Demonstration of immunoglobulin G in normal human epidermis by peroxidase-labeled antibody.

Cytoplasmic immunoglobulin G (IgG) in normal human epidermis was defined by a peroxidase-labeled antibody method. A correlation between cytoplasmic staining and the serum level of IgG was found. Epidermal cells containing IgG were not present when the serum level of IgG was less than 1000 microgram/ml.</p

Cardiovascular adverse reactions associated with escitalopram in patients with underlying cardiovascular diseases: a systematic review and meta-analysis

BackgroundDespite the anticipated efficacy of escitalopram in treating depression and anxiety in individuals with preexisting cardiovascular conditions, persistent concerns regarding its adverse effects have emerged. In this systematic review, we aimed to evaluate the cardiovascular safety profile of escitalopram compared with that of placebo in patients with underlying cardiovascular disease.MethodsWe used a predefined search strategy in PubMed, Cochrane Central Register of Controlled Trials, Embase, International Clinical Trials Registry Platform, and ClinicalTrials.gov to identify studies evaluating adverse cardiovascular reactions to escitalopram in patients with underlying cardiovascular disease. Randomized controlled trials (RCTs) that provided results on cardiovascular safety outcomes were included. Two independent reviewers screened the abstracts and full texts of the individual studies. The risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.ResultsThe primary outcomes were the frequency of major adverse cardiovascular events (MACE), QTc prolongation, and discontinuation of study medication. We identified 5 RCTs with 773 participants who met the inclusion criteria. Escitalopram was not associated with significantly increased risk of MACE (risk ratio [RR] = 1.85; 95% confidence interval [CI] 0.80 to 4.26; I2 0%; 5 RCTs; n = 773, moderate certainty of evidence), discontinuation of study medication (RR = 1.03; 95% CI 0.84–1.26; I2 0%; 5 RCTs; n = 773, low certainty of evidence), and QTc prolongation (RR = 1.20; 95% CI 0.76–1.90; I2 0%; 4 RCTs; n = 646, low certainty of evidence).ConclusionEscitalopram does not significantly increase the risk of cardiovascular adverse reactions compared with placebo in patients with underlying cardiovascular disease. However, the presence of wide CIs and the limited number of included studies highlight the need for further studies with larger sample sizes to enhance the precision and reliability of these findings.Systematic review registration: International Prospective Register of Systematic Reviews [CRD42022298181]

Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia A Global Call to Action

Q1Q1Artículo completoE1-E13IMPORTANCE Familial hypercholesterolemia (FH) is an underdiagnosed and undertreated genetic disorder that leads to premature morbidity and mortality due to atherosclerotic cardiovascular disease. Familial hypercholesterolemia affects 1 in 200 to 250 people around the world of every race and ethnicity. The lack of general awareness of FH among the public and medical community has resulted in only 10% of the FH population being diagnosed and adequately treated. The World Health Organization recognized FH as a public health priority in 1998 during a consultation meeting in Geneva, Switzerland. The World Health Organization report highlighted 11 recommendations to address FH worldwide, from diagnosis and treatment to family screening and education. Research since the 1998 report has increased understanding and awareness of FH, particularly in specialty areas, such as cardiology and lipidology. However, in the past 20 years, there has been little progress in implementing the 11 recommendations to prevent premature atherosclerotic cardiovascular disease in an entire generation of families with FH. OBSERVATIONS In 2018, the Familial Hypercholesterolemia Foundation and the World Heart Federation convened the international FH community to update the 11 recommendations. Two meetings were held: one at the 2018 FH Foundation Global Summit and the other during the 2018 World Congress of Cardiology and Cardiovascular Health. Each meeting served as a platform for the FH community to examine the original recommendations, assess the gaps, and provide commentary on the revised recommendations. The Global Call to Action on Familial Hypercholesterolemia thus represents individuals with FH, advocacy leaders, scientific experts, policy makers, and the original authors of the 1998 World Health Organization report. Attendees from 40 countries brought perspectives on FH from low-, middle-, and high-income regions. Tables listing country-specific government support for FH care, existing country-specific and international FH scientific statements and guidelines, country-specific and international FH registries, and known FH advocacy organizations around the world were created. CONCLUSIONS AND RELEVANCE By adopting the 9 updated public policy recommendations created for this document, covering awareness; advocacy; screening, testing, and diagnosis; treatment; family-based care; registries; research; and cost and value, individual countries have the opportunity to prevent atherosclerotic heart disease in their citizens carrying a gene associated with FH and, likely, all those with severe hypercholesterolemia as well

Clinical characteristics and social frailty of super-elderly patients with heart failure: The Kitakawachi clinical background and outcome of heart failure registry

Kensuke Takabayashi, Akihiro Ikuta, Yoshinori Okazaki, Mariko Ogami, Kotaro Iwatsu, Koichi Matsumura, Tsutomu Ikeda, Tahei Ichinohe, Yuko Morikami, Takashi Yamamoto, Ryoko Fujita, Kotoe Takenaka, Hiroyuki Takenaka, Yoshisumi Haruna, Hiroyuki Muranaka, Masaaki Ozaki, Tetsuhisa Kitamura, Shouji Kitaguchi, Ryuji Nohara, Clinical Characteristics and Social Frailty of Super-Elderly Patients With Heart Failure　― The Kitakawachi Clinical Background and Outcome of Heart Failure Registry ―, Circulation Journal, 2017, Volume 81, Issue 1, Pages 69-76, Released December 22, 2016, [Advance publication] Released November 30, 2016, Online ISSN 1347-4820, Print ISSN 1346-9843, https://doi.org/10.1253/circj.CJ-16-0914, https://www.jstage.jst.go.jp/article/circj/81/1/81_CJ-16-0914/_article/-char/e

テイアン カラ ドウイ ニ イタル カイワ ノ ブンセキ ニホンゴ ボゴ ワシャ ト ニホンゴ ヒボゴ ワシャ ノ カダイ カイケツ オ メザス カイワ データ オ モト ニ

本稿では,課題解決型の話し合いにおいて,ほとんど面識のない日本語母語話者(NS)と日本語非母語話者(NNS)がどのように提案をし,同意に至っているのか,その過程と言語表現に着目して分析した。その結果,提案から同意に至る会話の流れの型には,提案の発話から始まるものと,意見要求など何らかの前置きをした後に提案を行なうものの,2つのパターンが見られた。会話の流れと提案の表現形式との関連を見ると,提案の発話から始まるものは直接的な表現が多用されていたが,前置きの後に提案をする場合には,相手に判断を求める表現や断定を避ける表現,可能性を示す表現が用いられており,より例示的,暗示的な表現を用いる傾向があった。また,話している内容と会話の流れの型にもある一定の傾向が見られた。写真の分類など意見の一致が容易でありそうな場合には,提案の発話から始まるものが多かったが,会話参加者の意見の一致が難しい場合やこれまでの話の内容とは全く異なる提案を行なう場合には前置きから提案を行なうという流れが多かった。また,会話者の人間関係と会話の流れとの関連を見ると,初対面の会話参加者の場合,上下関係や指示系統が確立されていないためか,決定を促したり行なったりする流れは見られず,会話参加者が協力して提案や理由述べを行なっていた。これは,初対面の場合,参加者間の関係が明確でないため,できるだけ良好な雰囲気で会話を進め,より良い人間関係の構築を目指そうとしているためではないかと考えられる

テイアン カラ ドウイ ニ イタル カイワ ノ ブンセキ ニホンゴ ボゴ ワシャ ト ニホンゴ ヒボゴ ワシャ ノ カダイ カイケツ オ メザス カイワ データ オ モト ニ

本稿では,課題解決型の話し合いにおいて,ほとんど面識のない日本語母語話者(NS)と日本語非母語話者(NNS)がどのように提案をし,同意に至っているのか,その過程と言語表現に着目して分析した。その結果,提案から同意に至る会話の流れの型には,提案の発話から始まるものと,意見要求など何らかの前置きをした後に提案を行なうものの,2つのパターンが見られた。会話の流れと提案の表現形式との関連を見ると,提案の発話から始まるものは直接的な表現が多用されていたが,前置きの後に提案をする場合には,相手に判断を求める表現や断定を避ける表現,可能性を示す表現が用いられており,より例示的,暗示的な表現を用いる傾向があった。また,話している内容と会話の流れの型にもある一定の傾向が見られた。写真の分類など意見の一致が容易でありそうな場合には,提案の発話から始まるものが多かったが,会話参加者の意見の一致が難しい場合やこれまでの話の内容とは全く異なる提案を行なう場合には前置きから提案を行なうという流れが多かった。また,会話者の人間関係と会話の流れとの関連を見ると,初対面の会話参加者の場合,上下関係や指示系統が確立されていないためか,決定を促したり行なったりする流れは見られず,会話参加者が協力して提案や理由述べを行なっていた。これは,初対面の場合,参加者間の関係が明確でないため,できるだけ良好な雰囲気で会話を進め,より良い人間関係の構築を目指そうとしているためではないかと考えられる

Flowchart of discontinuation from continuum care.

<p>Flowchart of discontinuation from continuum care.</p