Association between gefitinib and hemorrhagic cystitis and severely contracted bladder: a case report

<p>Abstract</p> <p>Background</p> <p>Gefitinib remains an excellent treatment option for patients with a variety of cancers, including non small cell lung cancer (NSCLC). However, clinicians must be aware of the potential of gefitinib to cause an inflammatory reaction in the skin, lungs and bladder.</p> <p>Case Presentation</p> <p>We present a case on hemorrhagic cystitis and severaly contracted bladder in a patient with NSCLC on gefitinib.</p> <p>Conclusions</p> <p>Further studies are needed to substantiate the association of gefitinib therapy with hemorrhagic cystitis and contracted bladder.</p

Differences in Velopharyngeal Structure during Speech among Asians Revealed by 3-Tesla Magnetic Resonance Imaging Movie Mode

Objective. Different bony structures can affect the function of the velopharyngeal muscles. Asian populations differ morphologically, including the morphologies of their bony structures. The purpose of this study was to compare the velopharyngeal structures during speech in two Asian populations: Japanese and Thai. Methods. Ten healthy Japanese and Thai females (five each) were evaluated with a 3-Tesla (3 T) magnetic resonance imaging (MRI) scanner while they produced vowel-consonant-vowel syllable (/asa/). A gradient-echo sequence, fast low-angle shot with segmented cine and parallel imaging technique was used to obtain sagittal images of the velopharyngeal structures. Results. MRI was carried out in real time during speech production, allowing investigations of the time-to-time changes in the velopharyngeal structures. Thai subjects had a significantly longer hard palate and produced shorter consonant than Japanese subjects. The velum of the Thai participants showed significant thickening during consonant production and their retroglossal space was significantly wider at rest, whereas the dimensional change during task performance was similar in the two populations. Conclusions. The 3 T MRI movie method can be used to investigate velopharyngeal function and diagnose velopharyngeal insufficiency. The racial differences may include differences in skeletal patterns and soft-tissue morphology that result in functional differences for the affected structures

Relationship between patients' characteristics and efficacy of calcimimetics for primary hyperparathyroidism in the elderly

Calcimimetic treatment has been reported to be effective for primary hyperparathyroidism (PHPT). Nine elderly PH PT patients who had been treated with calcimimetics were retrospectively analyzed. It was found that calcimimetics can reduce elevated serum calcium levels in elderly PHPT patients with low femoral DEXA %YAM and low urinary cAMP levels

Clinical Relevance of Blood Glucose and Gastroesophageal Reflux Symptoms to Depressive Status in Patients with Type 2 Diabetes Mellitus

A relationship between diabetes and depression is apparent. To clarify the clinical relevance of diabetic patients’ gastroesophageal symptoms to their psychological status, we retrospectively analyzed the data from a Selfrating Depression Scale (SDS) and a Frequency Scale for Symptoms of Gastroesophageal reflux disease (FSSG) among 143 type 2 diabetic patients who visited a general medicine department. Among the 45 Japanese patients enrolled, the group with relatively high SDS scores (≥ 36) showed higher (FSSG) dysmotility symptom scores versus the low-SDS (< 36) group, although the 2 groups’ characteristics and laboratory data were not significantly different. Positive correlations of postprandial plasma glucose (PPG) levels with FSSG scores (R=0.321, p<0.05), particularly with reflux scores (R=0.455, p<0.01) were revealed. PPG and HbA1c levels were not correlated with SDS scores. The patients’ SDS scores were significantly correlated with their FSSG scores (R=0.41, p<0.01), suggesting that depressive status is linked to GERD-related manifestations. Considering that the patients’ PPG levels were correlated with GERD-related symptoms, diabetic patients’ blood glucose levels are associated with depressive status. Collectively, key symptoms related to GERD and glucose level values would be helpfu

Clinical Manifestations of Patients with Influenza Differ by Age : A Prospective, Multi-centered Study in the Setouchi Marine Area

Influenza potentially has a high mortality rate when it affects the elderly. We aimed to examine the differences in clinical manifestations in patients with influenza according to their age. This multicenter prospective study was performed in six medical institutions in Okayama and Kagawa prefectures (Japan). Between December 1, 2019 and March 31, 2020, we collected data on adult patients diagnosed with influenza type A, who were strat-ified into younger (20-49 years), middle-aged (50-64 years), and older groups (≥ 65 years). We compared the presence or absence of fever, respiratory symptoms, and extrapulmonary symptoms according to age group. In total, 203 patients (113, younger; 51, middle-aged; and 39, older) were eligible for the analysis. The maxi-mum body temperature and temperature at first physician visit in the older group were significantly lower than those in the younger group. The incidence of respiratory symptoms was not different among the three groups. Chills, muscle pain, and arthralgia as systemic symptoms were noted significantly more frequently in the younger (80.9%) and middle-aged (75.5%) groups than in the older group (51.3%) (p = 0.002). Fever and sys-temic symptoms were less likely to appear in older patients, possibly resulting in the delaying of hospital visits among older adults

Antimicrobial prescription practices for outpatients with acute respiratory tract infections: A retrospective, multicenter, medical record-based study

Antimicrobial stewardship for outpatients with acute respiratory tract infections (ARTIs) should be urgently promoted in this era of antimicrobial resistance. Previous large-sample studies were based on administrative data and had limited reliability. We aimed to identify current antimicrobial prescription practices for ARTIs by directly basing on medical records. This multicenter retrospective study was performed from January to December in 2018, at five medical institutes in Japan. We targeted outpatients aged >= 18 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting ARTIs. We divided the eligible cases into three age groups (18-64 years, 65-74 years, and >= 75 years). We defined broad-spectrum antimicrobials as third-generation cephalosporins, macrolides, fluoroquinolones, and faropenem. Primary and secondary outcomes were defined as the proportion of antimicrobial prescriptions for the common cold and other respiratory tract infections, respectively. Totally, data of 3,940 patients were collected. Of 2,914 patients with the common cold, 369 (12.7%) were prescribed antimicrobials. Overall, compared to patients aged >= 75 years (8.5%), those aged 18-64 years (16.6%) and those aged 65-74 years (12.1%) were frequently prescribed antimicrobials for the common cold (odds ratio [95% confidential interval]; 2.15 [1.64-2.82] and 1.49 [1.06-2.09], respectively). However, when limited to cases with a valid diagnosis of the common cold by incorporating clinical data, no statistical difference was observed among the age groups. Broad-spectrum antimicrobials accounted for 90.2% of the antimicrobials used for the common cold. Of 1,026 patients with other respiratory infections, 1,018 (99.2%) were bronchitis, of which antimicrobials were prescribed in 49.9% of the cases. Broad-spectrum antimicrobials were the main agents prescribed, accounting for nearly 90% of prescriptions in all age groups. Our data suggested a favorable practice of antimicrobial prescription for outpatients with ARTIs in terms of prescribing proportions, or quantitative aspect. However, the prescriptions were biased towards broad-spectrum antimicrobials, highlighting the need for further antimicrobial stewardship in the outpatient setting from a qualitative perspective

ダンスの習熟過程における運動時心拍数の変化について

本研究は,フィリピン地方で踊られている民族舞踊のBamboo Danceを参考にしてつくった,簡単なダンスを習熟する過程で,その運動強度が,習熟の度合いに応じてどのように変化するものかを実験的に追究した。実験はそれぞれの習熟段階における心拍数の測定をおこなった。また,運動中の心拍数は,その時の気象や身体条件により多少の反応を異にすることから,ダンスの実験終了後,一定条件のもとでの自転車漕ぎ運動を行なわせ,そのときの心拍数を測定しダンス中の心拍数の変化の意義を追究する一助とした。なお運動中の心拍数測定には,胸部双極誘導法によるテレメーターを使用した。これらの実験から次のような結果が得られた。1)ダンス中の心拍数の変動は,運動開始2分20秒後には毎分150から165位のほぼ定常状態を示している。さらに各習熟段階における運動中の最高心拍数では,技術的に未熟な段階での第1回目の実験で156であり,ほぼ完全に習熟したと思われる第5回目の実験では170と,回を重ねるにつれて高い値を示す傾向がみられた。2)自転車漕ぎ運動における心拍数の変動は,運動開始1分40秒後には毎分130から140位のほぼ定常状態を示している。さらに運動中の最高心拍数は,第1回目の実験で158,第3回目で146,第5回目では139と,回を重ねるに従い低い値を示し,ダンスの場合とまったく逆の傾向を示している。3)以上の成績から,全く同じリズム,運動時間,動作でありながら,技術的に上達するに従ってその運動中の心拍数は,高い値を示すことがわかった。このことは,技術的に高い水準に達すれば,その技術が未熟な段階にくらべて,緊張と解緊のタイミングがよくなり,さらにそれにともなって動きも大きくダイナミックなものとなり,同じダンスでもその運動量が増大するためと考えられる。Experimental studies were perfomed on how the intensities of exercises would vary with the degrees of mastering the technics of a dance. In this experiment a folk dance in the Philippines was chosen and moditied to a simplified form. The results revealed that the heart rates during the exercises got higher with the mastering the technics, though the rhythm, time and movement were kept same in every performance. This finding would be attributed to the possibility that as the technical of the dance became better the timing between the tension and the relaxation become better in comparison with those at the unskilled stage. The movement got spontaneous causing larger amounts of exercises even in the case of the same dance

ダンス指導における伴奏音楽の効果 : 二拍子のBalance-Stepについて

The purpose of this study is to clarify the effects of accompaniment music in performing the duple time balance-steps. For this purpose, two experiments (Melody-Steps-Test and Beat-Steps-Test) were conducted. Subjects were nineteen junior high school girls and eighteen female college students. The results were as follows: 1) The mean value of time lags of Melody-Steps-Test was significantly shorter than that of Beat-Steps-Test. 2) At Melody-Steps, a tendency of change in compliance with the feeling of music was observed. But it didn\u27t appear at Beat-Steps. 3) In the case of experiments of junior high school girls, subjects were homogeneously divided into two groups. All subjects of Melody-Steps group could work well, but two subjects of Beat-Steps group couldn\u27t perform to the rhythm. From the above results, for the training of duple time balance-steps, it seems that the use of the most suitable accompaniment music to its motion was more effective than that of the monotonous beat sounds