Aerobic exercise is known to reduce pulse wave velocity (PWV), which reflects arterial stiffness. However, aerobic exercise has a depressor effect, and PWV strongly depends on blood pressure (BP). Therefore, improvement of PWV with aerobic exercise may have an indirect effect on reducing BP. In this study, the relationship between changes in BP and regional PWV measured by oscillometric and tonometry sensors before and after exercise therapy emphasizing aerobic exercise was evaluated in 46 elderly people receiving outpatient treatment for lifestyle-related diseases (7 males and 39 females, mean age : 68 years). In all subjects, BP and PWV measurements were performed before and after exercise therapy. PWV was measured between the brachium and ankle (baPWV), between the heart and femoral artery (hfPWV), and between the femoral artery and ankle (faPWV). During 6 months of exercise therapy, BP, baPWV, hfPWV and faPWV decreased significantly. By multiple regression analysis, the changes in systolic BP were extracted as factors correlated with changes in baPWV and faPWV. The changes in baPWV (r=0.639, p<0.01) and faPWV (r=0.649, p<0.01) correlated significantly with changes in systolic BP. However, changes in hfPWV were not extracted as a factor correlated with changes in systolic BP (r=0.228, p=n. s). In conclusion, exercise therapy emphasizing aerobic exercise was suggested to reduce the stiffness of both the lower limb artery (peripheral artery) and the aorta (central artery). Peripheral arterial stiffness improved concurrently with a reduction in BP as a result of exercise therapy ; but there is a possibility that the improvement of central arterial stiffness is not dependent on reducing BP.

Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.

BACKGROUND: We investigated factors associated with prolonged viral clearance of SARS-CoV-2 among non-severe adult patients in Osaka, Japan. A total of 706 laboratory-confirmed COVID-19 patients were enrolled in this longitudinal observational study between 29 January 2020 and 31 May 2020, across 62 hospitals and three non-hospital recuperation facilities. METHODS: Logistic regression analysis was performed to investigate the factors associated with prolonged (29 days: upper 25% in duration) viral clearance of SARS-CoV-2. Linear regression analysis was conducted to assess these factors 14 days after symptom onset. RESULTS: The median duration of viral clearance was 22 days from symptom onset. After adjustment for sex, age, symptoms, comorbidity, and location of recuperation, comorbidities were associated with prolonged duration: (OR, 1.77 [95% CI, 1.11-2.82]) for one, (OR, 2.47 [95% CI, 1.32-4.61]) for two or more comorbidities. Viral clearance 14 days after symptom onset was 3 days longer for one comorbidity and 4 days longer for two or more comorbidities compared to clearance when there was no comorbidity. CONCLUSION The presence of comorbidity was a robust factor associated with a longer duration of viral clearance, extending by 3 to 4 days compared to patients with no comorbidity.
Adult ; COVID-19 ; Humans ; Japan/epidemiology* ; RNA, Viral ; SARS-CoV-2 ; Virus Shedding