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.

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.

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.

BACKGROUND: Studies on the adverse effects of Asian dust (AD) on respiratory function in children are scarce. The objective of this study was to examine the association between AD and respiratory function by measuring peak expiratory flow rates (PEFRs) in asthmatic children. METHODS: The study was carried out from March to May from 2014 through 2016. One hundred ten children with bronchial asthma were recruited from four hospitals in the Goto Islands and south Nagasaki area in Nagasaki prefecture. The parents were asked to record their children's PEFRs every morning/evening and clinical symptoms in an asthma diary. AD was assessed from light detection and ranging data, and a linear mixed-effects model was used to estimate the effects of AD on daily PEFR. Time-stratified case-crossover analyses were performed to examine the association between AD and asthma attacks defined by reduction levels in PEFR. RESULTS: AD was detected on 11 days in the Goto Islands, and on 23 days in the south Nagasaki area. After adjusting for age, sex, temperature, and daily oxidants, we found a consistent association between AD and a 1.1% to 1.7% decrease in PEFR in the mornings and a 0.7% to 1.3% decrease in the evenings at a lag of 0 to 5 days. AD was not associated with the number of asthma attacks, respiratory symptoms, or other symptoms at any lag days examined. CONCLUSIONS Exposure to AD was associated with reduced PEFR, although the effects were not large enough to induce clinically apparent symptoms, in clinically well-controlled asthmatic children.

High-intensity interval exercise leads to greater improvements in the vascular endothelial function than continuous exercise at moderate intensity. However, few studies have been performed on the effects of repetition exercise consisting of high-intensity exercise followed by complete rest on the arterial function. Therefore, the purpose of this study was to investigate the effects of repetition exercise on the vascular endothelial function determined by flow-mediated vasodilation (FMD). Eleven healthy male subjects completed two exercise sessions on a cycle ergometer in a counterbalanced order. The exercise sessions were 20 min cycling at 50% maximal work rate (Wmax) (continuous exercise, CE) and 20 × 20-sec intervals at 100%Wmax interspersed with 40-sec intervals at complete rest (repetition exercise, RE). Before and after each protocol, the brachial systolic and diastolic blood pressure were measured in the supine position. Relative FMD was assessed at rest and 30 and 60 min after each exercise regimen, and then the normalized FMD (nFMD) was calculated from the peak shear rate. The FMD significantly increased 30 min after RE (8.2 ± 1.5% to 11.5 ± 3.1%, p<0.01) and non-significantly increased 30 min after CE (7.5 ± 1.6% to 8.1 ± 2.1%, n.s.) before returning to baseline at 60 min after both exercise regimens. The FMD value at 30 min after RE was significantly greater than that at 30 min after CE (p<0.01). The nFMD (a.u.) significantly increased 30 min after RE (1.38 ± 0.64 to 2.00 ± 0.94, p<0.05) and non-significantly increased 30 min after CE (1.20 ± 0.54 to 1.49 ± 0.57, n.s.) before returning to baseline at 60 min after both exercise regimens. These results suggest that repetition exercise may lead to an acute improvement in the vascular endothelial function.

High-intensity interval exercise (IE) leads to greater improvements in the arterial function than continuous exercise at moderate intensity (CE). However, few studies have been performed on the effects of the repetition exercise (RE) on the vascular endothelial function. The purpose of this study was to compare the effects of CE vs. IE vs. RE during aerobic exercise on the vascular endothelial function determined by flow-mediated vasodilation (FMD). Ten healthy male subjects randomly performed 3 trials as follows: CE (20-min cycling at 50%W_max), IE (10 × 1-min intervals cycling at 75%W_max interspersed with 1-min intervals cycling at 25%W_max), and RE (30 × 20-sec intervals cycling at 100%W_max interspersed with 20-sec intervals at rest). FMD was assessed at rest and 30 and 60 min after each exercise, and then the normalized FMD (nFMD) was calculated from the peak shear rate. The nFMD (a.u.) significant increased 30 min after IE (1.2 ± 0.2 to 3.0 ± 1.0, p<0.05) and increased 30 min after CE (1.0 ± 0.2 to 1.4 ± 0.2, n.s.) and returned to baseline at 60 min after both exercises, while the nFMD decreased 30 min after RE (1.3 ± 0.2 to 1.2 ± 0.1, n.s.) and was sustained at 60 min. The nFMD value at 30 min after IE was significantly greater than that at 30 min after RE (3.0 ± 1.0 versus 1.2 ± 0.1, p<0.05). These results suggest that RE may lead to a less improvement in the vascular endothelial function than CE and IE.

Habitual exercise is important for improving or maintaining the arterial function with age. However, the role of functional fitness on arterial stiffness in the elderly is unclear. This study was conducted to examine the relationships between functional fitness and arterial stiffness in elderly woman. Four hundred and seventy-nine elderly woman participated in the present investigation. The systolic/diastolic blood pressure and brachial to ankle pulse wave velocity were obtained in the supine position using an automatic pulse wave form analyzer. Four items of functional fitness (standing/sitting, walking, hand working, and self-care working) were assessed. The measurement variables were calculated for five chronological classifications (60~64, 65~69, 70~74, 75~79 and 80 yrs or over). The four items of functional fitness and brachial to ankle pulse wave velocity increased linearly with age. A multiple stepwise regression analysis revealed that systolic blood pressure (β= 0.366), age (β= 0.225), heart rate (β= 0.188), body mass index (β= -0.102), and standing/sitting (β= 0.098) were independent contributors to brachial to ankle pulse wave velocity, accounting for 29.6% of the variability. The physical function, especially standing/sitting, influences the arterial function in elderly women.

Objective: To determine the factors affecting the antimicrobial effect of VCM on MRSA.
Study Design: Case series study.
Methods: This study was conducted on pneumonia patients admitted to a university-affiliated hospital between January 2000 and December 2008 and had MRSA in their sputum culture.  From seven days prior to the starting VCM administration through the end of the administration, detailed information such as underlying diseases, VCM serum concentration and quantity of MRSA were recorded.  Logistic regression analysis was carried out on current diseases, trough concentration, surgery experience, and the detection of Gram-negative bacteria to verify the antimicrobial effect of VCM.
Results: The number of subjects investigated this study was 55 subjects.  Multiple logistic regression analysis did not yield any significant factors when carried out using the factors affecting the antimicrobial effect of VCM on MRSA as independent variables.
Conclusions: Multivariable analysis yielded no factors as being significant in affecting the antimicrobial effect of VCM, but did indicate in that patients aged 70 and older, the antimicrobial effect of VCM was poor for MRSA.  This suggests that when pharmacists intervene in antimicrobial treatment for improved effects, it is important to consider not only the serum concentration of VCM, but also the background of the patient.

It is essential to prolong the term as possible in the treatment of threatened premature delivery. We report a case of threatened abortion successfully treated with hochuekkito. The patient was 31 year-old pregnant woman with lower abdominal pain. She was diagnosed to be at the risk of premature delivery on 21 weeks and 5 days of gestation. Intravenous ritodrine hydrochloride was started and she had to stay in bed. Severe side effects of ritodrine hydrochloride such as palpitation, tachycardia, tremor, nausea, and loss of appetite were appeared and she was consulted to our department on 23 weeks and 1 day of gestation. Those symptoms were markedly improved after administration of hochuekkito extract. She delivered a male infant of 1230g birth weight on 28 weeks of gestation. Hochuekkito suppressed severe side effects, and enabled to continue the infusion of ritodrine hydrochloride, suggesting the usefulness of Kampo therapy in the treatment of threatened premature delivery.

We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.