Background: Constipation causes substantial morbidity worldwide. Methods: This survey assessed constipation-related factors in Japan using the Japanese version of the Irritable Bowel Syndrome Quality ...of Life (IBS-QOL-J) instrument. We also examined the relationship among laxative type, Bristol Stool Form Scale (BSFS) scores, and treatment cost. Finally, we examined differences in satisfaction scores according to laxative type, treatment type, treatment cost, and BSFS score. Results: IBS-QOL-J was higher among those taking salt and/or irritation laxatives. Those paying >JPY 5000 (USD 50.00) had the lowest IBS-QOL-J. IBS-QOL-J was significantly lower among those with a BSFS score of 1 or 2 (severe constipation). Conclusions: This study’s findings suggest that a variety of factors, including treatment type and cost, are associated with defecation satisfaction. Those who had hard stools, used multiple laxatives, or spent more on treatment were less satisfied. Future strategies should target therapies that do not require multiple laxatives with lower treatment costs. Adequate defecation with a small number of appropriate laxatives at minimal cost appears to improve defecation satisfaction. It is desirable to identify appropriate laxatives and improve dietary habits and exercise routines. It is also necessary to stop blindly increasing laxative usage and properly diagnose constipation disorders such as anatomical abnormalities other than functional constipation.
Numbness is a term commonly used in clinical practice to describe an abnormal sensory experience that is produced by a stimulus or is present even without a stimulus. However, there is still much ...that remains obscure in this field, and also, few reports have focused on its symptoms. In addition, while pain itself is known to have a significant impact on quality of life (QOL), the relationship between numbness and QOL is often unclear. Therefore, we conducted an epidemiological survey and analyzed the relationship between painless numbness and QOL, using type, location, and age as influencing factors, respectively.
A nationwide epidemiological survey was conducted by mail using a survey panel designed by the Nippon Research Center. Questionnaires were sent to 10,000 randomly selected people aged 18 and over from all over Japan. Out of the 5682 people who responded, the relationship between numbness and QOL was analyzed using the EuroQol 5 Dimension-3L (EQ5D-3L) for patients who are currently experiencing painless numbness.
The results suggest that painless numbness affects QOL and that QOL decreases as its intensity increases. Furthermore, the two factors of numbness of feet and numbness among the young may be less likely to affect QOL. This study may be of great significance in the field of numbness research.
Neuropathic Pain Igari, Hiroki; Ushida, Takahiro
Brain and nerve = Shinkei kenkyū no shinpo
75, Številka:
5
Journal Article
Many diseases are associated with "neuropathic pain", which is not usually manageable with common analgesics, such as NSAIDs and acetaminophen. Calcium ion channel α2δ ligands, ...serotonin-noradrenaline reuptake inhibitors, and tricyclic antidepressants have been used as first-line drugs. If there are no improvements after using these drugs for a while, vaccinia virus inoculation of rabbit inflammatory skin extract, tramadol, and eventually opioid analgesics, may be considered.
We have succeeded in significantly enhancing fluorescence from intrinsically phosphorescent palladium octaethylporphyrin (Pd-porphyrin) that has an intersystem crossing efficiency of ∼1 by using ...silver nanoprisms (AgPRs). This was achieved by controlling the wavelength of the localized surface plasmon (LSP) resonance of AgPRs and the distance between the Pd-porphyrin molecules and the AgPR surfaces. In addition to enhancing phosphorescence by spectrally overlapping the phosphorescence band with the LSP resonance band, tuning the LSP wavelength to approximately 520 nm led to the appearance of a new emission band around the wavelength corresponding to the fluorescent radiation. The appearance of fluorescence suggests that the nonradiative energy transfer from the singlet excited state of Pd-porphyrin to the LSP of AgPRs overcame the ultrafast intramolecular intersystem crossing to the triplet excited state, manifesting the spectral properties of the singlet excited state of Pd-porphyrin. The fluorescence nature of this radiation was strongly supported by lifetime measurements of the hybrids of Pd-porphyrin and AgPRs. Furthermore, the dependence of the emissive intensities on the distance between the Pd-porphyrin molecules and the AgPR surfaces showed interesting opposite trends. The fluorescence intensity was increased as the distance between the molecules and the AgPRs was decreased from 10.5 to 1 nm, while the phosphorescence intensity was decreased, which indicates that the LSP-induced fluorescence radiation process from Pd-porphyrin near the AgPRs outweighed the quenching by the AgPRs, even though the phosphorescence significantly suffered quenching.
With an intention to clarify creep-fatigue behavior of welded joint of Ni-based alloy HR6W (23Cr-45Ni-6W), creep-fatigue tests at 700℃ were carried out for both uniaxial cross-weld and stub weld ...subjected to cyclic displacement. The location of crack at creep-fatigue life Nf was at a base metal near a Heat Affected Zone (HAZ) for uniaxial cross-weld; and at a toe of weld for stub-weld specimen. Elastic-plastic-creep FEM analysis using cyclic stress-strain behavior at Nf/2 was performed for the two types of welded joint to clarify a strain-concentration behavior and to predict a creep-fatigue life using a local strain. FEM results considering material behaviors depending on hardness distribution in welded joints, revealed that creep-fatigue life for the two types welded joint could be predicted by a factor of about two.
In a previous retrospective observational study, a 3-day regimen of oseltamivir as post-exposure prophylaxis (PEP) for preventing transmission of influenza in wards was shown to be comparable to 7- ...to 10-day regimens provided index cases were immediately separated from close contacts. In order to confirm the efficacy of a 3-day regimen, we started to conduct a prospective, multi-center, single-arm trial.
This study is a prospective, multi-center, single-arm study designed by the Sectional Meeting of Clinical Study, Japan Infection Prevention and Control Conference for National and Public University Hospitals. Index patients with influenza are prescribed a neuraminidase inhibitor and are discharged immediately or transferred to isolation rooms. The close contacts are given oseltamivir as 75 mg capsules once daily for adults or 2 mg/kg (maximum of 75 mg) once daily for children for 3 days as PEP. All close contacts are monitored for development of influenza for 7 days after starting PEP.
A 3-day regimen of oseltamivir as PEP has advantages over 7- to 10-day regimens in terms of costs, medication adherence and adverse effects. Trial registration The Institutional Review Board of Hokkaido University Hospital for Clinical Research, 015-0518, registered on November 11, 2016. UMIN Clinical Trials Registry, UMIN000024458, disclosed on October 31, 2016. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000027881 . Japan Registry of Clinical Trials, jRCTs011180015, disclosed on March 14, 2019. https://jrct.niph.go.jp/latest-detail/jRCTs011180015.
•All carbapenemase-producing Enterobacterales (CPE) were IMP-type metallo-β-lactamase-producers.•The Enterobacter cloacae complex was predominant in CPE.•Klebsiella aerogenes and the Enterobacter ...cloacae complex were the major species in non–carbapenemase-producing (non-CP) carbapenem-resistant Enterobacterales (CRE).•The 28-day mortality was comparable in both CPE and non-CP CRE groups.•In CRE patients, bloodstream infections, mechanical ventilation, and cancer with metastasis were independent risk factors for 28-day mortality.
The dissemination of difficult-to-treat carbapenem-resistant Enterobacterales (CRE) is of great concern. We clarified the risk factors underlying CRE infection mortality in Japan.
We conducted a retrospective, multicentre, observational cohort study of patients with CRE infections at 28 university hospitals from September 2014 to December 2016, using the Japanese National Surveillance criteria. Clinical information, including patient background, type of infection, antibiotic treatment, and treatment outcome, was collected. The carbapenemase genotype was determined using PCR sequencing. Multivariate analysis was performed to identify the risk factors for 28-day mortality.
Among the 179 patients enrolled, 65 patients (36.3%) had bloodstream infections, with 37 (20.7%) infections occurring due to carbapenemase-producing Enterobacterales (CPE); all carbapenemases were of IMP-type (IMP-1: 32, IMP-6: 5). Two-thirds of CPE were identified as Enterobacter cloacae complex. Combination therapy was administered only in 46 patients (25.7%), and the 28-day mortality rate was 14.3%. Univariate analysis showed that solid metastatic cancer, Charlson Comorbidity Index ≥3, bloodstream infection, pneumonia, or empyema, central venous catheters, mechanical ventilation, and prior use of quinolones were significant risk factors for mortality. Multivariate analysis revealed that mechanical ventilation (OR: 6.71 1.42–31.6, P = 0.016), solid metastatic cancers (OR: 5.63 1.38–23.0, P = 0.016), and bloodstream infections (OR: 3.49 1.02–12.0, P = 0.046) were independent risk factors for 28-day mortality.
The significant risk factors for 28-day mortality in patients with CRE infections in Japan are mechanical ventilation, solid metastatic cancers, and bloodstream infections.
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