Objectives: The purpose of this study was to examine the beneficial effects of balneotherapy in patients with chronic heart failure (CHF).
Background: Some reports have shown that balneotherapy reduces systemic blood pressure in healthy volunteers. However, it is not clear whether balneotherapy improves the status of CHF. We hypothesized that hyperthermia using hot water would improve cardiac and peripheral endothelial function and clinical symptoms.
Methods: Twenty-six patients with chronic systolic heart failure classified as New York Heart Association (NYHA) functional status II or III were divided into two groups. In the balneotherapy group, patients were immersed in a hot spring at 40°C for 10min daily for two weeks; in the control group, patients took a daily shower. We measured plasma brain natriuretic peptide (BNP) and asymmetric dimethylarginine (ADMA). The left ventricular ejection fraction (LVEF) and cardiothoracic ratio (CTR) were evaluated by echocardiography and chest radiography, respectively. Brachial-ankle pulse-wave velocity (baPWV) was measured non-invasively using an automatic device.
Results: Clinical symptoms were improved after two weeks of hot spring therapy. Although heart rate and CTR did not change, clinical symptom and LVEF improved and mean blood pressure, BNP, ADMA and PWV significantly decreased.
Conclusions: Repeated immersion in a hot spring improves peripheral vascular endothelial function, thus leading to improvement of clinical activity and symptoms in patients with CHF.

75-year-old man had the right lower lobe resected because of pulmonary adenocarcinoma (stage IIB) and received 4 courses of postoperative chemotherapy 4 years earlier. Thereafter, he continued to complain of cough, sputum, and progressive exertional breathlessness. The preoperative chest CT showed ground glass opacity (GGO) at the bottom of both lung fields, and over time the GGO changed to honeycombing with traction bronchiectasis. He was administered prednisolone, clarithromycin, and pirfenidone but with little improvement. He exhibited hypoxemia (PaO₂ 56 mmHg) and was admitted. An interview revealed that he had worked in the poultry farming business for 45 years having had contact with and breeding 3,000 game fowl at the time of hospitalization. We suspected bird-related hypersensitivity pneumonitis. Results of the reaction to pigeon dropping extracts (PDE) were high, with PDE IgG 0.697 and PDE IgA 0.445. He was diagnosed with chronic bird-related hypersensitivity pneumonitis. Although the chest CT appearance was difficult to distinguish from that of idiopathic interstitial pneumonia, the test for PDE and the interview were useful for reaching a diagnosis.

PURPOSE: Mumps vaccine has not been included in the routine national immunization program in Japan, leading to low vaccine coverage rates and periodic epidemics approximately every 5 years. Our hospital (a secondary community hospital in Japan) experienced an increased number of mumps-related complications with a nationwide epidemic in 2016. Using previously reported data and mumps-related cases in our hospital, we estimated the cost-effectiveness of routine mumps vaccination in Japan with a static model using current epidemiologic data. MATERIALS AND METHODS: With a decision tree flowchart of mumps infection and adverse events, we estimated the burden of mumps-related complications in our hospital for 5 years, and calculated the current annual national burden. Finally, we compared the current burden and assumptive burden of the stable state after routine vaccination in Japan using a static model. RESULTS: The cost-benefit ratios with sensitivity analysis were 3.69 (1.08-9.52) and 6.84 (1.51-23.73) in independent inoculation and simultaneous inoculation, respectively, from a social perspective in addition to an annual gain of 9,487 (3,227-14,659) quality adjusted life years. CONCLUSION: We contributed additional evidence in terms of cost-effectiveness that routine mumps vaccination should be introduced in Japan with simultaneous inoculation.
Asian Continental Ancestry Group* ; Cost-Benefit Analysis ; Decision Trees ; Hospitals, Community* ; Humans ; Immunization Programs ; Japan* ; Mumps Vaccine ; Mumps* ; Quality-Adjusted Life Years ; Software Design ; Vaccination*