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3. Neurodevelopmental outcomes after antenatal therapy for fetal supraventricular tachyarrhythmias: 3-year follow-up of a multicenter trial.

Author

Miyoshi, T., Maeno, Y., Matsuda, T., Ito, Y., Inamura, N., Kim, K.‐S., Shiraishi, I., Kurosaki, K., Ikeda, T., Sago, H., Horigome, H., Yoda, H., Tsukahara, S., Teramachi, Y., Takahashi, K., Toyoshima, K., Nakai, M., Katsuragi, S., Kim, K-S, and Japan Fetal Arrhythmia Group

Subjects
HYDROPS fetalis, NEURAL development, SUPRAVENTRICULAR tachycardia, DEVELOPMENTAL psychology, ATRIAL flutter, PSYCHOMETRICS
Abstract

Objectives: Although many studies have supported the efficacy of transplacental treatment for fetal supraventricular tachyarrhythmias, the long-term neurodevelopmental outcome after antenatal antiarrhythmic treatment is not well understood. The aim of this study was to clarify prognosis and neurodevelopmental outcome after protocol-defined antenatal therapy for fetal supraventricular tachyarrhythmias, in addition to the incidence of tachyarrhythmias after birth.Methods: This 3-year follow-up study of a multicenter trial for fetal supraventricular tachycardia and atrial flutter evaluated the primary endpoint of mortality and neurodevelopmental impairment (NDI). NDI was defined as any of the following outcomes: cerebral palsy, bilateral blindness, bilateral deafness, or neurodevelopmental delay. The detection rate of tachyarrhythmia was also evaluated as the secondary endpoint. In addition, the correlations between NDI and perinatal factors or postnatal factors were analyzed at 36 months of corrected age.Results: Of 50 patients, the exclusions during the protocol-defined transplacental treatment were 1 patient because of withdrawal of consent and 2 patients with fetal death, leaving 47 patients available for enrollment in this follow-up study. Among these 47 neonates, 45 were available for analysis after 2 were lost to follow-up. The mortality rate was 2.2% (1/45) during a median follow-up of 3.2 years (2.1-9.4 years). Of these 45 infants, 2 dropped out, of whom 1 died at age 2.1 years, and 1 had missing neurodevelopmental assessment data. For the remaining 43 infants, at 36 months of corrected age, NDI was detected in 9.3% (4/43) of infants overall and in 2 of 3 infants of fetal hydrops with subcutaneous edema; cerebral palsy was found in 2 infants with severe subcutaneous edema or ascites at early gestational age; and neurodevelopmental delay was found in 2 infants with tuberous sclerosis or heterotaxy syndrome. Tachyarrhythmias were present in 31.9% (15/47) in the neonatal period and gradually decreased to 8.9% (4/45) and 4.5% (2/44) at 18 and 36 months of corrected age, respectively. The ventricular rate at diagnosis was significantly higher in infants with NDI than those without (median, 265 bpm vs. 229 bpm, P=0.003). In infants with NDI, fetal hydrops with subcutaneous edema at diagnosis was more common (50.0% vs. 2.6%, P=0.019), and the duration of fetal effusion was longer (median, 10.5 days vs. 0 day, P=0.013) than those without. Whereas postnatal arrhythmia and physical development abnormalities were not associated with NDI.Conclusions: Our multicenter 3-year follow-up study was the first to demonstrate the long-term mortality and morbidity of infants born with protocol-defined transplacental treatment for fetal supraventricular tachycardia and atrial flutter. NDI was associated with the presence of fetal hydrops with subcutaneous edema at diagnosis and longer duration of fetal effusion. Neurodevelopmental delay was detected only in infants with severe congenital abnormalities. Therefore, the risk of NDI was rather low in the absence of other comorbidities. The risk for long-term neurologic morbidity might be considered, especially in cases of fetal hydrops with subcutaneous edema and/or associated severe congenital abnormalities. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

Published
2023
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13. Clinical Case Poster session 2P608Infective endocarditis in an adult female with bicuspid aortic valve, hypertrophic cardiomyopathy and amyopathic dermatomyositisP609Left ventricular massP610A rare case of mitral stenosis - Shones syndromeP611The added value of three-dimensional echocardiography in the late diagnosis of a pacemaker complication in a patient with severe congestive heart failureP612Percutaneous paravalvular leak closure - procedure pitfallsP613A case of late left ventricular pseudoaneurysm after aortic valve replacement for infective endocarditis.P614Pseudoaneurysm of right ventricle and acute heart failure caused by prosthetic aortic valve endocarditisP615A misclassification of pulmonary stenosis severity during pregnancyP616A problematic case of left ventricular hypertrophyP617High variability of dynamic obstruction in a patient with hypertrophic obstructive cardiomyopathy and tako-tsubo-cardiomyopathyP618Arterio-venous pulmonary fistula in patient after cerebral strokeP619Rapid myocardial calcification in acute sepsisP620Acute right heart failure after delivery in patient with new-diagnosed pulmonary arterial hypertensionP621When the right ventricle plays hide-and-seekP622Adult congenital heart disease: when what grows wrong goes wrongP623Prenatal diagnosis of mixed type total anomalous pulmonary venous connection in aspleniaP624Uncorrected single ventricle in an adult patient: do coexisting valvular abnormalities matter?P625Ventricular septal aneurysm associated with bicuspid aorta: a case report

Author

Tojino, AL, primary, Laymouna, R., primary, Monteiro, A., primary, Velcea, A., primary, Almeida Morais, L., primary, Enzan, N., primary, Wang, TL., primary, Kemaloglu Oz, TUĞBA, primary, Mursa, A., primary, Pfeiffer, B., primary, Tomaszewski, M., primary, Cuddy, S., primary, Giubertoni, A., primary, Rojo Prieto, N., primary, Ruivo, C., primary, Saito, M., primary, Dorobantu, DM., primary, Kemal, HS., primary, Sta Maria, HF., additional, Tiongco, RP., additional, Elsharkawy, E., additional, Morsy, Y., additional, Elshafei, M., additional, Elgowelly, M., additional, Almaghraby, A., additional, Branco, L., additional, Agapito, A., additional, Sousa, L., additional, Galrinho, A., additional, Pinto, F., additional, Rio, P., additional, Rosa, S., additional, Portugal, G., additional, Ferreira, R., additional, Mihaila, S., additional, Patrascu, N., additional, Adronic, A., additional, Cinteza, M., additional, Vinereanu, D., additional, Fiarresga, A., additional, Cacela, D., additional, Rodrigues, R., additional, Banazol, N., additional, Ferreira, L., additional, Tsutsumi, T., additional, Matsumoto, T., additional, Uchida, T., additional, Yamada, A., additional, Hsiung, MC., additional, Eren, MEHMET, additional, Zarma, L., additional, Popescu, BA., additional, Ginghina, C., additional, Jurcut, R., additional, Neugebauer, A., additional, Rigopoulos, A., additional, Seggewiss, H., additional, Czekajska-Chehab, E., additional, Pietura, R., additional, Tomaszewski, A., additional, Sullivan, V., additional, Cosgrave, J., additional, Daly, C., additional, Murphy, R., additional, Zanaboni, J., additional, Gravellone, M., additional, Piccinino, C., additional, Marino, PN., additional, Lezcano Pertejo, C., additional, Hernandez Diez, C., additional, Alvarez Roy, L., additional, Martinez Paz, E., additional, Ascencio Lemus, MG., additional, Lopez Benito, M., additional, Fernandez-Vazquez, F., additional, Martin Gutierrez, E., additional, Castano Ruiz, M., additional, Guardado, J., additional, Santos, L., additional, Montenegro Sa, F., additional, Saraiva, F., additional, Correia, J., additional, Morais, J., additional, Mahara, K., additional, Ueda, T., additional, Ishii, T., additional, Hamamichi, Y., additional, Katsuragi, S., additional, Enache, R., additional, Platon, P., additional, Vladaia, A., additional, Ginghina, CD., additional, Gunsel, A., additional, Cerit, L., additional, and Duygu, HS., additional

Published
2016
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14. A case study of Cotard's syndrome: stages and diagnosis

Author

Katsuragi S, Yamada K, and Fujii I

Subjects
medicine.medical_specialty, Pediatrics, medicine.medical_treatment, Severity of Illness Index, Cotard's syndrome, Electroconvulsive therapy, medicine, Humans, Affective spectrum, Stage (cooking), Electroconvulsive Therapy, Psychiatry, Depression (differential diagnoses), Psychiatric Status Rating Scales, Depressive Disorder, Chronic stage, Cognition, Syndrome, Middle Aged, medicine.disease, Combined Modality Therapy, Antidepressive Agents, Psychiatry and Mental health, Chronic Disease, Anxiety, Female, medicine.symptom, Psychology, Follow-Up Studies
Abstract

We report the case of a middle-aged woman with Cotard's syndrome in whom clinical course was evaluated according to stages. Longitudinally this syndrome seems to have three stages, namely germination, blooming and chronic (depressive type/paranoid type) stages. In this patient, the chronic stage, primarily characterized by delusions, was observed without raising suspicion of affective disorder. She did not respond to any pharmacotherapies, but improved dramatically after ECT performed during the chronic stage. Although symptoms change according to the stage, most cases of Cotard's syndrome may belong to the affective spectrum and are probably best treated with ECT, as documented here. In evaluation of the mode of separation between emotion and cognition during follow-up it is important to consider stage and diagnosis.

Published
2007

18. Prolonged shedding of respiratory syncytial virus in a child with heart transplant and resolution after conversion from everolimus to MMF: a case report

Author

Nawa, N., primary, Kogaki, S., additional, Uchikawa, T., additional, Okada, Y., additional, Narita, J., additional, Maekawa, S., additional, Ishida, H., additional, Ichimori, H., additional, Mihara, S., additional, Katsuragi, S., additional, Fukusima, N., additional, Sawa, Y., additional, and Ozono, K., additional

Published
2011
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25. Better Working Conditions Won by ‘Nurse Wave’ Action: Japanese nurses’ experience of getting a new law by their militant campaign.

Author

Katsuragi, S.

Subjects
*NURSING ethics, *NURSE strikes & lockouts, *NURSES
Abstract

Japanese nurses, like their counterparts in many other countries, are suffering from staff shortages and severe working conditions. The Japan Federation of Medical Workers’ Unions (Nihon Iroren) launched a campaign in 1989 for nurses called the ‘Nurse Wave’. Their demands were many: to increase the numbers of nursing staff, the regulation of night shifts, the implementation of a five-day working week everywhere, a fair appraisal of nurses’ work, better vocational training, etc. Nurses in white uniforms assembled at meetings, marched and took part in nationwide strikes. They collected over 5.4 million petition signatures, which they submitted to Parliament. After three years of campaigning, they won the enactment of a law for securing sufficient numbers of nursing personnel. This struggle, which highlighted the most pressing demands of nurses and was supported by the general public, was a new experience for Japanese nurses. It was a militant movement which demanded that the Government should change its health policy. Against the sluggish image of the Japanese labour movement, strikes and demonstrations organized by nurses dressed in white have made a strong impression on the Japanese people. As health care is a public service on which the life and death of people depend, a strike at a health institution naturally has constraints and must follow specific procedures. In this article, the measures taken by Nihon Iroren to minimize the consequences of strikes on patients and the local community, the impact of the nurses’ movement on the society, as well as the lessons drawn from the campaign, are presented. [ABSTRACT FROM AUTHOR]

Published
1997
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