50 results on '"Ushio, Y."'
Search Results
2. AB0941 FECAL CALPROTECTIN IN JAPANESE PATIENT WITH SPONDYLOARTHRITIS
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Sugihara, K., primary, Shimada, H., additional, Nakashima, S., additional, Wakiya, R., additional, Miyagi, T., additional, Ushio, Y., additional, Mizusaki, M., additional, Kagawa, R., additional, Yamaguchi, H., additional, and Dobashi, H., additional more...
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- 2024
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Catalog
3. POS0921 CLINICAL CHARACTERISTICS OF JAPANESE BEHCET’S DISEASE PATIENTS WITH ARTHRITIS
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Sugihara, K., primary, Wakiya, R., additional, Nakashima, S., additional, Shimada, H., additional, Miyagi, T., additional, Ushio, Y., additional, Mizusaki, M., additional, Kagawa, R., additional, Yamaguchi, H., additional, and Dobashi, H., additional more...
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- 2024
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4. POS0885 NINTEDANIB COMBINED WITH IMMUNOSUPPRESSIVE AGENTS INCREASED FORCED VITAL CAPACITY IN CONNECTIVE TISSUE DISEASE-ASSOCIATED PF-ILD: A SINGLE-CENTER STUDY IN JAPAN
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Ushio, Y., primary, Wakiya, R., additional, Nakashima, S., additional, Miyagi, T., additional, Sugihara, K., additional, Mizusaki, M., additional, Kagawa, R., additional, Yamaguchi, H., additional, Shimada, H., additional, and Dobashi, H., additional more...
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- 2024
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5. POS0305 THE EFFICACY AND SAFETY OF AVACOPAN IN REMISSION INDUCTION THERAPY FOR MPA/GPA AND THE EFFECTS OF AVACOPAN ON SERUM C5a AND S100A9 LEVELS: A SINGLE-CENTER STUDY IN JAPAN
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Ushio, Y., primary, Wakiya, R., additional, Nakashima, S., additional, Miyagi, T., additional, Sugihara, K., additional, Mizusaki, M., additional, Kagawa, R., additional, Yamaguchi, H., additional, Shimada, H., additional, and Dobashi, H., additional more...
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- 2024
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6. AB0836 SIGNIFICANCE OF RO52 AND PREGNANCY OUTCOMES IN ANTI-SS-A ANTIBODY POSITIVE RHEUMATIC DISEASE PATIENTS
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Shimada, H., primary, Mino, R., additional, Nakashima, S., additional, Miyagi, T., additional, Sugihara, K., additional, Ushio, Y., additional, Mizusaki, M., additional, Kagawa, R., additional, Yamaguchi, H., additional, Wakiya, R., additional, and Dobashi, H., additional more...
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- 2024
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7. Effects of anti-interleukin-17 treatment on osteoblastic activity as assessed by 18 F-sodium fluoride positron emission tomography/computed tomography in ankylosing spondylitis: a case report
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Ushio, Y, primary, Wakiya, R, additional, Kameda, T, additional, Nakashima, S, additional, Shimada, H, additional, Miyagi, T, additional, Sugihara, K, additional, Mino, R, additional, Mizusaki, M, additional, Chujo, K, additional, Kagawa, R, additional, Yamaguchi, H, additional, Yamamoto, Y, additional, Norikane, T, additional, Nishiyama, Y, additional, Kadowaki, N, additional, and Dobashi, H, additional more...
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- 2023
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8. POS1132 HYDROXYCHLOROQUINE, WHICH REGULATES IFN, IS HIGHLY EFFECTIVE IN SLE WITH ELEVATED SERUM S100 PROTEIN
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Wakiya, R., primary, Shimada, H., additional, Ueeda, K., additional, Nakashima, S., additional, Miyagi, T., additional, Ushio, Y., additional, Sugihara, K., additional, Mino, R., additional, Mizusaki, M., additional, Chujo, K., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2023
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9. AB0643 THE ANALYSIS OF RISK FACTORS FOR PRETERM BIRTH AND LOW BIRTH WEIGHT IN SLE PATIENTS WITH OR WITHOUT ATTAINED LLDAS AT THE CONCEPTION
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Shimada, H., primary, Wakiya, R., additional, Nakashima, S., additional, Miyagi, T., additional, Ushio, Y., additional, Sugihara, K., additional, Mino, R., additional, Mizusaki, M., additional, Chujo, K., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2023
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10. AB1489 CLINICAL COURSES AND PREGNANCY OUTCOMES OF TWELVE CASES COMPLICATED WITH BEHCET’S DISEASE IN OUR INSTITUTION
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Shimada, H., primary, Wakiya, R., additional, Nakashima, S., additional, Miyagi, T., additional, Ushio, Y., additional, Sugihara, K., additional, Mino, R., additional, Mizusaki, M., additional, Chujo, K., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2023
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11. POS1253 TIMP-1 AS WELL AS IL-6 IN PULMONARY CAPILLARIES REFLECT THE COMPLICATIONS AND SEVERITY OF PH IN SYSTEMIC SCLERODERMA
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Nakashima, S., primary, Kameda, T., additional, Shimada, H., additional, Wakiya, R., additional, Miyagi, T., additional, Ushio, Y., additional, Mino, R., additional, Chujo, K., additional, and Dobashi, H., additional more...
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- 2023
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12. POS1556 EFFICACY OF APREMILAST TREATMENT FOR ARTHRITIS IN BEHÇET’S DISEASE
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Wakiya, R., primary, Ushio, Y., additional, Shimada, H., additional, Nakashima, S., additional, Miyagi, T., additional, Sugihara, K., additional, Mino, R., additional, Mizusaki, M., additional, Chujo, K., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2023
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13. POS1362 THE EFFICACY AND CYTOKINE PROFILES DURING TREATMENT WITH APREMILAST IN PATIENTS WITH BEHÇET ‘S DISEASE
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Wakiya, R., primary, Ushio, Y., additional, Ueeda, K., additional, Shimada, H., additional, Nakashima, S., additional, Kato, M., additional, Miyagi, T., additional, Sugihara, K., additional, Mizusaki, M., additional, Mino, R., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2022
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14. AB0313 CLINICAL FEATURE OF 100 CASES OF METHOTREXATE ASSOCIATED LYMPHOPROLIFERATIVE DISORDERS WITH RA PATIENT
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Kameda, T., primary, Ushio, Y., additional, Nakashima, S., additional, Shimada, H., additional, Wakiya, R., additional, Kato, M., additional, Miyagi, T., additional, Sugihara, K., additional, Mino, R., additional, Mizusaki, M., additional, and Dobashi, H., additional more...
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- 2022
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15. AB0689 Clinical courses and pregnancy outcomes of eight cases complicated with Polymyositis/Dermatomyositis (PM/DM) in single center
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Mino, R., primary, Shimada, H., additional, Wakiya, R., additional, Nakashima, S., additional, Kato, M., additional, Miyagi, T., additional, Sugihara, K., additional, Ushio, Y., additional, Mizusaki, M., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2022
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16. AB0438 EFFICACY OF BELIMUMAB TREATMENT FOR SYSTEMIC LUPUS ERYTHEMATOSUS AT OUR HOSPITAL
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Mizusaki, M., primary, Wakiya, R., additional, Nakashima, S., additional, Shimada, H., additional, Sugihara, K., additional, Kato, M., additional, Miyagi, T., additional, Ushio, Y., additional, Mino, R., additional, Chujo, K., additional, Kameda, T., additional, and Dobashi, H., additional more...
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- 2022
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17. Effects of anti-interleukin-17 treatment on osteoblastic activity as assessed by 18F-sodium fluoride positron emission tomography/computed tomography in ankylosing spondylitis: a case report.
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Ushio, Y, Wakiya, R, Kameda, T, Nakashima, S, Shimada, H, Miyagi, T, Sugihara, K, Mino, R, Mizusaki, M, Chujo, K, Kagawa, R, Yamaguchi, H, Yamamoto, Y, Norikane, T, Nishiyama, Y, Kadowaki, N, and Dobashi, H more...
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POSITRON emission tomography , *COMPUTED tomography , *ANKYLOSING spondylitis , *BONE growth , *FLUORIDES , *RADIATION exposure - Abstract
This article discusses the use of anti-interleukin-17 treatment in a case of ankylosing spondylitis (AS), a chronic inflammatory disease that primarily affects the spinal joints. The formation of new bone is a hallmark of advanced AS, leading to loss of flexibility in the vertebrae. The study used 18F-sodium fluoride positron emission tomography/computed tomography (PET/CT) to assess osteoblastic activity before and after treatment with an interleukin-17 inhibitor (IL-17i). The results showed a decrease in osteoblastic activity and new bone formation after treatment, indicating the effectiveness of IL-17i in reducing abnormal bone growth in AS. The study suggests that 18F-NaF PET/CT may be a useful tool for evaluating disease activity in AS. However, the use of this imaging modality may be limited due to increased radiation exposure compared to conventional methods, and further validation in larger patient populations is needed. [Extracted from the article] more...
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- 2023
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18. THE ANALYSIS OF RISK FACTORS FOR PRETERM BIRTH AND LOW BIRTH WEIGHT IN SLE PATIENTS WITH OR WITHOUT ATTAINED LLDAS AT THE CONCEPTION.
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Shimada, H., Wakiya, R., Nakashima, S., Miyagi, T., Ushio, Y., Sugihara, K., Mino, R., Mizusaki, M., Chujo, K., Kameda, T., and Dobashi, H.
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- 2023
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19. CLINICAL COURSES AND PREGNANCY OUTCOMES OF TWELVE CASES COMPLICATED WITH BEHCET'S DISEASE IN OUR INSTITUTION.
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Shimada, H., Wakiya, R., Nakashima, S., Miyagi, T., Ushio, Y., Sugihara, K., Mino, R., Mizusaki, M., Chujo, K., Kameda, T., and Dobashi, H.
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- 2023
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20. EFFICACY AND SAFETY OF NINTEDANIB IN COMBINATION WITH IMMUNOSUPPRESSIVE AGENTS FOR PROGRESSIVE FIBROSING CTD-ILD IN CLINICAL PRACTICE.
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Ushio, Y., Wakiya, R., Kameda, T., Nakashima, S., Shimada, H., Miyagi, T., Sugihara, K., Mino, R., Mizusaki, M., Chujo, K., and Dobashi, H.
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- 2023
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21. EFFICACY OF APREMILAST TREATMENT FOR ARTHRITIS IN BEHÇET'S DISEASE.
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Wakiya, R., Ushio, Y., Shimada, H., Nakashima, S., Miyagi, T., Sugihara, K., Mino, R., Mizusaki, M., Chujo, K., Kameda, T., and Dobashi, H.
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- 2023
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22. TIMP-1 AS WELL AS IL-6 IN PULMONARY CAPILLARIES REFLECT THE COMPLICATIONS AND SEVERITY OF PH IN SYSTEMIC SCLERODERMA.
- Author
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Nakashima, S., Kameda, T., Shimada, H., Wakiya, R., Miyagi, T., Ushio, Y., Mino, R., Chujo, K., and Dobashi, H.
- Published
- 2023
- Full Text
- View/download PDF
23. HYDROXYCHLOROQUINE, WHICH REGULATES IFN, IS HIGHLY EFFECTIVE IN SLE WITH ELEVATED SERUM S100 PROTEIN.
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Wakiya, R., Shimada, H., Ueeda, K., Nakashima, S., Miyagi, T., Ushio, Y., Sugihara, K., Mino, R., Mizusaki, M., Chujo, K., Kameda, T., and Dobashi, H.
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- 2023
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24. A case of malignant melanoma in which adalimumab was effective for steroid-resistant uveitis caused by dabrafenib/trametinib combination therapy.
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Nakano F, Kan T, Ushio Y, Ito H, Kamegashira A, Sone T, Hiyama T, Harada Y, and Tanaka A
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- 2024
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25. Clinical characteristics and quality of life of patients with Behcet's disease with arthritis in Japan.
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Sugihara K, Wakiya R, Kameda T, Shimada H, Nakashima S, Miyagi T, Ushio Y, Mino R, Mizusaki M, Chujo K, Kagawa R, Yamaguchi H, Manabe N, Kadowaki N, and Dobashi H
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- Humans, Male, Female, Japan epidemiology, Adult, Middle Aged, Severity of Illness Index, Behcet Syndrome psychology, Behcet Syndrome complications, Quality of Life, Arthritis psychology, Arthritis epidemiology
- Abstract
Arthritis is one of the most common symptoms of Behcet's Disease (BD) observed in 57% of Japanese patients with BD. The relationship between arthritis and other clinical symptoms of BD and the impact of arthritis on the quality of life (QOL) of patients with BD are still unclear. Therefore, the current study aimed to clarify the differences in clinical symptoms depending on the presence or absence of arthritis and evaluate the impact of arthritis on QOL in these patients. Fifty-three Japanese patients diagnosed with BD and being treated for more than 6 months were included in this study. Patients were divided based on the presence of arthritis symptoms into an arthritis and a non-arthritis group. Clinical symptoms, disease activity, and QOL of both groups were compared using the Patient's global assessment (PGA), Evaluator's global assessment (EGA), and Behcet's disease current activity form (BDCAF) as indices of disease activity. To evaluate disease activity related to lesions other than arthritis, BDCAF excluding arthritis items was also calculated. The Behcet's disease quality of life (BDQOL) scale was used to assess patients' QOL. Oral ulcers and skin lesions were significantly more frequent in the arthritis group than in the non-arthritis group (p = 0.009 and 0.048, respectively). Among skin domains, papulopustular lesions tended to be more frequent in the arthritis group. EGA and BDCAF (both including and excluding arthritis-related items) scores were significantly higher in the arthritis group (p = 0.019, < 0.0001, and 0.0004 respectively). Although PGA and BDQOL tended to be higher in the arthritis group, the difference between the two groups was not statistically significant. The disease course in Japanese BD patients with arthritis was more frequently complicated by oral ulcers and skin lesions than in those without arthritis. In addition, BD patients with arthritis tended to have generally higher disease activity and low QOL than their non-arthritis counterparts. Further research is required to confirm these results., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Faculty of Medicine, Kagawa University (2023-057) and conducted in accordance with the Declaration of Helsinki. The Ethics Committee of the Faculty of Medicine at Kagawa University waived the need for written informed consent due to the retrospective nature of the study., (© 2024. The Author(s).) more...
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- 2024
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26. Urinary casts containing crystals in light chain proximal tubulopathy.
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Ushio Y, Yokoyama T, Manabe S, Seki M, Kawaguchi Y, Kobayashi S, Makabe S, Seino H, Ito N, Nakayama H, Horita S, Kataoka H, Taneda S, Honda K, and Hoshino J
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- 2024
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27. Protocol for the nationwide registry of patients with polycystic kidney disease: japanese national registry of PKD (JRP).
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Nakatani S, Kawano H, Sato M, Hoshino J, Nishio S, Miura K, Sekine A, Suwabe T, Hidaka S, Kataoka H, Ishikawa E, Shimazu K, Uchiyama K, Fujimaru T, Moriyama T, Kurashige M, Shimabukuro W, Hattanda F, Kimura T, Ushio Y, Manabe S, Watanabe H, Mitobe M, Seta K, Shimada Y, Kai H, Katayama K, Ichikawa D, Hayashi H, Hanaoka K, Mochizuki T, Nakanishi K, Tsuchiya K, Horie S, Isaka Y, and Muto S more...
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- Humans, Japan epidemiology, Prospective Studies, Kidney Failure, Chronic epidemiology, Retrospective Studies, Polycystic Kidney, Autosomal Recessive therapy, Polycystic Kidney, Autosomal Recessive epidemiology, Adult, Male, Female, Middle Aged, East Asian People, Registries, Polycystic Kidney, Autosomal Dominant therapy, Polycystic Kidney, Autosomal Dominant epidemiology, Polycystic Kidney, Autosomal Dominant complications
- Abstract
Background: Autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD) are major genetic polycystic kidney diseases that can progress to end-stage kidney disease (ESKD). Longitudinal data on the clinical characteristics associated with clinical outcomes in polycystic kidney disease (PKD), including the development of ESKD and cardiovascular disease (CVD) are lacking in Japan. To address this unmet need the authors are establishing a novel, web-based, Nationwide Cohort Registry Study-the Japanese Registry of PKD (JRP)., Methods: The JRP is a prospective cohort study for ADPKD (aim to recruit n = 1000 patients), and both a retrospective and prospective study for ARPKD (aim to recruit n = 100). In the prospective registry, patients will be followed-up for 10 years every 6 months and 12 months for patients with ADPKD and ARPKD, respectively. Data collection will be recorded on Research Electronic Data Capture (REDCap) starting on April 1, 2024, with recruitment ending on March 31, 2029. (jRCT 1030230618)., Results: Data to be collected include: baseline data, demographics, diagnostic and genetic information, radiological and laboratory findings, and therapeutic interventions. During follow-up, clinical events such as development of ESKD, hospitalization, occurrence of extra kidney complications including CVD events, and death will be recorded, as well as patient-reported health-related quality of life for patients with ADPKD., Conclusions: The JRP is the first nationwide registry study for patients with ADPKD and ARPKD in Japan, providing researchers with opportunities to advance knowledge and treatments for ADPKD and ARPKD, and to inform disease management and future clinical practice., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.) more...
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- 2024
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28. Association of hyperphosphatemia with renal prognosis in patients with autosomal dominant polycystic kidney disease.
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Nitta K, Kataoka H, Manabe S, Makabe S, Akihisa T, Ushio Y, Seki M, Tsuchiya K, Hoshino J, and Mochizuki T
- Abstract
Background: Serum phosphate (P) levels are generally lower in autosomal dominant polycystic kidney disease (ADPKD) than in other kidney disorders, potentially masking the clinical significance of hyperphosphatemia. This study aimed to determine if serum P levels can predict renal outcomes in ADPKD patients., Methods: We included 235 patients with ADPKD who were not taking drugs to treat hyperphosphatemia. Survival analysis was performed for the renal outcome of a 50% reduction in estimated glomerular filtration rate or initiation of renal replacement therapy., Results: Multivariable Cox regression analyses revealed that serum P (1 mg/dL increase, HR = 2.03, P < 0.0001) was a significant risk factor for kidney disease progression. Similarly, hyperphosphatemia (P > 3.5 mg/dL, HR = 2.05; P > 4.0 mg/dL, HR = 1.90; P > 4.5 mg/dL, HR = 2.78; P > 5.0 mg/dL, HR = 27.22) was significantly associated with renal prognosis. Kaplan-Meier analysis showed significantly lower kidney survival rates in patients with P > 3.5 mg/dL than in those without hyperphosphatemia (log-rank test, P < 0.0001), and similar Kaplan-Meier analysis results were found for P > 4.0 mg/dL, P > 4.5 mg/dL, and P > 5.0 mg/dL. The 2 year kidney survival rate for ADPKD patients with P > 3.5 mg/dL was 66.7% overall and 41.4% in those with stage 4-5 CKD. For patients with P > 4.0 mg/dL, the survival rate dropped to 46.8% overall and 28.2% in those with stage 4-5 CKD, indicating a very poor prognosis., Conclusion: Hyperphosphatemia was associated with renal prognosis in patients with ADPKD. In these patients, attention should be paid to even mild serum P elevation of > 3.5 or > 4.0 mg/dL., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.) more...
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- 2024
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29. A case of crystalglobulin-induced nephropathy wherein M protein was identified by mass spectrometry and immunoglobulin G subclass staining.
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Mochida H, Kyoda M, Ushio Y, Morito T, Kamiyama T, Oyagi H, Hirasawa A, Hasegawa N, Kakuta Y, Kang D, Honda K, Taneda S, and Hatano M
- Abstract
Crystalglobulin-induced nephropathy is a rare disease that causes the deposition of crystallized monoclonal immunoglobulins into the glomerular capillary and arteriole spaces. Here, we report the case of a patient who presented with skin ulcers, urinary protein, and renal dysfunction. The patient underwent renal and skin biopsies, and the biopsy tissue samples were subjected to mass spectrometry. The patient was diagnosed with crystalglobulin-induced nephropathy. A literature review suggested that pathological examinations using electron microscopy, mass spectrometry, and immunofluorescent staining of paraffin-embedded biopsy samples treated with pronase may be useful for the diagnosis of this condition., (© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.) more...
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- 2024
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30. Nintedanib combined with immunosuppressive agents improves forced vital capacity in connective tissue disease-associated PF-ILD: a single-center study.
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Ushio Y, Wakiya R, Kameda T, Nakashima S, Shimada H, Miyagi T, Sugihara K, Mino R, Mizusaki M, Chujo K, Kagawa R, Yamaguchi H, Kadowaki N, and Dobashi H
- Abstract
Background: In 2020, Nintedanib (NTB), a tyrosine kinase inhibitor, was the first drug approved worldwide for treating progressive fibrosing interstitial lung disease (PF-ILD). This study evaluated the efficacy and safety of NTB in Japanese patients with CTD-associated PF-ILD in a real-world setting, as there are few reports on this topic. We also evaluated the efficacy and safety of combination therapy with NTB and immunosuppressive agents (IS)., Methods: CTD-associated PF-ILD patients receiving NTB at our institution were included in this retrospective study. To evaluate the efficacy and safety of NTB, we investigated changes in forced vital capacity (FVC) (%), diffusing capacity for carbon monoxide (DLCO) (%), monthly change in FVC (%/month), serum Krebs von den Lungen-6 (KL-6) levels (U/mL) before and after NTB treatment, and adverse events (AEs) during NTB treatment. Moreover, to evaluate the efficacy of the NTB + IS combination therapy, we divided the patients into two groups: one received only NTB (NTB group), and the other received both NTB and IS (NTB + IS group) following the diagnosis of CTD-associated PF-ILD. We analyzed the differences in the changes of these variables between the two groups., Results: Twenty-six patients with CTD-associated PF-ILD were included. After NTB treatment, there were no significant deteriorations in FVC (%) and DLCO (%), while the monthly change in FVC (%/month) significantly increased (p < 0.001). The changes in FVC (%) and the monthly change in FVC (%/month) were significantly greater in the NTB + IS group than in the NTB group. Following NTB treatment, the mean serum KL-6 levels significantly decreased (p < 0.001). AEs associated with NTB in this study were similar to those in previous clinical trials, and there was no significant difference in the incidence of AEs between the two groups., Conclusions: This study demonstrates that NTB is an effective medication for slowing the progression of CTD-associated PF-ILD in real-world settings. NTB + IS combination therapy for CTD-associated PF-ILD may be more effective than NTB alone in slowing the progression of CTD-associated PF-ILD., (© 2024. The Author(s).) more...
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- 2024
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31. Immediate drop of urine osmolality upon tolvaptan initiation predicts impact on renal prognosis in patients with ADPKD.
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Akihisa T, Kataoka H, Makabe S, Manabe S, Yoshida R, Ushio Y, Sato M, Yajima A, Hanafusa N, Tsuchiya K, Nitta K, Hoshino J, and Mochizuki T
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- Humans, Male, Female, Prospective Studies, Prognosis, Osmolar Concentration, Adult, Middle Aged, Benzazepines therapeutic use, Follow-Up Studies, Tolvaptan therapeutic use, Polycystic Kidney, Autosomal Dominant drug therapy, Polycystic Kidney, Autosomal Dominant urine, Polycystic Kidney, Autosomal Dominant physiopathology, Antidiuretic Hormone Receptor Antagonists therapeutic use, Glomerular Filtration Rate
- Abstract
Background: Tolvaptan, a vasopressin V2 receptor antagonist, is used for treating autosomal dominant polycystic kidney disease (ADPKD). We focused on changes in urinary osmolality (U-Osm) after tolvaptan initiation to determine whether they were associated with the therapeutic response to tolvaptan., Methods: This was a single-centre, prospective, observational cohort study. Seventy-two patients with ADPKD who received tolvaptan were recruited. We analysed the relationship between changes in U-Osm and annual estimated glomerular filtration rate (eGFR) in terms of renal prognostic value using univariable and multivariable linear regression analyses., Results: The mean value of U-Osm immediately before tolvaptan initiation was 351.8 ± 142.2 mOsm/kg H2O, which decreased to 97.6 ± 23.8 mOsm/kg H2O in the evening. The decrease in U-Osm was maintained in the outpatient clinic 1 month later. However, the 1-month values of U-Osm showed higher variability (160.2 ± 83.8 mOsm/kg H2O) than did those in the first evening of tolvaptan administration. Multivariate analysis revealed that the baseline eGFR, baseline urinary protein and U-Osm change in the evening of the day of admission (initial U-Osm drop) were significantly correlated with the subsequent annual change in eGFR., Conclusions: U-Osm can be measured easily and rapidly, and U-Osm change within a short time after tolvaptan initiation may be a useful index for the renal prognosis in actual clinical practice., (© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.) more...
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- 2024
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32. Factors associated with early-onset intracranial aneurysms in patients with autosomal dominant polycystic kidney disease.
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Ushio Y, Kataoka H, Akagawa H, Sato M, Manabe S, Kawachi K, Makabe S, Akihisa T, Seki M, Teraoka A, Iwasa N, Yoshida R, Tsuchiya K, Nitta K, Hoshino J, and Mochizuki T
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- Humans, Female, Male, Middle Aged, Adult, Risk Factors, Sex Factors, Age of Onset, Age Factors, Hypertension complications, Hypertension epidemiology, Retrospective Studies, Glomerular Filtration Rate, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage epidemiology, Subarachnoid Hemorrhage etiology, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic etiology, Logistic Models, Aged, Intracranial Aneurysm complications, Intracranial Aneurysm epidemiology, Intracranial Aneurysm etiology, Polycystic Kidney, Autosomal Dominant complications
- Abstract
Background: Recently, the importance of attribute-based medicine has been emphasized. The effects of early-onset intracranial aneurysms on patients can be significant and long-lasting. Herein, we compared the factors associated with intracranial aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) according to age categories (≥ 50 years, < 50 years)., Methods: We included 519 ADPKD patients, with a median age of 44 years, estimated glomerular filtration rate of 54.5 mL/min/1.73 m
2 , and total follow-up duration of 3104 patient-years. Logistic regression analyses were performed to determine factors associated with intracranial aneurysms., Results: Regarding the presence of intracranial aneurysm, significant interactions were identified between the age category (age ≥ 50 years), female sex (P = 0.0027 for the interaction) and hypertension (P = 0.0074 for the interaction). Female sex and hypertension were associated with intracranial aneurysm risk factors only in patients aged ≥ 50 years. The presence of intracranial aneurysm was significantly associated with chronic kidney disease (CKD) stages 4-5 (odds ratio [OR] = 3.87, P = 0.0007) and family history of intracranial aneurysm or subarachnoid hemorrhage (OR = 2.30, P = 0.0217) in patients aged < 50 years. For patients aged ≥ 50 years, in addition to the abovementioned factors [OR = 2.38, P = 0.0355 for CKD stages 4-5; OR = 3.49, P = 0.0094 for family history of intracranial aneurysm or subarachnoid hemorrhage], female sex (OR = 4.51, P = 0.0005), and hypertension (OR = 5.89, P = 0.0012) were also associated with intracranial aneurysm., Conclusion: Kidney dysfunction and family history of intracranial aneurysm or subarachnoid hemorrhage are risk factors for early-onset intracranial aneurysm. Patients aged < 50 years with a family history of intracranial aneurysm or subarachnoid hemorrhage or with CKD stages 4-5 may be at an increased risk of early-onset intracranial aneurysm., (© 2024. The Author(s) under exclusive licence to Italian Society of Nephrology.) more...- Published
- 2024
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33. PLA2R-positive membranous nephropathy in IgG4-related disease.
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Ushio Y, Akihisa T, Karasawa K, Seki M, Kobayashi S, Miyabe Y, Kataoka H, Ito N, Taneda S, Akiyama S, Hebisawa A, Kawano M, Honda K, and Hoshino J
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- Male, Humans, Aged, Receptors, Phospholipase A2, Immunoglobulin G, Autoantibodies, Glomerulonephritis, Membranous complications, Glomerulonephritis, Membranous diagnosis, Immunoglobulin G4-Related Disease complications, Immunoglobulin G4-Related Disease diagnosis, Nephrotic Syndrome complications, Nephritis, Interstitial complications, Nephritis, Interstitial diagnosis
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Background: IgG4-related disease (IgG4-RD) is a fibroinflammatory disease that affects multiple organs, including the pancreas, lacrimal glands, salivary glands, periaortic/retroperitoneum, and kidney. Interstitial nephritis is a typical renal disorder associated with IgG4-RD, but membranous nephropathy is also seen in some cases., Case Presentation: Herein we report on the case of a 77-year-old male patient with nephrotic syndrome and IgG4-related lung disease. His serum phospholipase A2 receptor (PLA2R) antibody was positive. His renal biopsy specimen was also positive for PLA2R. The renal biopsy specimen showed membranous nephropathy with equal IgG3 and IgG4 immunofluorescence staining and no interstitial nephritis, suggesting IgG4-RD manifesting as membranous nephropathy., Conclusions: Nephrotic syndrome caused by membranous nephropathy is sometimes associated with IgG4-RD. In such cases, even if serum PLA2R antibody is positive, it should be considered that the membranous nephropathy may be secondary to IgG4-RD., (© 2024. The Author(s).) more...
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- 2024
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34. Colchicine-responsive chronic recurrent multifocal osteomyelitis associated with familial Mediterranean fever in the presence of MEFV mutation: A case report.
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Izumikawa M, Kato M, Wakiya R, Kameda T, Nakashima S, Shimada H, Miyagi T, Sugihara K, Ushio Y, Mino R, Mizusaki M, Chujo K, Hiraishi T, Kadowaki N, and Dobashi H
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- Adult, Pyrin genetics, Osteomyelitis, Female, Mutation, Humans, Abdominal Pain, Colchicine therapeutic use, Familial Mediterranean Fever complications, Familial Mediterranean Fever diagnosis, Familial Mediterranean Fever drug therapy
- Abstract
A 38-year-old female was referred with a history of fever, polyarthralgia, and bone pain. She was diagnosed with chronic recurrent multifocal osteomyelitis based on imaging and biopsy findings. Non-steroidal anti-inflammatory drugs and bisphosphonate caused no improvement. Then, she developed recurrent diarrhoea and abdominal pain. Genetic testing revealed MEFV mutation. Based on the symptoms and genetic mutation results that emerged during the course of these events, she was diagnosed with familial Mediterranean fever. All symptoms, including bone pain, improved with daily colchicine administration. This case was considered familial Mediterranean fever complicated with a clinical diagnosis of chronic recurrent multifocal osteomyelitis, which is included in the spectrum of pyrine autoinflammatory diseases. Considering this case, patients with chronic recurrent multifocal osteomyelitis with MEFV gene variants may respond to colchicine., (© Japan College of Rheumatology 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) more...
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- 2023
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35. Immunological disease activity parameters at conception are risk factors for preterm birth and low birth weight in patients with systemic lupus erythematosus.
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Shimada H, Wakiya R, Kameda T, Nakashima S, Miyagi T, Sugihara K, Ushio Y, Mino R, Mizusaki M, Chujo K, Kanenishi K, Kadowaki N, and Dobashi H
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- Pregnancy, Humans, Infant, Newborn, Female, Retrospective Studies, Antibodies, Antinuclear, Infant, Low Birth Weight, Risk Factors, Lupus Erythematosus, Systemic complications, Premature Birth epidemiology
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Objective: This study aimed to identify which disease activity parameters may be risk factors for preterm birth (PB) and low birth weight (LBW) in patients with systemic lupus erythematosus (SLE). We also analyzed the extent to which these parameters affected PB and LBW., Methods: We collected the SLE Disease Activity Index (SLEDAI), the rate of lupus low disease activity state (LLDAS) attainment, complement levels, and the titer of anti-double stranded DNA (dsDNA) antibody as disease activity parameters. We retrospectively analyzed the associations of these parameters with PB and LBW., Results: Sixty pregnancies were included in this study. C3 levels and anti-dsDNA antibody titers at conception were strongly associated with PB ( p = 0.03 and p = 0.01, respectively), whereas C3 and CH50 levels were associated with LBW ( p = 0.02 and p = 0.03, respectively). A logistic regression analysis showed that the cutoff values of C3 and anti-dsDNA antibody for PB were 62.0 mg/dl and 5.4 IU/ml, respectively. The cutoff values of C3 and CH50 for LBW were 87.0 mg/dl and 41.8 U/ml, respectively. The risk of PB or LBW was increased when divided by the cutoff value, and the combination of these cutoff values showed a significantly higher risk of PB and LBW ( p = 0.01 and p < 0.01, respectively)., Conclusions: PB and LBW are strongly associated with disease activity parameters in patients with SLE. Therefore, strictly monitoring and controlling these disease activity parameters, with or without clinical manifestation, is important for women who want to become mothers. more...
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- 2023
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36. Burr hole locations are associated with recurrence in single burr hole drainage surgery for chronic subdural hematoma.
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Hashimoto H, Maruo T, Kimoto Y, Nakamura M, Fujinaga T, and Ushio Y
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Background: Various factors have been reported as risk factors for chronic subdural hematomas (CSDH) recurrence. However, few studies have quantitatively evaluated the impact of CSDH locations and burr hole positions on recurrence. This study aimed to reveal the relation between CSDH recurrence and the locations of CSDH and burr holes., Methods: Initial single burr hole surgeries for CSDH with a drainage tube between April 2005 and October 2021 at Otemae Hospital were enrolled. Patients' medical records, CSDH volume, and CSDH computed tomography values (CTV) were evaluated. The locations of CSDH and burr holes were assessed using Montreal Neurological Institute coordinates., Results: A total of 223 patients were enrolled, including 34 patients with bilateral CSDH, resulting in 257 surgeries investigated. The rate of CSDH recurrence requiring reoperation (RrR) was 13.5%. The RrR rate was significantly higher in patients aged ≥76 years, those with bilateral CSDH, and those with postoperative hemiplegia. In RrR, the preoperative CSDH volume was significantly larger, and CTV was significantly smaller. The locations of CSDH had no influence on recurrence. However, in RrR, the locations of burr holes were found to be more lateral and more ventral. Multivariate Cox proportional hazards regression analysis showed that bilateral CSDH, more ventral burr hole positions, and postoperative hemiplegia were risk factors for recurrence., Conclusions: The locations of burr holes are associated with CSDH recurrence. In RrR, CSDH profiles tend to show a larger volume and reduced CTV. Hemiplegia after burr hole surgery serves as a warning sign for RrR., Competing Interests: The authors report no conflict of interest., (© 2023 The Authors.) more...
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- 2023
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37. Pregnancy course and outcomes of patients with polymyositis and dermatomyositis (PM/DM) managed in a single center.
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Mino R, Shimada H, Wakiya R, Nakashima S, Miyagi T, Sugihara K, Ushio Y, Mizusaki M, Chujo K, Kameda T, Kanenishi K, Kadowaki N, and Dobashi H
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- Pregnancy, Infant, Newborn, Humans, Female, Glucocorticoids therapeutic use, Retrospective Studies, Pregnancy Outcome, Dermatomyositis drug therapy, Dermatomyositis complications, Polymyositis drug therapy, Polymyositis complications
- Abstract
We aimed to determine the association between disease activity during pregnancy and pregnancy outcomes of women with polymyositis and dermatomyositis (PM/DM). Patients with PM/DM who were managed from pregnancy to delivery at Kagawa University Hospital from March 2006 to May 2021 were enrolled. Clinical data were retrospectively analyzed to evaluate the association between disease activity during pregnancy and pregnancy outcomes. Eight pregnancies in 5 women with PM/DM were analyzed. The mean age at conception was 28.3 ± 3.8 years, and mean disease duration was 6.3 ± 3.2 years. Four patients required an increased glucocorticoid dosage because of worsening disease activity (sustained elevation of creatine phosphokinase [CPK] concentration). Two patients who continuously received immunosuppressive drugs from conception to delivery showed no increase in disease activity and did not need increased glucocorticoid dosages. The pregnancy outcomes were 1 spontaneous abortion and 7 live births. The mean gestation length was 35.3 ± 5.2 weeks, and mean birthweight was 2297.7 ± 1041.4 g. Five adverse pregnancy outcomes (APOs) occurred (2 preterm births and 4 low birthweights); most of these cases had sustained elevation of CPK concentration and increased glucocorticoid dosages. No APOs occurred in the 2 patients who received continuous immunosuppressive medication. Continued use of pregnancy-compatible medications and control of disease activity with lower glucocorticoid dosages in pregnancies with PM/DM may be important to achieve good pregnancy outcomes., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
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- 2023
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38. Citric acid-based bicarbonate dialysate attenuates aortic arch calcification in maintenance hemodialysis patients: a retrospective observational study.
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Akiyama KI, Moriyama T, Hanafusa N, Miura Y, Seki M, Ushio Y, Kawasoe K, Miyabe Y, Karasawa K, Sugiura H, Uchida K, Okazaki M, Komatsu M, Kawaguchi H, Kuro-O M, Nitta K, and Hoshino J
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- Humans, Dialysis Solutions, Aorta, Thoracic diagnostic imaging, Citric Acid, Renal Dialysis adverse effects, Bicarbonates, Vascular Calcification diagnostic imaging, Vascular Calcification etiology, Vascular Calcification prevention & control
- Abstract
Background: Progression of aortic calcification is associated with all-cause and cardiovascular mortality in hemodialysis patients. Blood calciprotein particle (CPP) levels are associated with coronary artery calcification and were reported to be inhibited when using citric acid-based bicarbonate dialysate (CD). Therefore, this study aimed to examine the effect of CD on the progression of the aortic arch calcification score (AoACS) and blood CPP levels in hemodialysis patients., Methods: A 12-month retrospective observational study of 262 hemodialysis patients was conducted. AoACS was evaluated by calculating the number of calcifications in 16 segments of the aortic arch on chest X-ray (minimum score is 0; maximum score is 16 points). The patients were divided into the following groups according to their baseline AoACS: grade 0, AoACS = 0 points; grade 1, AoACS 1-4 points; grade 2, AoACS 5-8 points; grade 3, AoACS 9 points or higher. Patients on bisphosphonates or warfarin or with AoACS grade 3 were excluded. Progression, defined as ΔAoACS (12-month score - baseline score) > 0 points, was compared between the CD and acetic acid-based bicarbonate dialysate (AD) groups before and after adjusting the background using propensity score matching., Results: The AoACS progression rate was significantly lower in the CD group than in the AD group (before matching: P = 0.020, after matching: P = 0.002). Multivariate logistic regression analysis showed that CD was significantly associated with AoACS progression (odds ratio 0.52, 95% confidence interval 0.29‒0.92, P = 0.025)., Conclusion: CD may slow the progression of vascular calcification in hemodialysis patients., (© 2022. The Author(s) under exclusive licence to Italian Society of Nephrology.) more...
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- 2023
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39. Influence of discontinuation of prophylactic antimicrobial agent for trabeculectomy.
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Ushio Y, Yoshikawa H, Murase T, Kataoka T, Miyamoto S, Maruko K, Okamoto S, Shibata Y, Toda R, Kiuchi Y, and Matsuo H
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Background: There is no unified view of the necessity of prophylactic antimicrobial agents in trabeculectomy. Preoperative prophylactic antimicrobial agent injection and cefazolin sodium (CEZ) for trabeculectomy were discontinued at the Hiroshima University Hospital. In this study, we evaluated whether discontinuation of preoperative administration of CEZ in ophthalmology affects the incidence of postoperative infections., Methods: We retrospectively investigated patient background, concomitant medications, subconjunctival dexamethasone sodium phosphate (DEX) injection at the end of the surgery, and the incidence of infective endophthalmitis within 6 weeks after surgery in the CEZ and non-CEZ groups. We also performed propensity score matching for background matching. Statistical analysis was performed using the Mann-Whitney U-test and Fisher's exact test., Results: The incidence of postoperative endophthalmitis was not significantly different between 629 and 751 patients in the CEZ and no-CEZ groups, respectively (0 in the CEZ group and 2 in the no-CEZ group, P = 0.504). More patients in the CEZ group were taking diabetes drugs preoperatively (P = 0.028) and fewer patients were receiving subconjunctival DEX at the end of surgery (P < 0.001) than those in the non-CEZ group. Propensity scores were calculated using the risk factors for postoperative infection as covariates, and matching (580 patients in the CEZ group and 580 patients in the non-CEZ group) showed no significant difference in the incidence of postoperative endophthalmitis (P = 0.500)., Conclusions: There was no significant difference in the incidence of endophthalmitis after trabeculectomy between the CEZ and non-CEZ groups, suggesting a decreased need for CEZ injections before trabeculectomy., (© 2023. The Author(s).) more...
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- 2023
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40. Brain abscess in a patient with generalized dystonia after deep brain stimulation: illustrative case.
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Nakamura M, Maruo T, Hashimoto H, Goto S, and Ushio Y
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Background: Infections related to deep brain stimulation (DBS) devices are not rare, but abscess formation in brain parenchyma is extremely rare., Observations: A 50-year-old man with generalized dystonia had undergone DBS of bilateral globus pallidus internus. The authors attempted to remove the bilateral DBS system due to repeated device infections caused by metal allergies. However, the intracranial lead had to be left in place, because the lead was strongly adherent to brain parenchyma. Five years later, magnetic resonance imaging showed ring-like enhancement localized around the tip of the intracranial lead, suggesting brain abscess. In response to the symptoms, the remaining left intracranial electrode was removed. Brain abscesses require several months of treatment with appropriate antibiotics, but good outcomes can be achieved with appropriate treatment., Lessons: Brain abscess is a rare complication of DBS. In the present case, the infection spread from the subcutaneous infected foci to the intracranial area through the lead, resulting in the formation of a brain abscess. Removing as much of the device as possible from the body is therefore important, even if adhesions with brain parenchyma or other tissues are present, because of the risk of serious complications, as seen in this case. more...
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- 2023
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41. Machine learning for morbid glomerular hypertrophy.
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Ushio Y, Kataoka H, Iwadoh K, Ohara M, Suzuki T, Hirata M, Manabe S, Kawachi K, Akihisa T, Makabe S, Sato M, Iwasa N, Yoshida R, Hoshino J, Mochizuki T, Tsuchiya K, and Nitta K
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- Humans, Glomerular Filtration Rate, Linear Models, Hypertrophy, Machine Learning, Nephrectomy
- Abstract
A practical research method integrating data-driven machine learning with conventional model-driven statistics is sought after in medicine. Although glomerular hypertrophy (or a large renal corpuscle) on renal biopsy has pathophysiological implications, it is often misdiagnosed as adaptive/compensatory hypertrophy. Using a generative machine learning method, we aimed to explore the factors associated with a maximal glomerular diameter of ≥ 242.3 μm. Using the frequency-of-usage variable ranking in generative models, we defined the machine learning scores with symbolic regression via genetic programming (SR via GP). We compared important variables selected by SR with those selected by a point-biserial correlation coefficient using multivariable logistic and linear regressions to validate discriminatory ability, goodness-of-fit, and collinearity. Body mass index, complement component C3, serum total protein, arteriolosclerosis, C-reactive protein, and the Oxford E1 score were ranked among the top 10 variables with high machine learning scores using SR via GP, while the estimated glomerular filtration rate was ranked 46 among the 60 variables. In multivariable analyses, the R
2 value was higher (0.61 vs. 0.45), and the corrected Akaike Information Criterion value was lower (402.7 vs. 417.2) with variables selected with SR than those selected with point-biserial r. There were two variables with variance inflation factors higher than 5 in those using point-biserial r and none in SR. Data-driven machine learning models may be useful in identifying significant and insignificant correlated factors. Our method may be generalized to other medical research due to the procedural simplicity of using top-ranked variables selected by machine learning., (© 2022. The Author(s).) more...- Published
- 2022
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42. Impact of kidney function and kidney volume on intracranial aneurysms in patients with autosomal dominant polycystic kidney disease.
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Kataoka H, Akagawa H, Yoshida R, Iwasa N, Ushio Y, Akihisa T, Sato M, Manabe S, Makabe S, Kawachi K, Hoshino J, Tsuchiya K, Nitta K, and Mochizuki T
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- Humans, Middle Aged, Glomerular Filtration Rate, Kidney, Disease Progression, Polycystic Kidney, Autosomal Dominant diagnosis, Intracranial Aneurysm complications, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm epidemiology, Subarachnoid Hemorrhage complications
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Presently, only personal or family history of intracranial aneurysm/subarachnoid hemorrhage (IA/SAH) has been established as a risk factor for IA in autosomal dominant polycystic kidney disease (ADPKD). This study aimed to verify the association between kidney function/volume and IAs in patients with ADPKD. This study included 519 patients with ADPKD. At baseline IA screening, the median age and estimated glomerular filtration rate were 44 years and 54.5 mL/min/1.73 m
2 , respectively. Family IA/SAH history was confirmed in 18.1% of the patients, and 54.3% of the patients had hypertension. The IA point prevalence was 12.5%. During clinical follow up of 3104 patient-years, de novo IA was detected in 29 patients (0.93% patient-years). The IA period prevalence was 18.1% (median age, 60 years). Multivariable logistic regression demonstrated that total kidney volume (TKV) ≥ 1000 mL (odds ratio [OR] = 2.81), height-adjusted TKV ≥ 500 mL (OR = 2.81), Mayo imaging classification Class 1D-1E (OR = 2.52), and chronic kidney disease stages 3-5 (OR = 2.31) were significantly associated with IA formation. IAs in patients with ADPKD may be associated not only with general risk factors for IAs but also with declining kidney function and increased KV. Kidney disease progression may contribute to effective IA screening and treatment planning in patients with ADPKD., (© 2022. The Author(s).) more...- Published
- 2022
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43. Humoral immune response against BNT162b2 mRNA COVID-19 vaccine in patients with rheumatic disease undergoing immunosuppressive therapy: A Japanese monocentric study.
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Sugihara K, Wakiya R, Kameda T, Shimada H, Nakashima S, Kato M, Miyagi T, Ushio Y, Mizusaki M, Mino R, Chujo K, Nomura Y, Inoo M, Kadowaki N, and Dobashi H
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- Humans, Antibodies, Viral, Immunosuppressive Agents therapeutic use, Japan, SARS-CoV-2, Spike Glycoprotein, Coronavirus, BNT162 Vaccine immunology, COVID-19 prevention & control, Immunity, Humoral, Immunosuppression Therapy, Rheumatic Diseases drug therapy
- Abstract
We investigated serum total antibody titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein receptor-binding domain after BNT162b2 mRNA vaccination against coronavirus disease 2019 (COVID-19) in Japanese patients taking various immunosuppressive medications for rheumatic disease. In 212 outpatients with rheumatic diseases at Kagawa University Hospital and 43 healthy volunteers (controls), all of whom had received 2 doses of BNT162b2 vaccine, serum antibody titers of SARS-CoV-2 spike protein were analyzed at least 14 days after the second dose. Many of the patients were taking immunosuppressive agents to manage their rheumatic disease. The antibody titers against SARS-CoV-2 spike protein in these patients were significantly lower than those in controls. The analysis of therapeutic agents revealed that the antibody titers in patients treated with rituximab were much lower than those in controls. In patients treated with tacrolimus, baricitinib, azathioprine, mycophenolate mofetil, abatacept, tumor necrosis factor inhibitors, cyclosporine, interleukin-6 inhibitors, methotrexate, or glucocorticoids, antibody titers were moderately lower than those of controls. Interleukin-17 and interleukin-23 inhibitors did not impair the humoral response. In addition, the combination of methotrexate with various immunosuppressive agents reduced titers, although not significantly. In Japanese patients with rheumatic disease, many immunosuppressants impaired the immune response to the BNT162b2 vaccine. The degree of decline in antibody titers differed according to immunosuppressant. When used concomitantly with other immunosuppressants, methotrexate may impair the immune response to the BNT162b2 vaccine. However, immunomodulatory treatments such as interleukin-17 and -23 inhibitors may not attenuate this response in patients with rheumatic disease., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
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- 2022
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44. Systemic lupus erythematosus with various clinical manifestations in a patient with hereditary angioedema: a case report.
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Ushio Y, Wakiya R, Kameda T, Nakashima S, Shimada H, Mansour MMF, Kato M, Miyagi T, Sugihara K, Mino R, Mizusaki M, Ibuki E, Kadowaki N, and Dobashi H
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Background: Hereditary angioedema (HAE) is an inherited disease characterized by recurrent angioedema without urticaria or pruritus. The most common types of HAE are caused by deficiency or dysfunction in C1 esterase inhibitor (C1-INH-HAE). The association between C1-INH-HAE and systemic lupus erythematosus (SLE) is known; however, variations in the underlying pathophysiology, disease course, and treatment in this population remain incompletely understood., Case Presentation: A 31-year-old Japanese woman with a prior diagnosis of HAE type 1 based on the episodes of recurrent angioedema, low C1 inhibitor antigen levels and function, and family history presented with new complaints of malar rash, alopecia, and arthralgias in her hands and elbows. She later developed fever, oral ulcers, lupus retinopathy, a discoid rash localized to her chest, and malar rash. Investigations revealed positive antinuclear antibody, leukopenia, thrombocytopenia, hypocomplementemia, and nephritis. Based on these findings, she was diagnosed with SLE according to the 2019 European League Against Rheumatism/American College of Rheumatology classification criteria. There did not appear to be a correlation between HAE disease activity and the timing of presentation with SLE, because HAE disease activity had been stable. The patient was able to achieve and maintain remission with immunosuppressive therapy including prednisolone, hydroxychloroquine, and tacrolimus., Conclusions: Our patient presented with a variety of symptoms, including fever and cytopenia in addition to mucocutaneous, joint, ocular, and renal lesions. It is important to better characterize the clinical characteristics of SLE in patients with C1-INH-HAE, and to clarify the mechanisms of SLE in this population., (© 2022. The Author(s).) more...
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- 2022
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45. Efficacy and safety of apremilast and its impact on serum cytokine levels in patients with Behçet's disease.
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Wakiya R, Ushio Y, Ueeda K, Kameda T, Shimada H, Nakashima S, Kato M, Miyagi T, Sugihara K, Mizusaki M, Mino R, Kadowaki N, and Dobashi H
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- Humans, Interferon-gamma, Interleukin-10, Interleukin-23, Interleukin-6, Interleukin-8, Tumor Necrosis Factor-alpha, Behcet Syndrome complications, Behcet Syndrome diagnosis, Behcet Syndrome drug therapy, Cytokines blood, Oral Ulcer diagnosis, Oral Ulcer drug therapy, Oral Ulcer etiology, Thalidomide analogs & derivatives, Thalidomide therapeutic use
- Abstract
To evaluate the long-term clinical efficacy of apremilast in Behçet's disease (BD) and its effect on serum cytokine levels. This study included 15 BD patients who were treated with apremilast. The rates of change in oral and genital ulcers, skin lesions, arthritis, and arthralgia were evaluated every 3 months for 12 months. The efficacy of apremilast was compared between patients with and without oral ulcer remission. Changes in the serum levels of interferon-gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin (IL)-10, IL-17A, IL-6, IL-8, and IL-23 between baseline and 3 months after apremilast initiation were compared. After 3 months, oral and genital ulcers disappeared in most cases. The skin and joint lesions tended to improve for up to 6 months; however, recurrence was observed after 9 months. The improvement of genital ulcers was earlier in the oral ulcer remission group than the oral ulcer non-remission group, with the genital ulcers disappearing within the first 3 months. The baseline levels of serum cytokines, analyzed in seven patients, did not exhibit significant associations with specific organ lesions. After administration of apremilast, the TNF-α and IL-23 levels significantly decreased; however, the IFN-γ, IL-6, IL-8, and IL-10 levels did not show significant changes. The rates of decrease in the serum IL-6, IFN-γ, and IL-10 levels were greater in patients with improved oral ulcers. Modulation of serum cytokine levels with apremilast might underlie the efficacy of apremilast in oral ulcers in BD patients., (© 2022 Wiley Periodicals LLC.) more...
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- 2022
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46. Initial decline in eGFR to predict tolvaptan response in autosomal-dominant polycystic kidney disease.
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Akihisa T, Kataoka H, Makabe S, Manabe S, Yoshida R, Ushio Y, Sato M, Tsuchiya K, Mochizuki T, and Nitta K
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- Antidiuretic Hormone Receptor Antagonists pharmacology, Antidiuretic Hormone Receptor Antagonists therapeutic use, Glomerular Filtration Rate, Humans, Kidney, Retrospective Studies, Tolvaptan pharmacology, Tolvaptan therapeutic use, Polycystic Kidney, Autosomal Dominant drug therapy
- Abstract
Background: Tolvaptan, a vasopressin V2 receptor antagonist, is used to treat autosomal-dominant polycystic kidney disease (ADPKD). Although tolvaptan curbs disease progression, a few reports have examined factors related to treatment response. The estimated glomerular filtration rate (eGFR) decreases soon after tolvaptan is initiated. We investigated whether initial eGFR decline affects renal prognosis of patients., Methods: This was a single-center, retrospective observational cohort study. Eighty-three patients with ADPKD who initiated tolvaptan were selected. We analyzed the relationship of the initial eGFR change with clinical parameters and analyzed the annual eGFR change in terms of renal prognostic value using univariable and multivariable linear regression analyses., Results: The initial eGFR change was - 4.6 ± 8.0%/month. The initial eGFR change correlated significantly with the annual eGFR change in multivariable analysis, suggesting that the larger decline in the initial eGFR change, the better the renal prognosis. Furthermore, the change in fractional excretion (FE) of free water (FEH
2 O) correlated positively with initial eGFR change. FEH2 O and urea nitrogen FE (FEUN) increased significantly; however, sodium FE (FENa) level remained unchanged. In approximately half of the patients, FENa unexpectedly decreased., Conclusions: The initial eGFR decline might be caused by suppressing glomerular hyperfiltration, due to the pharmacological effect of tolvaptan, and/or by reducing renal plasma flow, due to potential volume depletion. The initial eGFR change reflects the tolvaptan effect, can be easily evaluated in clinical practice, and may be useful as one of the clinical indicator for predicting renal prognosis in patients under tolvaptan., (© 2022. The Author(s), under exclusive licence to The Japanese Society of Nephrology.) more...- Published
- 2022
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47. First case of a renal cyst infection caused by Desulfovibrio: a case report and literature review.
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Okamoto Y, Miyabe Y, Seki M, Ushio Y, Sato K, Kasama E, Akiyama K, Karasawa K, Uchida K, Kikuchi K, Nitta K, Moriyama T, and Hoshino J
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- Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Bacteremia microbiology, Cysts, Desulfovibrio, Polycystic Kidney, Autosomal Dominant complications, Polycystic Kidney, Autosomal Dominant diagnostic imaging
- Abstract
Background: Genus Desulfovibrio species is a sulphate-reducing anaerobic gram-negative rod that resides in the human oral cavity and intestinal tract. It was reported as the causative pathogen of bacteraemia and abdominal infections, but not renal cyst infection, and Desulfovibrio fairfieldensis has higher pathogenicity than other Desulfovibrio species., Case Presentation: A 63-year-old man was on haemodialysis for end-stage renal failure due to autosomal dominant polycystic kidney disease. On admission, he had a persistent high-grade fever, right lumbar back pain, and elevated C-reactive protein levels. His blood and urine cultures were negative. He received ciprofloxacin and meropenem; however, there was no clinical improvement. Contrast-enhanced computed tomography and plain magnetic resonance imaging revealed a haemorrhagic cyst at the upper pole of the right kidney. The lesion was drained. Although the drainage fluid culture was negative, D. fairfieldensis was detected in a renal cyst using a polymerase chain reaction. After the renal cyst drainage, he was treated with oral metronidazole and improved without any relapse., Conclusions: To the best of our knowledge, this is the first reported case of a renal cyst infection with Desulfovibrio species. D. fairfieldensis is difficult to detect, and polymerase chain reaction tests can detect this bacterium and ensure better management for a successful recovery., (© 2022. The Author(s).) more...
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- 2022
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48. Factors associated with the utilization of community assessment models among Japanese nurses.
- Author
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Shiomi M, Yoshioka-Maeda K, Kotera S, Ushio Y, and Takemura K
- Subjects
- Humans, Japan, Surveys and Questionnaires, Nurses, Public Health education, Public Health Nursing education
- Abstract
Objectives: This study aimed to identify factors related to the practical utilization of community health needs assessment (CHNA) models that public health nurses (PHNs) learned in their fundamental education., Design: A nationwide questionnaire survey was conducted via postal mail., Sample: We randomly selected 630 public health institutes in Japan. The participants were 3397 full-time novice and mid-level PHNs., Measurements: The questionnaire included the participants' basic personal information, six items regarding the perception of CHNA with a 4-point Likert scale, learned models in their undergraduate education, their utilization in practical settings, and the reasons for their answer in narrative form., Results: There were 951 valid responses. The results of logistic regression showed that the significant positively factors with model utilization were perception of CHNA as "not troublesome" or "not impossible as they learned," continuing education with 5 years of experience, and identification of the learned model in continuing education. Furthermore, the results of text mining showed the reasons for non-utilization of the model included being "busy" and having a lack of "opportunity.", Conclusions: This study showed the associated factors with rare utilization of a learned model for PHNs. These findings may suggest improvement of continuing education and development of an appropriate assessment model., (© 2021 Wiley Periodicals LLC.) more...
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- 2022
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49. Masked diabetes insipidus in pituitary metastasis from breast cancer after thalamic biopsy: a case report.
- Author
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Hashimoto H, Maruo T, Nakamura M, Ushio Y, Hirata M, and Kishima H
- Subjects
- Aged, Biopsy, Female, Humans, Thalamus, Breast Neoplasms, Diabetes Insipidus diagnosis, Diabetes Insipidus etiology, Diabetes Mellitus, Lung Neoplasms, Pituitary Neoplasms complications
- Abstract
Background: Symptomatic pituitary metastasis is rare; furthermore, it can result in diabetes insipidus and panhypopituitarism. Since diabetes insipidus is masked by concurrent panhypopituitarism, it can impede the diagnosis of pituitary dysfunction., Case Presentation: A 68-year-old Japanese female suffering from pituitary and thalamic metastases caused by untreated breast cancer, underwent a biopsy targeting the thalamus, not the pituitary. She lacked prebiopsy pituitary dysfunction symptoms; however, these symptoms unexpectedly occurred after biopsy. Diabetes insipidus was masked by corticosteroid insufficiency, and she showed normal urinary output and plasma sodium levels. Upon commencement of glucocorticoid replacement therapy, the symptoms of diabetes insipidus appeared., Conclusions: In this case, thalamic biopsy, as opposed to pituitary biopsy, was performed to preserve pituitary function. However, pituitary dysfunction could not be avoided. Caution is necessary for asymptomatic patients with pituitary metastases as invasive interventions, such as surgery, may induce pituitary dysfunction. Moreover, with respect to masked diabetes insipidus, there is a need to carefully consider pituitary dysfunction to avoid misdiagnosis and delayed treatment., (© 2021. The Author(s).) more...
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- 2022
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50. Preterm birth is strongly affected by the glucocorticoid dose during pregnancy in women complicated by systemic lupus erythematosus.
- Author
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Shimada H, Wakiya R, Kanenishi K, Miyatake N, Nakashima S, Mansour MMF, Kato M, Miyagi T, Sugihara K, Ushio Y, Mino R, Mizusaki M, Kameda T, Kadowaki N, and Dobashi H
- Subjects
- Female, Glucocorticoids adverse effects, Humans, Infant, Newborn, Pregnancy, Pregnancy Outcome epidemiology, Retrospective Studies, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic drug therapy, Pregnancy Complications drug therapy, Premature Birth epidemiology
- Abstract
Background: This study aimed to investigate the effect of glucocorticoid doses on adverse pregnancy outcomes (APOs) in women complicated by systemic lupus erythematosus (SLE)., Methods: We investigated 74 pregnancies complicated by SLE or SLE-dominant mixed connective tissue disease. The pregnancies were managed from conception to delivery in our institution. We retrospectively evaluated whether the mean glucocorticoid dose during pregnancy is associated with APOs, including preterm birth (PB), low birth weight (LBW), and light-for-date (LFD). We also calculated the cut-off dose of glucocorticoid that affected APOs., Results: All APOs occurred in 35 (50.7%) patients, with 14 cases of PB, 23 cases of LBW, and 10 cases of LFD. Patients with all APOs or PB had a higher dose of glucocorticoid during pregnancy than patients without all APOs or with full-term birth (P = 0.03, P < 0.01, respectively). Logistic regression analysis for all APOs and PB showed that the cut-off values of the mean glucocorticoid dose were 6.5 and 10.0 mg/day, respectively. Patients who delivered LBW or LFD newborns showed no significant difference in the glucocorticoid dose used during pregnancy than patients without LBW or LFD newborns. Patients who delivered LBW newborns were more likely to have used glucocorticoids during pregnancy (P < 0.01)., Conclusions: In pregnancies complicated by SLE, a relatively lower dose of glucocorticoid than previously reported is significantly related to APOs, especially PB. Therefore, the disease activity of patients with SLE should be managed with the appropriate lower dose of glucocorticoid during pregnancy., (© 2021. The Author(s).) more...
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- 2022
- Full Text
- View/download PDF
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