The Telehealth Program for Kindergarten and Nursery Teachers in Charge of Children with Behavioral Problems

This study provided a telehealth program for kindergarten and nursery teachers in charge of children with, or suspected of having, developmental disabilities. We examined teacher participation, behavior intervention plans (BIP), practice, and improvement of children’s behavior. Six sessions of online lectures and two online consultations based on functional behavioral assessments (FBA) were held. All ten teachers conducted the FBA, and seven created the BIP. Additionally, six out of seven teachers recorded their children’s problem behaviors, showing improvement in the problem behavior of these children. Moreover, the non-targeted problem behaviors also showed improvement following the intervention

Approach to the asymptomatic patients with Brugada syndrome

Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of coved-type ST segment elevation in the right precordial leads and an increased risk of sudden cardiac death (SCD) as a result of polymorphic ventricular tachyarrhythmia or ventricular fibrillation (VF). Data from large patient studies and a meta-analysis of previous reports have shown that patients with a history of syncope or SCD and a spontaneous type 1 Brugada type ECG are at high risk for SCD. However, risk stratification of asymptomatic patients with Brugada type ECG is still a challenge. In particular, the use of electrophysiological study (EPS) for risk stratification remains controversial. Although some investigators have reported the possibility of use of EPS for distinguishing between high- and low-risk patients with Brugada type ECG, no precise predictor of risk for SCD in asymptomatic patients has yet been determined. The approach to treatment of these patients is thus still unclear. Large clinical prospective studies with uniform diagnostic criteria and protocols for EPS as well as extended follow-up periods of over ten years are required for prediction of SCD

The effects of nifekalant hydrochloride on the spatial dispersion of repolarization after direct current defibrillation in patients with oral amiodarone and β-blocker therapy

AbstractBackgroundAlthough nifekalant hydrochloride (NIF) has been demonstrated to suppress ventricular tachyarrhythmias, especially electrical storms, the mechanism by which it does so is still unclear. We examined the effects of NIF on the spatial dispersion of repolarization (SDR) after implantable cardioverter-defibrillator (ICD) shock.Methods and ResultsIn 35 patients with oral amiodarone and β-blocker therapy, and an ICD, we recorded the 87-lead electrocardiogram during sinus rhythm (CONTROL-1 group) under general anesthesia, and just after the termination of induced ventricular fibrillation (VF) by ICD shock, with or without NIF administration. In all recordings, the corrected QT interval (QTc) was measured in each lead. The dispersion of QTc (QTc-D; maximum QTc minus minimum QTc) was also measured. Compared with that in the CONTROL-1 group, the QTc-D exhibited significant deterioration after ICD shock (61±14 and 90±19ms1/2, respectively; p<0.05). However, after the termination of induced VF by ICD shock with NIF administration, the QTc-D did not differ significantly from that in the CONTROL-1 group (63±20 and 61±14ms1/2, respectively).ConclusionsNIF suppressed the deterioration of the SDR after ICD shock. This might be one of the mechanisms by which NIF suppresses recurrence of ventricular tachyarrhythmia just after ICD shock in patients with oral amiodarone and β-blocker therapy

Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

Despite intensive lipid-lowering interventions, patients treated with statins develop atherosclerotic cardiovascular disease (ASCVD), and these patients have an increased risk of developing recurrent cardiovascular events during follow-up. Therefore, there is a need to focus on the residual risks in patients in statin therapy to further reduce ASCVD. The aim of this study was to retrospectively investigate the 10-year trend (2011-2019) regarding changes in polyunsaturated fatty acids (PUFAs) in patients with acute coronary syndrome (ACS) in a single center. We included 686 men and 203 women with ACS admitted to Kagawa Prefectural Central Hospital. Plasma PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-gamma-linolenic acid (DGLA), were measured at admission for suspected ACS. A secular decreasing trend in the levels of EPA and DHA and the EPA/AA ratio, but not of AA and DGLA, was observed. The analyses based on age (>70 or <70 years) and sex showed that the decreasing trend in the levels of EPA and DHA did not depend on age and remained significant only in men. Further studies are needed to obtain robust evidence to justify that the administration of n-3 PUFA contributes to the secondary prevention of ACS

Effect of Early Initiation of Evolocumab on Lipoprotein(a) in Patients with Acute Myocardial Infarction: Sub-Analysis of a Randomized Controlled Trial

Elevated circulating lipoprotein(a) levels are associated with an increased risk of cardiovascular events. We reported that early initiation of evolocumab, a proprotein convertase subtilisin/kexin type 9 inhibitor, in addition to a statin substantially reduced the lipoprotein(a) levels in patients with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). This sub-analysis sought to investigate the effect of evolocumab on lipoprotein(a) based on baseline lipoprotein(a) levels and characteristics. This study was a prespecified analysis of a randomized controlled trial that enrolled 102 patients who underwent primary PCI for AMI. Patients received pitavastatin (2 mg/day) alone or pitavastatin and evolocumab 140 mg subcutaneously within 24 h and 2 weeks after the index PCI. The evolocumab group showed significantly suppressed lipoprotein(a) levels in patients with baseline lipoprotein(a) levels of 20 mg/dL compared with the control group, as well as similar reductions in lipoprotein(a) levels in all patient subgroups. Among these subgroups, evolocumab tended to show more favorable effects in patients with diabetes mellitus. In AMI patients, early initiation of evolocumab therapy within 24 h of primary PCI suppressed the increase in lipoprotein(a) levels within 4 weeks, regardless of baseline levels and characteristics

Giant multiple caloric effects in charge transition ferrimagnet

磁場と圧力でマルチに冷却可能な酸化物新材料 --フェリ磁性電荷転移酸化物におけるマルチ熱量効果の実証--. 京都大学プレスリリース. 2021-06-22.Caloric effects of solids can provide us with innovative refrigeration systems more efficient and environment-friendly than the widely-used conventional vapor-compression cooling systems. Exploring novel caloric materials is challenging but critically important in developing future technologies. Here we discovered that the quadruple perovskite structure ferrimagnet BiCu₃Cr₄O₁₂ shows large multiple caloric effects at the first-order charge transition occurring around 190 K. Large latent heat and the corresponding isothermal entropy change, 28.2 J K⁻¹ kg⁻¹, can be utilized by applying both magnetic fields (a magnetocaloric effect) and pressure (a barocaloric effect). Adiabatic temperature changes reach 3.9 K for the 50 kOe magnetic field and 4.8 K for the 4.9 kbar pressure, and thus highly efficient thermal controls are achieved in multiple ways

Arterial infusion chemotherapy for the patient of unresectable pancreatic carcinoma with multiple liver metastases : a case report

Introduction : Despite various treatment trials for unresectable pancreatic carcinoma with liver metastases, the outcome has not been satisfactory. This paper reports a case of pancreatic carcinoma with multiple liver metastases that responded well to arterial infusion chemotherapy. Case report : A 65-year-old male was diagnosed with multiple liver tumors, and needle biopsy revealed adenocarcinoma. With endoscopic ultrasonography, a tumor in the pancreatic head was detected, and pancreatic carcinoma with multiple liver metastases was diagnosed. He received arterial infusion chemotherapy : cisplatin at a dose of 10mg/body/day and 500mg/body/day of 5-fluorouracil. After 14 days administration, liver metastases had decreased in number and size, but thereafter, because of hepatic arterial occlusion, the same dose of drugs was administered intravenously. The patient was discharged from the hospital and was given chemotherapy 3 days a week on an outpatient basis. Although the chemotherapy was effective, it was stopped because of severe general fatigue 5months after discharge. His general status continued to gradually worsen,and he died 12 months after diagnosis. Conclusions : Prognosis of pancreatic carcinoma with liver metastases is poor however, transarterial infusion chemotherapy may be effective to improve the prognosis and quality of life of the patients