BMI >35 kg/m2 after BGs and sodium–glucose cotransporter 2 inhibitors .
Conclusions
DPP4i usage was as high as that of BG in the analysis of Japanese type 2 diabetes mellitus patients with relatively low BMI. This was considered to be a treatment option appropriate for the pathophysiology in Japanese patients.
Oral antidiabetic drug prescribing patterns in patients with type 2 diabetes by year from 2002 to 2019.
We previously reported in the study of preventive effects of alogliptin on diabetic atherosclerosis (SPEAD-A) that alogliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, attenuated the progression ...of carotid atherosclerosis in subjects with type 2 diabetes and no history of cardiovascular disease. This extension study of the SPEAD-A trial investigated whether early alogliptin initiation improved long-term cardiovascular outcomes. The SPEAD-A trial randomized 341 subjects with type 2 diabetes to either alogliptin or conventional treatment to investigate the effects of alogliptin on atherosclerosis. All subjects who completed that trial were eligible for this prospective, observational cohort study. The primary endpoint was the first occurrence of a major cardiovascular event, defined as death due to any cause, acute myocardial infarction, or stroke. During the 520-week follow-up period, composite primary outcome events occurred in only a few subjects in each group 8 (5.4%) in the alogliptin group and 9 in the conventional treatment group (5.9%). There were no significant differences in the incidence rate of the primary outcome between the two groups. Post hoc Poisson regression analysis showed no significant difference between the two groups in the incidence rate of composite recurrence events for the same outcomes as the primary endpoint. On the other hand, this incidence rate was significantly lower in subjects who received DPP-4 inhibitors before an initial cardiovascular event than in those who did not (5.8 vs. 13.3 per 1000 person-years, respectively, p = 0.04). Early initiation of alogliptin was not associated with a reduced risk of composite cardiovascular disease, which could be attributed to fewer events and/or the addition of DPP-4 inhibitors during the follow-up period.
Aims/Introduction
To assess the prevalence of diabetic polyneuropathy (DPN)‐related sensory symptoms/signs and associated factors in patients with polyneuropathy, considering non‐linear effects for ...numerical variables.
Materials and Methods
A cross‐sectional survey of patients with type 2 diabetes mellitus from 17 primary care clinics across Japan was carried out. DPN and DPN‐related sensory symptoms/signs were diagnosed according to the Diabetic Neuropathy Study Group in Japan criteria.
Results
Of the 9,914 patients with type 2 diabetes mellitus in this study, 2,745 had DPN and 1,689 had DPN‐related sensory symptoms/signs (61.5% of patients with DPN). There were significant correlations between DPN‐related sensory symptoms/signs and smoking status (odds ratio 2.04 for current and 1.64 for former; P < 0.001 and P = 0.002, respectively), sex (odds ratio 0.56 for male/female; P < 0.001) and alcohol consumption (odds ratio 2.02 for former/never; P = 0.004). Based on the non‐linear logistic regression model, significant correlations were observed between the presence of DPN‐related sensory symptoms/signs and higher systolic blood pressure (SBP), longer diabetes duration, and decreasing age. The logarithm of odds for SBP increased until reaching approximately 130 mmHg, then it plateaued.
Conclusions
Some modifiable factors assessed in the large survey database might be associated with DPN‐related sensory symptoms/signs, namely smoking, alcohol consumption and SBP. Maintaining SBP <130 mmHg was associated with lower odds of DPN‐related sensory symptoms/signs in patients with DPN.
This manuscript presents the results of a cross‐sectional Japanese study that assessed the risk factors associated with diabetic peripheral neuropathy‐related symptoms among patients with type 2 diabetes and diabetic peripheral neuropathy, with consideration for non‐linear effects for numerical variables. Some of the modifiable risk factors assessed in the large survey database appeared to be associated with diabetic peripheral neuropathy‐related symptoms, namely smoking, alcohol consumption and systolic blood pressure.
Vorinostat (suberoylanilide hydroxamic acid, SAHA, Zolinza) is a histone deacetylase inhibitor with clinical activity in cutaneous T‐cell lymphoma (CTCL). A phase I trial of oral vorinostat was ...conducted in Japanese patients with malignant lymphoma. Vorinostat 100 or 200 mg was administered twice daily for 14 consecutive days followed by a 1‐week rest interval. Of 10 patients enrolled, four had follicular lymphoma (FL), two mantle cell lymphoma (MCL), two diffuse large B‐cell lymphoma, and two CTCL (median age, 60 years; median number of prior regimens, 3). Vorinostat was well tolerated up to 200 mg with only one of six patients developing a dose‐limiting toxicity (DLT; Grade 3 anorexia/hypokalemia). Common Grade 3 events were reversible neutropenia (30%), thrombocytopenia, and hypermagnesemia (20% each). The median number of treatment cycles was five (range, 1–36); two patients were continuing treatment. The overall response rate was 40%, with two complete responses/unconfirmed (CRu) and one partial response among FL patients and one CRu among MCL patients. One FL patient maintained CRu for 18.0 months. The median time to achieve CRu among the three patients was 8 months. These data suggest that further investigations of vorinostat in non‐Hodgkin lymphoma, focusing on FL and MCL, are warranted. (Cancer Sci 2009)
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