1.A Survey on Osteoporosis Treatment for Cancer Patients Provided by Designated Cancer Hospitals in Japan
Shun ISHII ; Takuya FUKUSHIMA ; Ryo KOZU ; Noriaki MIYATA ; Jiro NAKANO
Palliative Care Research 2024;19(1):59-66
Purpose: This study aimed to understand the details of osteoporosis treatment for cancer patients provided by designated cancer hospitals. Methods: This web-based survey included questions on the evaluation and treatment of osteoporosis in cancer patients provided by physicians in the departments of urology, gynecology, hematology, respiratory medicine, respiratory surgery, gastroenterology medicine and gastroenterology surfery. Results: The gynecology, hematology, breast surgery, and urology departments had high rates of bone densitometry and prescriptions of osteoporosis treatment for cancer patients. The most frequently used selection criteria were age, hormone therapy, and steroid use. Conclusion: Osteoporosis treatment and associated selection criteria for cancer patients is different in each department, so we need to educate the evaluation and treatment of cancer treatment-induced bone loss.
2.Importance of Initial Ambulation as a Factor Influencing Length of Hospital Stay after Surgery for Colorectal Cancer
Sachi HOKAMA ; Chiemi UEHARA ; Takuya FUKUSHIMA ; Yuki NAKASHIMA ; Tsuyoshi HARADA ; Seiko KAMEYAMA
The Japanese Journal of Rehabilitation Medicine 2024;():24006-
Objective:This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods:This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results:This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion:The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.
3.Importance of Initial Ambulation as a Factor Influencing Length of Hospital Stay after Surgery for Colorectal Cancer
Sachi HOKAMA ; Chiemi UEHARA ; Takuya FUKUSHIMA ; Yuki NAKASHIMA ; Tsuyoshi HARADA ; Seiko KAMEYAMA
The Japanese Journal of Rehabilitation Medicine 2024;61(9):877-886
Objective:This study investigated whether the day of initial ambulation during rehabilitation affects postoperative outcomes in patients with colorectal cancer.Methods:This retrospective observational study was conducted at the Urasoe General Hospital. Patients who underwent scheduled surgery and requested preoperative rehabilitation between June 2019 and December 2021 were included in this study. Patient characteristics and surgery- and rehabilitation-related data were retrieved from the medical records. The patients were divided into early- and late-discharge groups according to their median postoperative hospital stay. The cut-off value of initial ambulation during the postoperative hospital stay was calculated, and logistic regression analysis was performed to determine the impact of initial ambulation on delayed postoperative hospital stay.Results:This study included 184 patients. The cutoff value for initial ambulation during the postoperative hospital stay was three days. In the univariate analysis, rectal cancer, operation time, blood loss, postoperative complications of Clavien-Dindo classification grade II or higher, and the initial ambulation day were identified as potentially significant factors. In the multivariate analysis, which included these potentially significant factors as input variables, postoperative complications, operation time, and the initial ambulation day were determined to be significant independent factors affecting postoperative hospital stay.Conclusion:The initial ambulation day can affect postoperative hospital stay in patients with colorectal cancer. It is important that the rehabilitation interventions undertaken after colorectal cancer surgery facilitate ambulation within the third postoperative day.
4.Accuracy verification of dental cone-beam computed tomography of mandibular incisor root canals and assessment of its morphology and aging-related changes
Katsuyuki AOKI ; Masamitsu SERIKAWA ; Takuya HARADA ; Akinobu USAMI
Anatomy & Cell Biology 2023;56(2):185-190
The root canal morphology undergoes aging-related changes, and relevant quantitative analyses have not yet been reported. We compared the cone beam computed tomography (CBCT) and micro-computed tomography (microCT) scans of extracted mandibular incisors to check the accuracy of morphological measurements. Thereafter, the root canal morphology and aging-related changes in the mandibular incisors of Japanese individuals were assessed using CBCT.Six extracted teeth were fixed in a phantom head and imaged using CBCT and micro-CT. The correlation between the findings of the two imaging modalities was examined. Further, CBCT reconstructed images of the mandibular incisors of 81 individuals were observed. Age-related changes of the root canals were compared between participants aged <30 years and those aged ≥30 years. The CBCT and micro-CT findings regarding the root canals of the extracted teeth coincided in 94.4% of the cases. Mandibular incisors exhibiting two root canals in either cross-section accounted for 9.9% of central incisors and 12.4% of lateral incisors. Mandibular central incisors with two root canals were observed in two (6.3%) individuals aged <30 years and six (12.2%) aged ≥30 years. Mandibular lateral incisors with two root canals were observed in one (3.1%) individual aged <30 years and nine (18.4%) aged ≥30 years. CBCT allows accurate evaluation of complex root canal morphologies and is useful for endodontic preoperative assessment. Mandibular incisors have more frequent occurrence of two root canals with aging.
5.The Details of Inpatient Cancer Rehabilitation Provided by Designated Cancer Hospitals in Japan
Takuya FUKUSHIMA ; Tetsuya TSUJI ; Jiro NAKANO ; Shun ISHII ; Shinsuke SUGIHARA ; Hiroshi SATO ; Juichi KAWAKAMI ; Hitoshi KAGAYA ; Akira TANUMA ; Ryuichi SEKINE ; Keita MORI ; Sadamoto ZENDA ; Akira KAWAI
Palliative Care Research 2023;18(2):143-152
Objective: This study aimed to clarify the details of inpatient cancer rehabilitation interventions provided by designated cancer hospitals in Japan. Methods: This questionnaire-based survey asked specialists regarding the outline of their facilities’ inpatient cancer rehabilitation, Dietz classification, disease, and intervention details. Results: Restorative interventions were the most common, and the most common cancer was lung cancer followed by colorectal cancer; hematologic malignancy; gastric cancer; and liver, gallbladder, and pancreatic cancer. Intervention proportions for colorectal and gastric cancer were significantly higher in general hospitals than in university hospitals and cancer centers; in contrast, those for hematological malignancy were significantly higher in university hospitals than in general hospitals. For bone and soft tissue sarcomas, intervention proportions in cancer centers were significantly higher than those in university and general hospitals; and for oral, pharyngeal, and laryngeal cancers, they were significantly higher in university hospitals and cancer centers than in general hospitals. The most common intervention was walking training, followed by resistance training, basic motor training, activities of daily living training, and respiratory rehabilitation. Respiratory rehabilitation was performed significantly more frequently in university and general hospitals than in cancer centers.Conclusion: The diseases had differed according to the characteristics of the facilities, and the interventions were considered accordingly. In future, it will be necessary to verify the effectiveness of inpatient cancer rehabilitation according to facility characteristics and to disseminate information on inpatient cancer rehabilitation.
6.Yokukansan Suppresses Gastric Hypersensitivity and Eosinophil-associated Microinflammation in Rats With Functional Dyspepsia
Shaoqi DUAN ; Nobuko IMAMURA ; Takashi KONDO ; Hirosato KANDA ; Yoko KOGURE ; Takuya OKUGAWA ; Masashi FUKUSHIMA ; Toshihiko TOMITA ; Tadayuki OSHIMA ; Hirokazu FUKUI ; Koichi NOGUCHI ; Yi DAI ; Hiroto MIWA
Journal of Neurogastroenterology and Motility 2022;28(2):255-264
Background/Aims:
Herbal medicine is an important complementary therapy for functional dyspepsia (FD). However, its effect against gastric hypersensitivity in patients with FD has rarely been evaluated. Yokukansan (YKS), a traditional Japanese herbal medicine, is effective against neuropathic and inflammatory pain. This study aims to use a maternal separation (MS) stress-induced FD model to investigate the effects of YKS against gastric hypersensitivity, gastric motility, and duodenal micro-inflammation.
Methods:
The MS stress model was established by separating newborn Sprague-Dawley rats from their mothers for 2 hours a day from postnatal days 1 to 10. At the age of 7-8 weeks, the rats were treated with YKS at a dose of 5 mL/kg (1 g/kg) for 7 consecutive days. AfterYKS treatment, electromyographic activity in the acromiotrapezius muscle by gastric distention and the gastric-emptying rate were assessed. Immunohistochemical analysis of eosinophils in the duodenum and phosphorylated extracellular signal-regulated kinase(p-ERK) 1/2 in the spinal cord was performed.
Results:
YKS treatment suppressed MS stress-induced gastric hypersensitivity and decreased the elevated levels of p-ERK1/2 in the spinal cord.In the gastroduodenal tract, YKS inhibited eosinophil-associated micro-inflammation but did not improve gastric dysmotility.
Conclusions
YKS treatment improved gastric hypersensitivity by alleviating eosinophil-associated micro-inflammation in the gastroduodenal tract.This treatment may be considered an effective therapeutic option for epigastric pain and micro-inflammation in patients with FD.
7.Hip Extensor Strength Influences Dynamic Postural Changes during Gait in Patients with Adult Spinal Deformity: A Cross-Sectional Study Using Three-Dimensional Motion Analysis
Keita SATO ; Ryoji TOMINAGA ; Tatsuya ENDO ; Takuya MIURA ; Masumi IWABUCHI ; Toshikazu ITO ; Osamu SHIRADO
Asian Spine Journal 2022;16(5):643-650
Methods:
Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis.
Results:
Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=−0.41, R2=0.12).
Conclusions
We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.
8.Factors Associated with Fatigue in Patients with Hematological Malignancies Undergoing Chemotherapy
Shun ISHII ; Ayumi NATSUZAKO ; Takuya FUKUSHIMA ; Ryo KOZU ; Noriaki MIYATA ; Jiro NAKANO
Palliative Care Research 2022;17(4):181-189
Objective: This study aimed to identify factors associated with fatigue in patients with hematological malignancies undergoing chemotherapy. Method: A total of 90 patients with hematological malignancies undergoing chemotherapy were enrolled in this study. Simple regression analysis was performed using total, physical, emotional, and cognitive fatigue as dependent variables. On the other hand, the patient’s sex, age, blood test findings, physical function, activities of daily living (ADL), performance status, presence or absence of anxiety or depression, physical symptoms, and nutritional status were used as independent variables. Multiple regression analysis was conducted with the items that showed significant differences in the simple regression analysis as independent variables. Results: Multiple regression analysis with total fatigue as the dependent variable identified depression as an associated factor. Additionally, physical fatigue was noted to be associated with pain and depression, while emotional fatigue was reported to be associated with ADL and depression. Conclusion: Our results suggest that patients with hematological malignancies who have symptoms of fatigue should be managed taking in consideration possible causes of their fatigue, such as depression, pain, and ADL.
9.Relationship between Lower Limb Pain Intensity and Dynamic Lumbopelvic-Hip Alignment in Patients with Degenerative Lumbar Spinal Canal Stenosis: A Cross-Sectional Study
Takuya MIURA ; Ryoji TOMINAGA ; Keita SATO ; Tatsuya ENDO ; Masumi IWABUCHI ; Toshikazu ITO ; Osamu SHIRADO
Asian Spine Journal 2022;16(6):918-926
Methods:
Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups.
Results:
Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group.
Conclusions
Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.
10.The Effect of a Behavior Change Intervention with Feedback on Motor Function and Physical Activity for Patients with Hematological Malignancies Undergoing Chemotherapy: A Historical Controlled Study
Shun ISHII ; Ayumi NATSUZAKO ; Takuya FUKUSHIMA ; Ryo KOZU ; Noriaki MIYATA ; Jiro NAKANO
Palliative Care Research 2021;16(2):123-131
Objective: This study aimed to investigate the effectiveness of an intervention that applied a behavioral change approach to the usual rehabilitation for patients with hematological malignancies undergoing chemotherapy. Methods: Patients with hematological malignancies undergoing chemotherapy were divided into two groups: patients who underwent conventional rehabilitation (control group, n=12) and a counterpart who received a behavioral change intervention with feedback on motor function and physical activity (feedback group, n=13). We analyzed the changes in motor function and physical activity between the two groups from the start of rehabilitation to discharge. Results: There were a significant difference in walking speed between baseline and discharge. Changes in weekly steps were significantly higher in the feedback group than those in the control group. Conclusion: A behavioral change intervention with feedback on motor function and physical activity may improve voluntary exercise in patients with hematological malignancies undergoing chemotherapy.


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