A Case Report of Oral Care for a Patient of Nasu-Hakola Disease with Teeth Clenching Habit

那須-ハコラ病は膜性脂肪異栄養症による多発性の骨の嚢胞様病変と若年性痴呆を主症状とする大変まれな疾患である.平成16年2月28日,誤嚥性肺炎予防のために口腔内の衛生管理を求め後藤病院歯科に51歳の寝たきり女性が紹介された.患者は27歳時に那須-ハコラ病と診断され,16年前から多発性の病的骨折と痴呆症のために寝たきりとなった.平成15年の暮れから度重なる肺炎罹患のために後藤病院整形外科に入院している.患者の下顎骨には大きなエックス線透過病変が認められ,易骨折性が示唆された.また,くいしばり癖のために口腔清掃時に開口器の使用が必要と考えられた.パロティスロール^を上下顎間歯肉頬移行部に用い開口させ,吸引チューブ付き歯ブラシで刷掃することで,口腔衛生状態を良好に保ち,誤嚥性肺炎を防止することが可能であった.Nasu-Hakola disease is an extremely rare disease characteristied by multiple cystic bone lesions due to membranous lipodystrophy and pre-senile dementia. On February 28, 2004, a 51-year-old bedridden woman was referred to the dental department of Goto Hospital for the management of oral hygiene for the to prevention of aspiration pneumonia. She had caught Nasu-Hakola disease from a 27-year-old. Sixteen years, she became bedridden because of multiple pathological fractures and dementia. She had frequent bouts of pneumonia from the end of 2003 and was admitted to Orthopedics of Goto Hospital. Bilateral large cystic radiolucent areas, which could easily cause pathological fractures, were observed in her mandibular bone. Because of her teeth clenching habit, it was difficult to clean her mouth clean without using mouth opener. Inter-maxillary weak force using buccal application of Parotisroll^ to open her mouth and brushing combined with a suction tube had good results for keeping good oral hygiene and for the prevention of aspiration pneumonia.10KJ00004293440症例CASE REPORTdepartmental bulletin pape

Clinical effectiveness of four neuraminidase inhibitors (oseltamivir, zanamivir, laninamivir, and peramivir) for children with influenza A and B in the 2014-2015 to 2016-2017 influenza seasons in Japan

The clinical effectiveness of four neuraminidase inhibitors (NAIs) (oseltamivir, zanamivir, laninamivir, and peramivir) for children aged 0 months to 18 years with influenza A and B were investigated in the 2014-2015 to 2016-2017 influenza seasons in Japan. A total of 1207 patients (747 with influenza A and 460 with influenza B) were enrolled. The Cox proportional-hazards model using all of the patients showed that the duration of fever after administration of the first dose of the NAI was shorter in older patients (hazard ratio = 1.06 per 1 year of age, p < 0.001) and that the duration of fever after administration of the first dose of the NAI was shorter in patients with influenza A infection than in patients with influenza B infection (hazard ratio = 2.21, p < 0.001). A logistic regression model showed that the number of biphasic fever episodes was 2.99-times greater for influenza B-infected patients than for influenza A-infected patients (p < 0.001). The number of biphasic fever episodes in influenza A-or B-infected patients aged 0-4 years was 2.89-times greater than that in patients aged 10-18 years (p = 0.010), and the number of episodes in influenza A-or B-infected patients aged 5-9 years was 2.13times greater than that in patients aged 10-18 years (p = 0.012)