Carotid artery calcification at the initiation of hemodialysis is a risk factor for cardiovascular events in patients with end-stage renal disease: a cohort study

<p>Abstract</p> <p>Background</p> <p>Vascular calcification has been recognized as a risk factor for cardiovascular (CV) events in patients with end-stage renal disease (ESRD). However, the association of carotid artery calcification (CAAC) with CV events remains unknown. The aim of this study was to elucidate whether CAAC is associated with composite CV events in ESRD patients.</p> <p>Methods</p> <p>One-hundred thirty-three patients who had been started on hemodialysis between 2004 and 2008 were included in this retrospective cohort study. These patients received multi-detector computed tomography to assess CAAC at the initiation of hemodialysis. Composite CV events, including ischemic heart disease, heart failure, cerebrovascular diseases, and CV deaths after the initiation of hemodialysis, were examined in each patient.</p> <p>Results</p> <p>CAAC was found in 94 patients (71%). At the end of follow-up, composite CV events were seen in 47 patients: ischemic heart disease in 20, heart failure in 8, cerebrovascular disease in 12, and CV deaths in 7. The incidence of CAAC was 87% in patients with CV events, which was significantly higher than the rate (62%) in those without. Kaplan-Meier analysis showed a significant increase in composite CV events in patients with CAAC compared with those without CAAC (p = 0.001, log-rank test). Univariate analysis using a Cox hazards model showed that age, smoking, common carotid artery intima-media thickness and CAAC were risk factors for composite CV events. In multivariate analysis, only CAAC was a significant risk factor for composite CV events (hazard ratio, 2.85; 95% confidence interval, 1.18-8.00; p = 0.02).</p> <p>Conclusions</p> <p>CAAC is an independent risk factor for CV events in ESRD patients. The assessment of CAAC at the initiation of hemodialysis is useful for predicting the prognosis.</p

Abscess of ligamentum teres hepatis

Ligamentum teres hepatis (LTH) abscess is extremely rare, with few case reports stating that surgical excision should be considered rather than conservative treatment. We report a case of LTH abscess in a child with successful conservative therapy. A 1-month-old girl was transferred from another hospital due to a space-occupying lesion in the liver. Contrast enhanced computed tomography and abdominal ultrasonography revealed an LTH abscess. Staphylococcus aureus was identified from the abscess contents. Cefazoline was administered for 14 days, after which the lesion could not be identified with ultrasonography. The abscess had not recurred by the 6-month outpatient clinic follow-up visit. Unlike other reported cases, in our case, the abscess decreased in size with conservative treatment, thus our case could be improved. Keywords: Abscess, Ligamentum teres hepatis, Falciform ligamen

The trial of animal assisted education in kindergarten : Study on the effect of interaction with living things on the daily rhythm of preschool children

附属三原幼稚園において,「①年長児に対する生き物を通した活動に関する調査②園児の生活リズムモニタリング法の開発」を行った。①では,保護者に発行している「組だより」の内容を分析して生き物にかかわる活動の抽出,活動の位置づけを考察した。その結果,生き物を介在することで,理科的な知識だけでなく,異年齢間の交流や身体的活動の促進,命の不思議さに対する興味への動機付けなどにつながり,園児の生活リズム付けにも貢献することがわかった。②では,アクティウオッチを園児の非利き腕に2日間装着して測定し,生活リズムのモニタリングを行った。今回の調査から,アクティウオッチを用いた方法は,園児の日常の活動に支障なく,正確にデータを記録できたことから有効であると考えられる