Medicine
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Comparative Study
Comparison of pleiotropic effects of statins vs fibrates on laboratory parameters in patients with dyslipidemia: A retrospective cohort study.
Differences in the mechanism of action and potential pleiotropic effects between statins and fibrates would potentially drive a different effect on various laboratory parameters, but this remains controversial because of a paucity of reports comparing them. Therefore, the aim of this study was to compare the effects of statins and fibrates on laboratory parameters in Japanese patients in routine clinical practice. This retrospective cohort study included patients with dyslipidemia who had been newly treated with statin or fibrate monotherapy between January 2005 and December 2017. ⋯ The mean changes in aspartate aminotransferase and hemoglobin A1c levels were not significantly different between statin users and fibrate users. In LDL cholesterol-matched pairs, the differences in changes of all laboratory parameter levels between statin users and fibrate users were similar to those in TG-matched pairs. We demonstrate here that fibrates have a greater effect of increasing creatinine and urea nitrogen levels and of reducing eGFR, ALT level, and RBC count than statins, and that the lowering effect on PLT count is greater with statins than with fibrates.
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Observational Study
Copeptin levels predict left ventricular systolic function in STEMI patients: A 2D speckle tracking echocardiography-based prospective observational study.
In the present study, we aimed to investigate whether copeptin values on admission are related to left ventricle (LV) systolic function and its improvement at 6 months in ST-segment elevation myocardial infarction (STEMI) patients. In this single-center, prospective observational study, we included 122 STEMI patients from January 2016 to November 2016. LV systolic functions in the form of global longitudinal strain (GLS) in addition to conventional echocardiography parameters were evaluated on admission and at 6-month. ⋯ In addition, we observed that copeptin values were negatively correlated with the improvement of GLS at 6-month follow-up (r = -0.458, P < .001 and r = -0.357, P = .005, respectively). Serum copeptin levels in STEMI patients at the time of admission may predict early and 6-month LV systolic function assessed by two-dimensional GLS. To the best of our knowledge, this study is the first to specifically address the relationship between copeptin values and GLS in STEMI patients.
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Case Reports
Primary leptomeningeal melanomatosis successfully treated with PD-1 inhibitor pembrolizumab: A case report.
Primary leptomeningeal melanoma is an extremely rare disease of the central nervous system. There are no standard treatment protocols with a poor prognosis in very few reported cases. Immunotherapy in primary brain melanoma has not been successfully applied so far. ⋯ Our report describes durable intracranial tumor response suggesting the efficacy of PD-1 inhibitor pembrolizumab for central nervous system primary leptomeningeal melanoma.
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School sandplay group therapy is a useful clinical treatment method for adolescents who cannot adapt to school due to various emotional and behavioral problems. In this study, we conducted 10 weeks of group therapy in 70 adolescents referred to as maladjustment behavior problem in the school. ⋯ There was a statistically significant difference in clinical scales such as depression, masculinity- femininity, social introversion, anger, subjective depression, need for affection, somatic complaint, and internal/external alienation after school sandplay group therapy. Sandplay therapy is estimated to have clinical effects not only on the emotional problems of maladapted high school students but also on physical problems.
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The transmission of tuberculosis has been declared as an important occupational hazard for health care workers of tuberculosis dispensary. Here, we evaluated the filtration efficiency and respiratory resistance of different respirators along with the increase of wear time. Filter efficiency and breathing resistance were tested to determine the performance of different types of respirators, and the N95 respirator were simulatively worn by volunteers to determine the optimal time for N95 respirator as a tuberculosis control measure. ⋯ In addition, there were no significant differences in the exhalation resistance of N95 respirator, ranging from 13.8 ± 0.9 mmH2O of 0 day to 11.6 ± 0.9 mmH2O of 14 days. Our results demonstrate that only N95 respirator provides promising protective efficiency for health care workers against tuberculosis. In addition, N95 respirator could produce adequate protective efficacy after 3-day wear time.