Adverse effect profile of trichlormethiazide: a retrospective observational study

<p>Abstract</p> <p>Background</p> <p>Trichlormethiazide, a thiazide diuretic, was introduced in 1960 and remains one of the most frequently used diuretics for treating hypertension in Japan. While numerous clinical trials have indicated important side effects of thiazides, e.g., adverse effects on electrolytes and uric acid, very few data exist on serum electrolyte levels in patients with trichlormethiazide treatment. We performed a retrospective cohort study to assess the adverse effects of trichlormethiazide, focusing on serum electrolyte and uric acid levels.</p> <p>Methods</p> <p>We used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and July 31, 2010, to identify cohorts of new trichlormethiazide users (n = 99 for 1 mg, n = 61 for 2 mg daily dosage) and an equal number of non-users (control). We used propensity-score matching to adjust for differences between users and control for each dosage, and compared serum chemical data including serum sodium, potassium, uric acid, creatinine and urea nitrogen. The mean exposure of trichlormethiazide of 1 mg and 2 mg users was 58 days and 64 days, respectively.</p> <p>Results</p> <p>The mean age was 66 years, and 55% of trichlormethiazide users of the 1 mg dose were female. In trichlormethiazide users of the 2 mg dose, the mean age was 68 years, and 43% of users were female. There were no statistically significant differences in all covariates (age, sex, comorbid diseases, past drugs, and current antihypertensive drugs) between trichlormethiazide users and controls for both doses. In trichlormethiazide users of the 2 mg dose, the reduction of serum potassium level and the elevation of serum uric acid level were significant compared with control, whereas changes of mean serum sodium, creatinine and urea nitrogen levels were not significant. In trichlormethiazide users of the 1 mg dose, all tests showed no statistically significant change from baseline to during the exposure period in comparison with control.</p> <p>Conclusions</p> <p>Our study showed adverse effects of decreased serum potassium and increased serum uric acid with trichlormethiazide treatment, and suggested that a lower dose of trichlormethiazide may minimize these adverse effects. These findings support the current trend in hypertension therapeutics to shift towards lower doses of thiazides.</p

Study of Sharing Patient Information by Nurses Between Inpatient and Outpatient Wards in Japan

Studies in Health Technology and Informatics Volume 284Shortening hospital stays increases communication needs between nurses in inpatient and outpatient wards. Smooth information sharing is required to reduce the workload of nurses and improve the quality of patient care. However, electronic medical records (EMR) system does not have sufficient functions to support information sharing between wards, because EMR has been developed mainly for recording. This study led to three improvements; unified communication tool, common patient list linked to EMR, and outpatient nursing diagnosis

Effect of Blast Furnace Slag Powder and Fly Ash on Durability of Concrete Mixed with Seawater

According to the report of the United Nations, it is said that two-third of world population would be influenced by water shortage before 2050. To use fresh water effectively, the usage of seawater in concrete industry seems imperative. However, the usage of seawater as concrete material is prohibited in almost all the standards or specifications around the world. In this article, the usage of seawater as a material of concrete based on the results of experimental works and deterioration prediction was discussed. Especially, the effects of by-products such as blast furnace slag or fly ash on the durability of concrete mixed with seawater were evaluated. In the experimental works, the measurements of the material diffusivity/permeability such as chloride ion diffusivity, carbonation rate, and oxygen permeability in concrete/mortar were conducted. Also, the time-dependent changes of corrosion rate of steel bar embedded in mortar were periodically measured. At the same time, immobilization ability of cement matrix and corrosion threshold chloride ion content of steel bar were evaluated. Based on the above data, the initiation and propagation periods were predicted, and the durability of concrete mixed with seawater and the effectiveness of adding by-products were discussed. Based on the results of the present article, it was said that the period before the generation of cracks due to steel corrosion in concrete mixed with seawater was almost same with that with fresh water under severe chloride attack environment. Also, it could be concluded that the addition of blast furnace slag powder or fly ash might contribute significantly to the corrosion resistance of steel bar as well as low penetrability of materials

Effect of candesartan monotherapy on lipid metabolism in patients with hypertension: a retrospective longitudinal survey using data from electronic medical records

<p>Abstract</p> <p>Background</p> <p>Studies focusing on the add-on effects of angiotensin II type 1 receptor blockers (ARBs) other than their antihypertensive effect are receiving attention. However, the effects of prolonged administration of ARBs on lipid metabolism in clinical cases are unclear. Our aims were to survey the changes in plasma lipid profile in patients with hypertension over a one-year period, and to examine the correlations between these values and the time after the start of ARB monotherapy with candesartan.</p> <p>Methods</p> <p>We carried out candesartan monotherapy in patients with mild to moderate hypertension and examined the longitudinal changes in plasma lipid profile. Data from 405 patients for triglyceride (TG), 440 for total cholesterol (TC), 313 for high density lipoprotein cholesterol (HDL-C) and 304 for low density lipoprotein cholesterol (LDL-C) were obtained from the electronic medical records (EMRs) in the Clinical Data Warehouse (CDW) of Nihon University School of Medicine (NUSM). The inverse probability of treatment weighting (IPTW) method (calculated from the inverse of the propensity score) was used to balance the covariates and reduce bias in each treatment duration. Linear mixed effects models were used to analyse the relationship between these longitudinal data of blood examinations and covariates of patient sex, age, diagnosis of diabetes mellitus (DM) and duration of candesartan monotherapy.</p> <p>Results</p> <p>Plasma HDL-C level was associated with sex, duration of treatment, and interaction of sex and treatment duration, but not with age or diagnosis of DM. HDL-C level was significantly decreased during the 6~9 months period (p = 0.0218) compared with baseline. TG and TC levels were associated with sex, but not with age, diagnosis of DM or treatment duration. LDL-C level was not associated with any covariate. Analysis of the subjects divided by sex revealed a decrease in HDL-C in female subjects (during the 6~9 months period: p = 0.0054), but not in male subjects.</p> <p>Conclusions</p> <p>Our study revealed that administration of candesartan slightly decreased HDL-C in female subjects. However, TG, TC and LDL-C levels were not influenced by candesartan monotherapy. Candesartan may be safely used for patients with hypertension with respect to lipid metabolism, because the effect of candesartan on lipids may be small.</p

NoisyILRMA: Diffuse-Noise-Aware Independent Low-Rank Matrix Analysis for Fast Blind Source Extraction

In this paper, we address the multichannel blind source extraction (BSE) of a single source in diffuse noise environments. To solve this problem even faster than by fast multichannel nonnegative matrix factorization (FastMNMF) and its variant, we propose a BSE method called NoisyILRMA, which is a modification of independent low-rank matrix analysis (ILRMA) to account for diffuse noise. NoisyILRMA can achieve considerably fast BSE by incorporating an algorithm developed for independent vector extraction. In addition, to improve the BSE performance of NoisyILRMA, we propose a mechanism to switch the source model with ILRMA-like nonnegative matrix factorization to a more expressive source model during optimization. In the experiment, we show that NoisyILRMA runs faster than a FastMNMF algorithm while maintaining the BSE performance. We also confirm that the switching mechanism improves the BSE performance of NoisyILRMA.Comment: 5 pages, 3 figures, accepted for European Signal Processing Conference 2023 (EUSIPCO 2023

A Coupled Spintronics Neuromorphic Approach for High-Performance Reservoir Computing

The rapid development in the field of artificial intelligence has increased the demand for neuromorphic computing hardware and its information-processing capability. A spintronics device is a promising candidate for neuromorphic computing hardware and can be used in extreme environments due to its high resistance to radiation. Improving the information-processing capability of neuromorphic computing is an important challenge for implementation. Herein, a novel neuromorphic computing framework using spintronics devices is proposed. This framework is called coupled spintronics reservoir (CSR) computing and exploits the high-dimensional dynamics of coupled spin-torque oscillators as a computational resource. The relationships among various bifurcations of the CSR and its information-processing capabilities through numerical experiments are analyzed and it is found that certain configurations of the CSR boost the information-processing capability of the spintronics reservoir toward or even beyond the standard level of machine learning networks. The effectiveness of our approach is demonstrated through conventional machine learning benchmarks and edge computing in real physical experiments using pneumatic artificial muscle-based wearables, which assist human operations in various environments. This study significantly advances the availability of neuromorphic computing for practical uses

TRPC6 regulates phenotypic switching of vascular smooth muscle cells through plasma membrane potential-dependent coupling with PTEN

Vascular smooth muscle cells (VSMCs) play critical roles in the stability and tonic regulation of vascular homeostasis. VSMCs can switch back and forth between highly proliferative synthetic and fully differentiated contractile phenotypes in response to changes in the vessel environment. Although abnormal phenotypic switching of VSMCs is a hallmark of vascular disorders such as atherosclerosis and restenosis after angioplasty, how control of VSMC phenotypic switching is dysregulated in pathologic conditions remains obscure. We found that inhibition of canonical transient receptor potential 6 (TRPC6) channels facilitated contractile differentiation of VSMCs through plasma membrane hyperpolarization. TRPC6-deficient VSMCs exhibited more polarized resting membrane potentials and higher protein kinase B (Akt) activity than wild-type VSMCs in response to TGF-β1 stimulation. Ischemic stress elicited by oxygen-glucose deprivation suppressed TGF-β1-induced hyperpolarization and VSMC differentiation, but this effect was abolished by TRPC6 deletion. TRPC6-mediated Ca2+ influx and depolarization coordinately promoted the interaction of TRPC6 with lipid phosphatase and tensin homolog deleted from chromosome 10 (PTEN), a negative regulator of Akt activation. Given the marked up-regulation of TRPC6 observed in vascular disorders, our findings suggest that attenuation of TRPC6 channel activity in pathologic VSMCs could be a rational strategy to maintain vascular quality control by fine-tuning of VSMC phenotypic switching.Fil: Numaga-Tomita, Takuro. No especifíca;Fil: Shimauchi, Tsukasa. Kyushu University; JapónFil: Oda, Sayaka. No especifíca;Fil: Tanaka, Tomohiro. No especifíca;Fil: Nishiyama, Kazuhiro. Kyushu University; JapónFil: Nishimura, Akiyuki. Kyushu University; JapónFil: Birnbaumer, Lutz. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; ArgentinaFil: Mori, Yasuo. No especifíca;Fil: Nishida, Motohiro. Kyushu University; Japó

Lymphoepithelial Carcinoma in the Lateral Tongue: The Case Report

Lymphoepithelial carcinoma (LEC) of the tongue is a rare subtype of squamous cell carcinoma. Histologically, it is an undifferentiated carcinoma with rich lymphocyte and plasma cell infiltration. The most common location for LEC in the head and neck is the salivary glands, and LEC of the oral cavity is extremely rare. The second case report of LEC in the lateral tongue is presented. In addition, a review of the literature was performed, and the relationship between LEC and Epstein-Barr virus infection was considered