Therapeutic Research
Volume 37, Issue 2, 2016
Volumes & issues:
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INFORMATION:日本循環器学会 第15回プレスセミナー不整脈デバイス治療の現況と未来
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INFORMATION: 日本循環器学会 循環器救急医療委員会プレスセミナー日本の循環器救急制度の実状:進む医師高齢化と広がる地方格差
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TOPICS:ジカウイルス感染症の国内流行を防ぐために
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INFORMATION
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Symposium:J-CLEAR秋季セミナー
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Symposium:第49回ペーシング治療研究会
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- 一般演題
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心臓再同期療法デバイス植込み患者の心不全急性増悪に対する取り組みと効果
37巻2号(2016);View Description Hide DescriptionPatients with heart failure are frequently hospitalized for fluid overload. A reliable method for chronic monitoring of fluid status is therefore desirable. In our hospital, we established the team system for heart failure care consisted of medical doctors, specialized nurses and medical engineering staffs(ME). In our system, ME check patients CRM before medical examination and obtain various data including intrathoracic impedance and activity level, and provide these data to medical doctor. The purpose of this study was to evaluate the efficacy of our system for heart failure patient care. No significant differences were found between changes of data of CRM and patients status and symptoms. However, tendency of improvement of data was found in patients provided additional therapy, ex. exercise therapy. In conclusion, our system might be effective to evaluate the efficacy of our heart failure care. -
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原著
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Evaluation of the Severity of Intermittent Claudication Based on the Ankle Brachial Pressure Index Recovery Time after 1 Minute’s Treadmill Walking
37巻2号(2016);View Description Hide DescriptionObjective:Recently, it was established that ankle brachial pressure index(ABI) values recorded after 1 minute’s treadmill walking(TW)(hereafter referred to as Ex1minABI values)exhibit similar diagnostic accuracy for detecting peripheral arterial disease(PAD)to ABI values recorded after 5 minutes’ TW(Ex5minABI). In addition, measuring the Ex1minABI instead of the Ex5minABI is useful for diagnosing PAD in patients that find exercise difficult. However, the relationships between the ABI recovery time after 1 minute’s TW and walking impairment questionnaire(WIQ)‒derived parameters remain unclear. Material and Methods:Thirty‒one patients who had been diagnosed with PAD based on the detection of significant stenosis on computed tomographic angiography and predefined Ex5minABI criteria were subjected to 1 minute’s TW, 5 minutes’ TW, and the WIQ. Results:The subjects’ mean ABI recovery time after 1 minute’s TW was significantly shorter than that seen after 5 minutes’ TW. However, a strong correlation was detected between the ABI recovery times observed after 1 and 5 minutes’ TW. The ABI recovery times recorded after 1 and 5 minutes’ TW were both negatively correlated with the WIQ score. Conclusion:The severity of intermittent claudication can be assessed by measuring the ABI recovery time after 1 minute’s TW. -
FOLFIRINOX 療法を施行した切除不能膵癌の5 例
37巻2号(2016);View Description Hide Description目的:切除不能膵癌患者に対するFOLFIRINOX(5‒フルオロウラシル,ロイコボリン,オキサリプラチン,イリノテカン)療法について検討する。方法:2013 年12 月から2015 年11 月までに,当科でFOLFIRINOX 療法を施行した切除不能膵癌の5 例について,その臨床像を後ろ向きに検討する。結果:投与期間は2~22(中央値14)コース。初期投与量はfull dose(A 群)2 例,イリノテカンのみ1 段階減量(UGT1A1*28 ヘテロ型のため,B 群)2 例,イリノテカン1 段階減量および5‒フルオロウラシル急速静注中止(C 群)1 例(modified FOLFIRINOX 療法)。途中減量は7 であり,減量時期は2 コース目2(全例B群),3 コース目2(全例A 群),4 コース目1(B群),8 コース目1(A 群),15 コース目1(C群)。次コース延期は11 であり,延期時期は2コース目3(A 群1,B 群2),3 コース目2(全例A 群),7 コース目1(A 群),8 コース目1(A群),10 コース目1(C 群),11 コース目1(A群),13 コース目1(A 群),15 コース目1(C群)。抗腫瘍効果:部分奏功2(A 群1,B 群1),安定3(A 群1,B 群1,C 群1)。奏効率40%,病態制御率100%。無増悪生存期間中央値7.6 ヵ月(範囲1.4~9.5 ヵ月),生存期間3.1~14.9 ヵ月(生存2,死亡3)。治療関連死なし。grade 3以上の有害事象は全例で認め,発熱性好中球減少2(A 群1,B 群1),好中球減少5(A 群2,B 群2,C 群1),食欲不振2(A 群1,B 群1),嘔気1(B 群),アレルギー反応1(B 群),末梢神経障害1(B 群),低カリウム血症1(C 群)。結論:少数例での検討ではあるが,FOLFIRINOX療法は従来のレジメンと比較して抗腫瘍効果に優れていると考えられる。また,A 群,B 群の全例で3 コース以内に次コース開始延期を伴う減量が必要となっており,切除不能膵癌患者に対してはmodified FOLFIRINOX 療法がより妥当と考えられる。
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TOPICS
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