Aim
Atomoxetine (ATX) is a non‐central stimulant and a standard treatment for adult attention‐deficit/hyperactivity disorder (ADHD). The long‐term efficacy of Atomoxetine is about 40% at 6 months. ...The variability in efficacy between individuals is thought to be related to patient‐specific factors, but no detailed research has been conducted. In this retrospective cohort study, we aimed to identify the factors associated with Atomoxetine efficacy.
Methods
A total of 147 patients with attention‐deficit/hyperactivity disorder aged ≥18 years who were using Atomoxetine for the first time were included in this study. The outcome was treatment success (treatment maintained for at least 6 months and improvement in symptoms). Symptom assessment was based on the overall improvement in symptoms judged by an expert physician.
Results
Of the patient sample, 103 (70.1%) achieved the outcome. Logistic regression analysis identified “the maximum dose of ATX” and “gambling habit” as factors associated with efficacy ( P < 0.05). In the process of Atomoxetine titration, the larger the maximum dose, the higher the efficacy was shown to be. Gambling habits may be indicative of impulsivity, which is among the core symptoms of attention‐deficit/hyperactivity disorder. Thus, a gambling habit may be considered a surrogate marker for impulsivity.
Conclusions
Knowledge of these factors will help healthcare professionals to predict the likely efficacy of Atomoxetine in a given patient before subscribing it, facilitating individualized pharmacotherapy for adult attention‐deficit/hyperactivity disorder.
We retrospectively examined factors associated with the efficacy of atomoxetine for adult ADHD. The maximum dose of atomoxetine and gambling habit were identified as significant factors related to the efficacy.
To retrospectively investigate the association between dry eye symptoms and clinical or
confocal microscopy parameters in patients with dry eye disease (DED), and to compare these parameters between ...eyes with DED and normal subjects.
This retrospective, cross-sectional, controlled study comprised 25 consecutive patients with non-Sjögren dry eye disease and age- and sex-matched 25 healthy subjects. Each patient underwent a complete examination of the ocular surface in the following order: tear osmolarity measurements, InflammaDry test, tear break-up time, corneal fluorescein staining, Schirmer I test, subjective symptoms questionnaire using the dry eye-related quality-of-life score (DEQS), and
confocal microscopy analysis of the central cornea. Beck depression inventory (BDI) as depressive scale and history of medications and smoking were also evaluated. Stepwise multiple regression analysis was used to assess the factors affecting the DEQS.
In univariate analysis, DEQS was associated with tear break-up time (
=-0.48,
=0.01), oral medications, such as hypotensive drug (
=0.56,
=0.004) and anti-depressant (
=0.57,
=0.003), and BDI (
=0.61,
=0.001) in patients with DED. In multiple regression analysis, explanatory variables relevant to the DEQS were the anti-depressant medications (
=0.04, partial regression coefficient B=21.04) and BDI (
=0.02, B=0.76, adjusted
=0.54) in these patients.
Our study shows a significant association between depression and dry eye symptoms. It suggests that dry eye symptoms associate with higher depressive symptoms and its medications, although our patients were not followed longitudinally.
Abstract The condylar sizes in Japanese, Korean, and Egyptian individuals were compared using cone-beam computed tomography (CBCT). CBCT was used to measure the condylar sizes of 406 participants ...(179 Japanese individuals, mean age: 27.4 +- 8.7 years; 71 Korean individuals, mean age: 25.3 +- 6.4 years; and 156 Egyptian individuals, mean age: 24.2 +- 5.1 years) who visited or were recruited at medical institutions in their respective countries. Condylar size (length, height, and width) was measured using Invivo 5(TM) Anatomy imaging software and compared among the ethnic groups. The condylar length of Japanese participants was significantly larger than those of the other ethnic groups, while the condylar height of Korean participants was significantly higher than those of the other ethnic groups. Significant differences were not observed in the condylar width among the ethnic groups. The Egyptian condyle tended to be smaller than the condyles in other ethnic groups. Ethnic differences were noted in a comparison of condylar sizes among Japanese, Korean, and Egyptian participants.
Children with Kawasaki disease are prescribed acetylsalicylic acid powder as an antipyretic analgesic and antiplatelet agent; however, some of it remains in the mouth, leading to a bitter or sour ...taste. To address this issue, an in-hospital mini-tablet formulation of acetylsalicylic acid was developed. In order to use the mini-tablets safely and effectively, dissolution tests alone are not sufficient. Therefore, an open-label crossover study on six healthy participants was conducted to evaluate comparative pharmacokinetic parameters. The pharmacokinetic parameters of salicylic acid were Cmax: 4.80 ± 0.79 mg/L (powder; P), 5.03 ± 0.97 mg/L (mini-tablet; MT), AUC0–12: 18.0 ± 3.03 mg-h/L (P), 18.9 ± 4.59 mg-h/L (MT), those of acetylsalicylic acid Cmax: 0.50 ± 0.20 mg/L (P), 0.41 ± 0.24 mg/L (MT), AUC0–12: 0.71 ± 0.27 mg-h/L (P), 0.61 ± 0.36 mg-h/L (MT), with no significant differences between the mini-tablet and powder formulations. Although pharmacokinetic results obtained from adults cannot be directly applied to children, the results of this study are important for predicting pharmacokinetics. Furthermore, a formulation that can improve medication adherence in children who have difficulty taking acetylsalicylic acid powder, thus contributing to pediatric drug therapy.
Patients under cardiopulmonary resuscitation (CPR) are at high risk of aspirating gastric contents. Nasogastric tube insertion (NGTI) after tracheal intubation is usually performed blindly. This ...sometimes causes laryngopharyngeal mucosal injury (LPMI), leading to severe bleeding. This study clarified the incidence of LPMI due to blind NGTI during CPR.
We retrospectively analyzed 84 patients presenting with cardiopulmonary arrest on arrival, categorized them into a Smooth group (Smooth; blind NGTI was possible within 2 min), and Difficult group (blind NGTI was not possible), and consequently performed video laryngoscope-assisted NGTI. The laryngopharyngeal mucosal condition was recorded using video laryngoscope. Success rates and insertion time for the Smooth group were calculated. Insertion number and LPMI scores were compared between the groups. Each regression line of outcome measurements was obtained using simple regression analysis. We also analyzed the causes of the Difficult group, using recorded video laryngoscope-assisted videos.
The success rate was 78.6% (66/84). NGTI time was 48.8 ± 4.0 s in the Smooth group. Insertion number and injury scores in the Smooth group were significantly lower than those in the Difficult group. The severity of LPMI increased with NGT insertion time and insertion number.
Whenever blind NGTI is difficult, switching to other methods is essential to prevent unnecessary persistence.
Recent retrospective investigations have suggested that optical coherence tomography (OCT) enables the diagnosis of underlying acute coronary syndrome (ACS) causes such as plaque rupture, plaque ...erosion, and calcified nodule. The relationships of these etiologies with clinical outcomes, and the clinical utility of OCT-guided primary percutaneous coronary intervention (PCI) are not systematically studied in real-world ACS treatment settings.
The TACTICS registry is an investigator-initiated, prospective, multicenter, observational study to be conducted at 21 hospitals in Japan. A total of 700 patients with ACS (symptom onset within 24 h) undergoing OCT-guided primary PCI will be enrolled. The primary endpoint of the study is to identify the underlying causes of ACS using OCT-defined morphological assessment of the culprit lesion. The key secondary clinical endpoints are hazard ratios of the composite of cardiovascular death, non-fatal myocardial infarction, heart failure, or ischemia-driven revascularization in patients with underlying etiologies at the 12- and 24-month follow-ups. The feasibility of OCT-guided primary PCI for ACS will be assessed by the achievement rates of optimal post-procedural results and safety endpoints.
The TACTICS registry will provide an overview of the underlying causes of ACS using OCT, and will reveal any difference in clinical outcomes depending on the underlying causes. The registry will also inform on the feasibility of OCT-guided primary PCI for patients with ACS.
The TACTICS (Tokyo, Kanagawa, Chiba, Shizuoka, and Ibaraki active OCT applications for ACS) registry.
ACS, acute coronary syndrome; OCT, optical coherence tomography; PCI, percutaneous coronary intervention. Display omitted
•TACTICS is an investigator-initiated prospective multicenter observational study.•Optical coherence tomography (OCT)-guided primary percutaneous coronary intervention (PCI) will be performed.•The primary endpoint is to identify the underlying causes of acute coronary syndrome (ACS).•Clinical outcomes and feasibility of OCT-guided PCI will be clarified.
Osteoclasts are important target cells for osteoporosis treatment. Recently, a real-time cell analysis (RTCA) system was developed to observe cell morphology and adhesion; however, the use of RTCA to ...study osteoclastogenesis has not been reported. Here, we investigated whether osteoclast formation could be monitored in real-time using RTCA. The cell index determined via electrical impedance using RTCA, and the number of osteoclasts exhibited a significant positive correlation. RTCA was useful for determining the effect of (−)-epigallocatechin-3-gallate on the inhibition of bone resorption. We established a new method of measuring osteoclast formation in real-time using RTCA.
Purpose
To evaluate a new rapid and sensitive method for analyzing human tears and plasma for nonsteroidal anti-inflammatory drugs (NSAIDs) and investigate the influence of the transfer of NSAIDs in ...an ocular lesion.
Methods
In this cross-over study, a single dose of 200 mg of ibuprofen and 60 mg of loxoprofen sodium were orally administered to six healthy Japanese subjects. Collected samples were analyzed by ultra-fast liquid chromatography tandem mass spectrometry (UFLC-MS/MS).
Results
Recoveries of the two drugs spiked in the tears and plasma were 96.0–117.0 % in the tears and 99.0–105.7 % in the plasma. Regression equations for both NSAIDs showed excellent linearity from 0.02–1.0 μg/ml for the tears and 0.1–5.0 μg/ml for the plasma, with the limits of detection at 0.02 μg/ml for tears and 0.1 μg/ml for plasma.
Conclusion
This new high-throughput NSAID determination method only requires a small tear amount (10 μl) and plasma volume (20 μl) and thus will be useful in clinical and toxicological analyses. Analytical results also showed the presence of ibuprofen and loxoprofen in the actual tears and plasma, which confirms the transition of NSAIDs from the tears to the plasma.
The combination of venetoclax (VEN) and azacitidine (AZA) (VEN+AZA) leads to higher complete remission rates and longer overall survival (OS) in patients with untreated acute myeloid leukemia (AML) ...who are ineligible for intensive combination chemotherapy. In practice, the doses of VEN and AZA are reduced at the attending physician's discretion to avoid adverse events; however, the impact of dose and duration reductions has not been fully clarified. We analyzed whether the efficacy was maintained with reduced VEN+AZA compared to AZA monotherapy in the real world.
A total of 33 patients were included; 17 (10 newly diagnosed, 7 primary refractory or relapsed) received VEN+AZA, and 16 (7 newly diagnosed, 9 primary refractory or relapsed) received AZA. We analyzed complete remission (CR) and CR with incomplete hematologic recovery (CRi) rates, OS, and the incidence of adverse events.
CR/CRi were achieved in 7/17 (41.2%) and 11/17 (64.7%) patients in the VEN+AZA group and 0/15 (0%) and 2/15 (6.7%) patients in the AZA group, respectively. The CR/CRi rate was higher in the VEN+AZA group than in the AZA group (p=0.001). OS was longer in the VEN+AZA group than in the AZA group (p=0.03), with a median of 506 days 95% confidence interval (CI)=234-585 days and 208 days (95% CI=52-343 days), respectively.
The doses of the VEN+AZA combination were reduced at the attending physician's discretion, resulting in a higher CR/CRi rate and longer OS than AZA monotherapy and is considered useful for AML in the real world.
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