Search

We determined the clinical utility of the direct Coombs’ test in the absence of hemolytic anemia as an indicator of disease activity and therapeutic response in systemic lupus erythematosus (SLE). SLE patients without hemolytic anemia who visited our hospital from January 2016 to November 2016 were retrospectively evaluated with a direct Coombs’ test. Clinical features, including SLE disease activity index (SLEDAI), treatment and laboratory findings were analyzed. For patients with lupus nephritis, we additionally evaluated the cumulative complete renal response rate over one year after induction therapy. Among 182 patients evaluated, 10 (5.8%) patients had a positive direct Coombs’ test in the absence of hemolytic anemia. They had a higher SLEDAI (p < 0.01), higher circulating immune complex levels (p = 0.01), higher anti-DNA titers (p < 0.01) and a lower complete renal response rate (p = 0.03) compared with those who were negative. Multivariate analysis indicated that SLEDAI was an independent factor correlated with the direct Coombs’ test without hemolytic anemia (odds ratio 2.4, 95% confidence interval 1.66–4.98, p < 0.01). A positive direct Coombs’ test in the absence of hemolytic anemia may therefore represent a useful biomarker for assessing disease activity and therapeutic response. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the prevalence of anti-signal recognition particle (anti-SRP) antibody in connective tissue diseases (CTDs) and investigate the clinical characteristics of patients without inflammatory myopathy.Method: Sera from 6180 patients with CTD were examined by immunoprecipitation (IPP) assays, and the records of patients positive for anti-SRP antibody were reviewed retrospectively. The antibody against the 54-kDa protein of SRP (SRP54) was quantified by enzyme-linked immunosorbent assay (ELISA) in patients with anti-SRP antibody.Results: Of the 28 patients positive for anti-SRP antibody, nine (32.1%) did not have inflammatory myopathy. The clinical diagnoses and characteristics of those patients varied considerably. In patients with inflammatory myopathy, the index of anti-SRP54 was much higher than in those without myopathy (1.15 vs. 0.46; p = 0.036).Conclusions: The prevalence of anti-SRP antibody was 0.5% in a cohort of Japanese patients with CTD, and one-third of them did not have inflammatory myopathy. Sera from patients with inflammatory myopathy recognized SRP54 more strongly than in those without myopathy. [ABSTRACT FROM AUTHOR]

Antibodies against double-stranded DNA (dsDNA) are widely used to diagnose systemic lupus erythematosus (SLE) and evaluate its activity in patients. This study was undertaken to examine the clinical utility of circulating anti-dsDNA antibody-secreting cells for evaluating SLE patients. Anti-dsDNA antibody-secreting cells quantified using an enzyme-linked immunospot assay were detected in the spleen, bone marrow and peripheral blood from MRL/lpr but not in control BALB/c mice. Circulating anti-dsDNA antibody-secreting cells were detected in 29 (22%) of 130 patients with SLE, but in none of 49 with non-SLE connective-tissue disease or 18 healthy controls. The presence of circulating anti-dsDNA antibody-secreting cells was associated with persistent proteinuria, high SLE disease activity index and systemic lupus activity measures, and a high serum anti-dsDNA antibody titre measured with an enzyme-linked immunosorbent assay. The positive predictive value for active disease was 48% for circulating anti-dsDNA antibody-secreting cells versus 17% for serum anti-dsDNA antibodies. A prospective cohort of patients with circulating anti-dsDNA antibodies and inactive SLE showed that the cumulative disease flare-free rate was significantly lower in patients with than without circulating anti-dsDNA antibody-secreting cells (p < 0.001). Circulating anti-dsDNA antibody-secreting cells are a useful biomarker for assessing disease activity in SLE patients. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to conduct group reminiscence therapy by using cooking activities among elderly dementia patients and to assess its efficacy. We conducted reminiscence therapy for 11 patients in a total of 9 sessions, once a week, 60 minutes each. Evaluations were performed on three occasions: one week before the start of the intervention and one week and four weeks after completion of the intervention. No particular adverse events were noted during the conduct of the study. There were significant improvements in the patients' scores for cognitive function and in their behavior, and the improvement in cognitive function continued until four weeks after the intervention. Based on these results, it will be necessary to verify the efficacy by means of a randomized controlled study in a larger number of patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the prevalence of depression among residents of a health care institution for the elderly and to identify factors associated with it. The subjects were 44 elderly persons who had resided in a health care institution for the elderly for 3 months or more. The Cornell Scale for Depression in Dementia was used to evaluate depression. The results showed that 50% of the residents exhibited mild to moderate depression and that visual impairment, hypochondriac symptoms, grooming ability, and social cognition ability were significantly associated with it. These results suggested that rehabilitative interventions focused on grooming and social cognition may prevent or mitigate the depression of residents of health care institutions for the elderly. However, a longitudinal study is necessary to elucidate case-effect relationships. [ABSTRACT FROM AUTHOR]

Background: Metformin, widely used in the treatment of type 2 diabetes mellitus, reduces the risk of cancer and relapse after treatment. Fertility-sparing treatment for endometrial cancer (EC) with progestin is associated with a high chance of disease regression, and the high relapse rate continues to be a problem. We assessed the efficacy of metformin in preventing recurrence after medroxyprogesterone acetate (MPA) as fertility-sparing treatment for atypical endometrial hyperplasia (AEH) and EC. Patients and methods: This phase II study enrolled 17 patients with AEH and 19 patients with EC limited to the endometrium (age, 20-40 years). MPA (400 mg/day) and metformin (750-2250 mg/day) were administered for 24-36 weeks to achieve a complete response (CR). Metformin was administered until conception, even after MPA discontinuation. The primary end point was relapse-free survival (RFS) after remission. We analyzed all efficacy end points in the full analysis set. Results: The body mass index was ≥25 kg/m² in 27 patients (mean, 31 kg/m²; range, 19-51 kg/m²), and the homeostasis model assessment for insulin resistance index was ≥2.5 in 24 patients (mean, 4.7; range, 0.7-21). Two patients showed progression at 12 weeks [6%; 95% confidence interval (CI) 2-18]. At 36 weeks, 29 (81%; 95% CI 65-90) patients achieved CR, and 5 (14%; 95% CI 6-29) patients achieved partial response. During a median follow-up of 38 months (range, 9-66 months) after remission, relapse was confirmed in three of the patients who had achieved CR (relapse rate, 10%). The 3-year estimated RFS rate was 89%. No patients experienced severe toxicity. Conclusions: Metformin inhibited disease relapse after MPA therapy. The combination of metformin and MPA in EC treatment should be studied further. [ABSTRACT FROM AUTHOR]

We assessed the efficacy and safety of sitagliptin compared with α-glucosidase inhibitor ( αGI) in 120 of Japanese patients with type 2 diabetes mellitus ( T2DM) inadequately controlled on stable ≤2 mg/day glimepiride alone [mean hemoglobin A1c ( HbA1c) 7.7%] by the randomized, active-controlled, non-inferiority trial. Patients were randomly assigned to receive additional sitagliptin or αGI for 24 weeks. The primary endpoint was change in HbA1c from baseline to week 12. After 12 weeks, sitagliptin reduced HbA1c by −0.44% (p < 0.001) relative to αGI. At 24 weeks, the reduction was almost identical between the groups (−0.091%, p = 0.47). Gastrointestinal disorders were more common with αGI than with sitagliptin, but only minor hypoglycaemia occurred in both groups at similar frequency. These data suggested that sitagliptin was not inferior to αGI for reduction of HbA1c in Japanese T2DM patients receiving glimepiride alone, and well tolerated with minimum risk of gastrointestinal symptoms and hypoglycaemia. [ABSTRACT FROM AUTHOR]

Copper-64 was produced by the 64Ni(p, n)64Cu reaction using enriched 64NiO target. We investigated and compared the production yield of 64Cu for proton beams of various energies by using a thick target. Enriched 64Ni was recovered with high yield by simple procedures. Imaging studies using positron emission tomography (PET) and positron emitting tracer imaging system (PETIS) were performed. We obtained clear images in PET and PETIS studies. The results of this study indicate that 64Cu can be utilized as a biomedical tracer for the molecular imaging both in animals and plants. [ABSTRACT FROM AUTHOR]

The radionuclide 67Cu was produced via the 68Zn(p,2p)67Cu reaction by irradiating enriched 68Zn targets with 70 MeV proton beam. Copper-67 was chemically separated from the zinc target by ion-exchange chromatography using Chelex-100 chelating ion-exchange resin. Procedure for recovery of the enriched 68Zn was developed. The target recovery yield of this method was evaluated to be more than 97%. [ABSTRACT FROM AUTHOR]