1.Trough level of infliximab is useful for assessing mucosal healing in Crohn's disease: a prospective cohort study.
Akihiro KOGA ; Toshiyuki MATSUI ; Noritaka TAKATSU ; Yasumichi TAKADA ; Masahiro KISHI ; Yutaka YANO ; Takahiro BEPPU ; Yoichiro ONO ; Kazeo NINOMIYA ; Fumihito HIRAI ; Takashi NAGAHAMA ; Takashi HISABE ; Yasuhiro TAKAKI ; Kenshi YAO ; Hirotsugu IMAEDA ; Akira ANDOH
Intestinal Research 2018;16(2):223-232
BACKGROUND/AIMS: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2). METHODS: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses. Study 2 involved 35 patients who were evaluated endoscopically. RESULTS: In Study 1, there were no differences between the 2 assays in ROC curve analyses; the TLI cutoff value for LOR was 2.6 µg/mL (sensitivity, 70.9%; specificity, 79.2%), and the ATI cutoff value was 4.9 µg/mL (sensitivity, 65.5%; specificity, 67.9%). The AUROC (area under the ROC curve) of TLI was greater than that of ATI. AUROC was useful for discriminating between the 2 conditions. In Study 2, the TLI was significantly higher in the colonic MH group than in the non-MH group (2.7 µg/mL vs. 0.5 µg/mL, P=0.032). CONCLUSIONS: TLI is better than ATI for clinically diagnosing LOR, and a correlation was observed between TLI and colonic MH.
Antibodies
;
Cohort Studies*
;
Colon
;
Crohn Disease*
;
Humans
;
Infliximab*
;
Prospective Studies*
;
ROC Curve
;
Sensitivity and Specificity
2.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
3.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
4.Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya OKU ; Junji HATAKEYAMA ; Keibun LIU ; Kentaro TOJO ; Masafumi IDEI ; Shigeaki INOUE ; Kazuma YAMAKAWA ; Takeshi NISHIDA ; Shinichiro OHSHIMO ; Satoru HASHIMOTO ; Shuhei MARUYAMA ; Yoshitaka OGATA ; Daisuke KAWAKAMI ; Hiroaki SHIMIZU ; Katsura HAYAKAWA ; Yuji FUJINO ; Taku OSHIMA ; Tatsuya FUCHIGAMI ; Hironori YAWATA ; Kyoji OE ; Akira KAWAUCHI ; Hidehiro YAMAGATA ; Masahiro HARADA ; Yuichi SATO ; Tomoyuki NAKAMURA ; Kei SUGIKI ; Takahiro HAKOZAKI ; Satoru BEPPU ; Masaki ANRAKU ; Noboru KATO ; Tomomi IWASHITA ; Hiroshi KAMIJO ; Yuichiro KITAGAWA ; Michio NAGASHIMA ; Hirona NISHIMAKI ; Kentaro TOKUDA ; Osamu NISHIDA ; Kensuke NAKAMURA
Annals of Rehabilitation Medicine 2025;49(1):49-59
Objective:
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods:
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results:
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.