Background: This study aimed to clarify the association between the co-existence of possible sarcopenia (PS) and dysphagia in patients with acute stroke and the functional outcomes 12 months after stroke. Methods: This multicenter retrospective cohort study was conducted on patients with stroke admitted to two acute care hospitals in Japan between November 2020 and October 2023. PS was defined based on grip strength (males <28 kg, females <18 kg) and calf circumference (males <34 cm, females <33 cm) on admission. Dysphagia was defined as a Functional Oral Intake Scale score of less than 4. The outcome was defined as a composite of either poor functional outcome (modified Rankin Scale [mRS] score of 3–6) or failure to recover to the premorbid mRS at 12 months after stroke onset. Modified Poisson regression analysis was used to examine the association between the co-existence of PS and dysphagia and poor functional outcomes. Results: This study included 604 patients (median age 76 years; 367 men). Compared with the non-PS and non-dysphagia group, the PS and dysphagia group had a higher proportion of poor functional outcomes. Subsequently, modified Poisson regression analysis was performed. The interaction between PS and dysphagia was significantly associated with poor functional outcomes (risk ratio=4.348, 95% confidence interval 2.683–7.046). Conclusion In patients with acute stroke, the co-existence of PS and dysphagia was associated with poor functional outcomes 12 months after stroke. Future multicenter prospective interventional studies are required to clarify the effectiveness of multifaceted intervention programs in high-risk patients.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

As new evidence emerges, treatment strategies toward the functional cure of chronic hepatitis B are evolving. In 2019, a panel of national hepatologists published a Consensus Statement on the functional cure of chronic hepatitis B. Currently, an international group of hepatologists has been assembled to evaluate research since the publication of the original consensus, and to collaboratively develop the updated statements. The 2.0 Consensus was aimed to update the original consensus with the latest available studies, and provide a comprehensive overview of the current relevant scientific literatures regarding functional cure of hepatitis B, with a particular focus on issues that are not yet fully clarified. These cover the definition of functional cure of hepatitis B, its mechanisms and barriers, the effective strategies and treatment roadmap to achieve this endpoint, in particular new surrogate biomarkers used to measure efficacy or to predict response, and the appropriate approach to pursuing a functional cure in special populations, the development of emerging antivirals and immunomodulators with potential for curing hepatitis B. The statements are primarily intended to offer international guidance for clinicians in their practice to enhance the functional cure rate of chronic hepatitis B.

Background/Aims: Asymptomatic esophageal eosinophilia (aEE) is considered to be a potential precursor of eosinophilic esophagitis (EoE). However, there are few clinical parameters that can be used to evaluate the disease. Therefore, we aimed to clarify the factors involved in the symptoms of EoE by examining the clinicopathological differences between aEE and EoE. Methods: We reviewed 41 patients with esophageal eosinophilia who underwent endoscopic ultrasonography and high-resolution manometry. They were divided into the aEE group (n=16) and the EoE group (n=25) using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score. The patients’ clinicopathological findings were collected and examined. Results: The median Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease score was 3.0 in the aEE group and 10.0 in the EoE group. There was no significant difference in patient characteristics, endoscopic findings and pathological findings. The cutoff value for wall thickening was 3.13 mm for the total esophageal wall thickness and 2.30 mm for the thickness from the surface to the muscular layer (total esophageal wall thickness: 84.0% sensitivity, 75.0% specificity; thickness from the surface to the muscular layer: 84.0% sensitivity, 68.7% specificity).The high-resolution manometry study was abnormal in seven patients (43.8%) in the aEE group and in 12 (48.0%) in the EoE group. The contractile front velocity was slower in the EoE group (p=0.026). Conclusions The esophageal wall thickening in the lower portion of the esophagus is an important clinical factors related to the symptoms in patients with EoE.

BACKGROUND: Previous cardiovascular risk prediction models in Japan have utilized prospective cohort studies with concise data. As the health information including health check-up records and administrative claims becomes digitalized and publicly available, application of large datasets based on such real-world data can achieve prediction accuracy and support social implementation of cardiovascular disease risk prediction models in preventive and clinical practice. In this study, classical regression and machine learning methods were explored to develop ischemic heart disease (IHD) and stroke prognostic models using real-world data. METHODS: IQVIA Japan Claims Database was searched to include 691,160 individuals (predominantly corporate employees and their families working in secondary and tertiary industries) with at least one annual health check-up record during the identification period (April 2013-December 2018). The primary outcome of the study was the first recorded IHD or stroke event. Predictors were annual health check-up records at the index year-month, comprising demographic characteristics, laboratory tests, and questionnaire features. Four prediction models (Cox, Elnet-Cox, XGBoost, and Ensemble) were assessed in the present study to develop a cardiovascular disease risk prediction model for Japan. RESULTS: The analysis cohort consisted of 572,971 invididuals. All prediction models showed similarly good performance. The Harrell's C-index was close to 0.9 for all IHD models, and above 0.7 for stroke models. In IHD models, age, sex, high-density lipoprotein, low-density lipoprotein, cholesterol, and systolic blood pressure had higher importance, while in stroke models systolic blood pressure and age had higher importance. CONCLUSION Our study analyzed classical regression and machine learning algorithms to develop cardiovascular disease risk prediction models for IHD and stroke in Japan that can be applied to practical use in a large population with predictive accuracy.
Humans ; Cardiovascular Diseases/epidemiology* ; Prognosis ; Prospective Studies ; Japan/epidemiology* ; Stroke/etiology* ; Myocardial Ischemia/epidemiology* ; Risk Assessment/methods*

Objective: Following the amendment of the Pharmaceutical and Medical Device Act in December 2019, continuous follow-up of patients during treatment has been mandated for pharmacists. The follow-up methods may involve contacting patients via telephone and social networking services (SNS). The SNS is advantageous over telephone, because patients can respond to the pharmacists at their convenience. Therefore, we developed a patient compliance instruction support system “FollowNavi” using LINE. We prepared a content of inhalation drugs used to treat bronchial asthma for assessment using FollowNavi and conducted questionnaire surveys among patients and pharmacists to validate its utility.Methods: FollowNavi was used from May1 to July 31, 2020, to follow up patients diagnosed with bronchial asthma for whom long-term control medicine (inhalation drugs) was prescribed for the first time or prescriptions were changed from other inhalation drugs. Subsequently, when the patients revisited the pharmacy, we conducted a questionnaire survey regarding the usability of FollowNavi. We also conducted a questionnaire survey among the pharmacists.Results: Seven and five responses were received from patients who were followed up via FollowNavi and pharmacists who used FollowNavi, respectively. Furthermore, 28.6% of the patients responded “I could solve the problem through LINE” and 71.4% responded “I did not have anything in particular that I could not understand.” As for pharmacists, 60.0% responded that they could obtain sufficient information from the patients through FollowNavi.Conclusion: The results suggest that follow-up after providing inhalation instructions using the inhalation drug content of FollowNavi may be useful for both patients and pharmacists.

An instantaneous blood pressure measuring system at the wrist based on the volume-compensation method is developed, and the characteristics and accuracy of the system is evaluated. The radial artery at the wrist is used as the detecting object, and a pad-type cuff as well as a newly designed electro- pneumatic converter is used in the system. Also, the comparative experiments between the system and the invasive blood measuring device (direct method) indicated that, the results obtained from the two methods are well correlated not only in rest condition, but also in a stressful condition. Therefore, the system is capable of non-invasive measuring instantaneous blood pressure in the radial artery.
Blood Pressure Determination ; instrumentation ; methods ; Equipment Design ; Humans ; Radial Artery ; physiology

OBJECTIVETo study the influence of soybean phytochemical extract containing isoflavones and soyasaponins (SPE) on blood glucose, blood lipids, plasma lipid peroxide and platelet aggregation activity in diabetic rats.

METHODSDiabetic rats were fed with fodder containing 20 g/kg of SPE for 20 weeks. Their plasma very low density lipoprotein (VLDL), low density lipoprotein (LDL) and high density lipoprotein (HDL) were separated by sequential ultracentrifugation.

RESULTSTwenty weeks after experiment, level of blood glucose, atherosclerotic index and plasma level of lipid peroxide were (11.9 +/- 0.9) mmol/L, 0.40 +/- 0.14 and (15.7 +/- 0.5) mmol/L, respectively in diabetic rats fed with SPE, significantly lower than those in control rats not fed with it, (14.2 +/- 2.0) mmol/L, 0.58 +/- 0.22 and (20.7 +/- 3.0) mmol/L, respectively. Accordingly, platelet aggregation rates induced by ADP and collagen in the two groups were (54.1 +/- 8.8)% vs (66.6 +/- 12.4)% and (58.0 +/- 7.9)% vs (69.6 +/- 9.4)%, respectively. Changes in all these indices were significantly different between the two groups.

CONCLUSIONSPE could significantly decrease blood glucose, improve atherosclerotic index, and inhibit lipid peroxidation and platelet aggregation in diabetic rats, which might be useful in prevention and control of diabetes mellitus and diabetes-associated atherosclerosis.

Animals ; Arteriosclerosis ; blood ; prevention & control ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cholesterol, VLDL ; blood ; Diabetes Mellitus, Type 2 ; blood ; prevention & control ; Flavonoids ; pharmacology ; Male ; Phytotherapy ; Random Allocation ; Rats ; Saponins ; pharmacology ; Soybeans ; Triglycerides ; blood