1.Distribution of Cases of Hepatitis C Virus Infection by Subtypes and Results of Interferon Therapy in the Southern Region of Ibaraki Prefecture.
Junichi TAZAWA ; Yoshinori SAKAI ; Shinnya MAEKAWA ; Chikara YAMAMOTO ; Fumihiko KUSANO ; Naoko SAZAKI ; Kazuo TAJIRI ; Noriaki MATSUI ; Kenichi KAWADA ; Hideomi FUJIWARA
Journal of the Japanese Association of Rural Medicine 1995;44(1):32-35
It has been made known that there isn't any significant regional difference in the frequencies of cases of viral hepatitis C by subtypes in our country. In the present study we investigated the subtypes in hepatitis C virus carring patients without blood transfusion history in the southern region of Ibaraki Prefecture to clarify the occurrence ratio of each subtype of the virus. The results of interferon therapy were also examined in those patients with chronic hepatitis C. The frequencies of subtypes 2, 3 and 4 were found to be 71%, 16% and 10%, respectively. Although these ratios were the same as the national average, a significantly high frequency (P>0.01) of subtype 3 was observed in the patients from Tsuchiura in the region, suggesting that there may have existed some particular source of infection other than blood transfusion. The effectiveness of interferon therapy was significantly higher (P>0.01) in the patients with subtype 3 (75%) than in those patients with subtypes 2 and 4 (23% and 43%, raspectively), suggesting that interferon is a remedy specific to subtype 3.
2.Association between Aortic Calcification Burden and the Severity of Erectile Dysfunction in Men Undergoing Dialysis: A Cross-Sectional Study
Naoki FUJITA ; Shingo HATAKEYAMA ; Masaki MOMOTA ; Yuki TOBISAWA ; Tohru YONEYAMA ; Teppei OKAMOTO ; Hayato YAMAMOTO ; Takahiro YONEYAMA ; Yasuhiro HASHIMOTO ; Kazuaki YOSHIKAWA ; Chikara OHYAMA
The World Journal of Men's Health 2023;41(2):373-381
Purpose:
Accelerated atherosclerosis is a major complication in patients with end-stage renal disease and it plays an important role in the pathogenesis of erectile dysfunction (ED). However, the association between aortic calcification burden and the severity of ED remains unclear. The aim of the present study was to investigate this association in men undergoing dialysis.
Materials and Methods:
This cross-sectional study included 71 men undergoing peritoneal dialysis and/or hemodialysis between July 2016 and May 2018 at Mutsu General Hospital. ED was assessed with the Sexual Health Inventory for Men (SHIM). Patients were divided into the mild/moderate (SHIM score ≥8) and severe ED groups (SHIM score ≤7). Aortic calcification index (ACI) was examined as a clinical indicator of abdominal aortic calcification. Multivariable logistic regression analysis was performed to identify the significant factors associated with severe ED.
Results:
The median age of the study participants was 64 years; all had ED, with 64.8% having severe ED. In the multivariable analyses, a slight association was observed between ankle-brachial index and severe ED (odds ratio [OR], 0.058; p=0.072), whereas ACI was significantly associated with severe ED (OR, 1.022; p=0.022).
Conclusions
Aortic calcification burden was independently associated with severe ED.
3.Can Erectile Dysfunction Severity Predict Major Adverse Cardiovascular Events in Men Undergoing Dialysis? A Prospective Cohort Study
Naoki FUJITA ; Masaki MOMOTA ; Yusuke OZAKI ; Yuki TOBISAWA ; Tohru YONEYAMA ; Teppei OKAMOTO ; Hayato YAMAMOTO ; Shingo HATAKEYAMA ; Takahiro YONEYAMA ; Yasuhiro HASHIMOTO ; Kazuaki YOSHIKAWA ; Chikara OHYAMA
The World Journal of Men's Health 2023;41(4):900-908
Purpose:
To evaluate the impact of severe erectile dysfunction (ED) on future major adverse cardiovascular events (MACE) in men on dialysis.
Materials and Methods:
This prospective cohort study included 71 men on dialysis. ED was assessed using the Sexual Health Inventory for Men (SHIM). Men were divided into the mild/moderate ED (SHIM score ≥8) and severe ED (SHIM score ≤7) groups. The primary endpoint was MACE-free survival. MACE was a composite of myocardial infarction, cardiovascular death, and stroke. The secondary endpoints were cardiac event-free survival and overall survival (OS). Moreover, the predictive abilities of severe ED for 5-year MACE, 5-year cardiac events, and 5-year overall mortality were evaluated.
Results:
The median age and follow-up period of the included men were 64 years and 58 months, respectively. The median SHIM score was 4.0; all had a degree of ED, and 64.7% had severe ED. In the background-adjusted multivariable analyses, severe ED was not significantly associated with shorter MACE-free survival (hazard ratio [HR], 1.890; 95% confidence interval [CI], 0.533–6.706; p=0.324), cardiac event-free survival (HR, 2.081; 95% CI, 0.687–6.304; p=0.195), and OS (HR, 0.817; 95% CI, 0.358–1.863; p=0.630). Severe ED did not significantly improve the predictive abilities for 5-year MACE, 5-year cardiac events, and 5-year overall mortality (p=0.110, p=0.101, and p=0.740, respectively).
Conclusions
ED severity was not associated with shorter MACE-free survival, cardiac event-free survival, or OS, and ED severity could not improve the predictive abilities for these outcomes in men undergoing dialysis.