1.Impact of the COVID-19 Pandemic on Adherence to Denosumab Therapy: A Single Center Study
Kazuyoshi KOBAYASHI ; Koji SATO ; Toshihiro ANDO ; Kei ANDO ; Saori IMURA
Asian Spine Journal 2023;17(5):842-850
Methods:
Participants included 376 patients who received denosumab (60 mg every 6 months) from January 2013 to June 2021. The time from therapy initiation to discontinuation was used to measure persistence, and that between initial and subsequent injections was used to determine adherence. The pandemic period was from March 2020 to December 2021.
Results:
Patients were divided into those treated after March 2020 (pandemic group, n=244) and those who discontinued treatment before March 2020 (non-pandemic group, n=132). Non-persistent cases accounted for 154, including 24 (20%), 64 (19%), and 66 (53%) aged ≤59 years, 60–79 years, and ≥80 years, respectively. The overall persistence rate at 78 months was 59.2%. Postponed cases were significantly lower in the non-pandemic group than in the pandemic group (8% vs. 15%, p =0.042). Postponement with a delay of 1–2 months did not significantly differ between the two groups, but with a significant difference for a delay of ≥3 months (0% vs. 36%, p =0.024).
Conclusions
Denosumab adherence remained constant but postponed cases significantly increased during the COVID-19 pandemic. Better communication by health providers on denosumab adherence and alternative administration may reduce dosing interruptions in similar pandemic situations.
2.The Myocardial Protection of Immersion Hearts in Perfluorochemicals during Ischemia.
Koichi Inoue ; Osamu Honda ; Yuji Hanabusa ; Susumu Ando ; Atsushi Ozawa ; Shigeaki Sekiguchi ; Seiro Nomoto ; Mitsutaka Kadokura ; Makoto Yamada ; Toshihiro Takaba
Japanese Journal of Cardiovascular Surgery 1995;24(5):305-310
Topical cardiac hypothermia has unequivocal preservation effects during ischemia, but it has some disadvantages. Topical cooling, especially with ice slush, can injure the phrenic nerve, disturb the equal distribution of the cardioplegic solution due to coronary artery spasm and damage the epicardium. It is easy to prevent cooling injury without topical hypothermia, but the myocardial oxygen demands are increased. In order to supply the myocardium with oxygen for the increased oxygen demands during ischemia, isolated rat hearts were immersed in perfluorochemicals (PFC) which have excellent transportation of oxygen. The effects of immersion in PFC during mild hypothermic ischemia (at 20°C without cardioplegia and at 30°C cardioplegic arrest) on the cardiac function on reperfusion were evaluated. Under 20°C hypothermic ischemia without cardioplegia, cardiac beating was maintained for 20±4 minutes in the hearts were immersed in PFC, and for 10±2 minutes in the hearts that were not immersed in any solution. In the recovery of cardiac function (LVDP and LVmax dp/dt) after mild hypothermic (30°C) cardioplegic arrest, the hearts immersed in PFC showed better results than hearts that were not immersed.