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後期高齢者歯科健康診査受診者の肺炎発症に関わる口腔保健関連因子の分析
Get PDF本研究の目的は，歯科健診データを用いて，誤嚥性肺炎を含めた後期高齢者の肺炎発症に関わる口腔保健関連因子を調べることである．対象者は，平成27年からの5年間に後期高齢者歯科健診プログラムを受診した75，80，85および90歳の徳島市住民3,747名である．解析には，各対象者から得られたアンケート調査と歯科健診結果をデータとして使用した．1年以内の肺炎発症の有無を横断的分析のアウトカムとし，高齢者の全身状態および口腔状態との関連性について調べた．また，平成27年に受診した677名については縦断的分析を行った．
横断研究における二項ロジスティック回帰分析では，肺炎発症に関わる口腔保健関連因子として，「飲み物がむせる」「口の渇き」「年に1回以上の定期歯科健診を受けていない」の項目との間に有意な関連性が認められた．また，縦断研究ではKaplan-Meier分析において，誤嚥性肺炎の発症に関連する因子として，「プラーク・食渣が中程度・多量」「4mm以上の歯周ポケットあり」の項目との間に有意な関連性を認めた．Cox比例ハザード分析により，感染性肺炎の発症に関連する因子として，「口の渇き」の項目との間に有意な関連性が認められた．
これらの結果より，後期高齢者歯科健診受診者の肺炎発症に関わる口腔保健関連因子として，定期歯科健診に加えて，飲み物がむせることや口の渇きなどの口腔機能低下も関与することが示唆された．The purpose of this study was to investigate oral health-related factors involved in the development of pneumonia, including aspiration pneumonia, in latter-stage older adults using oral health examination data. The participants enrolled in this cross-sectional study were 3,747 Tokushima City residents aged 75, 80, 85, or 90 years old who received oral health examination for latter-stage older adults during the five years of the study. As the onset of pneumonia within a year was the outcome of cross-sectional analysis, we investigated the association with oral health/general and oral conditions using data from the questionnaire survey and oral health examination obtained from each participant. A longitudinal analysis was also performed involving 677 participants who received oral health examinations in 2015.
“Choking on drinks”, “dry mouth”, and “no regular dental check-ups at least once a year” were factors related to the onset of pneumonia by binomial logistic regression analysis in the cross-sectional study. “Moderate/large amounts of plaque/food debris” and “periodontal pocket depth of 4 mm or more” were factors related to the onset of aspiration pneumonia by Kaplan-Meier analysis. Moreover, “dry mouth” was a factor related to the onset of infectious pneumonia by Cox proportional hazards analysis.
These results suggest that oral health-related factors involved in the onset of pneumonia in latter-stage older adults include a decreased oral function such as choking on drinks and dry mouth, in addition to oral hygiene, periodontal conditions, and regular dental check-ups.journal articl
Cutaneous ureterostomy following robot-assisted radical cystectomy : a multicenter comparative study of transperitoneal versus retroperitoneal techniques
Get PDFBackground: The aim of this study was to evaluate the differences in perioperative outcomes between transperitoneal and retroperitoneal techniques in cutaneous ureterostomy (CUS).
Methods: Between 2018 and 2023, 55 patients underwent CUS following robot-assisted radical cystectomy. Among the 55 patients, we compared 33 patients who underwent transperitoneal CUS (t-CUS) and 22 who underwent retroperitoneal CUS (r-CUS).
Results: Compared with the r-CUS group, the t-CUS group had significantly shorter operative times (p < 0.001); significantly less estimated blood loss (p < 0.001); and significantly lower incidence of complications (Clavien–Dindo classification grade ≤ 2) within 30 days (p = 0.005). Unexpectedly, the incidence of ileus within 30 days was lower, though the difference was not statistically significant (p = 0.064). During the median follow-up period of 24.3 months, no ileus was observed in either group after 30 days postoperatively. There was no significant difference in the stent-free rate between the groups (p = 0.449). There were also no significant differences in the rates of change in estimated glomerular filtration rate from preoperatively at 3, 6, 12, and 24 months postoperatively between the groups (p = 0.590, p = 0.627, p = 0.741, and p = 0.778, respectively).
Conclusions: Compared with r-CUS, t-CUS was associated with a shorter operative time and lower incidence of perioperative complications, including gastrointestinal complications. We believe that t-CUS can be performed safely and effectively.journal articl
はじめて父親となった男性が妻との関わりの中で幸せを感じるとき
Get PDF目的：はじめて父親となった男性が，妻との関わりの中で幸せを感じるときを明らかにする．
方法：地方都市にある周産期母子医療センターにて正期産で誕生した生後２～３か月の子どもを持つ男性に，半構造化面接調査を実施し，質的記述的に分析した．
結果：参加者は，13名であった．はじめて父親となった男性は，【妻と２人で子どもの成長を見守り心に余裕を感じる】ときや，【妻が父親となった自分を気にかけてくれていると感じる】とき，【妻への心遣いが届いていると感じる】ときに，幸せを感じていた．
結論：はじめて父親となった男性からは，夫婦間の相互性とコミュニケーションによる共感や親しさが語られ，子どもの誕生を通して夫婦関係を積極的に深めていく，夫婦関係の親密性の高まりが感じられた．子どもの親として，妻の夫として，相手を想い・想われながら関わることで，夫婦の親密性が保たれ，家族の調和が図られていくものと思われる．本研究結果は，子育てに伴う大変さと幸福感という両面の感情の理解に役立ち，幸福感を高める支援に繋がり，家族の調和を図る一助になると考える．Objective : The aim of this study was to clarify when first-time fathers feel happy in their relationship with his wife.
Methods : Qualitative descriptive research with semi-structured one-to-one interviews was conducted for 13 men.
Results : Three categories were revealed : （1）feeling at peace watching my child grow up together with my wife, （2）a feeling that the wife cares about the husband having become a father, and （3）a feeling that the wife is aware of the thoughtfulness shown by the husband'.
Conclusions : The subjects of this survey, men who had become fathers for the first time, talked about the empathy and intimacy that are achieved through communication between the husband and wife. The birth of a child led to a deepening of the relationship and an increase in intimacy between the husband and wife. The intimacy between the husband and wife is maintained and family harmony is achieved when they relate to each other as parents of the child and as husband and wife.
The results of this study will be helpful for understanding the feelings of both difficulty and happiness that are experienced when raising children and should be useful for enhancing subjective well-being and achieving family harmony.journal articl
Exploring the Mental Health of Japanese Graduate Trainees in Psychology : Comparison with Non-Trainees in Other Departments
Get PDFThis study investigated the mental states, such as depression and anxiety, of Japanese psychology graduate trainees (N = 57) who aspired to become psychologists, compared with non-trainees (N = 80) in other departments. The results showed that, among trainees, 25% exhibited mild depression, 26% exhibited moderate depression, 9% exhibited moderately severe depression, and 5% exhibited severe depression. Among non-trainees, the corresponding figures were 31%, 10%, 6%, and 4%, respectively. Welch’s t-test revealed that the trainees showed significantly higher anxiety and higher scores on the “work or study” subscale of the Sheehan Disability Scale (SDISS) compared with the non-trainees. A two-way ANOVA indicated that first-year trainees had a significantly higher SDISS total score than second-year trainees. The survey was conducted 2–4 months after the commencement of first-year clinical training, during which first-year trainees tend to face many new challenges. This might be the reason for their higher SDISS than the second-year trainees. These findings emphasize the importance of prioritizing the mental well-being of Japanese graduate students pursuing careers in psychology, given their high levels of anxiety.journal articl
Renin-angiotensin blockade ameliorates the progression of glomerular injury in podocyte-specific Ctcf knockout mice
Get PDFAim: Several studies have shown that the progression of proteinuria and renal tissue injury is associated with activation of the intrarenal renin-angiotensin system (RAS). CCCTC-binding factor (CTCF) is a DNA-binding factor that plays an essential role in the regulation of gene expression. In the present study, we aimed to investigate the phenotypic effects of CTCF deficiency in podocytes.
Methods: Angiotensin II type 1 receptor blockers (ARBs) were administered to the podocyte-specific Ctcf knockout mice, and histological and biochemical analyzes were performed. We also investigated the changes in the expression of podocin in podocyte cell cultures with or without stimulation with angiotensin II from glomeruli isolated using magnetic beads from podocyte-specific Ctcf -knockout mice.
Results: Mice in which Ctcf was deleted from podocytes developed glomerulopathy and mice developed severe progressive proteinuria, and impaired renal function. Moreover, ARBs suppressed the development of glomerulopathy in podocyte-specific Ctcf knockout mice. Both real-time polymerase chain reaction and western blotting showed that podocin expression was decreased in cell cultures stimulated with angiotensin II. Furthermore, RAS components gene expressions in podocyte cell cultures isolated from podocyte-specific Ctcf -knockout mice were significantly increased.
Conclusion: These results suggest that RAS is involved in the development of glomerulopathy in podocyte-specific Ctcf knockout mice. Elucidation of the pathophysiology of podocyte-specific Ctcf knockout mice may provide new insights into the relationship between podocyte injury and chronic glomerulonephritis.doctoral thesi
Exclusive Papers of the Editorial Board Members and Topical Advisory Panel Members of Catalysts in Section “Catalysis in Organic and Polymer Chemistry”
No full textjournal articl
Combined effects of polystyrene nanoplastics and lipopolysaccharide on testosterone biosynthesis and inflammation in mouse testis
No full textMicroplastics (MPs)/nanoplastics (NPs), as a source and vector of pathogenic bacteria, are widely distributed in the natural environments. Here, we investigated the combined effects of polystyrene NPs (PS-NPs) and lipopolysaccharides (LPS) on testicular function in mice for the first time. 24 male mice were randomly assigned into 4 groups, control, PS-NPs, LPS, and PS-NPs + LPS, respectively. Histological alterations of the testes were observed in mice exposed to PS-NPs, LPS or PS-NPs + LPS. Total sperm count, the levels of testosterone in plasma and testes, the expression levels of steroidogenic acute regulatory (StAR) decreased more remarkable in testes of mice treated with PS-NPs and LPS than the treatment with LPS or PS-NPs alone. Compared with PS-NPs treatment, LPS treatment induced more sever inflammatory response in testes of mice. Moreover, PS-NPs combined with LPS treatment increased the expression of these inflammatory factors more significantly than LPS treatment alone. In addition, PS-NPs or LPS treatment induced oxidative stress in testes of mice, but their combined effect is not significantly different from LPS treatment alone. These results suggest that PS-NPs exacerbate LPS-induced testicular dysfunction. Our results provide new evidence for the threats to male reproductive function induced by both NPs and bacterial infection in human health.journal articl