1.Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke TANAKA ; Hidenori OHKUBO ; Atsushi YAMAMOTO ; Kota TAKAHASHI ; Yuki KASAI ; Anna OZAKI ; Michihiro IWAKI ; Takashi KOBAYASHI ; Tsutomu YOSHIHARA ; Noboru MISAWA ; Akiko FUYUKI ; Shingo KATO ; Takuma HIGURASHI ; Kunihiro HOSONO ; Masato YONEDA ; Takeo KURIHASHI ; Masataka TAGURI ; Atsushi NAKAJIMA ; Kok-Ann GWEE ; Takaomi KESSOKU
Journal of Neurogastroenterology and Motility 2023;29(3):378-387
Background/Aims:
Natural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients.
Methods:
From October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course.
Results:
Forty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2 , 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care.
Conclusion
CIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.
2.Impact of COVID-19 spread on visit intervals and clinical parameters for patients with periodontitis in supportive periodontal therapy:a retrospective study
Mizuho YAMAZAKI-TAKAI ; Yumi SAITO ; Shoichi ITO ; Moe OGIHARA-TAKEDA ; Tsuyoshi KATSUMATA ; Ryo KOBAYASHI ; Shuta NAKAGAWA ; Tomoko NISHINO ; Namiko FUKUOKA ; Kota HOSONO ; Mai YAMASAKI ; Yosuke YAMAZAKI ; Yuto TSURUYA ; Arisa YAMAGUCHI ; Yorimasa OGATA
Journal of Periodontal & Implant Science 2024;54(2):75-84
Purpose:
This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020.
Methods:
Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020.Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated.
Results:
The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female.Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the highrisk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56).
Conclusions
The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.
3.Impact of COVID-19 spread on visit intervals and clinical parameters for patients with periodontitis in supportive periodontal therapy:a retrospective study
Mizuho YAMAZAKI-TAKAI ; Yumi SAITO ; Shoichi ITO ; Moe OGIHARA-TAKEDA ; Tsuyoshi KATSUMATA ; Ryo KOBAYASHI ; Shuta NAKAGAWA ; Tomoko NISHINO ; Namiko FUKUOKA ; Kota HOSONO ; Mai YAMASAKI ; Yosuke YAMAZAKI ; Yuto TSURUYA ; Arisa YAMAGUCHI ; Yorimasa OGATA
Journal of Periodontal & Implant Science 2024;54(2):75-84
Purpose:
This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020.
Methods:
Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020.Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated.
Results:
The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female.Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the highrisk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56).
Conclusions
The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.
4.Impact of COVID-19 spread on visit intervals and clinical parameters for patients with periodontitis in supportive periodontal therapy:a retrospective study
Mizuho YAMAZAKI-TAKAI ; Yumi SAITO ; Shoichi ITO ; Moe OGIHARA-TAKEDA ; Tsuyoshi KATSUMATA ; Ryo KOBAYASHI ; Shuta NAKAGAWA ; Tomoko NISHINO ; Namiko FUKUOKA ; Kota HOSONO ; Mai YAMASAKI ; Yosuke YAMAZAKI ; Yuto TSURUYA ; Arisa YAMAGUCHI ; Yorimasa OGATA
Journal of Periodontal & Implant Science 2024;54(2):75-84
Purpose:
This study investigated the relationship between the number of days that hospital visits were postponed and changes in clinical parameters due to the spread of coronavirus disease 2019 (COVID-19), after the Japanese government declared a state of emergency in April 2020.
Methods:
Regarding the status of postponement of appointments, we analyzed the patients who had visited the Nihon University Hospital at Matsudo for more than 1 year for supportive periodontal therapy (SPT) and classified them into low-, moderate- and high-risk subgroups according to the periodontal risk assessment (PRA). Clinical parameters for periodontal disease such as probing depth (PD), full-mouth bleeding score (FMBS), full-mouth plaque score, periodontal inflamed surface area (PISA), and periodontal epithelial surface area (PESA) were analyzed in 2 periods, from October 2019 to March 2020 and after April 2020.Correlation coefficients between days of deferral and the degree of changes in clinical parameters were calculated.
Results:
The mean age of the 749 patients was 67.56±10.85 years, and 63.82% were female.Out of 749 patients, 33.24% deferred their SPT appointments after April 2020. The average total of postponement days was 109.49±88.84. The number of postponement days was positively correlated with changes in average PD (rs=0.474) and PESA (rs=0.443) in the high-risk subgroup of FMBS, and average PD (rs=0.293) and PESA (rs=0.253) in the highrisk subgroup of tooth number (TN). Patients belonging to the high-risk subgroups for both FMBS and TN had a positive correlation between postponement days and PISA (rs=0.56).
Conclusions
The findings, the spread of COVID-19 appears to have extended the visit interval for some SPT patients. Moreover, longer visit intervals were correlated with the worsening of some clinical parameters for SPT patients with high PRA.