Internal medicine
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Multicenter Study Clinical Trial
Efficacy of azithromycin in the treatment of community-acquired pneumonia, including patients with macrolide-resistant Streptococcus pneumoniae infection.
The growing problem of drug resistance among respiratory pathogens in community-acquired pneumonia (CAP), particularly Streptococcus pneumoniae, (S. pneumoniae) has complicated initial empiric therapy of CAP. This study was undertaken to evaluate the efficacy and tolerability of a 3-day course of azithromycin in adults with mild to moderately severe CAP, and to determine whether in vitro macrolide resistance among strains of S. pneumoniae is related to clinical efficacy/failure. ⋯ Most patients responed well to azithromycin, indicating that azithromycin might be clinically effective for the treatment of CAP with macrolide-resistant S. pneumoniae. However, a larger study is necessary to prove the efficacy against macrolide-resistant S. pneumoniae.
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Multicenter Study Comparative Study
A cross-sectional survey of chronic kidney disease and diabetic kidney disease in Japanese type 2 diabetic patients at four urban diabetes clinics.
Management of chronic kidney disease (CKD) is a critical issue in public health in attempt to prevent kidney failure and dialysis dependency. Since 1998, diabetes mellitus has been the leading cause of dialysis dependency in Japan. Previous reports demonstrated that the prevalence of CKD in diabetic patients was high; however albuminuria was not always present. This cross-sectional survey was performed 1) to indicate the prevalence of CKD and co-morbid illness in diabetic patients seen at diabetic clinics, and 2) to demonstrate the relationship between estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR). ⋯ Our patients were relatively young and obese, reflecting urban clinical settings. The prevalence of CKD stage 3 patients was high. Clinicians need to check both eGFR and ACR to avoid underdiagnosis of CKD and diabetic kidney disease.
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Multicenter Study
Survey on the handling of chronic obstructive pulmonary disease by annual health check in Japan.
Since mild COPD can be detected in the annual health check by lung function tests, we conducted a questionnaire survey on how such examinations are used to assess chronic obstructive pulmonary disease (COPD). ⋯ At most facilities performing a comprehensive medical check-up, there was not a sufficient number of respirologists to ensure early diagnosis of COPD and this may have compromised COPD diagnosis. The newly proposed Japan Society of Comprehensive Medical Check-up (Ningen-dock) Standards based on the Japanese Respiratory Society may be useful to reveal early stages of COPD.
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Multicenter Study Comparative Study
Gender-related and city- and countryside-related differences in patients with ulcerative colitis in a Chinese population.
The purpose of this study is to determine gender-related and city- and countryside-related differences of ulcerative colitis in a Chinese population, and to determine information on the role of lifestyle in the onset of ulcerative colitis. ⋯ Both gender-related and city- and countryside-related differences were found in the expression of ulcerative colitis in the Chinese population. Lifestyle factors such as psychological stress and fatigue may contribute to the expression of ulcerative colitis.
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Multicenter Study Comparative Study
Effect of sevelamer hydrochloride on markers of bone turnover in Japanese dialysis patients with low biointact PTH levels.
In hemodialysis patients, adynamic bone disease has been reported to be closely associated with low levels of parathyroid hormone (PTH) due to exposure to high levels of serum calcium following the administration of calcium carbonate (CaCO3) or vitamin D agents. This study was conducted to clarify the therapeutic effect of a non-calcemic phosphate binder, sevelamer hydrochloride (sevelamer), for hypoparathyroidism in hemodialysis patients with or without diabetes mellitus. ⋯ Sevelamer reduced the calcium concentration and thereby increased PTH levels, resulting in the improvement of markers of bone turnover. The administration of sevelamer is of therapeutic benefit for the improvement of bone remodeling activity even in hemodialysis patients with diabetes.