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第33回 静岡県母性衛生学会学術集会プログラム
Get PDF静岡県母性衛生学会：第33回 総会ならびに学術集会プログラム教育講演：女性の将来を見据えたプレコンセプションケア一般演題：
1. ピアエデュケーションを用いた助産学生による性教育の効果
2. 帝王切開を体験した女性が抱くわだかまりの存在と関連要因 ?子どもが就学を迎える時の振り返り?application/pdfconference pape
Exophthalmos associated with chronic progressive external ophthalmoplegia
Get PDFPurpose Chronic progressive external ophthalmoplegia (CPEO) is a mitochondrial disease characterized by slowly progressive ptosis and limitations in ocular motility. Although exophthalmos is not considered to be a common feature of CPEO, this study focused on the incidence of exophthalmos in patients with CPEO.
Study design Retrospective observational case series
Methods We reviewed the clinical charts of patients who received a diagnosis of CPEO sometime during the period between January 2010 and December 2018. CPEO was diagnosed on the basis of detection of a deletion of mitochondrial DNA (mtDNA) from saliva, buccal mucosa, or extraocular muscle specimens obtained during strabismus surgery. Horizontal MRI/CT images or Hertel ophthalmometry was used in determining exophthalmos.
Results Seven patients (4 males) were identified. The mean age at diagnosis was 32.6 years (range, 13-53 years). mtDNA deletion mutations were detected in the buccal mucous membrane DNA in 5 patients and in the saliva and extraocular muscle DNA in 2 patients. MRI/CT was recorded in 6 patients, four of whom showed exophthalmos (cases 1-4), and case 5 was determined as exophthalmos on the basis of a Hertel ophthalmometer reading.
Exophthalmos was bilateral in 4 of the patients (cases 1, 2, 4, and 5) and unilateral in 1 patient (case 3). Exophthalmos was the chief concern of 2 of the patients; however, it was not clinically significant in the other patients.
Conclusions Although exophthalmos may not be recognized by either the patient or the clinician, it may be one of the common features of CPEO. A large multiethnic study should be performed.journal articl
Dietary and nutritional therapy for dialysis patients with cognitive impairment
Get PDF透析患者の認知症・認知機能低下に対する栄養学的な成因として，食事摂取不足による栄養障害に加え，高リン血症，ビタミンD不足，二次性副甲状腺機能亢進症などの CKD-MBD の病態が関与する．
地域居住高齢者において認知症予防に最も有用な食事は，果物，野菜，魚介類に加え，ナッツ類，オリーブオイル類，乳製品，豆類，ワインなどを含む「地中海食のような食事」，すなわち plant-based diets である．和食と比べて食塩が少なく，カリウム，カルシウム，マグネシウム，食物繊維が豊富に含まれる特徴がある．一方，認知症の予防にビタミンB群を含むサプリメントを投与することは推奨されていない．
現在，透析患者の認知症・認知機能低下に対する plant-based diets の有用性は明らかでない．少人数であるものの，ビタミンB類やL-カルニチンの投与によって認知機能低下が改善したことが報告されているが，エビデンスレベルは低い．現実には，認知機能低下はフレイルと密接に関連するため，フレイル予防の食事・栄養療法が認知機能低下の予防にも有用と思われる．journal articl
Influence of daily vs. alternate-day dosing of vonoprazan on intragastric pH, serum gastrin, and the antiplatelet function of clopidogrel
Get PDF雑誌掲載タイトル：Influence of daily versus alternate-day dosing of vonoprazan on intragastric pH, serum gastrin, and the antiplatelet function of clopidogrelBackground: Vonoprazan, a potassium-competitive acid blocker, inhibits gastric acid secretion and attenuates the antiplatelet function of clopidogrel more potently than esomeprazole. We investigated whether alternate-day dosing of vonoprazan might avoid this interaction with clopidogrel while providing sufficient gastric acid inhibition.
Methods: Following 24 h of pH monitoring (control regimen), 12 healthy volunteers received three regimens (clopidogrel-only regimen: clopidogrel 75mg daily (q.d.); vonoprazan alternate-day regimen: vonoprazan 10mg every other day (q.o.d.) + clopidogrel 75mg q.d.; vonoprazan daily regimen: vonoprazan 10mg q.d. + clopidogrel 75mg q.d. for 14 days in a randomized open-label crossover manner. Intragastric pH monitoring was performed for 24 hours on day 13 in the clopidogrel-only regimen and vonoprazan q.d. regimens and for 48 hours on days 13 and 14 in the vonoprazan q.o.d. regimen. Serum gastrin and inhibition of platelet aggregation (IPA) were measured before the commencement of pH monitoring in each regimen.
Results: Twelve volunteers completed the study. Equivalent median IPA values in the q.o.d. and q.d. regimens were measured (21.8% and 25%, respectively) and were significantly lower than that of the clopidogrel-only regimen (40.8%). Median pH4 holding time ratio on the vonoprazan q.o.d. regimen (49.7%) was superior to that of the clopidogrel-only regimen (18.4%), but was significantly inferior to that of the vonoprazan q.d. regimen (77.0%) (p<0.01).
Conclusion: Alternate-day administration of vonoprazan could not prevent the interaction between vonoprazan and clopidogrel and acid inhibition was inferior to vonoprazan daily administration, and appears to be of questionable clinical utility.journal articl
Palliative care in interstitial lung diseases
Get PDF通巻第1221号Patients with progressive fibrotic interstitial lung diseases (ILD) suffer from a high symptom burden, such as cough and dyspnea, and poor quality of life as the disease progresses. However, patients with ILD receive poor access to optimal palliative care in clinical practice. We have recently performed a nationwide, cross-sectional survey of certified pulmonary physicians about palliative care for patients with ILD. We found that pulmonologists experienced great difficulty in providing palliative care to patients with ILD compared to those with lung cancer. Opioids use for dyspnea were less frequent in patients with ILD than those with lung cancer. The aims of palliative care in ILD are to improve quality of life and ensure that patients with ILD live well through the course of disease. A multidisciplinary approach including symptom management, pulmonary rehabilitation, supplemental oxygen, and multi-professional integrated service is necessary for providing better palliative care in patients with ILD.journal articl
Metformin reduces pleural fibroelastosis by inhibition of extracellular matrix production induced by CD90-positive myofibroblasts
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
YTHDF1 and YTHDF2 are associated with better patient survival and an inflamed tumor-immune microenvironment in non-small-cell lung cancer
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi
Prostaglandin E-major urinary metabolite predicts relapse in patients with ulcerative colitis in clinical remission
Get PDF浜松医科大学博士（医学）doctoral医学系研究科thesi