Therapeutic Research
Volume 38, Issue 7, 2017
Volumes & issues:
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Information
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Information:日本循環器学会 第32回プレスセミナー迷える成人先天性心疾患患者:緊急を要する診療体制の構築
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Symposium:第43回難治性気道疾患研究会
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- 一般演題 I
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PR3–ANCA陽性重症潰瘍性大腸炎に合併した肺多発結節・小粒状病変に対して大腸全摘術を含む集学的治療が奏効した1例
38巻7号(2017);View Description Hide Description - 一般演題 II
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- 特別報告
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線毛機能不全症候群(PCD) 診断システムの確立を目指して- North Carolina 大学との連携から
38巻7号(2017);View Description Hide Description - 特別講演 I
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- 特別講演 II
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Symposium:第29回神奈川心不全研究会
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- 一般演題
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頻脈性心房細動を合併した低心機能心不全に対するビソプロロール貼付剤の有用性の検討
38巻7号(2017);View Description Hide DescriptionBackground: We often encounter difficulties in the treatment of atrial fibrillation (AF) with rapid ventricular response(RVR) in patients with acute decompensated heart failure. Calcium antagonists, such as intravenous verapamil and diltiazem, are used to control ventricular response during AF; whereas these have negative effects on heart failure. Landiolol, a short–acting intravenous beta–blocker, is widely used for AF with RVR, although, it is not effective in some cases with the heart rate ≧100 bpm. Here, we investigated the efficacy of bisoprolol transdermal patches in addition to landiolol in AF patients with RVR. Methods: This study conducted on patients with congestive heart failure with reduced cardiac function (left ventricular ejection fraction, LVEF; ≦45%), AF with RVR, and mild hypertension who were admitted to our hospital. Of these, 5 patients whose heart rate was ≧100 bpm after landiolol administration at the acute phase were additionally prescribed bisoprolol patches. Results: The mean age was 71.4±9.8 years and LVEF was 24.2±14.0%. Bisoprolol patches 3.6±0.9 mg in addition to landiolol 5.8±1.1μg/kg/min were initially administered; the dosage of bisoprolol patches was increased to 5.6±2.2 mg in 2.2±1.5 days. The heart rate was significantly decreased( 121±11 to 76±16 bpm, p = 0.02); however, no significant changes in systolic or diastolic blood pressure were found. There was a tendency of lower BNP, but it was not significant (p = 0.06). A significant improvement in LVEF was observed at hospital discharge( 24±14% to 45±17%, p= 0.02). Conclusions: The additional use of bisoprolol patches provided a favorable effect in AF patients with RVR at the acute phase; it would probably contribute to the early termination of intravenous landiolol administration. -
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原著
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アルツハイマー型認知症介護者が推測する本人の気持ちと認知症評価スケールに対するニーズ―アンケート調査報告―
38巻7号(2017);View Description Hide Description目的:アルツハイマー型認知症本人の気持ちを,介護者に想像してもらう形式でアンケート調査を実施し,現在の治療をどのように受け止め,期待をもっているかを明らかにする。方法:医療機関でアルツハイマー型認知症の治療を受けている家族の介護者(n=1053)を対象に,Webによるアンケート調査を実施した。結果:アンケート調査対象者(介護者)の平均年齢は53.4±10.4 歳,アルツハイマー型認知症本人の平均年齢は81.3±10.3 歳,女性611 名,男性442 名,平均罹患期間は5.0±4.0 年であった。アンケート調査対象者(介護者)の92%が,アルツハイマー型認知症本人の「認知症の進行が少しでも緩やかになってほしい」との願い・思いを示し,次いで,「不安を和らげてあげたい」88%,「いつまでも,いまのまま自分らしくあってほしい」83%,「可能な限りの治療を受けさせたい」80%が高い割合を示した。アンケート調査対象者(介護者)がアルツハイマー型認知症本人の気持ちを想像した場合,80%が「住み慣れた所などで暮らしたい」と回答し,次いで,「出来る限り家族と一緒に暮らしたい」69%,「いつまでも自分らしくあり続けたい」68%,「今後,自分がどうなるのか,不安」60%,「少しでも認知症の進行を遅らせたい」59%の回答結果であった。アンケート調査対象者(介護者)が,将来アルツハイマー型認知症になった場合を想定した場合,91%が「家族に迷惑をかけたくない」との考えを示し,次いで,「少しでも認知症の進行を遅らせてほしい」86%,「いつまでも自分らしくあり続けたい」86%,「今後,自分がどうなるのか,不安」83%の回答結果であった。物忘れなどを調べる「心理テスト」や介護者の負担を調べる「介護者向け調査」については,「薬剤の効果を実感できるものがより良い」と回答した割合が,それぞれ82%および79%であった。結論:アルツハイマー型認知症介護者が推測するアルツハイマー型認知症本人の気持ちと,介護者自身が発病した後に抱くと推測した気持ちは相反しており,介護の複雑な思いが反映された。
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症例
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居住地域が点在する山間部における転倒予防教室に参加した女性高齢者の身体組成・行動体力の現状と,教室の今後の課題―神奈川県清川村の事例から―
38巻7号(2017);View Description Hide DescriptionThe only village of Kanagawa Prefecture is located between mountains, with insufficient facilities of communication to cover all residents living in residential areas sparsely scattered throughout its vast land. The rate of aging is also relatively higher in the village than in other areas of the prefecture. This study aimed to clarify the challenges of fall prevention workshops held by the village office by examining the body compositions and fitness levels of 6 elderly females who had participated in them. Body composition analysis was performed using the rates of somatic fat and trabecular bone area, in addition to the lean mass. The fitness level was examined based on the muscle(hand grip) strength, balance(standing on one leg with the eyes open and functional reach), walking abilities(Timed Up & Go test score, 5‒m walking, and the maximum step length), and flexibility(bending forward while sitting with the legs straight). As part of the workshops, these measurements had been performed semiannually. In the study, the values obtained in September 2009 and August 2013 were compared. While there were no significant differences in values representing the body composition, those representing the fitness level markedly decreased:left hand grip strength:26.4±3.2 to 24.3±2.7 kg(p<0.05);and bending forward:41.6±1.3 to 39.3±1.4 cm(p<0.01). The results revealed favorable body compositions and activity levels of the elderly females living in a remote village after participating in the fall prevention workshops. On the other hand, as mountainous regions like this face a number of challenges, such as limited facilities of communication, unlike those with advanced living environments, it may be necessary to encourage village offices in remote areas to promote fall prevention workshops that perform awareness‒enhancing activities in the middle‒aged and elderly.
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INFORMATION
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