Reduction of Postoperative Pain by Addition of Intravenous Acetaminophen after Total Hip Arthroplasty: A Retrospective Cohort Study

We evaluated the analgesic effects of multimodal pain control in which intravenous acetaminophen (IV APAP) was added to the standard protocol for Japanese patients who had undergone a total hip arthroplasty (THA). We performed a retrospective cohort study of 180 patients aged 66.4±10.5 years (30% male) who had undergone a THA (Oct. 2014 to Feb. 2015) at our hospital. The control patients were administered the standard analgesic protocol: flurbiprofen axetil as a continuous intravenous infusion and oral celecoxib (NAPAP; n=109). The patients in the new analgesic protocol group received IV APAP in addition to the standard analgesic protocol (APAP; n=71). The primary outcome was the maximum value of postoperative pain the patients reported on a numerical rating scale (NRS) during the first 24 h post-surgery. A univariate analysis and multivariate analyses adjusted for age, sex, the stage of hip osteoarthritis, preoperative pain, and surgical time showed that the maximum postoperative pain NRS scores during the first 24 h after surgery was significantly lower when the APAP protocol was used. The addition of IV APAP to the current standard multimodal analgesia protocol for Japanese patients who have undergone a THA may decrease the patients’ postoperative pain

Polypharmacy and Clinical Outcomes in Hospitalized Patients With Acute Decompensated Heart Failure

BACKGROUND: Polypharmacy is a common problem among patients with acute decompensated heart failure (ADHF) who often have multiple comorbidities. OBJECTIVE: The aim of this study was to define the number of medications at hospital discharge and whether it is associated with clinical outcomes at 1 year. METHODS: We evaluated the number of medications in 2578 patients with ADHF who were ambulatory at hospital discharge in the Kyoto Congestive Heart Failure Registry and compared 1-year outcomes in 4 groups categorized by quartiles of the number of medications (quartile 1, ≤ 5; quartile 2, 6-8; quartile 3, 9-11; and quartile 4, ≥ 12). RESULTS: At hospital discharge, the median number of medications was 8 (interquartile range, 6-11) with 81.5% and 27.8% taking more than 5 and more than 10 medications, respectively. The cumulative 1-year incidence of a composite of death or rehospitalization (primary outcome measure) increased incrementally with an increasing number of medications (quartile 1, 30.8%; quartile 2, 31.6%; quartile 3, 39.7%; quartile 4, 50.3%; P < .0001). After adjusting for confounders, the excess risks of quartile 4 relative to those of quartile 1 remained significant (P = .01). CONCLUSIONS: In the contemporary cohort of patients with ADHF in Japan, polypharmacy at hospital discharge was common, and excessive polypharmacy was associated with a higher risk of mortality and rehospitalizations within a 1-year period. Collaborative disease management programs that include a careful review of medication lists and an appropriate deprescribing protocol should be implemented for these patients

Discovery of a Long-duration Superflare on a Young Solar-type Star EK Draconis with Nearly Similar Time Evolution for H alpha and White-light Emissions

Young solar-type stars are known to show frequent "superflares, " which may severely influence the habitable worlds on young planets via intense radiation and coronal mass ejections. Here we report an optical spectroscopic and photometric observation of a long-duration superflare on the young solar-type star EK Draconis (50-120 Myr age) with the Seimei telescope and Transiting Exoplanet Survey Satellite. The flare energy 2.6 x 10³⁴ erg and white-light flare duration 2.2 hr are much larger than those of the largest solar flares, and this is the largest superflare on a solar-type star ever detected by optical spectroscopy. The H alpha emission profile shows no significant line asymmetry, meaning no signature of a filament eruption, unlike the only previous detection of a superflare on this star. Also, it did not show significant line broadening, indicating that the nonthermal heating at the flare footpoints is not essential or that the footpoints are behind the limb. The time evolution and duration of the H alpha flare are surprisingly almost the same as those of the white-light flare, which is different from general M-dwarf (super-)flares and solar flares. This unexpected time evolution may suggest that different radiation mechanisms than general solar flares are predominant, such as: (1) radiation from (off-limb) flare loops and (2) re-radiation via radiative back-warming, in both of which the cooling timescales of flare loops could determine the timescales of H alpha and white light

Probable detection of an eruptive filament from a superflare on a solar-type star

太陽型星のスーパーフレアから噴出する巨大フィラメントを初検出 --昔の、そして今の惑星環境や文明に与える脅威--. 京都大学プレスリリース. 2021-12-10.Solar flares are often accompanied by filament/prominence eruptions (~10⁴ K and ~10¹⁰⁻¹¹ cm⁻³), sometimes leading to coronal mass ejections that directly affect the Earth’s environment. ‘Superflares’ are found on some active solar-type (G-type main-sequence) stars, but the filament eruption–coronal mass ejection association has not been established. Here we show that our optical spectroscopic observation of the young solar-type star EK Draconis reveals evidence for a stellar filament eruption associated with a superflare. This superflare emitted a radiated energy of 2.0 × 10³³ erg, and a blueshifted hydrogen absorption component with a high velocity of −510 km s⁻¹ was observed shortly afterwards. The temporal changes in the spectra strongly resemble those of solar filament eruptions. Comparing this eruption with solar filament eruptions in terms of the length scale and velocity strongly suggests that a stellar coronal mass ejection occurred. The erupted filament mass of 1.1 × 10¹⁸ g is ten times larger than those of the largest solar coronal mass ejections. The massive filament eruption and an associated coronal mass ejection provide the opportunity to evaluate how they affect the environment of young exoplanets/the young Earth6 and stellar mass/angular momentum evolution

Comprehensive autoantibody profiling in systemic autoimmunity by a highly-sensitive multiplex protein array

Comprehensive autoantibody evaluation is essential for the management of autoimmune disorders. However, conventional methods suffer from poor sensitivity, low throughput, or limited availability. Here, using a proteome-wide human cDNA library, we developed a novel multiplex protein assay (autoantibody array assay; A-Cube) covering 65 antigens of 43 autoantibodies that are associated with systemic sclerosis (SSc) and polymyositis/dermatomyositis (PM/DM). The performance of A-Cube was validated against immunoprecipitation and established enzyme-linked immunosorbent assay. Further, through an evaluation of serum samples from 357 SSc and 172 PM/DM patients, A-Cube meticulously illustrated a diverse autoantibody landscape in these diseases. The wide coverage and high sensitivity of A-Cube also allowed the overlap and correlation analysis between multiple autoantibodies. Lastly, reviewing the cases with distinct autoantibody profiles by A-Cube underscored the importance of thorough autoantibody detection. Together, these data highlighted the utility of A-Cube as well as the clinical relevance of autoantibody profiles in SSc and PM/DM

THE SUB-MILLIMETER WAVE SPECTROSCOPY OF MONODUTERATED AMIDOGEN RADICAL (NHD)

Author Institution: Department of Environmental Science, Toho University, 2-2-1 Miyama, Funabashi, 274-8510, Japan; Department of Physics, University of Toyama, 3190 Gofuku, Toyama, 930-8555, JapanThe amidogen radical, NH$_{2}$ is one of the basically significant triatomic molecules in molecular spectroscopy and interstellar chemistry, quantum chemistry and so on. In 1990s, the NH$_{2}$ radical was detected in Sgr B2., \textbf{416}, 183 (1993).} The monoduterated species, NHD radical, could be observed in interstellar clouds in the future. Since NHD is light molecule, the important transitions appear in the terahertz region. However, pervious report is limited to about 500 GHz. , \textbf{107}, 22 (1997).} \par In this study, the pure rotational spectrum of NHD radical in the ground state ($\tilde{X^{2}}A^{\prime\prime}$) was observed in sub-millimeter wave region by frequency modulated sub-millimeter wave spectrometer at Toho University. This radical were produced by a DC-glow discharge through NH$_{3}$ and D$_{2}$ mixture at around 220K. So far, 7$_{2,6}$-6$_{3,3}$ and 3$_{1,2}$-3$_{0,3}$ of NHD lines were measured. We plan to measure terahertz transitions and report its analysis