Search

• Few treatments exist for acute attacks of trigeminal neuralgia. • Patients who received intravenous fosphenytoin therapy were reviewed retrospectively. • Reduction in pain 24 h following treatment was significant with no adverse effects. • Intravenous fosphenytoin may be used to treat acute trigeminal neuralgia crisis. Few treatments exist for acute attacks of trigeminal neuralgia. Therefore, this study aimed to investigate the efficacy and safety of an intravenous fosphenytoin therapy protocol in a trigeminal neuralgia crisis. We conducted a single-center, retrospective, observational study of the records of 20 patients with trigeminal neuralgia who received intravenous fosphenytoin therapy (15 mg/mL in normal saline at 50 mg/min for 15 min, total 750 mg) during hospitalization between September 2015 and August 2020. Serum phenytoin concentration was measured 30 min post-infusion. Pain severity was evaluated using a numerical rating scale and was analyzed for statistical significance. The mean age of the patients was 67.5 years (female, 50.0%). The median numerical rating scale score (interquartile range) of pain severity was 2.35 (0–10), 0.65 (0–5), 0.15 (0–1), 2.00 (0–8), and 4.30 (0–10) at 15, 30, and 60 min, and 12 and 24 h, respectively (p <.001); the numerical rating scale score was 10 before treatment. Reduction in pain 24 h following treatment was significant. The mean phenytoin concentration was 12.8 μg/mL 30 min post-treatment. While mild dizziness occurred in four patients, all could walk independently within 60 min. The mean age and weight of patients with mild dizziness were significantly higher and lower, respectively (p <.001), than those of other patients. These results may provide physicians with new insights into the innovative therapeutic option of intravenous fosphenytoin and contribute to advancements in treating acute trigeminal neuralgia crisis. [ABSTRACT FROM AUTHOR]

Abstract There are many psychosocial and biomedical risk factors for postpartum depression (PPD). However, associations between co-resident family members and PPD risk have not been examined. This study investigated whether co-resident family members were associated with risk for PPD during 1 month postpartum among Japanese women, and if these associations were modified by household income and their perceived partner's involvement in childcare. The sample comprised 86,490 women. Data were drawn from the Japan Environment and Children's Study, a large-scale national cohort study started in 2011. Our major predictor was co-resident family members when they registered around the first trimester of the women's pregnancy: partner, parent(s), parent(s)-in-law, or child(ren). The outcome was PPD at 1 month after delivery, assessed by the Edinburgh Postnatal Depression Scale. Adjusted odds ratios (OR) for family members and PPD incidence were calculated using multivariable logistic regression analysis. Subgroup analyses were conducted by household income and perceived partner's involvement in childcare. Adjusted ORs (95% confidence interval) for PPD for those not living with their partner, parent(s), parent(s)-in-law, or child(ren) compared with those who lived with these family members were 1.21 (1.07–1.37), 1.13 (1.03–1.24), 0.91 (0.84–0.98), and 1.42 (1.31–1.53), respectively. The level of perceived partner's involvement in childcare changed the identified association between family member and PPD. We found that "who a pregnant woman lives with" affects the risk of PPD in the first month postpartum, and high levels of perceived partner's involvement in childcare reduced harmful effects/increased protective effect of family members on PPD incidence. These findings suggested that interventions to increase perceived partner's support for childcare may be effective in preventing PPD, regardless of living situation. Highlights • No studies have examined whether family structure is associated with PPD risk. • Risk of PPD differs by "who a pregnant woman lives with.". • Perceived partner's childcare support affect these associations. • Assessing family structure/economic situation may help identify high-risk groups. • Interventions to promote partner's support for childcare may prevent maternal PPD. [ABSTRACT FROM AUTHOR]

Abstract: Despite the overall decline in cigarette smoking prevalence in the US, social class inequalities in smoking are likely to persist, or even to widen. One possible reason for the increasing gap in smoking prevalence across social class could be our lack of understanding of causal mechanisms: in other words, what accounts for the social gradient in smoking behavior? In this paper, we examine the mechanisms behind social gradients related to smoking cessation by use of path analysis techniques. The data come from a 3-year follow-up telephone survey of a cohort of US adults. The sample for the present analysis was drawn from the 481 respondents who reported being smokers and employed at baseline and who completed the follow-up interview. We examined two social class indicators, educational attainment and household income, in relation to smoking cessation. We tested the potential mediating effects of the following variables: differential use of resources for smoking cessation (e.g., booklet, pamphlet, quit line, nicotine replacement therapy and smoking cessation program), differential environments in terms of smoking at worksite and home, and differences in peer smoking. Our path analyses suggest that smokers from high social class are likely to use effective resources for smoking cessation and have restrictive home environment in terms of smoking, which leads to a relatively higher smoking cessation rate compared to those from low social class. The results of this study suggest that interventions should target resources for smoking cessation and home environments in terms of smoking to reduce socio-economic disparities in smoking cessation. [Copyright &y& Elsevier]

The purpose of this study is to explore neighborhood contextual factors in terms of smoking behaviors among middle-aged Japanese, by using a multilevel analysis. Subjects were Japanese men and women, between 40 and 59 years of age (40,961 for the cross-sectional analysis, and 9,177 for the longitudinal analysis), nested in 39 neighborhoods ( Kyuson ). The results showed that women in a less residentially stable neighborhood were more likely to be smokers. No associations were seen between current smoking and neighborhood deprivation; however, women in the most deprived neighborhood were more likely to quit smoking. This study is the first to demonstrate the associations between neighborhood environment and current smoking or smoking cessation, in a Japanese setting. The findings imply that policy makers should consider targeting neighborhood conditions in order to help reduce smoking prevalence, especially among women. [ABSTRACT FROM AUTHOR]