1.Efficacy and Safety of Abdominal Trunk Muscle Strengthening Using an Innovative Device in Elderly Patients With Chronic Low Back Pain: A Pilot Study
Satoshi KATO ; Satoru DEMURA ; Yuki KUROKAWA ; Naoki TAKAHASHI ; Kazuya SHINMURA ; Noriaki YOKOGAWA ; Noritaka YONEZAWA ; Takaki SHIMIZU ; Ryo KITAGAWA ; Hiroyuki TSUCHIYA
Annals of Rehabilitation Medicine 2020;44(3):246-255
Objective:
To examine the efficacy and safety of an innovative, device-driven abdominal trunk muscle strengthening program, with the ability to measure muscle strength, to treat chronic low back pain (LBP) in elderly participants.
Methods:
Seven women with non-specific chronic LBP, lasting at least 3 months, were enrolled and treated with the prescribed exercise regimen. Patients participated in a 12-week device-driven exercise program which included abdominal trunk muscle strengthening and 4 types of stretches for the trunk and lower extremities. Primary outcomes were adverse events associated with the exercise program, improvement in abdominal trunk muscle strength, as measured by the device, and improvement in the numerical rating scale (NRS) scores of LBP with the exercise. Secondary outcomes were improvement in the Roland-Morris Disability Questionnaire (RDQ) score and the results of the locomotive syndrome risk test, including the stand-up and two-step tests.
Results:
There were no reports of increased back pain or new-onset abdominal pain or discomfort during or after the device-driven exercise program. The mean abdominal trunk muscle strength, NRS, RDQ scores, and the stand-up and two-step test scores were significantly improved at the end of the trial compared to baseline.
Conclusion
No participants experienced adverse events during the 12-week strengthening program, which involved the use of our device and stretching, indicating the program was safe. Further, the program significantly improved various measures of LBP and physical function in elderly participants.
2.Impact of the Sensitivity to Empiric Antibiotics on Clinical Outcomes after Biliary Drainage for Acute Cholangitis
Satoshi KAWAMURA ; Yuki KARASAWA ; Nobuo TODA ; Yousuke NAKAI ; Chikako SHIBATA ; Ken KUROKAWA ; Junya ARAI ; Kazuyoshi FUNATO ; Shigeyuki KUROSAKI ; Shuya MAESHIMA ; Mayuko KONDO ; Kentaro KOJIMA ; Takamasa OHKI ; Michiharu SEKI ; Kazuhiko KOIKE ; Kazumi TAGAWA
Gut and Liver 2020;14(6):842-849
Background/Aims:
Empiric antibiotics are given in combina-tion with biliary drainage for acute cholangitis but sometimes turn out to be insensitive to microorganisms in blood and bile. Clinical outcomes were compared according to sensitiv-ity to microorganisms detected in blood and bile culture to evaluate the impact of sensitivity to empiric antibiotics in cholangitis.
Methods:
Consecutive patients who underwent biliary drainage for acute cholangitis were retrospectively studied. Clinical outcomes such as 30-day mortality, length of hospital stay and high care unit stay, organ dysfunction and duration of fever were compared in three groups: group A (sensitive to both blood and bile culture), group B (sensitive to blood culture alone) and group C (insensitive to both blood and bile culture).
Results:
Eighty episodes of cholangitis were classified according to sensitivity results: 42, 32 and six in groups A, B and C. Escherichia coli and Klebsiella were two major pathogens. There were no significant differences in 30-day mortality rate (7%, 0%, and 0%, p=0.244), length of hospital stay (28.5, 21.0, and 20.5 days, p=0.369), organ dysfunction rate (14%, 25%, and 17%, p=0.500), duration of fever (4.3, 3.2, and 3.5 days, p=0.921) and length of high care unit stay (1.4, 1.2, and 1.7 days, p=0.070) in groups A, B and C. Empiric antibiotics were changed in 11 episodes but clinical outcomes appeared to be non-inferior even in 31episodes of cholangitis who were on inadequate antibiotics throughout the course.
Conclusions
Sensitivity of empiric antibiotics was not associated with clinical outcomes in acute cholangitis.