Plos One
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Comparative Study Clinical Trial
High-pitch, 120 kVp/30 mAs, low-dose dual-source chest CT with iterative reconstruction: Prospective evaluation of radiation dose reduction and image quality compared with those of standard-pitch low-dose chest CT in healthy adult volunteers.
Objective of this study was to evaluate the effectiveness of the iterative reconstruction of high-pitch dual-source chest CT (IR-HP-CT) scanned with low radiation exposure compared with low dose chest CT (LDCT). ⋯ IR-HP-CT with 120 kVp and 30 mAs tube setting in addition to an iterative reconstruction reduced cardiac motion artifact and radiation exposure while representing similar image quality compared with LDCT.
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Clinical Trial
Pain characteristics and incidence of functional disability among community-dwelling older adults.
This study examined the association between pain characteristics and the incidence of functional disability among community-dwelling older adults. This prospective cohort study included 4,365 older adults (mean age 74.7 years, 53.5% female) living in community settings. Pain characteristics, including severity and duration of pain, were assessed in participants who also underwent monthly follow-up assessment of functional disability for 24 months based on the national long-term care insurance system. ⋯ After adjusting for covariates, severe pain remained a significant predictor (hazard ratio [95% confidence interval]: 1.66 [1.05-2.62]), but moderate (1.00 [0.69-1.47]) and chronic pain (1.04 [0.77-1.40]) did not. Our results established that moderate to severe pain or chronic pain affects functional disability; in particular, severe pain was independently associated with the incidence of disability. Subjective complaints of pain do not always correspond to physical causes; however, simplified questions regarding pain characteristics could be useful predictors of functional disability in community-dwelling older people.
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Comparative Study Observational Study
Longitudinal trends of and factors associated with inappropriate antibiotic prescribing for non-bacterial acute respiratory tract infection in Japan: A retrospective claims database study, 2012-2017.
Inappropriate antibiotic prescribing is a cause of antimicrobial resistance. Acute Respiratory Tract Infections (ARTI) are common diseases for those antibiotics are most likely prescribed in outpatient setting. ⋯ Inappropriate antibiotic prescribing for NB-ARTI is common in Japan. Although the antibiotic prescribing rate has decreased, further interventions are required to promote antimicrobial stewardship (ASP). Education and awareness for adults and promotion of ASP among physicians in clinics without beds are key drivers to reduce inappropriate antibiotic prescribing in Japan.
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As the factors that link education level with incident functional disability in elderly Japanese have never been investigated, the present study investigated this issue in an elderly Japanese population. A 9-year prospective cohort study (2006-2015) was conducted among 8,680 Japanese individuals (≥65 years), Ohsaki city, Japan. In a baseline survey, we collected data on education level and potential mediators. ⋯ This effect remained among those aged 65-74 years (19.9%) but became negligible among those aged ≥75 years. Other potential mediators (such as smoking and drinking status) were also tested, but these showed only small mediating effects. The inverse association between education level and the incident risk of functional disability appears to be largely mediated by participation in community activities among elderly Japanese, especially those aged 65-74 years.
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Although hypokalemia has been viewed as a significant concern among patients with heart failure (HF), recent advances in HF management tend to increase the risk of hyperkalemia. ⋯ Potassium levels below 4 mmol/L and above 5 mmol/L at and after HF diagnosis were associated with poor prognosis and the clinical actions. HF patients (particularly with risk factors for dyskalemia like black race and kidney dysfunction) may require special attention for both hypo- and hyperkalemia.